Christopher Stevens Tells of His Son's Autism, Paternal Age Probably Is Responsible

From the Guardian http://www.guardian.co.uk/society/2008/mar/16/mentalhealth


How our son taught us the secret songs of autism.

David is 11 and profoundly autistic, one of half a million Britons with a condition for which there is no cure. Christopher Stevens tells of his family's struggle to understand their son's inner world
Christopher Stevens The Observer, Sunday March 16 2008 Article historyAbout this articleClose This article appeared in the Observer on Sunday March 16 2008 on p34 We couldn't see David but we could hear him. He was singing. And the frightening thing was that we hadn't heard the tune before.

Our son is profoundly autistic. He can't communicate with words. His life has a language of its own, though, a musical soundtrack which he supplies. All his moods and activities are linked to songs - the snatches of melody which mean he's anxious, or blissfully content, or embarking on mischief.

This song, though, was a new one. David had darted upstairs and my wife Nicky and I followed him - we needed to keep him in sight, and preferably in arm's reach. The bathroom door was open, the shower curtain fluttered and the window above the bath gaped. It was less than two feet across, with hinges at the top. David must have dived through like a human cannonball.

At the back of the house our kitchen sticks out, with a roof that slopes up to a parapet above a concrete path. David was running to and fro on the parapet, arms pumping like a steam engine's pistons, chuff-chuffing to the end and peering over, then chuntering back, singing a wordless song in his clear, pure voice. 'David, no!' Nicky yelled. 'Stop that! Come here!' He didn't even look at her. Any other child would know they'd been caught - they might defy you, they might shout and argue, but they'd know they weren't getting away with this. David didn't even glance our way, because he knew he was out of reach. As we pleaded with him, he prised his shoes off and flicked them into the next garden. Then he stood on his heels above a sheer drop, wiggling his toes in space.

Negotiation is impossible with a child who cannot talk. He's immune to threats, orders and bribes: he can't understand them. And if there was a song that meant, 'Get off that parapet right now, my lad, before you break your neck', we didn't know what it was.

But autism has another component, even worse than the communication gulf. David has no imagination. He lives in the perpetual present, oblivious to danger and unable to foresee what will happen in the next instant. He's 11 and he would run into a busy road without a fear, because he can't imagine being knocked down. All he knows is that, on every occasion he has crossed a road, the traffic has stopped. The idea of death is meaningless to him - and there is no way to convey it.

David couldn't imagine slipping off that ledge and plunging 20ft to the concrete below. We could, though. He was balanced on his heels now, swaying like a high diver. I could taste the panic in my mouth, but Nicky stayed calm. 'He'll get overexcited if we yell at him,' she said. 'We need Rolos. Bribe him in.'

We offered him a whole tube. David stared sadly at the chocolates. He loved Rolos and he knew he was beaten. He held out a hand, as if he couldn't see why he shouldn't eat his chocolates on the roof, but it wasn't a serious standoff. Boosting his shoulders through the window, he slid headfirst into the bath and lay there scoffing sweets.

He had no idea he'd done anything wrong. That's the third factor in autism: an inability to know what other people are thinking and feeling, to see yourself as others see you. It's called mind-blindness. David is so profoundly mind-blind that when he waves, he keeps his palm to his face and displays the back of his hand. That makes sense - when people wave at him, he sees their palms. If he couldn't see his own, he'd be doing it wrong. And by the same logic, if he was happy to be lying in a bath munching choccies after an escapade, everyone would be happy.

Autism has spread so rapidly during my lifetime that many people are sceptical about the scale of the problem. In 1964, the year I was born, the Society for Autistic Children (now the National Autistic Society) issued an appeal through the Guardian: research suggested that there should be 5,000 people with autism in a British population of 50 million... and it could only find 2,000. Ten years later, it still hadn't found the full 5,000.

Today, the society estimates there are 525,000 people with autism. American figures suggest that, among the autistic population, the proportion of severely affected people, such as my son, is four times higher than it was 20 years ago. In other words, autism is spreading like an epidemic and the worst cases are multiplying even faster.

The cause is unknown. The cure is unavailable. Numerous theories exist: it's a genetic disorder linked to chromosome abnormalities; it's a neurological problem where the brain mishandles sensory input; it's the misfiring of 'mirror neurons' in the brain; it's a toxic reaction; it's a digestive dysfunction in which enzymes leak through the gut into the bloodstream; it's caused by mercury from coal-fired power plants... or pesticides, or petrol additives, or too much television.

The idea that one in 100 British children is affected by a mental disability that was almost unknown a generation ago is shocking and many people try to fend it off. 'Isn't this all down to better diagnosis?' they suggest. If they could see my son, blind to danger and deaf to our pleas, they'd realise it wouldn't take Sigmund Freud to spot there was something odd about this boy. Freud wouldn't have said David was autistic, though - he was dead by the time the word was coined in the early 1940s.

The leading US child psychologist Leo Kanner was so puzzled by similarities in cases he started getting from about 1938 that he announced he'd discovered a new syndrome. He found 11 examples in all and rounded them up in a paper titled Autistic Disturbances of Affective Contact. Like the classic case histories of Jung and Freud, it's worth reading simply as literature: in a clear, elegant style he describes and analyses the children's personalities with a novelist's eye for character.

In all his cases, he says, 'there is... an extreme autistic aloneness that, whenever possible, disregards, ignores, shuts out anything that comes to the child from the outside. Direct physical contact or such motion or noise as threatens to disrupt the aloneness is either treated "as if it weren't there" or, if this is no longer sufficient, resented painfully...'

When David is cross, he resents things painfully. During one screaming fit when he was six, with all our doors and double-glazed windows closed, he was audible at the bus stop 100 yards away. When he was a baby, sleeping just 40 minutes in every four hours, round the clock, he screamed so ferociously that one neighbour complained he was keeping her awake. She lived seven doors up the street.

These days he bangs his head before he screams. He seems to need the pain impulse to build up steam. In a seaside town near our home last month, without warning, he flicked his head sideways against a plate-glass window. It billowed in its frame like a sail, but it didn't shatter. I dropped to my knees to catch his head before he slammed it on to the flagstones and held him as he howled and howled.

A man was bellowing too: 'What's going on? What are you doing to him?' I couldn't even turn to look at him. David's screams had filled my head to bursting. When he closed his mouth, the screaming carried on - there was a plastic parrot with a microphone outside a gift shop and it was replaying the noise.

As I helped David into our car later, I heard a siren. He heard it too and smashed his head against the rear door, so hard that the frame buckled and the window burst out. The car is a Renault Scenic, built like a two-tonne armchair, but David's head is a tungsten cannonball. It was probably a siren that set off the first bout of banging and screaming: he hates the way they wail.

Children like David were almost unheard of before Kanner. There's one account, from Napoleonic France, of a boy found living wild in woods near Toulouse. Like our son, he treated people as tools. When he wanted to ride in a wheelbarrow, he would grab his doctor by the wrist, drag him across the garden, press his fingers around the handles and then climb into the barrow.

And there's a brilliant, beautiful report from 1869 by Mark Twain - he describes a piano recital in San Francisco by Blind Tom, an apparently autistic savant who could barely talk, yet who could imitate any sound, learn three melodies simultaneously and reproduce duets note for note at a single hearing.

But in all 19th-century literature, including the realist novels by Dickens and Tolstoy, and the sensation fiction of Collins and Braddon, there isn't one child with autistic symptoms. Those four writers had more than 30 children between them, but they can never have seen a boy remotely like my son... or the 525,000 who share his condition today.

Better diagnosis is simply a side-effect of the autism epidemic: we recognise it more easily now, because there's so much more of it about.

· Christopher and Nicola Stevens's book about their son, A Real Boy, is published by Michael O'Mara (£6.99)



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Adult autism or adult early childhood schizophrenia Wednesday, March 19, 2008
Executive dysfunction in Adults with ASDs.
A review of: Barnard, L., Muldoon, K., Hasan, R., O'Brien, G., Stewart, M. (2008). Profiling executive dysfunction in adults with autism and comorbid learning disability. Autism, 12(2), 125-141. DOI: 10.1177/1362361307088486


In this well designed study, the authors first reviewed the basic theory of Executive Function. Executive function (EF) refers to neurocognitive processes associated with the planning and implementation of actions. Some researchers have proposed that autism is directly linked to anomalies in EF. Deficits EF lead to difficulty in the planning and initiation of action, inhibition of inappropriate responses, and difficulty with strategy monitoring. One issue in assessing EF in children and adults with autism is that deficits in EF are also present in other developmental problems, such as learning disabilities, which are common in people with autism. In order to control for this possible confound, the authors compared 20 adults with autism and co-morbid learning disability against 23 adults with learning disability only. These two groups were matched for age and IQ. The authors compared their performance on a battery of neuropsychological tests of EF*. The authors found that although the group with autism performed consistently worse than the group with learning disabilities on all tasks, none of these differences reached statistical significance. The authors then created a composite score of different domains of EF and found significant differences between the groups. Specifically, the group with Autism had significantly lower scores on ‘working memory’ and ‘planning’. A few specific factors about this study are worth mentioning. The study was conducted with adults with intellectual impairment (Average IQ = 67), thus the findings may not generalize to people within the normative range of intellectual functioning. The sample size was also extremely small, which affects the ability to find statistically significant differences. Finally the authors discussed one interesting point regarding "causality". It is difficult, if not impossible, to understand the direction of the causal factors at play. Is executive functioning one contributing factor to autism (a possible cause), or is it simply a byproduct of other impairments related to autism (caused by)?

*For those interested in the specific tasks used, these included the: Tower of London, Mazes, the Knock and Tap task, Verbal Conflict, WCST, COWA, Non-verbal



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High Functioning Autism by aspie_pr... Member since:
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It would be very easy to miss a diagnosis of Asperger's Syndrome or High Functioning Autism, especially if the teen is in an environment where he is allowed or encouraged to be "geeky," like hyper-focusing on certain subjects, or his quirks are accepted as "normal," A child may be described as a picky eater, or have a preference for spending time alone. Our biggest problems with my son's autism come from being around people who don't accept his differences.
The criteria for an Autism Spectrum Disorder (ASD) fall into 3 categories: Sensory Integration, Social Interaction, and Communication

Sensory Integration differences include aversion to or cravings for certain textures, tastes, smells, a preference for darkend rooms, or bright rooms lit by only incadescent bulbs or natural light-almost universally, flourescent bulbs irritate people with autism, they can both see the flickering and hear the buzzing the bulbs make. A person with autism may rock back & forth incessantly, or hate to swing. They may hate any type of tight clothing or elastic bands or prefer wearing tight knits. They may need white noises to help concentrate or need perfect silence.

Social Interaction problems may manifest themselves as a preference for being alone, making too much or too little eye contact, needing more "space" than most people or ignoring personal boundaries. As a teen, he may be too clingy to a girlfriend or not be able to get one at all.

Communication differences that are more subtle is difficulty with abstract language & understanding hints. The person with autism may dominate a conversation, or may be reluctant to speak at all.
1 month ago