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Autism Disorders Unmasked

 

“The Revealing of Superheroes”

 

What do the following celebrities have in common…Mozart, Einstein, Darwin, Warhol, Thomas Jefferson and Sir Isaac Newton?

Autism. They all have some form of Autism Spectrum Disorder. Go figure, right?

What is “Autism”? What is “Autism Spectrum Disorder”?

There is not one condition called Autism. In short, Autism, or Autism Spectrum Disorder (ASD), refers to a range or a spectrum of conditions characterized by a wide variety of problems with social skills, communication, repetitive behaviors, and highly restrictive and unusual interests.

Autistic disorders typically emerge between 2 and 3 years of age but have been known to emerge as early as 18 months, exhibited by a wide variety of types, symptoms, and degrees of severity. ASD occurs in both genders and all ethnic, racial, and economic groups.

The Centers for Disease Control and Prevention estimates 1 in 68 children in the United States have ASD. This includes 1 in 42 boys and 1 in 189 girls.

Other serious medical and mental health issues frequently accompany autism, including gastrointestinal disorders, seizures, sleep disturbances, attention deficit and hyperactivity disorder, anxiety, and phobias.

The good news is that while ASD can last a lifetime, treatments and service can improve a person’s symptoms and ability to function in the world…and in many cases more than function…becoming practically superhuman in their own right…superheroes.

"Just as individuals with autism have a variety of difficulties, they also have some distinctive strengths."

Ozonoff, Dawson, and McPartland, A Parent's Guide to Asperger's Syndrome and High Functioning Autism

 

Ironman

Introducing Tony Stark, otherwise referred to as “Ironman.”1

Tony struggled mightily in school and was very isolated socially. He had an IQ of 135, was very interested in media, but was not much motivated by the whole schooling thing, often freezing up and becoming irritated with school staff and fellow students. He was easily agitated by academics and responsibilities.

His home dynamics weren’t much better, maybe worse. Everything there was based on how he would react, for fear he would become enraged. He had been diagnosed with ASD as a child, presenting a flat affect, stiff posture and rigid movement. Parents noticed early that Tony was not good at reciprocal interaction with anyone, often totally missing obvious social cues.

In school, Tony was often teased and bullied, but it was with adult authority that his rigid thinking and resistance to restrictive rules and procedures that he most came into conflict with. He would become argumentative and then totally enraged.

His parents tried family therapy, outpatient therapy, medications, and even short-term inpatient treatment, but nothing worked. Besides school, the family was in shambles.

At 17, Tony entered the Telos Residential Treatment program during his senior year in high school. At the time, he frequently isolated himself in the basement of his home, seemingly endlessly watching sports, and playing video games…and not much more. Both school and home were the last places he wanted to be.

Now 21, Tony is in his senior year in a top 20 university.  In college, he joined the university athletic department where he manages one of the school’s sports teams.  He also participates in intramural sports and attends football games. He even hosts social gatherings for his fellow classmates. By all accounts, Tony is doing very well in school and is bent on enjoying a rich and successful life.

What happened? Is he still autistic?

Yes, Tony Stark, a.k.a. Ironman still has ASD. But because his parents never gave up on him, recognizing that there was so much positive about Tony that was being obscured by his shortcomings, realizing that his autism was his own and needed highly individualized assistance, and unmasking the stereotype of autism that sought to blind everyone to the real person behind the disorder, Tony finally got a chance to fly.

Let’s start by doing the same, by seeing autism for what it really is, a spectrum or range of treatable conditions that need not chain any child to a life of frustration and obscurity.  They can be their own kind of superhero, just like Tony. It's important to not only look at those with ASD for what they cannot do but to also look at the very special things they can do, which more often than not only they can do.

 

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The Spectrum of Autistic Disorders

As asserted previously, there is not one autism but several types along a continuum and caused by different combinations of genetic and environmental influences. Those types most commonly referred to include Asperger’s, PDD, Autistic Disorder, and CDD. Each child with an autism spectrum disorder is likely to have a unique pattern of behavior and degree of severity, of which all will range from low to high functioning.2

 

“While there is no cure for autism spectrum disorder, intensive, early treatment can make a big difference in the lives of many children.”

Mayo Clinic, “Autism Spectrum Disorder,” 2018

 

Asperger’s Syndrome

Asperger’s Syndrome (AS) is on the less-severe end of the autism spectrum. A person with Asperger's may be very intelligent and able to handle daily life, and may be really focused on topics of personal interest and want to discuss them nonstop, but may have a much harder time socially.3

Pervasive Developmental Disorder

Pervasive Developmental Disorder (PDD) is a generalized diagnosis that includes most children whose autism is more severe than Asperger’s, but not as severe as other autistic disorders to the right of the spectrum. Also listed as atypical autism.3

Autistic Disorder

Autistic Disorder (AD) is an older expression that refers to autistic conditions at a more intense level, more than Asperger’s and PDD, but still not the rarest of the possible disorders. This disorder is also referred to as autism, childhood autism, early infantile autism, and Kanner’s Syndrome or infantile psychosis.3

Childhood Disintegrative Disorder

Childhood Disintegrative Disorder (CDD) is the rarest and most severe part of the autistic spectrum. It describes children who develop normally at first, and then quickly lose many social, language, and mental skills, usually between ages 2 and 4. Often, these children also develop a seizure disorder. This disorder is also known as dementia infantilism, and Heller’s Syndrome or disintegrative psychosis.3

Signs and Symptoms Those on the Spectrum Share

Persons with autism spectrum disorder, regardless of the particular disorder, often suffer from one or more of the following common problems, varying mostly by the degree of severity:4

Sensory Problems

Many children with autism spectrum disorders either underreact or overreact to sensory stimuli. They may ignore people speaking to them, even to the point of appearing deaf. Other times they may be disturbed by even the softest of sounds. Sudden noises such as a tire screech can be totally upsetting, and they may respond by covering their ears and making repetitive noises to drown out the offending sound. Children on the autism spectrum also tend to be highly sensitive to touch and to texture. They may cringe at a pat on the back or the feel of certain fabric against their skin. Food texture sensations apply here as well when the consistency of eating a banana will evoke not only immediate protest but a physical cringing too.

Emotional Difficulties

Children with autism spectrum disorders may have difficulty regulating their emotions or expressing them appropriately, even under non-threatening circumstances. For instance, an ASD child may start to yell, cry, or laugh hysterically for no apparent reason. When stressed, he or she may exhibit disruptive or even aggressive behavior in response, including breaking things, hitting others, or harming him or herself. The National Dissemination Center for Children with Disabilities also notes that kids with ASD may be totally unfazed by real and present dangers, like being amongst moving vehicles or being near great heights, yet be terrified of harmless objects such as a stuffed animal sitting harmlessly off to the side.

Uneven Cognitive Abilities

ASD occurs at all intelligence levels. However, even kids with normal to high intelligence may have unevenly developed cognitive skills. Not surprisingly, verbal skills tend to be weaker than nonverbal skills. Children with ASD typically do well on tasks involving immediate memory or visual skills, while tasks involving symbolic or abstract thinking are more difficult. An ASD savant, for instance, may not know how to calculate an algebraic problem but can tell you what calendar day Tuesday will fall on a decade from now.

Varying Degrees of Support for Varying Degrees of ASD

The current Diagnostic and Statistical Manual of Mental Disorders sets forth a 3 support-level or degree system for treating various levels or degrees of manifested ASD: Level 1, Level 2, and Level 3. Level 1 represents the highest level of functioning possible, while Level 3 represents the lowest. Level 1 persons may well be able to live independently, while Level 3 may not be able to at all.5

  • Level 1 ASD: Requires support
  • Level 2 ASD: Requires substantial support
  • Level 3 ASD: Requires very substantial support

"The designated functioning level defines where a child or adult falls on the autism spectrum and how well he or she can exist independently."

Vilma Ruddock M.D., Love to Know

Such diagnoses specify the level of treatment or support that is going to be needed. In the past, doctors assigned one of five basic forms of autism. Now, depending on the severity of symptoms presented, i.e. dysfunctions and impairments in communication, and behavioral and social skills, specialists can identify a person's particular level of functioning along a continuum and specify a much more specific set of therapy to help them.

Level 1 ASD Support

Individuals with Level 1 ASD (mildly autistic), without proper support, will display noticeable impairments in social communication. Common behaviors of persons with Level 1 ASD include:

  1. Inflexibility in behavior and thought
  2. Difficulty transitioning between activities
  3. Problems with executive functioning
  4. Atypical responses to others in social contexts
  5. And difficulty initiating social interactions.

Any support to be considered “proper” for Level 1 ASD individuals must include adaptive skills-based treatments that zero in on executive function, emotional regulation, cognitive flexibility, social communication skills, and anxiety reduction. 

Level 2 ASD Support

Individuals with Level 2 ASD (moderately autistic), with or without proper substantial support, will still display marked deficits in both verbal and non-verbal communication but can learn to manage problematic behaviors or deficits. Common behaviors of persons with Level 2 ASD include:

  1. Limited and abnormal responses to others
  2. Speaks in short and simple sentences
  3. Interests are limited to narrow and highly specialized subjects
  4. Restricted repetitive behaviors (tics, gestures, sounds)
  5. Distressed easily when having to change focus or attention.

Any support to be considered “proper” for Level 2 ASD individuals must include adaptive skills-based treatments like those for Level 1 persons, but that also show them how to live life, or taking care of their basic needs, like paying bills, buying groceries, and managing a living space. 

Level 3 ASD Support

Individuals with Level 3 ASD (severely autistic), with or without proper very substantial support, will still display extensive impairments in both verbal and non-verbal communication, ability to initiate social interactions, and ability to respond to social cues or overtures from others, but can learn to make the best of very serious deficits. Common behaviors of persons with Level 3 ASD include:

  1. Possesses very few words of intelligible speech (may even be non-communicative)
  2. Rarely, if ever, initiates social interactions with others
  3. Efforts to initiate are often highly unusual, and only to meet a specific need
  4. Unwillingness, or inability, to modify behaviors
  5. Rattled easily by changes (upset by changes in schedule or new experiences)
  6. Engages in restricted/repetitive behaviors (tics, habitual movements).

Any support to be considered “proper” for Level 3 ASD individuals must include intensive antecedent-based intervention and any number of other classroom interventions, differential reinforcement strategies, intensive social skills training, and visual supports.

Special Abilities Often Associated with Autism...Super Powers

Often, children with ASD get unique abilities, areas of strength. Not all children have special abilities, but children with autism commonly have exceptional skills in subjects like math, music, and art. These special skills might even be considered to be "superpowers."5 While a small percentage of children with autism have "savant" capabilities, genius-level abilities, many individuals with autism have somewhat lesser strengths that make them more than special.6, 7

"These areas of expertise can provide great satisfaction and pride for the child with autism."

1 Special Place

Ability to Focus in Great Detail

Many researchers believe it’s because of autism’s impact on the brain that people with ASD have to remain focused, and can, as a result, concentrate on the tiniest of details. And because they tend to enjoy detail-orientated work, and are able to work persistently in such an environment, they do so without getting distracted.

Strong Long-Term Memory

Many children with autism can memorize large amounts of information, like encyclopedic facts, long lists, and can repeat them verbatim.

Exceptional Math Skills

Bordering on possessing savant-like skills, some children with ASD can say on which day of the week any particular calendar date will fall. Others have been known to calculate math functions at astonishing speeds.

Instinctual Problem Solvers

Impressive mathematical abilities and problem-solving skills are tied to a unique pattern of brain organization in those with ASD. In studies, they have used sophisticated problem-solving strategies which didn’t rely on rote learning or counting on their fingers.

Advanced Music Ability

Many children with autism have exceptional tone recognition, able to pick out and identify particular musical details very easily and rapidly.

Stellar Artistic Ability

A large number of autistic children use art (drawing) to express vivid sensorial or observed experiences, especially those that are personally important to them. 

Ability to Think Visually

Autistic persons can be good at visual searching, like finding complex shapes or patterns or seeing letters obscured by particular backgrounds, even fixing jigsaw puzzles and matching unusual shapes.

Extra Creativity

More than a handful of people with autism excels at creativity. In one study, the participants were asked to think of as many uses for a brick and paper clip. Individuals with autism jumped straight to the more innovative solutions first while the other participants started with the more simple and obvious examples first.

Computer and Technical Abilities

Is it more than a stereotype that persons with ASD have a seemingly greater affinity with technology than their non-autistic counterparts, especially with computers. In addition, some have the innate ability to dismantle and re-assemble complex machines.

No one with autism may be leaping tall buildings in a single bound, running faster than a speeding bullet, or being more powerful than a locomotive, but they are superheroes nonetheless. What special superpower does your child possess?

"Once you work out what your child's strengths and abilities are, you can use them to promote your child's development."

Raising Children

A Who's Who Hall of Fame of Those on the Spectrum...I'll Bet You Didn't Know

History is full of people who had autism and made quite a name for themselves.8 Check the list and see.  Who knows if your child's name might be added at some point down the line. All we have to do is emphasize the positive and deal with the negative.

"Asperger's doesn't define me. It's a condition that I have to live with and work through..."

Susan Boyle, singer, Britian's Got Talent

Dan Aykroyd--comedic actor

Marty Balin--rocker

Susan Boyle--singer

Tim Burton--movie director

David Campion--snowboarder

Lewis Carroll--writer

Charles Darwin--naturalist

Bob Dylan--singer

Albert Einstein--mathematician

Jim Eisenreich--baseball player

Bobby Fischer--chess grandmaster

Bill Gates--Microsoft co-founder

Temple Grandin--ASD expert

Daryl Hannah--actress

Thomas Jefferson--3rd President of the U.S.

Steve Jobs--founder of Apple

Stanley Kubrick--movie director

Courtney Love--musician

Clay Marzo--surfer

Michelangelo--sculptor, painter

Mozart--concert pianist

Newton--physicist

Jerry Seinfeld--comedian

Steven Spielberg--movie producer

Tesla--inventor

Andy Warhol--modern artist

Satoshi Yajiri--creator of Pokeman

And that's not all. There are many more. The list goes on and on.

Parents of children with ASD. Teachers of students with ASD. Community members of future adults with ASD. Listen up! How do you know that those with ASD in your life won't be famous for something down the road? How do you know that they won't have something significant to contribute to the world, something that could make a bigger difference than you could imagine? How do you know it won't be their ASD that is the reason?

How do you know that despite their handicaps, they can rise to the occasion in their own way in this world through their special strengths? Why does this world define so many by what they aren't, or what they can't do? Why can't we first look at what they can do, and make sure that those God-given blessings don't get obscured by what they can't do?

Imagine being sad about a cat's future because it can't bark? Imagine believing all is lost for a fish that cannot fly? And what about a child who has Asperger's? Is it really the end of the world? How many tears must be shed? So silly, don't you think?

Let's start making capes out of the strengths of our young persons with ASD. Like Tony Stark, let's spend less time grounding them in what handicaps them, and focus on what will help them fly.

1 "Ironman," John Haw, LMFT, writing for the National Association of Therapeutic Schools and Programs (NATSAP).

2 "Autism Spectrum Disorder," National Institute of Mental Health (NIMH).

3 "Diagnostic and Statistical Manual of Mental Disorders-5," (DSM-5), American Psychiatric Association.

4 "Autism Spectrum Disorders," A Parent's Guide, Help Guide.

5 "What are the 3 Levels of Autism?" Carl Smoot, Very Well Health.

6 "Unique Abilities That May Accompany Autism," Autism Speaks.

7 "8 Unique Abilities That May Accompany Autism," 1 Special Place.

8 "History's 30 Most Famous Inspiring People on the Autism Spectrum," Applied Behavior Analysis.