A Curious Case of Autism Spectrum Disorder

I have read ‘The Curious Incident of the Dog in the Night-time’ and have also seen the play in London. I really enjoyed it and from my experience working with autistic children, in Romania, it made me want to investigate more. I also recently saw an article about the first person to be diagnosed with Autism and that inspired me to write this blog.

curious incident

‘The Curious Incident’ written by Mark Haddon and adapted for the stage by Simon Stephens is about a boy called Christopher who writes about his adventures; solving the mystery of the death of his neighbour’s dog, taking his Maths A-level, looking after his pet rat Toby and talking with people of whom he has never met before. Christopher has autism and the book is cleverly written to show the reader how a young person with autism sees and reacts to the world. It is an excellent book and I would highly recommend reading it.

Romania Project Team

Romania Project Team

From my experience working with children in Romania, a life for children with Autism in that country is very different to in England. Where Christopher, in the Curious Incident had a care-worker and many people looking out for him, I saw that the carers in Romania did not really know how to care for the children in a similar way. Many of them were left alone to do their own thing and the carers had to look after so many children at once, with other learning difficulties, that they were unable to give the boys with autism the extra attention they needed. I spent some time with a boy in Romania and integrated him into the activities we were doing, taking notice of what he liked and disliked. For example, when the children were given a painting activity, I noticed that this boy did not like getting his hands dirty so I sat with him and gave him many different materials to feel and find what he liked to work with- he absolutely loved the fur!

So, after all of this, it made me want to look further into Autism.

Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) is a life-long developmental disability that affects communication, behaviour, social interaction and interest. Children are usually diagnosed before the age of 3.

Around 1 in 100 people suffer from ASD and around 700,000 people in the UK are on the autism spectrum.

Interestingly, the term ‘autism’ was derived from the clinical description of the withdrawal and internalisation demonstrated by schizophrenia patients.

amygdala

The cause of autism is unknown but it is considered that a combination of genetic and environmental factors account for the changes in brain development. Some researchers believe that an abnormality in the area of the brain called the amygdala may play a part in the deficits of ‘social intelligence’ of the disorder (http://www.ncbi.nlm.nih.gov/pubmed/10781695)

ASD covers a range of different disorders, such as:

  • Autistic disorder
  • Asperger syndrome
  • Childhood disintegrative disorder
  • Pervasive developmental disorder

Symptoms:

Children and young people with autism often experience a range of cognitive, learning, emotional and behavioural problems, such as:

Behaviour:

  • Short attention span
  • Is overactive or very passive
  • Has very narrow interests
  • Uses repetitive body movements
  • Shows aggression towards others or themselves

Social Interaction:

  • Does not make friends
  • Do not get involved in interactive play
  • Does not react to eye contact or smiles
  • Shows a lack of empathy
  • Prefers spending time alone

Communication:

  • Cannot start or maintain a social conversation
  • Develops language slowly or not at all
  • Does not refer to self correctly (e.g. Says ‘you want water’ when they mean ‘I want water’)
  • Repeats words or memorised phrases

Many people with ASD suffer from difficulties with their senses:

  • Sight
  • Sound
  • Taste
  • Touch
  • Smell
  • Balance (Vestibular)
  • Body awareness (proprioception)

People with ASD can be hyposensitive or hypersensitive to any of these senses (this is something that I encountered whilst volunteering in Romania).

Many of the children in Romania who were hyposensitive to vestibular movements needed to rock or swing in order to achieve sensory input and we would spin them on a wheeled board around a room, which they really enjoyed. We also bought them a see-saw which many of the children really loved. We also worked with children who were hyper-proprioceptive and had difficulties with fine motor skills. These children found it very different to colour in small pictures and were unable to do up buttons on their clothes.

On the National Autistic Society website (http://www.autism.org.uk/about/behaviour/sensory-world.aspx) it talks about hyposensitivity to touch and how people like to hold others tightly, have a high pain threshold and may also self-harm. At the rehabilitation centre in Romania, I worked closely with a blind boy who, initially, was not allowed to get involved with the project as the Romanian carers did not see how he would benefit. I persisted and they allowed me to work with him; I sang with him but the leader of our project, an occupational therapist, suggested that I try to stimulate his senses in other ways. I used a stretchy piece of material and wrapped it around his body- he really enjoyed the tightness of the material and therefore when I held his hand, I would squeeze it slightly to stimulate these senses. However, despite being happier on the project, I also noticed that he would poke himself in the eyes for long periods of time; I thought it was because he could not see, and I’m sure to an extent it was, but also from reading this, it is suggesting that he could have suffered from ASD.

The first diagnosis of Autism

Donald Grey Triplett was the first person to be diagnosed with autism by the Baltimore psychiatrist Leo Kanner. It was then known as ‘infantile autism’. Triplett visited Kanner in 1938, at age 5, but Kanner was unable to diagnose his symptoms. However, by 1943, Kanner had encountered 10 other, similar cases and had published an article called “Autistic Disturbances of Affective Contact”, with Donald as case number 1.

Donald Grey Triplett

Donald Grey Triplett

Donald Triplett was born in 1933 in forest, Mississippi. He was a very withdraw child who seemed to mimic what other people had said, instead of forming his own conversations. However, he was a very intelligent young boy with an excellent memory, and was able to sing with perfect pitch at age 2.

In 1937, at age 3, Donald was sent to live in an institution, as instructed by his doctor, but in 1938 his parents took him out of the institution to visit Dr Kanner.

Donald is still alive today, at age 82, living in the home he grew up in, surrounded by a supportive community of friends.

For more about his story, follow this link: http://www.bbc.co.uk/news/magazine-35350880

Thanks, Rachel

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