YeshuaAgapao.com Blog

Made 3 sections – All have several sub-sections
DSM / self diagnoses / self observation section
Stuff from Autism-PDD.net
Stuff from Squarepegs

Its pretty long.

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DSM-IV
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From the DSM-IV
(Diagnostic And Statistical Manual Of Mental Disorders, 4th edition, 1994)

Diagnostic Criteria For 299.80 Asperger’s Disorder
A. Qualitative impairment in social interaction, as manifested by at least two of the following:
1. marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction

2. failure to develop peer relationships appropriate to developmental level

3. a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g. by a lack of showing, bringing, or pointing out objects of interest to other people)

4. lack of social or emotional reciprocity
B. Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following:
1. encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus

2. apparently inflexible adherence to specific, nonfunctional routines or rituals

3. stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)

4. persistent preoccupation with parts of objects
C. The disturbance causes clinically significant impairments in social, occupational, or other important areas of functioning

D. There is no clinically significant general delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years)
E. There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than social interaction), and curiosity about the environment in childhood

F. Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia

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From the DSM-IV
(Diagnostic And Statistical Manual Of Mental Disorders, 4th edition, 1994)

DIAGNOSTIC CRITERIA FOR 299.00 AUTISTIC DISORDER
A. A total of six (or more) items from (1), (2), and (3), with at
least two from (1), and one each from (2) and (3)

(1) qualitative impairment in social interaction, as manifested by at least two of the following:

a) marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction

b) failure to develop peer relationships appropriate to
developmental level

c) a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people, (e.g., by a lack of showing,
bringing, or pointing out objects of interest to other people)

d) lack of social or emotional reciprocity ( note: in the
description, it gives the following as examples: not actively
participating in simple social play or games, preferring solitary
activities, or involving others in activities only as tools or
“mechanical” aids )

(2) qualitative impairments in communication as manifested by at least one of the following:

a) delay in, or total lack of, the development of spoken language
(not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)

b) in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others

c) stereotyped and repetitive use of language or idiosyncratic
language

d) lack of varied, spontaneous make-believe play or social
imitative play appropriate to developmental level

(3) restricted repetitive and stereotyped patterns of behavior,
interests and activities, as manifested by at least two of the
following:

a) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in
intensity or focus

b) apparently inflexible adherence to specific, nonfunctional
routines or rituals

c) stereotyped and repetitive motor mannerisms (e.g hand or finger flapping or twisting, or complex whole body movements)

d) persistent preoccupation with parts of objects

B. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years:

(1) social interaction

(2) language as used in social communication

(3) symbolic or imaginative play

C. The disturbance is not better accounted for by Rett’s Disorder or Childhood Disintegrative Disorder

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Me Aspi

A: (Need 2)
A1 – Can do eye contact only for analytical purposes only or when told, good at faking eye contact (apparent eye contact, but mental focus shifted elsewhere in field of vision); I frequently miss or misinterpret body language and facial expressesions and my own body language and facial expressesions is sometimes different
A2 – I cannot handle large groups or clique culture. I have ddificulty with tact and deceptiveness and have difficulty with casual relationships with little or no intimacy (and thus prevent intimacy from forming).
A4 – I’m good at imitating, but ofthen don’t feel like it. I cannot integrate with anybody’s activity very well unless there is a very high compatibility level or a very high level of determination (soccer players).

B: (Need 1)
B1 – I am a very obssessive person with little self control in self-indulgence of interests and most apparrent self control is from fear of punishment or natural repercussions or logical managment of multiple obsessions competing for limited resources (time and money), usually with the losing obsession going back burner and getting minimal attention on it’s conflicted channels (money or time via multiple sensory attention channels, usually 1 per sense).
B3 – Hand flapping and rapid head stimulation with hands when home alone; partial / hidden with boredom and strees. I do pace alot when standing and bored or rock when bored on a rock-capabile chair though. ‘Stealth Stimmer’ now but Full in early childhood (<4 yrs -- Rocking and head banging)
B4 - I handle an touchy-feel an object and zone out the world when moderatly stressed and a little bored or when moderatly board or highly stressed; Mild in early childhood (<4 yrs)

C (Pass)
D - Fail - Had Major Language and significant motor coordination developmental Delay)
E - Pass - Was and still very annoying and nosey question asker)
F - Fail - Pass Autism)

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Me Auti

A:(Need 6 Total from 1,2,3)

1: (Need 2; Same as Aspi (A))
1a - Can do eye contact only for analytical purposes only or when told, good at faking eye contact (apparent eye contact, but mental focus shifted elsewhere in field of vision); I frequently miss or misinterpret body language and facial expressesions and my own body language and facial expressesions is sometimes different
1b - I cannot handle large groups or clique behavior. I have ddificulty with tact and deceptiveness and have difficulty with casual relationships with little or no intimacy.
1d - I'm good at imitating, but ofthen don't feel like it. I cannot integrate with anybody's activity very well unless there is a very high compatibility level.

2: (Need 1)
2a - I've had severe language delay that required extensive therapy beyond early intervention.
2b - I have much difficulty with any conversation that isn't self indulgent to me or conversation that involves a lot of small-talk or symbolic humor.
2d - Partial - I made believe as a kid a lot but but only on my own, in my own little world. It wasn't very varied or spontaneous though. I had difficulty discerning reality and fantasy as a kid but am better now but can easily splice conceptual reality and conecptual fantasy together. I have ddifuclty telling when somebody else is joking or fantasizing beyond rote empirical patterns or when they change between reality and fantasy modes.

3: (Need 2; Same as Aspi (B) but need 2 instead of 1)
3a - I am a very obssessive person with little self control in self-indulgence of interests and most apparrent self control is from fear of punishment or natural repercussions or logical managment of multiple obsessions competing for limited resources (time and money), usually with the losing obsession going back burner and getting minimal attention on it's conflicted channels (money or time via multiple sensory attention channels, usually 1 per sense).
3b - Hand flapping and rapid head stimulation with hands when home alone; partial / hidden with boredom and strees. I do pace alot when standing and bored or rock when bored on a rock-capabile chair though. 'Stealth Stimmer' now but Full in early childhood (<4 yrs -- Rocking and head banging)
3d - I handle an touchy-feel an object and zone out the world when moderatly stressed and a little bored or when moderatly board or highly stressed; Mild in early childhood (<4 yrs)

B: (Need 1)
1 - According to my mother, my speech was 2 words at age 3 and short discombulated sentences by kindergarten, with improvement mostly because of early-intervention preschool and extensive speech therapy in elementary school. I think Phonics perfect for autistic people with poor but some language. In my experience with foreign languages, I handle structured languages bessed and I learn to read and write the language way faster than I listen or speak. I never learned to handle foreign language beyond rote translation. I cannot translate and handle reversed grammar and pick and choose feminine and masculin articles at the same time (french/spanish). I have a very high rate of decay for unconnected rote-memorized things.
2 - I can't handle idioms, and have poor to mediocre handling of metaphores and have diffucult detecting switches in and out of joke or imagination mode (I default to serious/reality mode, probably because of conditioning). I have difficulty intentionally making someone laugh.. I handle similies very well though. I am mediocre with detecting unmarked analogies but I am pretty good at processing them.

C - Pass

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Layterms I learned

LFA Classic Autism; Infantile Autism
HFA Mildly Autistic
PDD-NOS Atypical Autism
AS Little Professor

(HFA/LFA are not differentiated in the DSM except perhaps on the 5th diagnostic axis - the GAF scale)

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Other self observations

LFA -- sensory integration and language probelems severe enough to cause mental retardation, IQ<70
AS -- Mildly Austistic with no language or developmental delay and no mental retardation
PDD-NOS -- Biggest subset of PDD-NOS is not recognized by the DSM are people who pass Asperger's Sydrome except for the 'no childhood language delay' part, but don't qualify fully for Autism, Rhetts, or Childhood Distintegrative Disorder, and feel more aspie than auti.

Retardation = deficits in both grey (neuron size/complexity or count) and white matter (neuron inter-connections) in the brain, Autism = deficits only in the grey matter; no deficit in white matter.

Rain-Main (The real one not the movie): Mix High Functioning Autism (Highly inter-connected, low decay memory) with a very high base IQ and true photographic memory.

Early intervention can make LFA function like HFA (overcome sensory integration and language problems enough to and early enough to avoid mental retardation), HFA function like (minimize fixation and stimming) AS.

My mom saying I am PDD-NOS/'atypical' may be from a staging diagnosis and a lack of later diagnosis of autism, PDD/PDD-NOS confusion on school forms, or maybe if the really old DSM-II (1977-1981) having mental retardation as a requirement for an autsim diagnosis.

I am truely austic on DSM-IV standards. I am High-Functioning (HFA, 40%), in the 2% 'elite outcome' category.
I'm not a Auti/Aspi 'tweener' subset of PDD-NOS that should grow out to its own diagnosis/ASD subcategory in the DSM-V.

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Autism-PDD.net
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PDD (Pervasive Developmental Disorders) OR ASD (Autism Spectrum Disorders) neither are a type of autism… they are the category or umbrella which 5 different diagnoses of autism are found under

1. Autism
A complex condition, autism is the most commonly diagnosed pervasive developmental disorder. Autism impairs a person??s ability to communicate, both verbally and non-verbally, to form relationships and to interact with others. It also typically results in a range of unusual and repetitive behaviors. A child with autism may initially appear to develop normally, but then withdraw and lose interest in others. Typically diagnosed by the time a child is age 3 or 4, autism can vary from mild to severe. Autism is frequently accompanied by mental retardation, but not always. In many cases, patients will show uneven levels of intelligence with highly developed talents in some areas.

2. Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS)
Also known as “atypical autism,” PDD-NOS is a diagnosis given to children who exhibit some symptoms of autism or other pervasive developmental disorder, but do not meet the specific diagnostic criteria for any one disorder in particular. Children with PDD-NOS generally have impaired social skills, problems with verbal and non-verbal communication, and engage in highly repetitive behaviors. In many cases, children initially given a diagnosis of PDD-NOS are later confirmed to have an identifiable disorder.

3. Asperger Syndrome
Often confused with high-functioning autism, Asperger Syndrome results in similar symptoms, but without the delays in language or the possibility of mental retardation seen in autism. Children with Asperger Syndrome often have impressive vocabularies and sharp cognitive skills, but display serious difficulties with social interaction. They may have an obsessive interest in a particular topic and become preoccupied with repetitive routines or behaviors. In addition, many children with Asperger Syndrome have a history of developmental delays in motor skills and display poor physical coordination.

4. Childhood Disintegrative Disorder (CDD)
Also known as Heller??s syndrome or regressive autism, CDD occurs more frequently in boys but is also found among girls. Children with CDD appear to develop normally in most areas until 2 to 4 years of age. At that point, a marked regression occurs, which may take place over a period of weeks or months. Previously learned skills, such as toilet training, language and social abilities, are lost. The child may stop speaking, become disinterested in play, and develop other characteristics typical of autism.

5. Rett Syndrome
Thought to be a genetic disorder, Rett Syndrome is most commonly seen in females. The condition causes a steep developmental regression in children after 6 to 18 months of age. Until this time, many children appear to be developing normally, but then begin to undergo rapid behavioral changes, including loss of language, problems with balance, lack of interest in social relationships, sleep abnormalities and extended tantrums. In addition, the heads of children with Rett Syndrome fail to grow at a normal rate and most patients with the condition have mental retardation. Gradually they lose the purposeful use of their hands, which leads to repetitive “hand washing” movements, perhaps the most characteristic symptom of the disorder.

HFA (High Functioning Autism) isn’t an actual diagnosis Its the difference between a child severely affected with autism and one who isnt severely affected. However, it is also a way some people describe a PDD-NOS diagnosis for someone who is on the higher functioning end of the spectrum…. Some when they refer to it say its like an aspergers diagnosis except to fit an aspergers diagnosis it says never having had a speech delay… so,… kids who have had a speech delay but function high like aspergers are said to have HFA but its still under the PDD-NOS criteria. However see below as the next page sorts High Functioning Autism from Low Functioning Autism by the IQ’s and struggles the child has.

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Why the overal category name ‘Pervasive Development Disorder’ (PDD) is being transistioned to ‘Autistic Spectrum Disorder’ (ASD) (PDD in DSM-III-R, PDD or ASD in DSM-IV, probably only ASD in DSM-V)
‘PDD vs PDD-NOS’, is somebody saying ‘PDD’ mainging the overal DSM category of austism disorders (of which Autism, Aspergers, etc.. are subcategories) or are they meaning PDD-NOS or ‘Atypical autism’.

o.k…my daughter is diagnosed as pdd-nos (pervasive development disorder-not otherwise specified). It too is under the autism umbrella. Usually these kids have a ’spectrumy’ feel to them (i am so scientific), but don’t meet all the criteria for an autism diagnosis..ie my daughter meets all the qualification for autism except for the self stim (which I think she does, but she is a stealth stimmer). Age is another factor..many times children under the age of 3 will receive a pdd-nos diagnosis which is changed to autism when they get a little older. However, from the sounds of the board..they are a lot quicker to give the autism diagnosis now, which may not be a bad thing if it helps secure services.

Pdd is a diagnosis. The doctor will say the child has pdd and in the forms for the medical insurance , ssi, schools, etc. they will put down pdd-nos. Maybe I should had clarified that in most instances pdd is short for pdd-nos. I know when I am having conversations with people I don’t say he has pdd-nos I say he has pdd. Alot of parents here do that. The schools even do that.

well here if you say he has PDD they will very quickly correct you and let you know that is not a diagnosis……PDD-NOS is…..I know I have been round and round about it……so that is why i explained the way I did……it can be very confusing…….so we have to be word savy here in va….lol…..but anyway…just wanted you to understand why i explained the way I did

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Low-Functioning & High-Functioning Autism

One of the most confusing aspects of autism is how it is unique to every person on the spectrum. No two people with autism are identical in how they display symptoms and behaviors; they also are completely unique in how each responds to a variety of treatments. Much of this uniqueness presents a struggle for the autism community.

One hint that I can give all parents and educators is to mentally divide autism into two major categories. Remember this isn’t hard and fast, but it will help you as you search for information and read the stories of other parents and their experiences. These two categories are:

Low-Functioning Autism

Children with low-functioning autism are more likely to display mental retardation, epilepsy, and extremely limited receptive/expressive language skills. They are extremely weak on ??theory of mind,?? and overload on too much sensory stimulation quite easily. As a rule of thumb, testing will show IQ ratings of 70 or below.

High-Functioning Autism

Children with high-functioning autism are much more efficient with expressive and receptive speech, less likely to suffer from epilepsy, and have IQ scores of 71 or above. Although too much sensory input can overload them, they have a higher tolerance and learn to desensitize themselves. These children have a stronger grasp on the theory of mind and can empathize with the feelings and reactions of others.

Just a Tip

Remember, these are general rules. It is a guide to tuck in the back of your mind for those times you are with other parents of children on the spectrum. In a forum or support group, you may find that the needs of one family differ greatly from the needs of your own, and you might be tempted to interject thoughts of what works for you. And that is good; that is what support systems are all about. But, if a parent is trying to decide if dating and driving is appropriate for their child with Asperger’s, a parent of an LFA child is apt to react negatively. Those are dilemmas that those parents don’t share. Misunderstandings and sometimes rather heated debates can be the result.

The needs of the child with low-functioning autism are very challenging. Parents are stretched to the limits emotionally, mentally, financially and quite often, physically. They worry about the future. And they worry about what others will say about them and unfortunately the tendency turns toward isolation.

I can’t tell you how many emails I have received from parents with LFA children. They are afraid to talk about the serious problems they have because of the responses they get. ??If you would just do…..,?? or ??The parenting methods you use are causing much of your problems and…?? You get the idea. I know the readers of this site are very informed about autism, so this is probably just ??more-of-the-same?? information.

But just maybe, it is a reminder about the bonds we have regardless of the roads others travel that we can never walk. Peace and blessings to all of you in 2005!

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The diagnosing autism is made when specified number of characteristics listed in the DSM-IV (Diagnostic And Statistical Manual Of Mental DisordersDSM-IV ) are present, in ranges inappropriate for the child’s age. Autism diagnosis usually occurs between the ages three and five. The autism prognosis is consistent across a broad range of studies – about 2% will attain normal functioning, with perhaps 40% labeled high functioning autistic.

These high functioning autistic generally show some oddities of behavior, and have few or no personal friends. Yet, with appropriate intervention, many of the autism behaviors can be positively changed, even to the point that the child or adult may appear, to the untrained person, to no longer have autism. This is where a parent, facing a system with many flaws and pitfalls, must not compromise their vision of their child’s future.

Learn more about Autism diagnosis>

Learn more about DSM-IV

What to look for in Baby Development.

Baby’s Communication Milestones
Keep in mind that this chart notes average progress.
The vast majority of children who do not meet these
milestones still end up with normal language skills.
COMMUNICATION AGE
Social smile 0-2 months
Cooing 0-3 months
Turns toward mother’s or father’s voice 4 months
Razzing sound 5 months
Recognizes mama and dada 6-9 months
Says first word 12 months
Has vocabulary of 8-10 words 15 months
Has vocabulary of 15-18 words 18 months
Speaks in two-word phrases; Has vocabulary of 50 words. 20-24 months
Can answer “who”, “why”, and “where”, questions; Has vocabulary of 500 words. 3 years
Can tell a story 4 years

Autism and related disabilities, such as PDD-NOS (Pervasive Developmental Disorder – Not OtherwiseSpecified), and Asperger’s Syndrome are difficult to diagnose, especially in young children where speech and reasoning skills are still developing. Parents who suspect autism in their child should ask their pediatrician to refer them to a child psychiatrist, who can accurately diagnose the autism and the degree of severity, and determine the appropriate educational measures. Autism is a serious, lifelong disability. However, with appropriate intervention, many of the autism behaviors can be positively changed, even to the point that the child or adult may appear, to the untrained person, to no longer have autism, and have a full range of life experiences.

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Squarepegs
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(My Note: This author blends High Functioning Autism (HFA) and Asperger’s Syndrome (AS) as a single category. The DSM-IV differentiates Autism and Aspergers, but not High and Low functioning Autism but i’m pretty sure the DSM-V will)

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Autism Is NOT…

* mental retardation
(70-80% reported during time when only severe cases came under clinical attention, common but not requirement, may be result of sensory integration errors, new HFA population should cause re-evaluation of this statistic)
* savant skill
(1-10% have unusual talent with a particular skill or subject)
* “Rain Man”, the movie with actor Dustin Hoffman
(a specific example, not a generalization, but a good reminder that adults can be autistic)
* violent outbursts or complete withdrawal
(possible frustration/ overload response, rarely a spontaneous unprovoked action)
* Obsessive-Compulsive behavior
(repetitions are fascinating not fearful)
* a developmental “phase”
(brain structure is different even for adults, please be as skeptical of cures for autism as of cures for homosexuality)
* “anti-social personality”
(that condition is associated with head trauma, prenatal exposure to alcohol/drugs, or encephalitis. it is not connected with autism)
* emotional impairment
(feelings exist! although occurrence may be different)

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From the Autism Society of America (ASA) website on characteristics of autism:

“One of the most devastating myths about autistic children is that they cannot show affection. While sensory stimulation is processed differently in some children with autism, they can and do give affection. But it may require patience on a parent’s part to accept and give love in the child’s terms.”

Autism IS…

* a neurological difference (brain structure is different)
* a social disability (difficulty interacting with people at school, work, or home)
* attention to limited topics of interest (narrow width, but significant depth)
* explosion of alternative thoughts (permutation exploration), or simple literal-mindedness (need precision and clarity at either extreme)

frequently encountered experiences:

* sensory integration problems (sense avoidance or stimming)
* avoidance of crowded areas (not the same as claustrophobia)
* digestive system problems
* frequent inability to recognize, generate, or value deceptions (lies)
* gaze aversion (sensory issue, unable to process vision and sound simultaneously)
* notable memory for details
* clumsy, uncoordinated (for some tasks)
* approximately 80% of autistics are male (there is discussion that some females may be undiagnosed or misdiagnosed)
* IQ scores were previously thought to be low for autistics, but the diagnosed population has changed substantially in the last decade with the introduction of Asperger’s Syndrome, so the average score is now unknown

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Some Autism History

1940s: Kanner’s and Asperger’s autism identified

1991: Asperger’s autism rediscovered

1993: Asperger Syndrome enters DSM-IV

From 1938 to 1944, Leo Kanner at John Hopkins Medical School in Baltimore Maryland studied 11 unusual children, and in 1943 he named a new disorder as “autism” (specifically, “early infantile autism”). Children with this form of autism often showed mental retardation, impairments in speech or verbalization, or other issues that caused significant problems with their socialization.

For many years, “Kanner’s Autism” was thought to be the only form of autistic impairment. Eventually, people began to question if these other factors were truly necessary conditions for autistic behavior. Research into autism in the 1980’s led to the 1991 translation into English of decades-old observations about a different expression of autism.

At the same time as Kanner made his observations, Hans Asperger in Vienna Austria during World War II studied another group of unusual children, and he also named a new disorder using the name “autism” (specifically, “autistic psychopathy”). (His observations remained unrecognized throughout Europe for decades, and his clinic was bombed during Allied attacks.) When researchers rediscovered his work in its 1991 English translation, they saw evidence that some autistics are articulate, creative, and capable of surviving in society with minimal assistance. “High-functioning autism” in its various forms gained interest from researchers and other interested parties.

The addition of Asperger Syndrome to the DSM-IV in 1993 opened an autism diagnosis to a new population of people. Adults began to recognize themselves in its description, so there has been a wave of adults (rather than children) being diagnosed in the last decade with this newly recognized form of autism.

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From “Autism: Explaining the Enigma” by Uta Frith, page 1:

Those familiar with images of children who suffer from other serious developmental disorders know that these children usually look handicapped. In contrast, more often than not, the young child with autism strikes the observer with a haunting and somehow otherworldly beauty. It is hard to imagine that behind the doll-like image lies a subtle yet devastating neurological abnormality.

What is this abnormality? How can one explain its many paradoxical features? These are questions that I shall try to answer in the course of this book. I will start with removing some obstinately persisting misunderstandings. The first of these is the idea that autism is a disorder of childhood. You hear a great deal about children with autism, far less about adults. In fact, autism starts to be noticed in childhood, but it is not a disorder of childhood. Instead it is a disorder of development.

In other words, yesterday’s autistic children are now today’s autistic adults. They are already here, and they are trying to be a part of the workforce. Their continuing difficulties with sensing and socializing, however, lower their productivity and reduce their career opportunities.

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Autistic Strengths reviewed for the workplace

* At its best, autism can offer these strengths:
* strong conceptualization skill
(able to mentally model complex systems, may develop instinctive understanding of the system from this internalized model)
* logical thinking
(strong skills in technical research or computer programming)
* exceptional memory
* attention to detail
(can identify inconsistencies in processes or communications)
* honest, straightforward
(can treat people fairly)
* intense focus
* willing and able to learn great depth of information in specific field

Autistic Weaknesses reviewed for the workplace

* Even at its best, autism may still offer these weaknesses:
* sensory sensitivities
* need for sensory escapes or stimulations
* slow to recognize people or objects
(persons with prosopagnosia would be bad at security duties)
* slow to verbalize
* slow to shift attention
(may need to avoid multiple responsibilities)
* resists change to working procedures
* unable/unwilling to navigate office politics
(may not recognize the need for hierarchical routing of communication, instead preferring direct communication with the person having information or decision authority)
* unable/unwilling to recognize or generate deceptions (“lies”), or bad at doing so
* unable/unwilling to comply with some social norms
(grooming style, clothing, desk neatness, phone protocol)
* poor skill with extemporaneous speaking
* poor understanding of metaphors
(or recognizing questions as rhetorical)

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Workplace Accommodations

Here are some concessions/changes that employers could make to ensure the participation of autistics in the workplace. Employers would need to work with employees in establishing the zones where concessions will be made. There will be obvious differences in possibilities between office work and manufacturing.

It may also be reasonable to negotiate lower salaries in exchange for reduced hours or workloads, if such changes are needed to meet the “reactive/planning” concessions described below. Cost for “sensory” or “social” concessions, however, should not be passed directly to the employee.

Note that some of these concessions are already being implemented because enough neurotypicals felt strongly about wanting them. Remember that autism may be an extreme version of traits and sensitivities that all people share to some degree. I expect that changes made specifically for autistics may also be popular with a sizable portion of the neurotypical workforce. Autistics would benefit most from these changes, but every person would benefit to some lesser degree.

* Workplace Accomodations Sensory

* sensory concessions allow (or hopefully provide) use of incandescent lighting at work area (to prevent flickering)
* allow (or hopefully provide) computer monitor/videocard with a high refresh rate (to prevent flickering)
* allow sunglasses, earplugs, headsets to block stimuli
* allow workers to avoid attending meetings in rooms with permanent sensory problems (near a kitchen area with scents, with “inaudible” television noise or ultrasonic sensors, with walls composed entirely of windows, with floors that vibrate because of building motion or nearby machinery)
* provide scent-free work areas where perfume, cologne, and cigarettes are forbidden
* allow non-disruptive “stimming” devices and other coping behaviors in the work area. these concessions could include:
chair replacements (a stool or an exercise ball),
rocking back and forth, or hand-flapping,
frequent breaks to isolated areas (perhaps hiding in a bathroom stall, vehicle, or unused room)
* allow non-standard clothing if the standard issue is a sensory irritant:
(starched cloth, constricting collar/necktie, fabric that generates noise or static, too-bright colors, dizzying patterns)

* Workplace Accomodations Social

* social concessions allow the circumvention of some difficult forms of communication:
avoid use of phone altogether, or allow redirection of calls directly to voicemail
* allow exemptions from attending group gatherings (the typical “mandatory” division or team meeting), always providing the same information in written or recorded form
* allow exemptions from attending “team-building” events, or find new creative processes that allow effective autistic participation rather than the typical social encounters
* allow exemptions from speaking before a group, instead use written material or a substitute speaker for communication
* recognize that the worker may not join meal events unless they can bring their own food and drink that meets their strict dietary requirements (some autistics are sensitive to flavors/odors, some are on strict medical diets free of certain molecules like gluten and casein)
* educate management and coworkers that “look at me when we’re talking” is a counter-productive command, distracting the autistic worker rather than focusing their attention. some autistics need to unfocus their eyes or focus away from their audience in order to pay attention.
* educate management and coworkers that the autistic worker is easily distressed when given confusing or conflicting information. communication may be taken literally. if there is any ambiguity, the autistic may follow their own uncommon interpretation. ensure that directions are very clear.
* educate management and coworkers that they should avoid having different people give different instructions to the worker. autistics may be unable to determine whose authority overrides the others, instead choosing either the first directive or the most recent one to follow.

* Workplace Accomodations Reactive/Planning

* reactive/planning concessions allow extra time to respond to bureaucratic forms, if they request it
* always provide text material that matches verbal communications (always)
* allow extra time to respond to voice conversation
* remind employees that they can request more frequent and/or more specific feedback
* allow a reduction in the number of simultaneous tasks that the worker must cope with
(frequent starting/stopping of tasks or other frequent shifting of attention may cause an autistic’s productivity to plummet far below normal levels)
* allow flexible work hours
(some autistics are notoriously bad about showing up on time, while others are strictly punctual)
* allow reduced work hours
(some autistics “burn out” when required to meet 40-hour schedules for extended periods)
* expect resistance to changes in work procedures. allow more time for them to adjust. their complaints may not be intended as a hostile threat to authority. make the requirements clear. expect them to change slowly, but require them to change eventually. give as much advance notice as possible for workplace changes.

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“Curing” Autism

Fitting in temporarily is absolutely a valuable skill. Just because we are capable of mimicking these desired behaviors for a short time, though, does not mean that we should be obligated to do so for a lifetime.

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You may hear the medical establishment speak about the importance of diagnosing autism in children. The intention is to identify autistic disability so that intervention may begin as soon as possible, teaching specific social skills that other children would discover instinctively without instruction. Early, comprehensive intervention is said to be very effective in teaching autistic children to interact socially. It is certainly beneficial to learn how to accomodate the needs of others, how to “fit in” or at least communicate effectively with a group. These intervention efforts are valuable for this purpose, and reaching people as early as possible will probably make the lessons easier for the children to incorporate into their daily behavior.

This education makes some autistic adults uncomfortable, however, because some of us see it as dangerously similar to brainwashing. It is easy to compare this social training with the encouragement of left-handed people to develop right-handed skills or the expectation of gay people to live heterosexual lives. Fitting in temporarily is absolutely a valuable skill. Just because we are capable of mimicking these desired behaviors for a short time, though, does not mean that we should be obligated to do so for a lifetime.

Our lives are more fulfilling when we embrace our differences, retaining the innate qualities that distinguish us from others. It is certainly helpful to learn how to accomodate the needs of others, such as when left-handed eaters switch to right-handed use of utensils to avoid disrupting the dining experience of other eaters at a crowded table. But it is far more satisfying to all of the eaters if accomodations are made for left-handed people to eat where their elbows will not cause distractions, such as at the left end of a table.

Autistics are beginning to demand the same accomodations for their unique needs. Teach us how to “fit in” when necessary, yes, for those moments when social conformance is truly important. But don’t try to suppress or eliminate our native behaviors entirely. Some autistic adults construe such attempts as acts of harm perpetrated against us. We are better served by learning to keep ourselves intact amidst a world designed for different standards; we are better served by changing those standards so that we have a proper home in society.

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Metaphors for autism

* “Vulcan” from Star Trek universe
(strongly logical mind tends to supercede emotional reactionism)
* geometric (from Phil Schwarz)
(neurotypical is a circle, autistic is polygon with fixed number of sides, social coping skills add additional sides but the approximation never exactly matches a true circle, using polygon as a wheel will always be a bumpy ride)
* linguistic (also from Phil Schwarz)
(a Japanese businessman learns social skills to function in Western markets, but learning does not cure him of his Japanese-ness and does not devalue his native culture… social skills curricula for autistics should be similarly constructed)
* “engineer’s disease”
(in fact, one British study found that families with a diagnosed autistic member were 3-4 times more likely to have a father or grandfather who was an engineer)
* saltwater fish in freshwater environment
(disability is obvious when placed in the wrong environment)
* “oops, wrong planet” syndrome
(almost, but not quite, like other people)

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Autism Vocabulary

Words and phrases that you will encounter if you spend time with the autistic community

* LFA (low-functioning autism)
* HFA (high-functioning autism, IQ 70+)
* AS (Asperger’s Syndrome, HFA without language delay)
* ASD (autism spectrum disorder)
* “on the spectrum” (having autistic traits)
* NT (neurotypical, neurologically typical)
* shadow traits/cousinhood
ANI website: A “cousin” is loosely defined as a person who does not have a diagnosis of autism, but who has some other significant social and communication abnormalities (shadow traits) that render him or her recognizably “autistic-like.”
* AC (autistics and cousins)

* sensory integration
* “stim”
* overload
* burnout
* perseveration
* nonverbal
* prosopagnosia
* echolalia
* savant ability

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Neurodiversity Vocabulary

Other ways of thinking

* Rett Syndrome
* AD/HD (Attention Deficit/Hyperactivity Disorder)
* OCD (Obsessive-Compulsive Disorder)
* dyslexia
* Tourette’s Syndrome
* depression
* bipolar disorder

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Theories of Autism

* neurobiological
* genetic
* socializing/systemizing
* theory of mind: “mindblind”
* exposure anxiety
* mercury poisoning (thimerosol)
* “leaky gut”
* topological (website at http://www.autismtheory.org)
* “refrigerator mother” (thoroughly discredited but historically significant)

Keep in mind that the autistic community, like the gay community, is sometimes harshly critical of any attempts to “cure” persons with their unique quality or to prevent new births of people like themselves. I present these theories only to provide a more complete exploration of autism, not to establish a basis for using corrective measures against autism.

When faced with the diversity of theories on the origins of autism, the only certain conclusion that can be made is that there is no conclusive theory yet. That uncertainty is why so many different options are being explored. It may be true that autism can result from any one of a variety of causes, like blindness, deafness, or high blood pressure may result from a variety of causes. It could be inherited genetically, induced by chemical contamination, triggered by prenatal developmental changes, or a host of other reasons.

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Counterpoint

Lest I create the false impression that autism is never a severe disability for some people, I must point out that autism is a biological difference with serious medical implications (comorbidities, in the medical terminology). It affects some people more dramatically (and negatively) than others. Sympathetic workplace changes are not enough to remove the problems of the entire autistic community. In addition to what I have described previously, autism may also occur with these sometimes-debilitating effects:

* epileptic seizures
* chronic diarrhea
* inability to understand language (socially deaf)
* inability to speak (socially mute)
* head banging (self injury)
* finger biting (self injury, not nail biting)
* inappropriate outbursts caused by frustration/overload
* Tourette’s Syndrome
* specific learning disabilities (uneven levels of ability)
* painful hypersensitivity to touch, light, or sound
* extreme withdrawal/isolation

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