April is Autism Awareness Month

And yet… so many people are completely unaware of what autism is.

Maybe you’ve seen “Rain Man”, starring Dustin Hoffmann, the guy from Top Gun, and the girl from Hot Shots.

Yeah, it’s like that, for some autistics.

But in the time since autism was identified and described as a syndrome of its own, over fifty years ago, it’s been realised that there’s a wide range to the effects of autism, both in the collection of symptoms and the depth of their effects on different individuals.

The terms “low functioning” and “high functioning” are often used to give a rough degree of overall effects on an individual, but should not be used as a means of guessing what symptoms an autistic person will possess. A “high functioning” individual may be almost completely non-verbal, preferring to communicate using picture cards or typing; similarly, a low functioning individual may be able to make a reasonable facsimile of small-talk by using echolalia – the wholesale repetition of mostly appropriate sentences, without understanding the words that comprise the sentences themselves.

Study in autism has been marked by some spectacularly popular – yet completely false – assertions, such as those of Bruno Bettelheim, who claimed that the cause of autism was a mother who consciously or unconsciously did not want their child to live, and as a result, became cold and unattached. Modern investigations, including Functional MRIs, have indicated that the physical structure of brains in autistic children is different from that of neurotypical (“NT”) children.

Much discussion has been made in the last decade of “Asperger’s Syndrome” – named after Hans Asperger, the “other” discoverer of autism (most American references to autism cite Kanner as the discoverer of autism, although Kanner and Asperger made their discoveries at or about the same time). While Kanner described a more severe, low functioning form of autism, Asperger noticed a wide range of patients with similar symptoms, and as a result the syndrome named for him is used to describe those patients with autistic behaviours who are not so severe as to classify under Kanner’s classification.

There is a growing concern that the distinction between Asperger’s and Autism is entirely artificial, and this is born out mostly in the diagnostic criteria, wherein the main difference between the two diagnoses is a lower-than-average IQ (autism), or a higher-than-average IQ (Asperger’s). Since many of the tests used for IQ testing in children are actually quite difficult to perform given autism’s symptoms, it seems a little like grading deaf children by shouting questions at them, and giving “high IQ” marks to those that respond because they were able to lip-read.

So, we talk about the Autism Spectrum – and although that sounds like a linear range, it’s more of a multivariate.

Kids with Asperger’s Syndrome are capable of huge achievement if they’re given support and have access to assistive therapies – speech therapy, occupational therapy and physical therapy. Yes, physical therapy, because for some reason there seems to be a lack of motor strength, balance, and coordination in most kids on the autism spectrum, and physical therapy allows for the development of techniques that will help build strength, balance, and coordination. Occupational therapy allows for the child to learn skills that provide him an ability to integrate into regular school life. Speech therapy and related therapies allow the child to learn how to interact socially with his peers.

Note that I keep referring to the child as “he” – while autism is not a wholly male syndrome, it affects males in a ratio of about four to one; why this is, is hotly debated, but there are certainly female autistics, including perhaps the most famous autistic of all, Temple Grandin, author of “Emergence: Labeled Autistic”, among several other books.

What of the lower-functioning autistics, though? Aren’t they doomed to lives in institutions, closeted away from society, forever rocking and banging their heads locked in their own worlds?

Surprisingly, no. As I hinted at with my analogy to shouting IQ test questions at deaf kids, it’s gradually emerging that many of these kids who were thought to have low IQ are simply not able to interact with the world around them. Once they are given an avenue of communication, whether it’s facilitated communication (which is a tad controversial), or something as simple as learning to use a keyboard, many children previously considered lower functioning and lower IQ are turning out to be quite intelligent, and often well-informed about the world around them.

I think the next few decades could see some interesting advances in learning how to make the best of an autistic child – autism brings some amazing skills and an “out-of-the-box? Didn’t see the box in the first place!” kind of thinking that produces astonishing effects when given full rein.

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