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"Almost one in a hundred children born are autistic with five times as many boys as girls." (p.1)
"With autism nothing is what it seems at first glance. Just because a child with autism doesn’t respond to your overtures, doesn’t mean that the child rejects you. The reasons for not responding are much deeper. Further, just because a child can remember words and pictures does not mean that they can remember names and faces of people. One of the most startling realizations that hit me was that being autistic could be in many ways worse than being born blind or deaf. Autistic children—barring exceptions—can see and hear, often exquisitely well. But, while blind and deaf children can still receive and respond to social signals through a special sense, autistic children don’t have this sense.
It is hard to imagine what it is like not to have a social sense, not to be tuned in to other people, their actions, reactions, and the signals they give out to you and each other. As it is, autistic children are not tuned into these things. However, they do have mental capacities that help them to learn about these signals. But they learn in a different way. Sadly, the knowledge they acquire is not the same as the ordinary ‘tuned in’ knowledge that we all take for granted. A colour-blind person can acquire knowledge of colours and name them correctly, but their experience of colours will remain different. So it is with autism and the experience of social communication." (p.2)
"When I see autistic children now, I am still surprised at how many cases are high functioning and how many cases have only mild and moderate degrees of autism. To see a child with classic autism has become the exception. But I am reassured that such cases are still there, and that they have the same features as they did forty years ago. However, autism is no longer a narrow category but has widened enormously to embrace a whole range of autistic conditions. It has now become generally accepted to talk about an autism spectrum.
What is meant by this spectrum? Actually, it hides a vast array of ‘autisms’. All the autisms originate from before birth, and all affect the developing brain. However, their effect on the developing mind can be very different. Consequently, there is a vastly different range of behaviours." (p.4)
"At the core, there is always a characteristic inability to engage in ordinary reciprocal social interaction. There is also a characteristic rigidity of behaviour, with a multitude of
consequences." (p.4)
"Now we shall look at three cases closely based on real cases from different parts of the autism spectrum. David has classic autism. Gary has an autism spectrum disorder (ASD) with a diffuse and atypical picture, but such complex cases are actually quite common. Edward has classic Asperger syndrome.
David was 3 when he was diagnosed as autistic. At that time he hardly looked at people, was not talking, and seemed lost in his own world. He loved to bounce on a trampoline for hours and was extremely adept at doing jigsaw puzzles. At 10 years of age David had developed well physically, but emotionally remained very immature. He had a beautiful face with delicate features. Family life has always had to fit around David, not the other way round. He was and still is extremely stubborn in his likes and dislikes. At one stage he only ate yoghurt and refused all other kinds of food. More often than not his mother has to give in to his urgent and repeated demands, which easily escalate into tantrums.
David learned to talk when he was 5. He now goes to a special school for autistic children, where he is happy. He has a daily routine, which he never varies. It is hard to tell how intelligent David is. Some things he learns with great skill and speed. For example, he learned to read all by himself. He now reads fluently, but he doesn’t understand what he reads. He also loves to do sums. However, he has been extremely slow to learn other skills, for example, eating at the family table, or getting dressed. David has an excellent memory. He imitates what he hears very precisely and has a beautiful singing voice. He also has perfect pitch." (p.5)
"When Gary was at primary school an experienced teacher observed that he had unusual problems in communicating with other children and could not manage to work in a group in class. Gary’s parents accepted these problems as part of his personality. He seemed to be a very obstinate child, and happy to play computer games for hours. Referred to an educational psychologist by the school when problems with Gary seemed only to get worse, he was eventually seen at a clinic at age 12. The psychologist explained that Gary had a Pervasive Developmental Disorder, a category that includes autism, Asperger syndrome, and a few other rare conditions. Actually Gary was diagnosed as having PDD-NOS, Pervasive Developmental Disorder—Not Otherwise Specified. This is a category for cases that have autistic features, but not all features are necessarily present. The psychologist also mentioned Asperger syndrome when she talked to Gary’s parents. They immediately favoured this label as it helped them to explain Gary’s problems to other people.
The psychological assessments showed that Gary also had attention deficit disorder, and dyspraxia, as evident in his clumsiness on motor tasks. His main problems, however, were poor communication skills and an inability to understand other people. Gary was placed in a succession of different schools. In each case he was said to be difficult and disruptive. He bitterly complained about being bullied. Sadly, he was. However, Gary’s classmates made some efforts to understand him. But they failed because Gary could not tell the difference between being teased or criticized.
Gary is now in his twenties and lives at home. So far, he has shown little interest in his mother’s suggestions for finding a job and still spends most of his time playing computer games. Gary often says that he would like to have a girlfriend. On one occasion he had started to follow an attractive young woman everywhere, waiting outside her house for hours, but never talking to her. Now Gary’s family are watching carefully for signs of inappropriate social behaviour. At his mother’s insistence, Gary has joined a social skills group for people with Asperger syndrome, and he now attends the monthly meetings without fail." (pp.6-7)
"Edward was diagnosed as having Asperger syndrome at the age of 8. Although clearly very bright, his teacher felt at her wits end with him. She said that she could not teach him, and that instead he taught himself, but only what he wanted to learn. He could not make any attempts to fit in with ordinary classroom activities and he refused point blank to follow the set curriculum. Edward’s family had not realized the extent of this problem. On the contrary, they had always thought of Edward as an extraordinarily gifted child. By 5 years of age he had acquired an astounding vocabulary, mainly by reading dictionaries. He was rather fearful of playing with other children, but relished the attention he got from adults. His family dotes on him and he seems to share a lot of interests and mannerisms with his father. Both are bookish people and can talk very persistently about their interests. Edward started to collect birds’ eggs from about the age of 4 and has developed an intricate system for classifying them.
Edward is now 20 years old and is about to study maths at a top university. He went to a private school where the teachers were sympathetic and let him follow his own interests. At school he obtained excellent marks in all science subjects. Other subjects simply did not interest him. He proclaimed loudly that literature was a waste of time. Apart from being in the chess club, he never became part of a circle of friends. Outwardly, Edward dismisses all social events as a bore. He is fluent when he talks with his father and corresponds with ornithologists all over the world, but seems to be tongue tied when faced with people his own age. Edward sticks out in a crowd, not only by his tall and lanky appearance, but also by his mannerisms and loud high-pitched voice. However, he has started to read books of manners and body language and is hoping they will improve his social skills.
Edward is very knowledgeable about Asperger syndrome and avidly participates in Asperger discussion forums on the web. He knows that he is far more intelligent than most ‘neurotypicals’. However, there are signs that Edward is often anxious and sometimes depressed, and he is being seen by a psychiatrist who will carefully monitor him in the transition period when he leaves home to go to college." (pp.7-
"In the case of David, the failure in social interaction can at first glance be described as a lack of social interest, or aloofness as regards other people. However, this aloofness is actually an inability to engage with others, even to the extent that he never asked to be taught to read, but taught himself. Gary is unable to read the social signals of others. He has no idea how to get a girlfriend although he would very much like to have one. Edward can socially interact with people who appreciate his intelligence, but avoids social interaction with his peers. He tries to find out about social rules." (p.9)
-Uta Frith, Autism. A Very Short Introduction, Oxford University Press, 2008, 129 pages.
