Tag Archives: High Functioning Autism

The Autistic Maelstrom …

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In the new, updated edition of “The Autistic Spectrum” (2002), Lorna Wing offered on page 23 a brief history of the chaos which seems to continue to this day, surrounding risen and fallen efforts to decide the main, and sub-categories of what she identified as the Autistic Spectrum. In order to justify my statement, please allow me to quote:

“The changes in ideas about autistic disorders can be seen in the history of the two international systems of classification of psychiatric and behavioural disorders. These are the International Statistical Classification of Diseases and Related Health Problems (ICD) published by the World Health Organisation, and the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association. The first edition of the ICD did not include autism at all. The eighth (1967) edition mentioned only infantile autism as a form of schizophrenia and the ninth (1977) edition included it under the heading of ‘childhood psychosis’.
The 10th edition of the ICD (1992) and the third (1980), third revised (1987) and fourth (1994) editions of the DSM take the modern view that there is a spectrum of autistic conditions and that they are disorders of development, not ‘psychoses’.”

On page 29 of the same book, Wing details the reasons for this nosologic maelstrom:

“When an autistic disorder is diagnosed, there is the further problem of deciding which sub-group in the spectrum the individual belongs to. Now that the term Asperger’s syndrome is being used more widely, parents and professional workers as well, want to know how it differs from other forms of autism. Since Asperger’s group, unlike Kanner’s, includes mostly those of average or high levels of ability, the main question is how to tell Asperger’s syndrome from high-functioning Kanner’s autism. There is no simple answer.” Because as she establishes further, while some individuals present all the features of either, other individuals fit neither of these symptoms precisely, having (as myself…) mixtures of features of both.

And we haven’t even touched the serious problem of symptomatic and existential gender differentials, which is becoming more and more obvious, at least for the individuals on the autistic spectrum, because for the diagnostic and assessment services (at least in the UK, in my understanding) the primary diagnostic differentials are only age related. However, the UK’s NAS (The National Autistic Society) proves a genuine awareness of the necessity for further research at http://www.autism.org.uk/about/what-is/gender.aspx

To make things even more confusing, the DSM-5 published in May 2013, factually canceled Asperger’s as a separate diagnosis and included it as an autism spectrum disorder, with adjacent severity stages. It mentions nevertheless, that “Individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger’s disorder, or pervasive developmental disorder not otherwise specified should be given the diagnosis of autism spectrum disorder.”

But if one may think that the ICD-10 is of any better clarity, a quick look at its ‘F84.5 Asperger syndrome’ entry, reveals an opening statement which I would call at least seriously problematic: “A disorder of uncertain nosological validity“, as I’m not really sure that a standard international classification should be based on anything “uncertain”.

The reason for the rather thought-twisting title of this post, can be found in a well hidden -in plain sight- introductory statement, on an oddly placed (right after the front cover page, without obvious authorship or number) page of Uta Frith’s “Autism and Asperger syndrome” (2010) edited book, which opens its last phrase with the statement “Current opinion on Asperger syndrome and its relationship to autism is fraught with disagreement and hampered with ignorance”, followed nevertheless by the reassurance that the book “gives the first coherent account of Asperger syndrome as a distinct variant of autism …” I have insofar found the attempts to systematize Autism maelstrom-like, because as their aquatic correspondents, they absorb all concepts and definitions in their way, just to scatter them on devastated, more or less scientific ocean-floors, without seemingly ever considering that behind words and terminologies, are real-life human beings, suffering the oftentimes indifferent detachment of those we trust(ed) for a better life…

And this very statement would be exactly the conclusion-prelude to a series of open enquiries attempting to discover the adult, gender specific understanding of first of all, the most commonly and widely used autism screening tool, the Autism Quotient 50 (AQ-50). As an incentive for the reader’s personal consideration and most welcome comments, I am providing a link to a short scientific paper from the “Journal of Autism and Developmental Disorders, Vol. 31, No. 1, 2001” at http://docs.autismresearchcentre.com/papers/2001_BCetal_AQ.pdf

In my next post, I will attempt to offer for an even more personalized analysis and comments, the first ten (1 ÷ 10) questions of the AQ-50 autism screening questionnaire, in the hope of initiating a “real-life” and “Actually Autistic” blog-forum, where especially adults on the autistic spectrum can evaluate in a safe, anonymously confidential environment their gender specific, unique understanding of the relevance of these questions for their own screening and diagnostic assessments, in an atmosphere of non-belligerent acceptance, mutual respect, civilised ‘agreement to disagree’ attitude and constructive tolerance.

Most sincere apology to my readers and followers, and Word of Caution:

Having painfully learnt my lessons elsewhere, and in order to protect the emotional wellbeing and dignity of all well-meaning viewers and participants, all comments and replies henceforth, will be monitored and subject to approval. Therefore, if your comment and/or reply doesn’t show immediately, please be patient. But if your comment and/or reply doesn’t show at all, please rephrase!

Because no one shall be bullied or harassed in my own blogyard! 👾🤓

 

Photo credit: By Walter Baxter, CC BY-SA 2.0, https://commons.wikimedia.org/w/index.php?curid=33579199

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Sixth of Asperger’s Ten Traits – “We have feelings of dread about even one event on the calendar”

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“6) We seek refuge at home or at a safe place. The days we know we don’t have to be anywhere, talk to anyone, answer any calls, or leave the house, are the days we take a deep breath and relax. If one person will be visiting, we perceive the visit as a threat; knowing logically the threat isn’t real, doesn’t relieve a drop of the anxiety. We have feelings of dread about even one event on the calendar. Even something as simple as a self-imposed obligation, such as leaving the house to walk the dog, can cause extreme anxiety. It’s more than going out into society; it’s all the steps that are involved in leaving–all the rules, routines, and norms. Choices can be overwhelming: what to wear, to shower or not, what to eat, what time to be back, how to organize time, how to act outside the house… all these thoughts can pop up. Sensory processing can go into overload; the shirt might be scratchy, the bra pokey, the shoes too tight. Even the steps to getting ready can seem boggled with choices–should I brush my teeth or shower first, should I finish that email, should I call her back now or when I return, should I go at all? Maybe staying home feels better, but by adulthood we know it is socially “healthier” to get out of the house, to interact, to take in fresh air, to exercise, to share. But going out doesn’t feel healthy to us, because it doesn’t feel safe. For those of us that have tried CBT (Cognitive Behavior Therapy), we try to tell ourselves all the “right” words, to convince ourselves our thought patterns are simply wired incorrectly, to reassure ourselves we are safe… the problem then becomes this other layer of rules we should apply, that of the cognitive-behavior set of rules. So even the supposed therapeutic self-talk becomes yet another set of hoops to jump through before stepping foot out of the house. To curl up on the couch with a clean pet, a cotton blanket, a warm cup of tea, and a movie or good book may become our refuge. At least for the moment, we can stop the thoughts associated with having to make decisions and having to face the world. A simple task has simple rules.”

Used with permission from @everydayaspergers. Originally published in Samantha Croft‘s -now former- blog, Everyday Asperger’s, as The Ten Traits.

In the neurotypical (NT) world, going to work next day, is just another day of going to work…

Get up, (and now I’m starring at the screen, as even the attempt of “thinking” neurotypically absolutely confuses me…), usual morning stuff, drive to work, work, drive back, evening stuff, sleep, another day tomorrow…

Compared to the above, anything in a neurodivergent’s life, even going to work, becomes a conscious “event”, which needs to be properly considered, thought through, planned, routine respected, analysed upon progression and evaluated.

To give anyone reading these posts an idea of how a neurodivergent (ND) brain functions, of what a High Functioning Autistic/Asperger’s adult’s mind has to abide by, please consider an example about stages of progress onto going to work, on a “normal” day:

-getting up in the morning without any clock, after another rough night of consciously trying to find the same position at every turn, while concentrating every time on one’s own breath in order to avoid absorbing al the chirps, cracks, breaths, squeaks, drips, ticks, tocks, sirens, etc

-consciously attempting to arrange the cover on the same side, the same way every time upon uncovering, followed by lifting left leg, right leg down, balancing left leg up and down, while body on the right side is pushed up on right elbow, left hand counterbalancing with wave motion from left side to right side down

-sitting on the side of the bed, rubbing nose/beard/nose, scratching head with right hand, planning the short walk to the slippers left exactly in the same place, by a piece of furniture which serves as a balance support for dyspraxia

-walking towards slippers, holding on to the furniture, putting on slippers, always left first, right second

-walking to the chair where depending on season and therefore temperature and air humidity, a sleeveless grey body warmer or a navy blue/black hoody is put on, back first, left arm second, right arm third, hood adjustment fourth, zipper fifth

-grab tablet on the way to toilet by placing right foot between chair and desk, hold it right hand between thumb and fingers 3, 4, 5, as index is used to open the door, while left hand pushes aside clothes on the tree hanger

-sit on the toilet, open tablet, start tablet, wait for log-on, logging on…

And I’ll stop here, for obvious reasons, even though it’s been around 1 1/2 minutes (90 seconds) since getting out of bed, with only 1438 1/2 to go until next morning’s identical/similar routine…

And EVERYTING else follows, same way, same routine, same order, with every detail thought about in advance as the minutes roll on.

So, in order to clarify why at the end of a day, a ND nearly collapses, please try to imagine the conscious thought process which has to go in our life’s each progressing detail, while all stimuli arriving through all senses are being processed throughout most of our cerebral cortex, with each and every unplanned and therefore unexpected event/detail mandatorily processed, categorised, catalogued and stored accordingly.

One of the reasons for the precise and detailed visual memory of NDs, called sometimes eidetic, is our brain’s capacity to assimilate randomly arrived information into well-established routine patterns, making therefore an incidental detail an incorporated part of a pre-existent pattern. From there, using other stored memory cues, these can be retrieved for periods of time depending on the individual’s unique neurobiology.

Would it be now maybe easier to understand why seeking refuge at home or at a safe place becomes a necessity?

And in case you still wonder why, please remember that even if our minds seem to possess peculiar computing capacities, our brains, together with our bodies, still burn the same carbohydrates as anyone else’s, making them therefore susceptible to fatigue, low fuel levels, and unfortunately burn-outs…

The difference is that while the NT brain/body engines count the carbohydrates burned per hour, the ND engines count them per minute…