The Gift of Autism

Autism may not be a blessing, but with it can come amazing talent the rest of us will never have.

FACT: Everyone – every human being on the planet – registers somewhere on the autistic spectrum. The principal signs of ASD might not always be obvious. For example, attention to detail is a sign of autism even though a lot of people pay attention to detail and would certainly not be diagnosed as autistic. The same could be said for perfectionists, people obsessed with cleanliness or people who are happier in their own company. It is only those with the most severe symptoms who are officially diagnosed with ASD.

Autism is a lifelong developmental condition that affects how a person communicates with, and relates to, other people. It often affects how those with the condition perceive and make sense of the world around them. Autistics can be both over-sensitive and under-sensitive to all the senses – sounds, touch, tastes, smells, light or colours. This means that their experiences of every facet of life can differ markedly from our own.

This might also be why, because they see the world in a different way, they are able to think about problems in a different way, often finding ‘outside the box’ solutions that elude the rest of us.

People assume autistics are not good learners but this is a mistaken belief. People with autism are often voracious consumers of knowledge. Forget the stereotypical and nerdy Sheldon in The Big Bang Theory because autistics excel at a limitless variety of subjects, not just maths and science.

People with autism know how to be social, it’s just that they find it more difficult. Most autistics wish people understood their genuine dislike of being touched instead of dismissing them as being rude or odd. But that doesn’t mean they don’t care about other people or don’t try to understand them – in truth, they try hard to understand other people.

They can take forever to get a joke and may find things that are interesting or fun to you and me might be utterly boring to them and vice versa. But people with autism are not always hopeless when it comes to social interaction – in fact many of them have learned ways of hiding their social awkwardness and learned how to interact socially by copying others.

Mozart was autistic. His remarkable, almost obsessive attention to perfection still holds musicologists in awe of his genius.

So, according to psychologists at Oxford and Cambridge, was Albert Einstein. His childhood learning difficulties and tendency in adulthood to repeat phrases and sentences are a dead giveaway, although unusually, he also had a sense of humour. But his autism was also his genius. Einstein’s General Theory of Relativity was an astonishing piece of original thinking that revolutionised scientific thinking and still remains unchallenged today.

And then there’s my namesake, Sir Isaac Newton. His limited social connections and difficulty with speech are indicators, not to mention his habit of lecturing to empty rooms if people turned up late. That’s typical autistic behaviour.

Likewise, Thomas Jefferson’s preoccupation with minority special interests, his social awkwardness and poor communication skills were also typical of autism.

And there’s Charles Darwin, whose single-minded focus and persistence with evolutionary theory occupied his entire life, not to mention his outside-the-box thinking.

Temple Grandin, one of the world’s leading psychologists and inventor of a humane system of shepherding cattle is one of the world’s most famous living autistics.

Add to this list film directors Stanley Kubric and Tim Burton, artist Andy Warhol, author Lewis Carroll and you can see where I’m going with this.

A Yale University study has found that the same genes responsible for higher intellectual achievement and exceptional brainpower are associated with the disorder and may trigger autism. This may explain why autism has not been eliminated by natural selection.

Genes that exert a negative effect on reproductive success normally die out, but a variety of genes known to boost brain growth are, in most cases, beneficial and that is why they continue to be passed on. But the downside is that the same genes increase the chances of putting their owner on the spectrum.

The researchers used a computer model to simulate the effects of natural selection on different sets of genes. They concluded that the genetic variants found in people with autism were present at a much higher level than could be the result of chance.

It appears that the genes have a ‘signature for positive selection’ that strongly suggests that these variants have undergone positive selection during the course of human evolutionary history.

So why are such a large number of gene variants that together give rise to traits like ASD retained in human populations and why aren’t they eliminated by evolution?

The answer is, during evolution, variants that have positive effects on cognitive function are selected, but at a cost – in this case an increased risk of ASD. Thus, there are many overlaps between autism and high IQ. These include having a larger brain, faster brain growth, increased visual, sensory and spatial abilities, increased attention focus, and descendant from a higher socio-economic background.

Other studies have also shown that the risk of autism is higher in people who were highly intelligent as children and spent longer in education.

The Yale research was the first to show that the genes linked to higher IQ and autism are being positively selected in evolution.

The gene variants boosting brain function did so in small, subtle ways because genes having a ‘large effect’ on the development of the nervous system would, in the vast majority of cases, be extremely damaging, leading to disabilities or death. Thus they would be rapidly be eliminated from the human gene pool.

An accumulation of lots of small beneficial modifications to the brain would be beneficial to most but detrimental to some.’

The study has been published PLOS Genetics and involved more than 5,000 people.

Autism should be treasured as a special and precious gift, a unique talent that can benefit humanity and enrich all our lives.

Autism Spectrum Disorder (ASD) affects around one in 100 people. Whenever I speak about autism I refuse to use the word ‘disorder’ because the only people with any disorder are those that don’t understand the condition, or recognise the amazing contribution they can make. ‘Sufferers’ of autism only suffer because of other’s lack of tolerance. We’re all different – get used to it! Autisitcs would be much happier if only people would stop trying to force them to ne ‘normal’ or worse, ‘cure’ them!

I’ve met people who have autism and they are very nice people – you’d never know they had it until you really get to know them and start to spot patterns of behaviour which may be a bit unusual… but not bad.

One friend of mine runs a successful taxi business in Wellington, New Zealand but is a stickler for cleanliness and smartness. He also complains if his delivered pizza hasn’t got the correct amount of toppings. ‘Would you be happy if that was yours?’ is one of his favourite phrases. So he’s a bit OCD… so what? He knows what he wants and has a right to expect what he paid for… he’s just a bit, well, you know… autistic. We joke about his OCD and then I remember I also have some similar minor obsessions with perfection.

The number of computer geniuses who suffer from autism is beyond counting – Silicon Valley is full of them. They’re the nerds who are happy performing repetitive tasks, which is one of the things that makes them good programmers. They fall in love with and marry other nerds and have nerdy children who will eventually inherit the earth.

Then there are the ones who get more of a thrill solving a complex mathematical formula (something that they regard as a thing of beauty) than they do from going to a ball game, which they find tediously boring.

The world is full of people with their own harmless quirks and habits, and I understand this, because I’m one of them. For me, lateness is the ultimate sin, punctuality the one true religion. So show me any talented individual and I’ll show you someone who isn’t completely normal.

In which case, it will come as no surprise that I do not consider autism to be an illness at all. Rather, I consider it a gift – a god given precious gift. The problem is that the gift is too often overlooked and there are too many people trying to cure it! At the risk of repeating myself, we really are all different; it’s just that some of us are different in a different way. Autism is of value… because the autistic mind can produce immense benefits for the rest of society.

ASD can be the cause of a wide range of symptoms that are usually grouped into two main categories. [More boys are diagnosed as autistic than girls.]

Autistics frequently shy away from social interaction, preferring texting and email to face-to-face communication. They often have problems starting and becoming involved in conversations and have difficulties with empathy and being aware of other people’s emotions, let alone understanding them.

Rigid thought patterns are another symptom – autistics prefer set routines and become upset if they are disrupted. Their thought patterns are repetitive and their behaviour very easy to predict.

Personally, I see no reason whatsoever why other people should try to seek out a ‘cure’ for this harmless behaviour, because it is in any event, incurable. There are a wide range of educational and behavioural support schemes in place, but generally speaking, autistics need a great deal of persuasion to take part in them.

There are subtle differences in the connections within the brains of autistic men and this could help explain why people with autism exhibit the symptoms they do. The bundles of nerves in the frontal lobe, which is involved in social interaction skills, look different from those without the disorder.

That means they were born with their brains wired that way and just as we embrace cultural diversity so we should embrace thought diversity. We are all human beings, and we all have something to contribute. Autistics can contribute new skills and new ways of thinking than people without the condition cannot.

I’m fed up of hearing about scientists talking about ‘discoveries that could reverse the process’ or who talk about autism as a disability, because they are in danger of being on the receiving end of a very stern talking to from me! This attitude is just another sort of prejudice.

Scientists from the Universities of Bristol, Harvard, MIT and Massachusetts General Hospital set out to identify if there is a genetic relationship between ASD and ASD-related traits in people not considered to have ASD. Their findings have revealed underlying ASD affects a range of behavioural and developmental traits in ALL people. [This work was published in the journal, Nature Genetics.]

Difficulties with social interaction, communication and language impairments, and stereotyped and repetitive behaviour are symptoms occurring to varying degrees in unaffected people. With recent advances in genome sequencing and analysis, a more accurate picture of the genetic landscape of ASD has begun to emerge.

It’s easy to think that autistics are being shy or indifferent, or that it’s a sign of social awkwardness, but people with autism often avoid eye contact, and some complain it feels like ‘burning.’

Researchers at the Massachusetts General Hospital used brain scans of autistic patients to investigate their complaints that eye contact is stressful and uncomfortable for them. Humans are drawn to the eyes of the human face from birth and this eye contact activates the subcortical system of the brain.

But in autistic people, this region is oversensitive to the effects of direct gaze and emotional expression. The scientists found that eye contact over-stimulates autistic people’s brains and now understand that the lack of interpersonal interest among people with autism is not due to a lack of concern, but a way to decrease an unpleasant excessive arousal stemming from over-activation of the subcortical system.

The scientists measured differences in activation within the face-processing components of the subcortical system in autistic people and in non-autistic control subjects as they viewed faces either freely or when directed to look just at the eyes.

Autistic people had similar results to non-autistic people when allowed to look freely at the faces, but when they were instructed to concentrate on the eyes, brain scans showed the autistic participant’s brains were activated to a much greater degree. Although this was especially true with fearful faces, similar effects were observed when viewing happy, angry and neutral faces.

The researchers say their findings, published in the journal Scientific Reports, support the idea that there is an imbalance between the brain’s excitatory network, which reacts to stimulation, and inhibitory network, which calms it down.

Forcing children with autism to look into someone’s eyes in behavioural therapy may create a lot of anxiety for them. Possibly a slow introduction to eye contact may help them overcome this overreaction and teach them to handle eye contact and so avoid the cascading effect this eye-avoidance has on the development of the social brain.

Research has shown that most ASD risk is polygenic – that is, it stems from the combined effects of thousands of genetic differences. Some cases are also linked to new rare genetic variants or mutations rather than inherited.

What all this means is that autism is not a condition that can be ‘cured.’ It cannot be dealt with [and should not be dealt with] in the same way as mental illness. It’s one thing to attempt to understand the causes of a condition, but quite another to attempt to contain or curtail its effects.

Autistics have a rich and valuable history of contributing to the arts and to science. They should be encouraged to continue to do so and not stymied or forced into programmes designed to change them. Autistic people are nice people and they have a lot to offer, and it’s about time we cut them a bit more slack.

As the study of autism and diagnostic techniques become more specialised, we are beginning to move further away from the old (and mistaken) stereotypes and toward a better understanding of the potential and value of autistic individuals. Specialists in autism have found that not only do autistics possess widely different levels of cognitive skills, they can also possess above-average intelligence.

The truth is, people with autism can be just as empathic and emotionally competent as the rest of us (it’s the psychopaths we really have to worry about!)

Like the rest of us, autistics enjoy feeling happy and content. They are also capable of feeling anger and frustration, and like other humans, occasionally they throw tantrums. However, their inability to recognise emotions in others and the difficulty they have describing their own feelings and thoughts is actually caused by another condition – Alexithymia – a condition that is also found in the rest of the population, although it is more common in autistics.

But not all autistics have alexithymia. Only about half of autistic people are cold or antisocial or disinterested in others. For those with alexithymia, there is a deficit of empathy and a difficulty understanding the emotions of others.

According to researchers at the International School for Advanced Studies (SISSA) in Italy and the University of Vienna, and published in the journal Scientific Reports, autistic people also have a greater tendency to avoid causing harm to others than those without the condition.

The researchers subjected autistic people who had high IQ’s to a series of moral dilemmas – hypothetical situations where a decision had to be made which could save the lives of some individuals by sacrificing others.

Participants were asked to choose between doing an action which caused the death of one person but saved a large number of others, or doing nothing, which meant not killing anyone directly, but resulted in the deaths of others.

A Spock-like cold logic would have encouraged a purely utilitarian decision based entirely on numbers. Conversely, an empathic attitude would prevent most people from choosing to kill voluntarily.

The results were that people with alexithymia were more likely to choose the first option because of their reduced empathy. But those with only the autistic trait were less likely to choose that, due to the effect of increased personal distress.

Autistics display strong emotional stress in response to situations where the individual tends to avoid performing harmful actions. This work offers even more insight, if not absolute proof that people with autism are more like the rest of us than we give them credit for.

The bottom line is that we need to lose the Rain Man image of autism. The Rain Man image has become entrenched in modern culture, not just because of Dustin Hoffman’s extreme portrayal of Rain Man but because autism is now typically thought of as a male problem – it isn’t. [OK, I did mention Temple Grandin earlier, but she is the exception. Out of all the famous autistics I can name off the top of my head, and I have a special interest in this, Dr Temple Grandin is the only female with the condition I can think of.]

Autistics don’t have the same social skills as most people – but so what? So what they don’t go in for all the luvvie-luvvie, touchy-feely stuff that everyone seems to go in for these days while they infect each other with their hideous germs? This business of hugging everyone in sight, including complete strangers is a late twentieth century behaviour only. It’s an unnecessary fad anyway, so what’s the problem? [Please don’t tell me autistic’s dislike of this behaviour is a disorder or I will get angry! – it’s bad enough that we have a very narrow impression of what constitutes autism without banging on about learning difficulties or bad behaviour because my anger may likely turn to fury.]

It’s because autistics think in different ways that many of them have extraordinarily high levels of intelligence and ability, especially, as we have seen, in areas like music and science. We simply must lose the image of the ‘nerdy’ male, socially impaired and with strange and quirky special skills, because less than 1% of autistics fall into that category.

Certainly males are more likely to be diagnosed as autistic than girls – somewhere between four times as likely and twice as likely at the more extreme end of the spectrum. But this view is a mistake because there is increasing awareness that the apparent ‘maleness’ of autism may be more to do with the failure to recognise the condition in females who, at the less impaired end of Autism Spectrum Disorder manage to exist under the diagnostic radar. The female experience of autism is very different to the male experience.

It might of course be that the condition in females is ignored simply because of confirmation bias. Or it could be because autism affects females in a different way, possibly because of biological differences, overlooked because of traditional male/female stereotyping. It could also be that the process of diagnosis itself is more geared toward males.

It could even be because women have two X chromosomes and these reduce the impact of genetic factors that would inhibit the condition from showing up in tests. This would explain why [particularly young] girls diagnosed with ASD tend to be at the more extreme end of the spectrum.

A recent study of 10,000 fraternal twins showed that girls with ASD came from families with a much higher incidence of autism in other family members or relatives who show evidence of autistic traits such as social awkwardness or obsessiveness. One major problem highlighted by the study is that parents of girls on the spectrum told researchers that the examples given to help them answer questions about their offspring’s unusual interests and obsessions are much more slanted towards ‘boy-type’ interests such as does your child have an unusual obsession with metal objects, lights or street signs? When in fact their daughter’s obsession might be more to do with particular animals or dolls or pop stars.

One school of thought is that girls have a range of ‘camouflaging’ tactics, possibly because they may be more likely for cultural reasons to have been taught to be polite and decorous. Girls are perceived to be more sensitive than boys – they have a greater awareness of the importance of social rules and conformity, of being sensitive to others, or forming friendship networks. Girls are more likely to rely on the support of other girls whereas boys don’t, at least not emotionally. To conform to this ideal, girl’s survival strategy is based more on learning to imitate expected behaviour.

This is a common theme among women on the spectrum who describe the exhausting process of continuously monitoring and copying the social interactions that appear instinctive to their peers. This behaviour is known as ‘hiding in plain sight.’ The National Autistic Society’s Autism in Pink campaign has identified some key issues, and researchers are focusing on the dichotomy of female autism.

So there is increasing awareness that our current understanding of autism is glossing over girls who have the condition. This is an important discovery as it is commonly accepted that early identification and access to the right support services are important factors in including autistics in society, and more important, recognising and respecting them.

Above all, autistic people are nice people. They are good people. All they want is for people to stop trying to change them! Imagine the outcry if the rest of us went round trying to change gay people! This is important! Autism is not any kind of mental illness – it should be accepted as something that just makes people a bit different, and interesting, and able to contribute to the rest of humanity. Diversity rules!!! Most important, people who are autistic are really nice people.

Most autistic children in Britain go to mainstream schools and academies, while some attend special schools. Almost half of all autistic children in England have been excluded from school at some time or another because teachers are unable to cope with their behaviour. In line with government guidelines, all exclusions must be formally recorded. Even so, around 20,000 children have been placed on reduced timetables, sent home early or told not to go into school on exam days or on school trips. According to m’learned friends, these exclusions are illegal if imposed without the school providing the requisite paperwork – sending pupils home early or for a cooling-off period is deemed unlawful.

Ambitious About Autism is a charity dedicated to improving opportunities for young people on the spectrum in the UK. Having conducted a survey of 745 families with autistic children, the charity found they were four times more likely to be permanently excluded from school than other children. Nearly 25% of autistic children had been formally expelled at some point of their school careers.

The report also discovered that children with autism not only miss out on vital school time because of illegal exclusions, but these exclusions go unrecorded and unreported so the scale of the problem is hidden, making it harder for families to ensure their children’s rights. A staggering 33% of head teachers confirmed they knew at least one child with autism who had been excluded in the last year.

If children with autism had their needs met in school, these exclusions would be nowhere near this level.

Teachers are, in the main, unaware of the kind of problems children with autism suffer. Autistics have difficulties with social interaction and anxiety and may suffer with the sort of sensory processing problems described above. They may be disruptive, aggressive and unpredictable, even to themselves and they are more often than not unable to communicate these difficulties to the very people that should be lending a sympathetic ear. Some children escape by locking themselves in their own world.

The charity’s report also stated that 75% of parents find it difficult to get the right support at school for their autistic child and that 80% of children with autism find school so stressful they experience anxiety about attending every day. More than half these children find this anxiety so debilitating that they miss school days anyway.

It is absolutely unacceptable that children with autism are excluded and thus stigmatised. It is a fundamental right that children should be allowed to grow up happy and make the most of their education, and to develop their skills to the benefit of everyone.

Every child deserves access to a good quality education, and children with autism are no exception. The truth is, children with autism are interested in learning, and they need to be supported properly.

So what is the relationship between anxiety and autism?

Alexithymia, emotional acceptance and intolerance of uncertainty, plays a critical role.

These factors alone account for 64% of the relationship between autism and anxiety.

Those on the autism spectrum have enough difficulty identifying and understanding their own emotions, never mind the emotions of others. This is the reason why they are around five times more likely to develop anxiety – and it’s very difficult for autistics to cope with anxiety.

Anxiety is one of the most common reasons why those with the condition seek support from health professionals.

Mindfulness has been found to help in the treatment of anxiety in autism, but even those autistics with high intelligence often have difficulties coping with uncertainty and have problems in accepting [negative] emotional experiences. They also suffer from an inability to recognise emotions in others and struggle to put feelings into words.

Social stigma towards people with autism has seen people with the condition described as cold, antisocial, and disinterested in others. But this is unfair! People with autism just see the world in a different way and they express themselves differently. Most autistics are just as emotionally caring as everyone else but alexithymia stops them feeling empathy and therefore stops them being demonstrative.

Mindfulness-based interventions are currently the most effective in terms of alleviating anxiety in autism. Mindfulness is designed to foster an individuals’ awareness of moment-by-moment experiences, including current thoughts and experiences, emotions and sensations.

Mindfulness could also be effective in alleviating anxiety in those with autism by improving their ability to identify, understand, and accept their emotions.

These findings have been widely published in the Journal of Abnormal Psychology.

Because autistics are unable to live up to the expectations of others in this regard, this social stigma can cause anxiety in those on the spectrum. So it begs the question, why can’t society be more tolerant? It seems to me that a great opportunity is being missed –

Instead of trying to ‘cure’ those with autism, something which is impossible anyway, it would be better to re-educate the rest of society to appreciate that although people with autism can be distant emotionally, even cold, they have talents and gifts which are just as important to the rest of us.

So far, there has been no treatment for autism that has succeeded in improving or modifying symptoms in the long-term. But there is now a new technique that can help parents improve their autistic child’s communication skills, according to a paper published in The Lancet on 25 October 2016.

Pre-School Autism Communication Therapy (PACT) will be taught to NHS therapists from January 2017.

This new technique is beautiful by virtue of its simplicity and its humanity! It doesn’t involve any drugs or medicines, but it does involve the people closest and most important to the child. For the first time, parents are being trained to enhance their own awareness and response to their child’s unique direct and indirect ways of communicating. This will help them to reciprocate in an appropriately focused way. Parents will be able to see beyond the unusualness of what the child is actually trying to communicate. This has an additional benefit in that it encourages the child’s social understanding and communication development.

Researchers at the University of Manchester, King’s College London and Newcastle University, have found that training parents to identify, understand and interpret their autistic child’s patterns of communication at a very young age has a significant effect on reducing the severity of the child’s autism symptoms. Further, this positive effect continues for at least six years after the treatment.

Children whose parents used the technique when their child was aged between two and four had less severe overall symptoms six years after the technique was put into practice, and also gained improved social communication and reduced repetitive behaviours.

The advantage of this new approach over therapist/child-based intervention is that it has the potential to affect the everyday life of the child in a positive way and represents an improvement in the core symptoms of autism previously thought resistant to change.

Autism charities have hailed the discovery as the first in the world to be proven to provide a sustained improvement. They said the findings could improve the lives of thousands of autistic children. The technique is by no means a cure in the conventional sense of the word, because children will still retain some symptoms, but it does suggest that teaching parents to better communicate with their children can lead to improvements in symptoms in the long-term.

Parents who took part in the trial watched videos of themselves interacting with their children and received feedback from therapists who then gave tips and guidance. In addition, parents took part in 12 therapy sessions over a six-month period as well as 30 minutes a day of planned communication and play activities. This was followed up with monthly support sessions over the next six months.

The study involved 152 families with autistic children aged two to four. 121 of the participants were re-assessed after six years. Of these, 59 had taken the PACT course.

Symptoms in the treated children were found to be less severe, although no changes were seen in other areas such as language, anxiety and challenging behaviour – additional techniques will be needed to address these difficulties. Nonetheless, the researchers regard the results as hugely significant.

To measure the success of their work, autism severity was scored from 1 to 10 using a standard international scale combining social communication and behaviour symptoms. The results showed a 17% reduction in the proportion of children suffering severe symptoms from the PACT group. The findings suggest that sustained changes in autism symptoms are possible with early intervention, something previously regarded as difficult to achieve.

According to an economic analysis of the condition’s impact, autism costs the UK economy £32billion a year, more than any other medical condition, and more than the cost of cancer, strokes and heart disease combined. The cost is high because of the costs of residential accommodation, medical care and loss of productivity linked to a condition that is life-long. The researchers say that underlines the importance of developing effective treatments that can be introduced early in life.

Courses such as the Early-Bird Programme help families to support children diagnosed with autism but this study is the first to achieve a sustained improvement.

The best news is that scientists have recently discovered a surprising connection between intelligence and autism. Researchers from the Centre for Neurogenomics and Cognitive Research in Amsterdam have discovered 40 new genes linked to human intelligence, most of which are mainly expressed in brain tissue and found that many people with those genes were also on the autistic spectrum.

This discovery could one day help shed light on the condition’s origins and also lead to new insights into the neurological and developmental bases of human intelligence, but for the time being, it confirms that autistic people really do have an intelligence we should all respect.

Most of the newly discovered gene variants, linked to elevated IQ, play a role in regulating cell development in the brain. Computers have made it possible to scan and compare hundreds of thousands of genomes, matching tiny variations in DNA with diseases, body types or, in this case, native smarts.

The human genome has some 25,000 genes composed of more than three billion pairings of building-block molecules. Many of the genetic variations linked with high IQ also correlated with other attributes, such as high educational achievement. In addition, people with the intelligence genes were less likely to have Alzheimer’s disease, depressive symptoms, smoking history, schizophrenia, high body mass index, or obesity. This profile is typical of individuals with autism spectrum disorder and although up to 70% of people with autism have some mental disability, some individuals with the disorder can exhibit higher than average non-verbal intelligence.

The study looked at 78,000 people of European descent and the researchers think that the findings could vary among different populations – different gene variations are often important in different populations, and this could be the case with intelligence.

In 2015, researchers from the University of Edinburgh found a similar association. Almost 10,000 people living in Scotland had their DNA analysed, before being put through a series of intelligence tests. Those carrying genetic variants linked to autism had slightly better test scores on average than those who didn’t carry the autism genes. Further evidence of the association emerged when the same tests were carried out on 921 teenagers, who took part in an Australian study.

 

Copyright Andrew Newton 2016. All rights reserved.