Can't Have One Without The Other

A recent newspaper discussion talked about creativity and disorders such as bipolar and schizophrenia being on the same gene. The article basically states that mild forms expression result in highly creative, intelligent people and that the gene survived evolution-wise because it is beneficial for progression of society to have people who "think outside the box."

I wonder if the same can be said for autism spectrum disorders. There appears to be a higher rate of Asperger-like traits in certain professions such as computer programmers and university professors.

Severe forms of any of these conditions can be extremely debilitating, but I wouldn't feel comfortable trying to eliminate the gene for autism because I'm not sure what else it might destroy.

There was a case in a certain African village where they killed off most of the mosquito population due to malaria. Shortly after, people's roofs began falling down. It turned out that the mosquito was a predator of another insect that ate straw.

I haven't dissapeared

I have been sick with something or other since the last few days in June. I am just beginning to feel better now. I will have some more interesting blog posts very soon.

In the meantime feel free to participate in the survey I am involved in with my research supervisor (link at top of page) or submit an article to the disability blog carnival (second link at top of the page).

That Child Needs a Good Smack

It’s the middle of a birthday party and a six-year-old girl is lying on the floor crying because her balloon popped. The other children go off to play games, the little girl remains on the floor screaming. The host of the party drags her to another room and closes the door. She continues to scream for the party. When she gets home, she gets in trouble, but she still doesn’t really grasp that there is a difference between crying briefly when a favourite toy breaks and ruining a birthday party. That six-year-old has Asperger Syndrome. That little girl was me in grade one.

Tantrums, sensation seeking behaviour, getting stuck on a topic and arguing it, taking things literally, and many other problem child behaviours are escalated with Asperger syndrome. Parents may be frustrated that their preteen cannot sit still in a restaurant to eat their dinner or handle their knife and fork right. Their elementary school child may not be able to get through a trip to the supermarket without a tantrum.

These behaviours are very difficult for parents to deal with, and can also disrupt others in a public place. Often well meaning people believe more discipline will magically cure the child of their Asperger Syndrome. (e.g. “If I had that child for one week, she’d be a different child).”

I do not believe AS is an excuse for bad behaviour. I’m glad my parents pushed me to learn appropriate social skills and set high expectations for me. These children have to learn that some behaviours are inappropriate and sometimes that means consequences. Consequences will vary depending on the situation and the family’s values. It always means a detailed explanation of why a certain behaviour is unacceptable. Reward systems such as sticker charts often work well with children with AS too. My parents used them with me as a child and I have also seen them used in places I volunteered at.

Besides discipline, explanations, and rewards, enlisting help of professionals is also essential in helping children with AS develop to their full potential.

Status Update: June 2009

I am enjoying my summer off and spending time with my family and animals. I’ve been swimming in the backyard pool, going in the hottub, playing the newly released Sims 3, and playing with the dogs. Annie is growing fast. She is now 3 months old. Maggie is 10 months and doesn’t look like a puppy anymore. Eva is 15 months and still acts like a big puppy. I know it takes large breeds longer to settle down.

We are unfortunately going to be finding a home for one of our cats, Tuffy. As our household grew with animals, he began urinating in the house. We have tried everything, including medication. We think he will do well in a single cat home as he did well as a single cat before. We are making whoever adopts him promise that if it doesn’t work out, he is returned to us. Then we would look into a program such as Barn Buddies which gives cats with litterbox problems safe, outdoor homes.

I’ve been having a few Asperger-related issues the last few weeks and am not feeling 100%. I’m asking that everyone reading this blog say a quick prayer for me. I also have a few silent prayer requests.

My brother, Greg is doing a family practice rotation in Slave Lake, then he’s doing a research rotation here in Edmonton. It will be nice to have him and Natalie here for a few wekes.

Medication and the Autism Spectrum

Recent developments in medication (by recent I mean the last few decades) have resulted in many individuals with Asperger Syndrome and other related disorders gaining some control over symptoms such as meltdowns, thus allowing for increased independence and quality of life. Unfortunately, medications come with some side effects. The media does an especially good job of pointing these out.

I believe, like my doctor does, in the lowest effective dose possible. Often exercise, relaxation, and dietary supplements like omega 3s can reduce the dosage of medication needed. For instance, exercise encourages the brain to naturally release chemicals such as serotonin.

Also, some side effects can be managed. For instance the popular drug risperdol may lead to increased appetite, but that can be controlled by eating low calorie foods when an individual has the urge to eat more than usual.

It is always a balance between having the lowest risks possible and the best possible quality of life. For instance an individual with Asperger Syndrome that is “medication free” but having public meltdowns is not acceptable, nor is an individual who is on such a high dose of medications that the side effects have serious impact on their quality of life. Also, in some cases, individuals may experience a side effect with a particular medication that is unbearable (e.g. development of severe tics with Dexedrine, but that does not mean that all medications are unsuitable for them). Some individuals with AS may do well without medication using other management techniques. It is a very individual issue in which the pros and cons should be discussed with a medical professional, preferably a psychiatrist.

Autism Services: Making the Grade for Schooling and Employment

I originally started this post as a comment on a facebook group, but I decided it was good enough to post on my blog. I find there are more services for children with AS than adults. Still, our province (Alberta) has some good programs for adults such as AISH (a disability system separate from welfare where individuals with disabilities who are unable to work full time can receive assistance and still earn some additional income). They also have employment training services such as onsite placement that works with people with disabilities in finding employment (including helping place those with university degrees in a program appropriate to their education). I would like to see more services specifically for high functioning adults on the spectrum though such as friendship or social skills groups. I would especially like to see services specific to university students and professionals with Asperger Syndrome as they are a growing group.

Alberta has some excellent children’s autism programs ranging from autism specific classrooms (often with the goal to integrate children back into mainstream classrooms by junior high school), social skills and early intervention groups provided by places such as the Glenrose rehabilitation hospital, and others. However, some parents are still concerned (as I mentioned in an earlier post and I tend to agree with this) that some of the services are too cookie-cutter to meet a child’s specific needs as every child on the spectrum is different. Also, it may be difficult to integrate a child who has been in a special education setting for years back into a mainstream classroom. For instance, a student with average to above average intellect may not receive academics appropriate to their intelligence level in a special education classroom even if the desperately need the help with communication or social skills. Also, an autism spectrum specific classroom may not necessarily address a child’s other potential challenges such as if they have a learning or physical disability in addition to being on the autism spectrum.

I would like to close by saying Alberta has better services than most of the provinces in the country and that some families move here specifically for autism services. However, like everywhere, there is still room for improvement.

Age Appropriate Protection

Individuals on the spectrum often need more support than their typical aged peers. For instance, I was 15 before I was allowed to ride my bike downtown because of getting lost easily. I knew of this limitation so I didn’t complain about being restricted. I lived in the same town for ten years, and it was only in my last year there (age 15-16), I began learning my way around it outside of my neighbourhood. I still had to ask for directions a lot.

People with Asperger Syndrome often have trouble with finding their way around places, coordination and spatial awareness, can be overly trusting of strangers, and can get very upset when frightened or in a meltdown state. With teens an young adults with AS, they want to have freedom as much as possible. However, unlike disabilities that affect intelligence/cognition, individuals with AS often know their own limitations. For instance, I know that due to my issues with depth perception and startling easily, I will be unable to drive in Edmonton. I might be able to learn with a lot of work in a small town.

Parents have to find a balance between encouraging their child or young adult to be independent or keeping them safe. For instance “Is it safe for Ryan to take the bus by himself to high school since there is a transfer in the middle?” Also, as individuals with AS grow older, parents and those that know them should help them be aware of their own limitations so when they live independently someday they can make judgements for themselves

Special Interests

I was the child who spent hours trying to teach my cats tricks (including how to read). I had an old bathtub full of frogs in my backyard and raised tadpoles every spring. I was also the little girl who came running home from the neighbours’ with a big snake by the tail that I wanted to keep for a pet. Strangers listened patiently as I talked excessively about these topics.

Over my life, I have had various special interests (I’m still an animal nut) ranging from buildings and structures (especially New York’s former World Trade Center and Toronto’s CN tower), the solar system, brain disorders, and psychology. I remember odd obscure facts such as how long it takes each planet to go around the sun (e.g. 248 years for Pluto) and the heights of some of the towers (e.g the WTCs were 1,362 and 1,368 feet).

I think this goes well with my earlier post on hyper focus as special interests are triggers for hyper focus. I could spend hours searching the internet for cats or planets as a child. Now, I get very involved in my psychology research, creative writing, and video games.

I think special interests add some enrichment to an individual’s life as long as they don’t completely exclude other topics of conversation or interacting with people. Sometimes, as in Temple Grandin’s obsession with cattle chutes, they can even lead to a lifelong career.