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Jul. 3rd, 2009

People are like numbers...

People are a lot like numbers... no, really, hear me out.

Look at these numbers:
6
10
15
30

They're different numbers, right? Unique, with all sorts of different properties to them?

OK. Prime factor time.

6=2x3
10=2x5
15=3x5
30=2x3x5

See those factors? They're parts of the numbers. Take the prime factor, set it at right angles to all the other prime factors, and you've got the number.

Those numbers are all made up of the same group of prime factors, and yet they've got different properties and different shapes.

People are a lot like that. You might have the same prime factor as somebody else, but that doesn't mean you're anything like them, because it doesn't predict the other prime factors you might have.

Replace prime factor with psychological trait, personality trait, neurological trait, and maybe you get what I mean.

There are ever so many more composite numbers than primes--infinitely many more. People are composite numbers, by their very nature, with more dimensions to them than anybody can even count. They can't be defined by any one trait any more than 30 can be completely defined by its status as a multiple of 2.

There's one way people are different from numbers, though. 30 will always be 2, 3, 5; but people are forever adding and dropping factors, changing their shapes and their places in the patterns of life.

Jul. 2nd, 2009

Needed: Writing Classes for Scientists

Have you ever read a journal article and realized, "Well, you know, this guy must be really smart, but I can't make head nor tail out of what he's saying"? And thought that the problem was that you weren't smart enough to understand it? And then come to realize that you actually would be smart enough to understand it--if you could only make your way through the tangled and sometimes overcooked spaghetti of the writer's style?

Yeah. My experience exactly.

I don't care if you have a Nobel Prize (this guy does, actually). It's no substitute for little niceties like... you know, paragraphs that actually contain information on the same topic instead of jumping around from one to another without warning, without any connecting words to warn you where the heck the writer is going, and without any attention to the fact that scientific language is meant to add precision, and does not have to be used when a common word is just as precise.

Arrrgh!

That is all.

Jun. 25th, 2009

Cassandra's Opposite

Okay, so, Cassandra Affective Deprivation Disorder: Made-up malady by women in failed relationships with Asperger's men, apparently disappointed that the man they married is... uh, the man they married. Apparently, if an Asperger's man doesn't tell you every night that he loves you, withdraws when he's overwhelmed, or freaks out over having to listen to that high-pitched sound from the old TV for the fiftieth time, the solution is not to try to figure out how to fix the relationship, or learn how to communicate properly, but to divorce the guy.

(I find it amusing that in the original Cassandra legend, Cassandra got her gift of prophecy cursed so no one would ever believe her. Why? She refused to show affection to Apollo, who'd fallen in love with her beauty and given her that gift in the first place. Someone apparently doesn't know her mythology very well.)

Aspies can be jerks. So can NTs. Marriages work better when people communicate better. Aspie/NT, like any relationship, is not doomed to fail, not made to succeed, and not going to survive without effort. Marriages have a 50% failure rate. Plenty of AS/NT marriages work out just fine. But we know this. We've gone over it a hundred times.

Let's go over the opposite, then: What happens when the autistic individual isn't the abusive partner?

We already know two things: First, autistic individuals tend to be "bully magnets". Not all are; but some definitely tend that way. Second, autistic individuals, by definition, have impaired communication. Recipe for danger: Someone who attracts abusers--and then has trouble figuring out how to tell anyone they are in trouble. Sometimes, doesn't even understand they are in trouble.

I was an autistic bully magnet as a kid. I got it at school; but school was still a refuge for me because the biggest bully actually happened to be my stepfather. My mom got taken in by a charming sociopath. She was really unlucky.

Or.... was she?

See, like me, my mom's probably autistic--or, anyway, has a lot of autistic traits. She's never been diagnosed; but there's a lot about her that just about screams "autism", or at least broader autistic phenotype, to me. My grandma has stories about her having tantrums because her sandwich had been cut the "wrong" way. She has a loud, unmodulated voice. She's socially isolated. She's overwhelmed by sensory stuff like shouting children and detergents. She's fascinated with Messianic Judaism, even though she's not Jewish, and spends just about all her spare time on it. She doesn't understand the point of fiction. She gets tangled in workplace politics because she doesn't understand it.

She's a lot like me.

Well, minus executive function issues, plus dislike of fiction. Plus, thankfully, employability--and a high degree of competence.

So was my mom unlucky... or was she an easy target?

Imagine: You're a single mom. You're trying to deal with two children, one of whom has the worst behavior you have ever seen, even though privately you're trying to make sure that the badly-behaved Older Girl doesn't get labeled with that new fad diagnosis called "Asperger Disorder". You're trying to keep a job, and your co-workers are a lot more socially savvy than you; and then you come home--totally exhausted--and you have to keep a house clean and make sure Older Girl takes showers and brushes her teeth and doesn't smash up the walls.

Your culture says: Children need two parents to grow up well.

You think: My Older Girl hasn't got a proper father. She needs a strong father who can handle her misbehavior properly. She won't listen to me. I'm not strong enough.

You conclude: This family needs a father.

And here comes this man... tall, muscular, charming... romantic. He helps you find a new car after you skidded on a gravel road and flipped the old car upside down--an accident that still has you in nervous knots every time you touch a vehicle. He takes you on walks. He listens to you. He says he'll work so you can stay at home, like a proper mother is supposed to do. And... he says he can handle your badly-behaved Older Girl.

Your life seems like every problem has just been solved. Weeks after you meet him, you marry him. Life is going to be perfect now.

And the nightmare begins.

Autism often means you don't read people very well. You take things at face value, because you expect that other people naturally tell the truth, just like you do. It works out great for relationships--if you love a trustworthy person. If you love a sociopath, you're trapped.

Autistic people often make the perfect victims. In many cases, we don't even know we're victims. My stepfather had my mother so thoroughly deceived that it took years for her to understand that he wasn't in college, didn't have a job, and hadn't actually spent her savings on tuition.

He had her so thoroughly deceived that she mistook abuse for discipline, or believed him when he said that I had simply been so badly-behaved that he couldn't help himself. A man was only human, after all. And he wouldn't do it again. In her mind, I think, she really believed he wouldn't.

My stepfather said that if my mother ever called anyone--or if she ever let me call anyone--then my sister and I would go to foster homes and be raped.

My mother doesn't trust the government--something he encouraged--so she believed him. It was the lesser of two evils to let him stay. Besides, he had said he was sorry. He would never do it again.

I tried to tell people anyway. I told a teacher and a Sunday school teacher. Each time, my stepfather explained that I was just a crazy little drama queen. I was badly behaved, you see. I had tantrums. I was immature.

When he yelled into my ears--he must have known I had hyperacusis; seen me cover my ears at loud sounds--he would tell her that he was only trying to make me listen. When he hit me, he would point out that he hadn't left a mark, even though I had marks from him holding me down and headaches from his yelling. After the first time he bent my glasses, he learned to take them off beforehand, so he wouldn't damage them.

There was no real evidence. Just a harried father trying to subdue his obviously badly-behaved daughter.

My little sister learned to hide. She became a non-entity in the house--always in her room, drawing horses.

I never learned to hide. I insisted on truth; and when I didn't see truth, I pointed it out.

Mommy, the Emperor's got no clothes on. Why is that, Mommy? I thought you said people had to wear clothes. I have to wear clothes. The rules should be the same for everybody. Why hasn't he got any on?

I was never badly damaged. I hurt my wrist once when I fell--I was never the best at keeping my balance; and being shoved while standing on the bottom few steps of a flight of stairs didn't help any. That was the worst of it. Most of it was really very minor.

It isn't the physical, you see. You can get all sorts of physical injuries from playing hockey or something of that sort, and they're not too bad. You put on an ice pack and you wait 'til you can move again and you get back out on the field. I hadn't got any injuries near as bad as what high-school athletes get every day. It's not the physical injuries; those are just incidental. The real point of it is to turn you into nothing--to subsume your personality into an extension of the abuser's will. It's all a mind game--all about making you so afraid that you can't think, so afraid you can only freeze and cower and beg. If he likes, a real expert can torture you without ever touching you.

I found out I would rather be a brat and take whatever I got than lose my identity. I learned that you could be screaming and begging and curled up in a corner, and still in your head be thinking about your next move. I learned that there was a part of you, if you could keep it for yourself, that would not listen to fear. I learned that if you got angry enough, nothing mattered anymore.

I was, you see, a rebellious teenager.

He yelled at my mother, too. I remember hiding in my room with a tape recorder, trying to get proof that my father mistreated my mother. I imagine she was going through her own hell at the same time I was going through mine. My memories don't include a lot of what happened to her; I suppose I was still young enough to be focused exclusively on my own life. I think he hit her a few times, though not as often as me.

When my stepfather deceived my mother, he forced her into becoming a sort of accomplice--made all the worse because she didn't perceive the force he used.

When he deceived her, took advantage of her trust, he took her ability to protect her children from her.

I think that is one of the worst things you can ever do to a woman--especially a woman like my mother, whose whole life revolved around her family.

He got in trouble with the law. I turned in evidence, scared out of my wits but having been well-educated in the matter of living with fear. Probation meant more mind games, less hitting. I left for college. He visited me; he, on the brink of marital collapse, and I struggling to live on my own at least five years too soon. We had a good long conversation, oddly amicable. My mother was causing him stress, he said, trying to change him. She was a manipulative bitch. She wouldn't stop nagging him. She was probably crazy. Actually, that was the problem, really; my mother was crazy. She was obsessed with nutrition and Messianic Judaism and wouldn't let him live his own life. She was controlling. She had to have everything her own way. He was going to leave her.

Then he did leave her.

Slowly, I recovered. My sister, too, after she ran away from home to live with my cousins. My mother... Well, she's too afraid now to marry again. She lives with her boyfriend. He's neurotypical; and he's her husband, really, in all but name; a good man whose physical disability and consequent early retirement give him time to pursue his hobby of refinishing antique furniture. I've seen his work; it's very good, very detailed. It takes patience to work with old wood like that--patience and gentleness. He can't walk very well; I guess, oddly, that reassures me. My littlest sister, the surprise baby born when I was a teen, still at home, can run fast enough to get away from him if she ever has to. I don't think she will have to.

That little girl--the third of us, the one that grew up without abuse--is confident. She's growing up well. She seems happy. I listen to her formal speech and hear her talk about Macintosh computers and how she really doesn't mind not having a lot of friends, and how she's written her first novel. I hear her play the harp, tinny over the long-distance telephone line, with the same musical talent my whole family has--except, appropriately, for my stepfather's tone-deaf attachment to repetitive country songs. I hear her talk about studying philosophy for the first time--she doesn't know she's studying philosophy, but she is--and declaring that she wants to make up her own mind about religion. I caution her: Really make up your own mind. Don't just believe the opposite of what you hear because it's the opposite. Okay, she says. Logic first. Don't just believe what people say. Check things out first. Make sure it makes sense. Listen to both sides.

If you are naturally trusting, it's so very easy to get trapped in an abusive relationship. If you have trouble communicating, it's so very hard to get out. If you have no real social life, you're very easily isolated so the abuse isn't noticed. If you have trouble thinking about the world around you, you may not even know you are being abused at all.

My sister and I survived. My mom survived. We are happy again. Not everyone is so lucky.

The problem of autistic people in abusive relationships is very real. It could be a spouse; it could be a parent; it could be an aide or a teacher or even a co-worker or fellow student. If anything, autistic people do not need to be taught to be more agreeable. We need to be taught to say, "No. This is wrong. This is not fair. Stop. No more."

And we need to be believed when we say it.

Jun. 15th, 2009

Effort

The last few days, I have been turning a rather frightening concept around and around in my mind. It is:

I am trying as hard as I can.

Over the years I have been told, and told myself very often, that I am lazy and should try harder, that my intelligence means I can do anything, anything I want, if only I want it badly enough. Only lately have I been realizing that trying itself is a limited resource, that a person can only try so hard before mental and physical reserves run dry and willpower fades.

The idea that I am actually trying as hard as I can seems like blasphemy. Apparently I have built myself a little religion that consists of telling myself, "You could do more. You're just being lazy. Just wait until you really buckle down." Apparently, in my little religion, I am omnipotent; only I'm not using my full power.

I do not let myself do any less than the best. If I don't, I feel like I'm failing everyone--everyone who let me have another chance after I was kicked out of college for failing and being crazy; everyone who might, like me, want a second chance; all the other autistic college students who want the same chance I've got.

Last week was finals week for me. I'm studying biomedical engineering. I want to become a rehabilitation engineer and design technology that will make it possible for people to do the things they want to do--especially, technology that people can use to communicate, because communication is the one thing nobody else can do for you. I had a research paper, and had been allowed to pick my topic; so I decided to research the design of AAC technology for autistic people. It was a fascinating topic--in fact, right in my area of special interest. And yet it took me a whole day to get started doing the paper, another half a day to get past the outline, and another day and a half to actually finish it. I had a lot of lapses of concentration, a lot of trouble pulling my thoughts together into any sort of coherence.

I was already exhausted from that paper when I learned that I couldn't get an A on my chemistry class, no matter how hard I tried, because my test scores were too solidly in the "B" range. And for a couple of days, every time I tried to study, I ended up crying. Then the day of the test, I finally managed to study. It was a very odd feeling, knowing I had to get a 57% on the final to drop to a C, and could not possibly get an A, and studied for the test anyway... It was a foregone conclusion, wasn't it, that my final grade was a "B"? But it just felt like I had to--had to do it because otherwise I wouldn't be fighting. I simply didn't want to go down without a struggle.

You know it's getting bad when I'm starting to use combat metaphors.

By the time I got to my anatomy final, I was so tired I barely managed to study at all. I guessed at too many of the questions. I might have messed up my grade in that class, too. I don't know how many times I ducked into odd corners of the school (I have them all mapped out) so nobody saw me bawling like a six-year-old.

So why do I feel I have to get "A"s? Why isn't a B good enough? It should be good enough. I'm taking what people consider to be difficult classes, even though I'm barely at a full-time course load, and plenty of people get B's on those.

I've got this internship for the summer; 40 hours a week of lab work, partnered with a professor at my university. And of course I have to do well at that, too. A lot of the other interns seem to be very intelligent. Half of them are going to be doctors. More than a few started taking college classes while they were in high school. And here I am, twenty-six years old, with a record of failing out of college altogether and being given this precious second chance I just can't pass up.

I'm afraid that if I let myself slip at all, it'll be back to D's and F's and "Withdrawn".

I'm afraid that if I don't do well, my mother will end up in a nursing home when she gets older and needs help because I won't be able to pay for someone to help her, and I'll feel horrible because I can't let her live with me and still stay sane.

I'm afraid that if I don't do well, people will think that people like me can't do well.

I have to do well because if I do, it will prove that giving people second chances is worth it.

I have to do well because I won't get any third chances, and I know it.

If I do well, it will prove that autistic students can succeed, and don't have to become non-autistic to do it.

I have to do well because if I don't, who will invent the technology that I might be able to think up, that might help a lot of people live their own lives instead of somebody else's concept of what they ought to be?

I feel like so much is riding on this... why me? Why can't the world pick a better person, someone more confident and capable, instead of someone who cries over a B and worries that if she slips up even the least little bit, it will be back to failing grades and hospital rooms and Haldol?

And then I feel even worse, because why in the world should I be so important? It's a horrible sort of pride, to think things couldn't possibly get better without you.

Insult to injury: You know what's on the sticker glued to the window of the office about two doors down from where I'm supposed to work? 

CURE AUTISM NOW.

Yeah.

Somebody should spray-paint some swastikas and burn some crosses and complete the collection.

I always used to comfort myself with the idea that I really wasn't trying as hard as I possibly could, that if I really, really wanted to, I could do whatever I set out to accomplish--that failure was never going to happen unless I allowed it. I guess I know better now. I might fail, despite my best efforts; and my "best efforts" might include, sometimes, not having enough concentration or willpower left to put out much effort at all.

Look at it one way, and that's a sort of peaceful thought--the same sort of peace you feel when you've set your battle plans and you're either going to win or lose and there's just the actual fighting to get over with before you can see which it will be. But the other way, it's a horrible fearful thought, because it means that my life, which is the only one I have to spend, may end up being wasted--without my being able to do a thing about it.

It may be just that I'm idealistic and I have set much too high a value on myself. Maybe it doesn't even matter if I succeed or fail at making some dent in the craziness and evil of the world... but that's even worse, because that means that my life is automatically wasted, no matter what effort I put out. If I truly believed it didn't matter, I probably wouldn't think life worth anything more than just counting time until I ended up as just one more cadaver in the anatomy lab.

I can't accept that. It has to matter. It has to be worth something, however small. I have to make some kind of impact, and it doesn' t matter if I'm the only one who knows I've done it. People's lives should matter. Nobody should have to live a life and leave the world unchanged.

Jun. 9th, 2009

Word Obsessions

When I was in the sixth grade, my teacher played a piece of classical music for us. I don't remember exactly which one it was; but it was big, crashing, a whole orchestra going at forte. I liked it. At that age, I liked dramatic music the best, though I do remember being introduced to the concept of a fugue that year, and enjoying the repetition of the familiar theme.

When the music was done playing, our teacher asked us, "What did the music make you think of?", nobody could give a good answer. Three kids said, "It made me think of an orchestra," or "I was conducting an orchestra."

I could go into a tirade on how kids aren't being taught about good music these days, except for one thing: I didn't have an answer to that question, either, and I've been "taught about good music" since I was very little. My mother used to sing in a classical choir. My grandmother loves opera and taught me how to sing properly. My father, apparently, had either perfect pitch or such a good ear for relative pitch and memory for reference tones that it amounted to the same thing. I was singing on-pitch by three, harmonizing instinctively by nine, arranging music in my teens (I've never really had the creativity to compose anything new)... I've been thoroughly exposed to good music.

So what was the problem? Why couldn't my sixth-grade class--including music-loving me--answer the question, "What did the music make you think of?"

Answer... We simply didn't have the words for it. Some people might say that that's a pity, that we'd gain the vocabulary later, that it's an expected deficiency one finds in youngsters, to be unable to translate music to words; but I don't think we really needed any words. To answer that question, all we needed to do was re-play the music, point to the stereo, and say, "That was what it made me think of."

And my teacher--who was pretty good at teaching--didn't get that. He wanted words.

Words aren't the direct experience of anything. They can only serve to summarize, to match roughly between an experience and an inexact vocabulary with words that refer to similar experiences. Take the word "love". There are so many connections to that word that it's totally ambiguous. You can say, "I love you", and mean a hundred thousand different things. And yet people fixate on being told, "I love you", by children or by romantic partners... even though "I love you" doesn't say very much about the experience of love at all.

It's not just "fuzzy" words, either. Take the word, "tree". Refer to a tree by the word, and you get a vague image of a plant with a woody stem and some sort of leaf. But Tree isn't the word; it's the full experience of Tree... the unexpected coolness of leaves, the mesmerizing pattern of light through the branches, the chemistry of its life, the physics of water transport and roots, its part in the ecosystem, the way it grows, the sentimental attachment someone may have to it... The word refers to a hundred thousand things; and they are different for any given tree. To really talk about a tree, you would have to take your friend out to the forest, place his hand on its trunk, and say, "Here. This is what I mean."

People are fixated on words. They want to pin everything down, categorize it in these vague boxes of "music" and "tree" and "love". You see it when they look at abstract art: "What does it mean?" they ask. "What does it represent? What does it symbolize?" Everything has to mean something, has to connect to a word. People don't seem to be very quick to realize that something can just be made to exist for its own sake, for the experience of interacting with it--like the music I heard in the sixth grade.

I don't, quite, think in words. When I think, "tree", the concept of a tree is a broad, branching thing, connected to a hundred thousand different ideas. Only one of those ideas is the word, "tree". The concept is at the base of everything. That's why I say I'm a "conceptual" thinker--I don't think in words, nor quite in visual images, but in concepts, in connections. I'm sure just about everybody uses concepts to some extent; that's how word-association games work (and yet, even that they insist on using words to express!). But for me, it's my main mode of thinking. I translate to written words, or to speech.

That's why I have such a large vocabulary. Language is the most efficient way to transfer information from one mind to another; and I've always been very aware of just how complex things are, and how clumsy language is. You can never say anything exactly; to find words as precise as possible is the next best thing. A lot of people do it by using non-verbal communication to clarify their vague verbal communication; I use words as close to the concept as I can get them. Lawyers and scientists use very precise words for that reason: The concept is more complex than the words available; so more words must be invented, or words must be given precise definitions.

People seem to lose a lot of their direct-experience thinking pretty early on--maybe they start losing it as soon as they learn language. For the socially oriented, language takes a position of supreme importance. Language serves to crystallize ideas--to cut off the extraneous branches of the concept, to bundle them into neat packages. It can be used to think precisely, to focus on only one path of a million possible; concepts are unwieldy and not many of them can be held in the mind at the same time. And yet... without language... there's the experience. A tree is just as truly a tree when nobody ever gives it a name. The experience of music exists, even when sixth-grade students can't describe it. And love is truly love, even when nobody labels it.

Language is useful--very useful--for internal and external communication. But I think, much of the time, people with word obsessions lose the idea that words are nowhere near the real thing.
Tags:

May. 31st, 2009

Let's clear this up...

When I say I am "Autistic":

I use "autistic" as a general term for the entire autism spectrum. I think Asperger's and other types of autism are too similar, with too much overlap between them and no clear dividing line, with too many cases on the borderline between them, to be truly separate entities. Certainly you can pick examples of other types of autism that are very far away from certain other examples of Asperger's, but you can also pick examples where they are entirely indistinguishable. I am more in favor of a broad range of expressions of Autism than separate entities with different names.
When I say I am "autistic", I am saying I am "on the autism spectrum", not that my official diagnosis has suddenly switched from Asperger's Disorder to Autistic Disorder (it hasn't, and there's been no reason to re-classify, since one is as good as the other and it gets me the services I need).

The way the ASDs are diagnosed, the names have become pretty close to meaningless. There's the whole annoying problem of the diagnostic criteria overlapping to the point that most Asperger's cases, including mine, can also be diagnosed as Autistic Disorder. Diagnosis is often based entirely on what the doctor thinks will get the child the proper services, or the doctor's impression of functioning level (which doesn't actually even have an official definition), or even an attempt not to say "autism" and diagnose PDD-NOS in a person who clearly fits into the Autistic Disorder category.

The only diagnostic sure thing I know of is that someone who is labeled Asperger's generally has some use of spoken language, though whether it's reliable or whether it was delayed is anyone's guess. They don't diagnose by-the-book, so the labels don't mean too much; and if they did diagnose by the book, the labels still wouldn't mean very much because the Autistic Disorder category would pick up so many more cases from the PDD-NOS and Asperger's groups.

In any one ASD category, you'll have wildly different people with the same label. Pick one person diagnosed Asperger's, and you might have a shy bookworm with a PhD; pick another one, and you might come up with a wildly eccentric extrovert who repeatedly embarrasses himself and doesn't care; pick a third, and you might have an overly polite housewife who doesn't get out much and spends a lot of time on the Internet. For that matter, you could pick the same three people out of the "Autistic Disorder" or "PDD-NOS" boxes.

If you can't predict what someone will be like based on the particular ASD they have, and if you can't predict what particular ASD they will be diagnosed with based on what they are like, then aren't the specific categories a bit meaningless to begin with?

So I have decided to forgo identifying as any precise diagnosis and simply gone for calling myself "autistic". This is the general term for anyone with a PDD--Autistic Disorder, Asperger's, Rett's, CDD, and PDD-NOS--and I much prefer it to compartmentalizing the spectrum artificially, especially since I have grown very annoyed with the tendency to say one group is either "better off" or "more truly autistic" than another. There's too much divide-and-conquer going on as it is; until there are better official criteria, I'm going to forget about specific labels altogether.

We're just going to have to deal with the fact that we are too diverse for any one way of experiencing autism to be anything near universal; and we're better off wasting no time making it clear that human rights apply no matter what sort of weird brain you have. Who says you can't demand universal human rights for people who don't experience autism the same way you do?

No, you don't know "what it's like" to be someone else. No, you can't speak for them any more than you could speak for your identically autistic twin. (Those who think we share an "autistic hive mind" are sadly mistaken and should see us argue some time!) Of course you can't; you can't move into someone else's brain and know what they are thinking! Besides, a lot of what this neurodiversity thing is all about is that everybody gets to speak for himself. That, and actually being represented by people who are autistic, not NT psychologists, which is about as silly as having somebody who's lived all his life in Canada represent the interests of people in Madagascar.

Bottom line: Despite all the diversity, there's no reason we shouldn't work together. After all, the only thing you really need to demand human rights for someone else is to be as human as they are. Last I heard, we all had that in common.

Overmedicating ADHD

Everybody loses their keys once in a while... everybody sometimes has trouble focusing on a boring book... everyone occasionally forgets things, or leaves a room messy, or daydreams in class. So that means ADHD is a fake diagnosis, right? People with ADHD are normal; they just need to be more disciplined... or do they?

So, yes; ADHD is definitely an extreme version of things most people experience. It's over-diagnosed, and it's sad that people will use drugs as first resort, instead of teaching better organization. But it does exist; by definition, anything that hampers your activities or causes you to require extra help can be diagnosed, and diagnosable ADHD does both. In fact, most mental illnesses and neurological conditions are exaggerations of some aspect of typical brain function; they're the far side of the bell curve--depression versus sadness, daydreaming versus intrusive dissociation, dreams versus hallucinations. That's a good thing, in one way, because it helps people near the middle of the Bell curve understand a little better what life is like on its edges; but it's also a bad thing because, like with ADHD, it can lead to the dismissal of a real problem because a typical individual experiences a mild version of it that doesn't come with any impairment.

If you cannot focus when you want to focus, there's a problem. There's a difference between needing some time for unstructured play and actually being unable to focus when you want. People with ADHD generally have trouble focusing even on leisure activities--it's not just schoolwork or "boring" things; they'll forget they were supposed to go hang out with friends, lose track of what they were doing in their video games, lose their possessions so repeatedly that they've replaced their driver's licenses or keys a dozen times in the last two months... This is a problem. Kids do need to run; and in fact ADHD kids learn better when allowed to move while doing it. But ADHD is real; it's not just annoyed teachers trying to drug a rambunctious kid. The difference between someone without ADHD and someone with, is that someone without ADHD can usually drum up the willpower necessary to do the boring thing, can usually re-organize after a period of messiness without much trouble. Someone with ADHD will try as hard as they can and will still fail, or only succeed when the pressure of a deadline or the specter of imminent failure looms (which can only be kept up for so long before the high stress levels required to focus create burnout.)

Best approach for ADHD? It's not drugs and it's not beating the kid into submission; it's education. You teach somebody to create external structure so it's easier to focus. Kids with ADHD should be taught things like using to-do lists, creating routines (like putting your keys on the same hook every time you come home), and finding out how they learn best and taking advantage of that. Maybe you use stimulants to help them focus while you teach them; maybe you don't. Maybe you just give them coffee. Maybe, in the worst cases, they stay on stimulants even after they learn; but in any case, the stimulants aren't there as a cure-all; they're there to make it easier to learn.

If a child is "drugged" or lethargic at all, the dose needs to be lowered or the medication needs to be stopped. People don't learn properly when they're half-asleep. I don't care how much trouble a fidgety child causes for a teacher; there is never an excuse to use drugs or restraints to make him stay in his chair.

I'm a college student now. I fidget while I learn--deliberately. I rock back and forth and play with things in my hands and tug on my hair and pop up and pace around. I wiggle my fingers and tap my feet and hum and whistle and stare at shiny things. It's how I learn best. And yes, I probably have ADHD. I either hyper-focus, or don't focus at all. No in-betweens. Laser-light brain. It gets really difficult to drag myself out of an unfocused stupor... half the time, because I don't even realize how badly I'm focusing in the first place. Time just... passes. Nothing constructive done. Another day lost. Even leisure activities are too overwhelming, too complex.

I have a weird brain. I don't learn the usual way. That shouldn't be an excuse to try to drug me into a stupor. Any dose of Ritalin more than 5 mg turns me into an instant zombie. (More proof that ADHD is real: Most people don't turn into zombies on stimulants. They speed up.) But what the heck is so wrong with being different--even being disabled? Nothing. Not to me. Apparently, to the people who like to label others defective, there's everything wrong with it and we've all got to be "fixed" like we're broken appliances.

It's just that recently they have turned mild ADHD into a disorder rather than calling these children "bad", re-named "minimal brain dysfunction" (and several other names for it) as severe ADHD, and over-medicated both groups. The number of kids needing special ed has increased only slightly, probably because we are better at keeping disabled kids alive--such as Down Syndrome kids whose lives are saved by surgical correction of heart defects. We're really just re-categorizing people.

I believe many people with ADHD are taking needlessly high doses of stimulants when they could be on a lower dose, or off the medication entirely, if they had training on how to organize themselves, how to inhibit impulses, and even how to use their constant "hyperactive" motion to help themselves think better. ADHD kids and adults would do much better in a non-distracting environment; and for that matter, typical people would probably find it less stressful, too. I've got nothing against medication; I've tried it myself (turns out it doesn't work very well for me, but I did try). I do, however, think that if medication is all a doctor doing, and raising medication is all he's doing when it doesn't work, then he's got a lot to learn about treating ADHD.

I'm not at all happy about the way people are medicalizing ADHD. I understand that medication is often helpful; I just get annoyed with all these pediatricians just handing out stimulants like candy without so much as a referral to a child psychologist or setting up appointments with a counselor. Maybe, in all the publicity it's taken to convince people that mental and neurological conditions are real illnesses and not just bad character, we've forgotten that they aren't in the same category as physical illnesses. There's more to ADHD than the physical; there are also habits, thoughts, and learning; those things, medication can't touch. The myth of "If you take your meds, you'll be fine; if you're not doing well, there must be a problem with the meds," is downright dangerous. It feels as though our minds, our personalities, and our thoughts are being reduced to biochemical systems with no real sentience--just machines to be tweaked by the proper technician.

May. 28th, 2009

Supercrip Mythology and Lowered Expectations

Definition, "Supercrip": A certain way of portraying people with disabilities as though they were amazing for going about their daily lives; or of seeing them as "inspirational" for "overcoming" their disabilities.

"Human interest" articles, all pretty much written in the same style, tend to pop up repeatedly in the newspapers and magazines today. They portray a person with some sort of disability, and then they talk about some accomplishment. Usually, it's a relatively minor accomplishment, on the general scale of things; a Deaf kid signing along with his high school choir, maybe, or an autistic teenager going to the high school prom, or a kid with CP starting a business. Or, maybe, it's an "unusual" occurrence, with the only unusual feature being the disability, like two people with Down Syndrome getting married. Some stories take it further: Rather than just doing something that is supposed to be reserved for "normal" people, a disabled person has done something that is an accomplishment for anyone--like a polio survivor becoming a marathon runner. These people are made out to be practically superheroes--someone so amazingly wonderful and determined that nobody else could ever measure up (and wait a minute, you had polio too; why aren't YOU running marathons? That other guy did!).

So what's the problem, you ask? Why not celebrate these accomplishments?

Well, here's the problem. When you write a news story about, say, an autistic kid at a high school prom, you are saying that what you're writing about is newsworthy. It's unusual. It doesn't happen often; it's a freak event, on display for others to gawk at. These, you're implying, are the lucky people who have managed to overcome their disabilities and become more like "the rest of us". They're to be applauded, but all those other people you're not writing about are to be pitied.

When just living your life is considered an accomplishment, what do people expect? They expect, usually, a great deal less. They don't expect the autistic teen to go to the prom, or the kid with CP to become a junior entrepreneur. They don't expect you to learn to drive or get a job or get married, because those are things that "normal" people do.

Inisidious, isn't it? By celebrating the accomplishments in an average disabled person's life, they imply that those accomplishments are unusual--not to be expected.

I remember, for example, the driver in the Assisted Transport service I often used telling me, "It's okay. Driving might not be for you." She probably knows I am autistic, since when I'm overwhelmed, it's most obvious, and it was always very obvious on that bus. She simply didn't expect me--or, probably, any other autistic person--to learn to drive. And then, when I did learn to drive, many people proclaimed it "amazing".

I've had people make similar pronouncements about my attending college or having my own apartment. I'm tired of it--I don't want to be seen as some odd sort of "hero". What was I supposed to do--sit at home and have my brain turn into an inert blob from not having anything to learn; or move in with my mom and have both of us go simulataneously crazy? I am not amazing, and saying that is not supposed to be some kind of false modesty that indicates I really actually want the compliments. Sure, "congratulations" is fine, but "you're amazing"? Nope. Sorry. I'm not buying it. If an average person isn't amazing for doing what they do, then I'm not amazing for doing what I do.

Well, okay, you're free to say I'm "amazing" for ordinary things, under one condition: You must allow me to follow you and constantly make comments like, "Wow! I can't beleive you calculated that 20% tip so accurately!", and, "You found your car in the parking lot! Good job!", and, "I can't believe you haven't had a toilet accident all month!" and call the newspapers every time something of that sort happens. Gonna take me up on that offer?

May. 27th, 2009

Endangered Species: The Ethical Psychologist

I've had a few mental-health problems over the years. I have also had several psychologists, psychiatrists, and counselors; and it seems like every time I had a new one, it was like playing Russian roulette with my sanity.

One therapist insisted I was manipulating him when I couldn't organize myself well enough to remember all my appointments; another said that my abusive stepfather would not have hit me if I had been better behaved. I've been diagnosed with Borderline Personality Disorder on the strength of a single symptom, and then had it presumed that anything I did was obviously manipulative, impulsive, or overly emotional. This diagnosis has a lot of stigma... I was very lucky to be rid of it not too long afterward, but I wonder how people with real BPD are supposed to get any help if they are treated the way I was.

During one in-patient visit, I was given Haldol simply because I was crying (lying on my bed and crying for twenty minutes--not in any danger of hurting myself or anyone else--and I do not have a disorder that involves psychosis). Another patient at the same hospital was restrained for half the day because he yelled at the nurses. I was overmedicated to the point that I couldn't think straight; and nobody consulted me about what I was thinking and feeling--they only threw more medication at me.

I have, of course, been assigned therapists I simply didn't match with very well. That was nobody's fault; communication styles differ.

On the other hand, I've had a few very good therapists, from whom I've learned very much. One finally figured out "autism" (which is rather difficult when you are treating an adult and not expecting childhood disorders), though she wasn't the first to know--I learned that my mother knew I was autistic when I was a child and didn't want me labeled. As a result, I understand myself better than I have ever done, and have become much more independent than ever before. Another counselor has helped me to recover from depression and slowly clean up the nasty automatic thoughts that one gains from such an episode. My current counselor has been so helpful in teaching organization and planning that I am seeing real differences in the way that I study and organize my house. I even started studying four days in advance for a test I had yesterday--though I was still too distracted and only thoroughly studied half the material, it's a great deal better than my record of finally buckling down at 2 a.m. the night before the exam.

One common trait of the therapists with whom I've made the best progress: They acted in ways that made it obvious they thought I was an important part of what was going to help me get better. I wasn't an object anymore; I didn't have to sit down and be a good little mental patient. They weren't superior; I wasn't defective. That made all the difference.

Oddly enough, they also tend to be the ones with the lower ranks on the psychology totem pole: A social worker; a graduate student in psychology; a nurse-practitioner. Coincidence? No idea.

How do you tell the difference between one kind and the other? It seems like some people really want to help, and are competent and ethical about it; and others--perhaps jaded over the years, or having a habit of feeling superior to their patients--have become negligent, incompetent, or outright abusive. You can't even tell from looking at them--they seem like nice people. I don't know that an NT could tell any better, seeing as how psychologists often have completely different behavior patterns between patients and "normal" people.

Professionals in the field of psychology see people when they are emotionally and cognitively very vulnerable. Getting quality treatment is important. And yet--if my experiences are typical--there doesn't seem to be that much quality control. How can you ever be sure of finding a competent therapist who will treat you with respect?

May. 23rd, 2009

Sensory annoyance

I am observing myself, and I am thinking: This is interesting.

Right now, it's about 90 degrees outside. That's 32 in Celsius and 305 in Kelvin. I'm going to ignore the Rankine scale because it's stupid.

I have the window open and a fan in it, so I'm actually quite comfortable, temperature-wise (though I had quite a lot of trouble doing the chores this morning--it's too hot to move around much unless you are sure of a cold shower afterward).

The neighbor is mowing his lawn outside (smell of grass, sound of mower, exhaust fumes) and the children on the other side are playing (shriek, shout, laugh, slap-slap-slap of jump rope), and they run by my window, drawing my attention whenever they pass with their white clothes flashing in the sunlight... This, and the usual background feeling of glasses on nose and clothing on skin and bra straps and the pressure from the chair and the warm plastic of my keyboard, of course...

So why is this interesting? Well, right now I'm fairly calm, fairly relaxed, still thinking quite clearly, and I've got the chance to actually observe what these little sensory irritants are doing to me.

Observation one: I'm annoyed. Physically, that asserts itself as a sort of mild tension in muscles, and increased skin sensitivity. Emotionally, it's a desire to escape, a sort of trapped feeling. I know I can't shut out both the heat and the noise at the same time, so I'm a bit frustrated. I feel this tension in my arms, especially, but also in my legs, which are still a little sore from exercising this morning. (Earplugs would help; I can't find mine. Of course they would feel funny in my ears, too, so in my case they are not always a net benefit. Your experiences may vary.)

Observation two: I notice the background sensations more than I normally would. The tiny messages from the little hairs in my skin being moved around by the wind from the fan are much stronger than they would usually be. The feeling of wearing clothing is amplified, as is the feeling from the parts of me that aren't wearing clothing and are exposed to the air. I can understand why when I was a tiny girl, I used to take off my clothing whenever I could, especially since my mother, who didn't know how much wool bothered me and wanted to keep me warm, often made me wear things that didn't feel good. Thankfully, she didn't mind too much, and I grew out it eventually; and now I simply buy clothing that feels as good as not wearing clothing.

Observation three: My threshold for tolerating other sensory stimuli, as well as frustration of the regular sort, is much lower. At the moment I've been working with a computer program that is supposed to help you learn chemistry; and my computer's not running some components properly. I'm much more annoyed at this than I would normally be; have, in fact, given up on it for now and gone to write this post. When I was just dealing with the man and his lawn mower, I was coping pretty well; but the lawn mower made me more vulnerable to the children--a multiplicative, not additive, effect. (Think about it this way: Either the lawn mower or the shrieking children alone would have been about three points on the scale; together, they're not six points, but nine.) An observer might have thought that I did not have problems with lawn mowers, only with shrieking children, because I only started to have problems when that second stimulus was added. That's part of the problem with looking for "triggers" in children who have meltdowns; it's often not the immediate effect that causes problems, but the cumulative effect of all the factors in play.

Observation four: I'm seeking comforting stimuli more than I usually do. I pause typing occasionally to hold a smooth, heavy, cool pebble. I've been running my fingers through my hair, too (well, running my fingers across my hair--it's down to a quarter inch again, as I trimmed it with the clippers again last Thursday--something I do for comfort, without which background annoyances would include the feeling of hair brushing against forehead and ears.) I find myself rocking slightly, too, but that might just be something I'm doing because I'm thinking about comforting stimuli.

The tension should dissipate pretty quickly. The man with the lawnmower is on the other side of his lawn now, and the children have evidently (and understandably) been drained of some of their energy by the heat. I'm in a safe place, and alone; no social demands, no intense anxiety. If I like, I can go into the next room and pull my pillow over my head. It wouldn't be so easy if I had to be in a public place, if someone were constantly demanding that I interact with them. Oh, yes, I'm happily asocial today; I've had my fill of socializing this morning when my mother called to discuss alternative medicine, messianic Judaism, and the way she gets tired at work if she talks to people too much.

I'm twenty-six. I've come a long way since sixteen; a long way since six. And yet... I have the same tendencies as that little girl who used to refuse wool sweaters and have tantrums when things got to be too much, who used to run away from class, hiding at the edge of the playground or behind the closed door of her room.

The single biggest change in my life since I was a little girl is that now I understand a great deal more about myself and about the world around me. I've learned both to control and understand sensory input and the results of too much of it. And I've learned to take advantage of the extra sensitivity that lets me see beauty in small things, like my pebble; or see patterns most don't notice; or enjoy simple pleasures--sunlight on skin; smell of paper; rhythm of leaves in the wind--that many people have left behind with their childhoods.

"I can't believe you noticed that," they say.
I can't believe they didn't.

May. 9th, 2009

The Little People

I think you really can't have a very happy life until you understand that it's OK to have a small role in the world. Otherwise, even if you end up being somebody extremely important, you'll never be satisfied with what you have, and you'll never be able to truly care about anyone else.

May. 3rd, 2009

Nutrition & Autism

(For those of you following my blog, I know this is going to sound like I've been doing a lot of complaining lately, as though I feel horrible about all my problems. But, to be honest, I'm quite happy; I'm doing pretty well--accommodations at school are letting me show my skill and get on the Dean's list, despite concentration and motivation difficulty; I've been off antidepressants for a year and in remission longer than that. It's just that when you have normal, good days, they're not all that interesting. If I wrote about those, it would be something like, "Well, I did some homework today; then I went to class; then I went home and fed the cats and played some computer games..." Boring. Unremarkable. So my life is actually OK, even though I am complaining.)

So, to the actual topic. When I say "nutrition and autism", I don't mean "How does nutrition affect autism," but, "How does autism affect nutrition"? 

There's all sorts of ways autism can affect your diet. (This, of course, is in addition to all the other food problems that NTs could have! We don't get a break on those, either.)

You might have a rigid diet, because you want your food to be predictable. Too few foods on the list, and you lose nutrients.
You might forget to eat, and end up too skinny.
You might be bad at shopping or overwhelmed by shopping, and end up with too little food in the house.
You might be bad at preparing food, and live on whatever you can manage to prepare that day.
You could use food as a stim, and eat for the sensory experience--creating problems like over-eating or a diet that's unbalanced in one direction or the other.
You could even be obsessed with nutrition, and develop very rigid eating habits based on how "healthy" something is.*

Or--and this is my problem--you could be theoretically capable of creating a perfect, balanced, diet... but it would take a large amount of energy, and you'd have to drop other things to compensate.

Theoretically, I could research nutrition to determine the perfect diet, go to the supermarket, shop for the perfect food, prepare it in a way that's tasty and healthy, and eat it in a consistent manner and in an amount that's just enough to balance my energy output.

Problem? Well, as it is, I'm barely managing to finish homework and keep my apartment clean and my cats fed. I'd have to drop things to make room for food preparation.

Ever since I've lived on my own (that would be about three years), I've been subsisting on things that are easy to prepare and easy to eat--nothing more complex than a sandwich or a box of pasta. Frozen vegetables, frozen dinners, anything that can be cooked in a microwave... fruit and bread are hit-or-miss because I have to remember to eat it before it spoils, though I've taken to freezing bread. I once spent a few days eating nothing but string cheese, because everything else in the house involved heating or mixing or measuring.

Lately, I've incorporated preparing the next day's meals into my night-time routine. It works nicely, when I can remember to do it. I measure the calories to make sure it's the right amount. That way, I don't do things like live on string cheese. I still don't do anything complicated. I'm thinking of cooking for the week on Sunday afternoons, now that I've mastered cleaning the apartment on Saturdays.

Typical day's food, this week--Raw oatmeal and milk; coffee; apple, banana, orange; frozen broccoli (microwaved); frozen spaghetti (also microwaved). This morning I had potato chips for breakfast--horrible, but such a typical college student choice!

Yes, if I wanted to, I could make myself proper food. But I'm saving whatever supply of concentration I have for mixing chemicals in the laboratory, instead of mixing ingredients in the kitchen. Believe you me, you don't want to mess up in chemistry lab. In the kitchen, when you mess up, you throw away the food and eat some string cheese instead. In the chem lab, when you mess up, you get a bad grade. Oh, and possibly create a large explosion that gets you thrown out of the lab altogether.

So yeah... that's the problem. I have an unbalanced diet. I'm not actually gaining or losing weight; my doctor's appointment last year showed me at exactly three pounds heavier than this year; but the kind of food you get that's quick to cook isn't the most nutritious out there. I take a multivitamin to offset any nutritional problems; but living on boxed meals and frozen dinners really isn't a "balanced diet", and multivitamins can only go so far.

I'm starting to regret learning to order food at a fast-food restaurant; craving McDonald's salads (which, incidentally, are not near as healthy as they seem, but do have a lot of lovely fresh vegetables that you don't have to cut by yourself) isn't exactly easy on the pocketbook. Right now my evaluation is that I'm high on fat and low on protein (except for when I'm eating too much string cheese) and almost certainly getting more vitamins and minerals via pill than in my food.

Here's my advice to people teaching autistics this kind of thing: It's not enough to teach people about nutrition. It's not even enough to teach them how to shop and pick out good food and cook and schedule their meals. You also have to do it in such a way that it's simple and doesn't take a lot of effort.

If it takes too much effort, they will stop doing it and eat nothing but string cheese instead.

*Research: "Orthorexia." I know one person with this eating style, and... wow, it really rules her life. I think it's a bona fide eating disorder.

May. 1st, 2009

Circadian Rhythm Sleep Disorder

"Circadian rhythm sleep disorder" is the official name for it. I describe it as "my brain doesn't know when it's day or night". I can be tired at 11 a.m. or tired at 3 a.m. and it's just about completely unpredictable. Apparently I'm unusually sensitive to the upheaval caused by artificial lighting. When I don't keep it carefully in check, my sleep cycle is so unpredictable that I might sleep for three hours or twenty, wake up at 3 a.m. or 6 p.m., and generally be either randomly narcoleptic or insomiac.

I've got a history of this dating back to babyhood. I didn't sleep through the night when I was an infant--my mom doesn't remember me ever starting to sleep through the night; I think I just eventually learned to be quiet when I woke at night.

Currently, my best efforts have brought my sleep/wake cycle into a roughly 24-hour pattern with the onset and end of sleep fitting into six to twelve hours that take place anytime from 9 p.m. at night to 2 p.m. the next day. This is much better than it has been in the past. That doesn't count the all-nighters, which can completely throw off everything for a few days.

Strategy:
--Take melatonin about 3-5 times a week to tell brain when it's time to sleep. (Melatonin is known to work for jet lag, and will also work to re-set an errant sleep cycle.)
--Raise blinds immediately after waking to tell brain it's time to be awake.
--Keep bedtime as strict as possible, but get up and read for a while if I haven't been to sleep in an hour. (That's to prevent insomnia--basically, if you get used to being annoyed that you can't go to sleep, you associate your bed with that and not with sleep; so to prevent that, if you can't get to sleep, you get up and try again later).
--Set alarm clock to go off across the room and prepare breakfast and coffee the night before.
--Prepare a tasty breakfast instead of just random cereal, so that I'll have a reason to get up.

It works OK. I only sleep through things I need to go to about twice a month. Yes, this is way more absenteeism than what is expected of the average person, but consider--It used to happen to me twice a week or more. This, believe it or not, is progress. I expect to be up to no sleep-related absences by the time I graduate from college.

If I could, I'd be nocturnal. The world does not, unfortunately, allow it.

Apr. 20th, 2009

Interconnection

Humanity has come a long way since we learned to plant crops and domesticate animals. Evidence of disabled people participating in society comes from as far back as ancient Egypt, where they've found adult mummies with what would have been disabilities, prosthetic limbs (cosmetic, not functional, for the most part), and some early wheelchairs. Arguably, Egypt was one of the most successful ancient societies, which is why it was able to support people who could not do everything for themselves.

Our modern society is similarly prosperous. We can afford to be interdependent, because we specialize to produce for people things that they cannot make for themselves. That doesn't just go for people with disabilities. Most likely, you buy your clothing from someone else; you drive a car that someone else manufactured; you send your kids to schools where someone else teaches them. We're a society of specialists, not generalists.

In a society for specialists, where not everyone needs to do the same work for the society to survive, people with disabilities are pretty much at the same level as anyone else. If you use your hands to do your specialized job, it doesn't matter if you can't use your feet. If you use your eyes, it doesn't matter if you can't use your ears. If you use your body, it doesn't matter if your mind isn't efficient. If you use your mind, it doesn't matter that your body doesn't work right. Add a few accommodations, use the strengths, and voila--specialization.

We don't have to be generalists anymore; and because anyone who can do anything can specialize, he can contribute. Doesn't even have to be profitable labor. You contribute just being part of a family or leaving your little legacy to the people you know. There's always mentoring, volunteering, being a part of an organization. You leave your mark whenever you, directly or indirectly, affect the life of another person. Nobody, but nobody, is useless--even if you don't consider people's intrinsic value (though you definitely should). And that's just from the outside in. From the inside out, there are even more factors, totally unrelated to disability, that make a life valuable--happiness, fulfillment, self-determination.

DNA has ceased to be the only thing we pass on to our children. Even in many animal species, parents teach their young; but in the huge, interconnected human society, we don't just teach our young--we collect data that can be accessed by the whole world. Our heritage isn't so much the DNA we pass along, but the information we collect. People who never have children can still have a huge impact on the world by the information they disseminate, whether that's art, science, politics, or even human interactions like marriage, friendship, apprenticeship, mentoring, and social organizations. Every time you teach someone what you know, you're contributing to society just as truly as you would be if you had had a child.

Apr. 19th, 2009

You might be dyspraxic if...

Dyspraxia: A condition often found in people with Asperger's that impairs the coordination of muscle movements.

You might be dyspraxic if...
  • You have to get a pharmacist to interpret your handwriting.
  • You keep a towel near your coffee maker for the inevitable early-morning spill.
  • Your house no longer contains any fragile objects.
  • Your main source of exercise while playing sports is chasing after the ball you couldn't manage to hit, kick, or catch.
  • You have worn out or broken multiple pieces of protective equipment.
  • Your cat knows to hang on for dear life when you pick her up--she sure can't count on you to hold on!
  • Dance? Well, yes, if you're allowed to do it while lying on the floor. You're going to end up there eventually anyway!
  • When buying a new pair of shoes, your most often-asked question is, "Do those come with Velcro?"
  • You consider high heels to be a sort of modern torture device. Actually, you consider any shoe without a wide, sturdy rubber sole and decent ankle support to be a modern torture device.
  • Every time you take a shower, you find new bruises you can't remember getting.
  • After lots of muttering about "liability issues", you spent your elementary-school PE career as the scorekeeper.
  • People constantly ask you why you're walking funny.
  • You're one of the 24% of drivers who don't consider themselves to be above average.
  • For a long time, your Christmas tree got new ornaments every year. You are now no longer allowed near your Christmas tree.
  • You consider climbing stairs to be an extreme test of your coordination ability.
  • Walking and chewing gum? Forget it! Also, forget walking and talking, walking and blinking, walking and breathing...
Got one? Add it in the comments :)

Apr. 17th, 2009

Zoning Out

What I'd call "spacing out" or "zoning out" is more of a brain-fog sort of thing, like a milder version of shutdown but not quite the same, when I retreat from clear thought and interaction. It's very frustrating to be in this state because I know I'm not connecting and I know I'm not processing things well, but I can't get myself engaged no matter how hard I try--and I'm not even really capable of putting out a great deal of effort in the first place. It can stick around for a full day. The only thing that reliably hits the reset button on spacing out is a full night's sleep--though it can of course happen again the next day. I used to actually hurt myself (among other reasons) to get myself out of this state, and while it sometimes worked, it usually didn't.

What's more frustrating is that it doesn't actually connect to sensory or environmental overload as clearly as full-on shutdown/meltdown does, so it's not (theoretically) easy to prevent like full-on meltdown is; it's more like I've suddenly become totally unmotivated, and frustrated because I know I am unmotivated and unengaged and I can't figure out how to start up again. Usually I spend the day doing stupid things I don't even really enjoy. Actually, I spent most of today that way... I fluctuate between that and hyperfocus, when the world is crystal-clear and I can make connections between anything and everything and come up with new ideas and solve problems and just about feel like a genius.

I wonder sometimes whether this is near-identical to what is experienced by people with inattentive ADHD--this sort of chronic under-arousal. What makes me think it might be is that I've found that constant motion of some sort--stimming, pacing, fidgeting--helps me to focus and tip the balance towards a more focused state. In fact, if I'm moving, it's almost always an indication that I'm thinking very hard and probably quite efficiently. But whether the movement is the cause of my increased focus or whether it simply accompanies it (which makes sense, if physical and mental alertness increase at the same time) is still up in the air.

But this zoning out is really a problem. It's a huge problem. It's affecting my life more than probably any other AS trait; and while the hyperfocus allows me to do some of my best work, the dark side of the whole thing is the dull, blank, indecisive, disorganized way I often end up spending my time. I feel like I'm losing half my life to it.

For one thing, wasting time like this instead of studying is keeping me from taking full advantage of the college education I'm fighting so hard to get. (It's not very easy for someone who is on disability to get a chance at a college education in the first place. I'm very lucky in that respect.)  I'm passing my classes, but only because eventually, when a deadline comes up, I end up finally punching through the inertia and working on the project or studying for the test, last-minute. I guess the deadline gives me just enough impetus to create the focus I need. It doesn't help that it often means studying through the night. Being sleep-deprived is a great way to completely lose it. Better figure out where the nearest public restroom is before you have that meltdown, kid, or you're going to be stuck frozen in the middle of the hallway or crying your eyes out like a three year old in front of a bunch of college students who are younger and a great deal more emotionally mature than you are.

What I want to do is really get interested in what we're studying. I know I could. I do, sometimes. I've asked questions that the profs didn't know the answers to. (They are actually very good profs; it's just that I have a knack for asking things that nobody knows yet.) And in anatomy class, we're studying the nervous sytem. I mean, the nervous system! You know, neuroscience? The same thing that's been a special interest of mine for longer than I can remember?! And here I sit, just barely able to concentrate well enough to write this post, with all that information in my textbook when it should be in my head. Every once in a while, somehow, I'll be able to concentrate, and suddenly I start categorizing and organizing information and connecting it to make new facts and integrating it with everything else I know. Those are the times I live for.

I feel like I am not living up to my potential. I feel like I should have at least gotten a master's degree by now--and not just gotten the degree, but really learned the knowledge that comes with it. Instead, I'm sitting in classes with 18-year-olds who want to be doctors, nurses, or engineers, who accomplish more than I do, even though they care a lot less, simply because they can concentrate when they want to and I can't.

Apr. 10th, 2009

Risperdal for ADHD!?

OK, so in my anatomy class yesterday we discussed neurotransmitters.

I learned that:
Low levels of dopamine are linked to ADHD, and Ritalin and other stimulants help partly because they raise dopamine levels.
A dopamine receptor antagonist is used to treat high levels of dopamine, like in schizophrenia.

So recently I was reading about ADHD online, and it seems a lot of psychiatrists are using Risperdal off-label to treat ADHD... which I thought was really weird, because Risperdal is a dopamine receptor antagonist.

"Dopamine receptor antagonist" means it binds to dopamine receptors and stops it from getting through. It's a way to effectively lower the levels of dopamine.

So... wouldn't Risperdal just make things worse? It seems like the exact opposite of what they'd need.

I checked for studies online and found this one:
Risperidone Effects in the Presence/Absence of Psychostimulant Medicine in Children with ADHD, Other Disruptive Behavior Disorders, and Subaverage IQ

These people studied Risperdal for ADHD, and noticed that it decreased "disruptive behavior and hyperactivity". They also said the top side effect was "somnolence"... should stand to reason that if you're tired, it's kind of hard to be hyperactive and disruptive.

I've already been annoyed for a long time at all the prescriptions of Risperdal for kids with even mild autism, just because it's FDA-approved for severe aggression in autism. Most of those kids don't even need it, and the side-effects are nothing to be sneezed at, either. So what's with all the neuroleptics for non-psychotic kids? I don't get it.

Apr. 8th, 2009

Facts, Procedures, Principles

Around the age of four to six, most children learn to do basic addition.

Let's look at three children and how they do it.

Little Jenny is taught to memorize single-digit addition facts:
1+1=2. 6+9=15. 2+9=11. She gets awfully fast at spitting out the answers to the questions, but a question like, "If I have twenty apples, and my friend gives me twenty-two more, how many apples do I have?" will completely stump her. (One simply must use apples for addition questions. Lemons or kiwifruit are off-limits, and kumquats are quite unthinkable!) Jenny hasn't generalized her addition facts to application to numbers above 9.

Billy is taught what Jenny knows, but he also learns:
"To add any number to another, you must add the ones, the tens, the hundreds, and so forth. Then add the results of those answers to each other." Billy learns the procedure of adding each digit and "carrying" an extra ten, hundred, etc., to the next place. He'll have no problem with Jenny's question, since he understands how to generalize single-digit facts to multiple-digit problems. But he'll still be unable to answer a question like, "If I have fifteen apples now, how many did I have before my friend gave me nine of them?" Billy knows a procedure for addition, and he can generalize it to any number, but unless he can extrapolate from what he's been taught, he won't be able to reverse it because he doesn't know the basic principles.

This is what Johnny is taught, in addition to what Billy and Jenny know:
"As you know, each number represents an amount. Addition is the process of taking two numbers and putting them together. When you count the amount that results, you get the answer to the addition problem.. Our number system has ten digits, which can be used to count ones, tens, hundreds, etc., as well as single objects. When you add a number, you can add the ones, add the tens, add the hundreds, etc., and then add all those sums to get the answer." Johnny will probably have no problem with Jenny's apple question, because he understands the basic principle of what addition is--that is, the process of taking two amounts and putting them together. If the put-together amount is fifteen, and one of the two amounts is nine, Johnny can count the amount between nine and fifteen to come up with the answer--even though he doesn't know algebra, or even subtraction.

When it comes to learning, I see three basic things you can teach.

You can teach facts--rote memory.
A cake includes flour, eggs, baking powder, and sugar.
Oxygen has an atomic number of 8.
"How are you?" is a greeting.

Facts are very simple and uncomplicated, but they're also unconnected. They can be memorized and repeated, but they cannot be applied without further thought.

You can teach procedures.
To bake a cake, follow the recipe.
To find the number of neutrons in an isotope, subtract its atomic number from its atomic weight.
Say, "How are you?" when you meet someone. If asked "How are you," reply, "Fine."

Procedures are more flexible. They connect actions in a logical way, much like a flowchart, and they can be generalized as long as the way they are to be generalized has been foreseen and put into the flowchart in the form of "If this, then that". However, if it's off the flowchart, the user of a procedure has no idea how to deal with it.

At the highest level, you teach principles.
The patterns in the periodic table.
Why it's important to put baking powder in a cake.
Why people greet each other.

Principles are the most flexible of all. They can be connected to each other, and procedures and facts can be derived from them. For example, though you may know nothing about cookies, knowing how baking powder works in a cake may make you surmise that cookies often contain baking powder, too; and knowing how all the ingredients in a cake work might make you capable of creating a new cake recipe. Though you may not have been told that argon is a noble gas, you will be able to derive that information by its position on the periodic table, and you'll know that argon is probably very reluctant to react with anything because you can extrapolate its structure. And though you may not understand that "Hey, what's up?" is a greeting, you may be able to divine that fact because it is said by someone who is walking up to you, waving, and making eye contact. (Important: Many people think they are teaching principles when they are actually teaching facts. If a child can recite an answer for the question, "Why do people greet each other?", but cannot identify a new greeting, he is memorizing facts, not using principles.)

Often times, we make the mistake of teaching children only facts and procedures. When test scores are paramount, knowing facts and procedures is often enough--and there's the nasty little phenomenon that happens when using principles: People make mistakes as a large part of the learning process. They may assume that sugar cookies contain baking powder, even though they do not. They may assume that radon will not react to anything because it is a noble gas, even though it will actually react with fluorine. They may assume that someone waving to them is greeting them with the intent to interact rather than simply acknowledging their presence.

The use of principles is risky. Creating new ideas, creating new ways of doing things, and synthesizing new facts from old principles is something you simply cannot do without the risk of failure. In a world where a mistake is unequivocally bad, children are not encouraged to take those risks. Did you put too much baking powder in the cake in an attempt to make it fluffier? Here, scrub out this pan and get out of my kitchen, you incompetent. You've never heard of radon fluoride? Here's a red mark on your paper--who taught YOU chemistry? Did you mess up because you tried to make up a new greeting instead of repeating the formula? No M&M for you.

It's bad enough with typical kids. School turns the enthusiastic experimentation of the toddler years into memorization and procedural drudgery. But when you assume, "Autistic children have impaired creativity," you're locking those children into facts, procedures, and fear of mistakes.

It's bad enough when you turn out kids who can't solve Jenny's addition problem because they don't know the basic principles of addition; but when you are trying to educate kids in skills that are even more vital than addition--self-regulation, social interaction, organization, communication--it can be downright disastrous not to teach principles. (This is another reason why I'm very leery of ABA. It teaches facts and procedures; it doesn't even make an attempt at principles. Inherent in the ABA model is the idea that autistic children are incapable of using principles at all.)

Life is complicated. Social interaction is complicated. Your own mind, emotions, and cognition are very complicated. Nobody can teach you enough procedures and facts to deal with it all. Even if they tried, things would change too fast for procedures and facts to keep up--you're changing; society changes; language changes from situation to situation and time to time.

Most of the time when I read about teaching autistic children, the assumption pops up that it's nice if the child understands the principles, but focusing on the procedures and the facts is much more practical. Nothing could be further from the truth. Procedures and facts have a limited application; principles are universal. Being willing to experiment, to make mistakes, to synthesize new ideas is the very foundation of learning. Understanding new facts and applying new procedures is just an indicator that learning is taking place.

Apr. 6th, 2009

IQ: A Number, Not a Destiny

You hear the stories all the time, don't you?: All his life, this autistic guy has been thought to be mentally retarded. And then, suddenly, he figures out language for the first time... and they give him an IQ test... and it turns out he's "actually gifted". Suddenly, people look at him differently. He jumps from the object of the sentence to the subject. He suddenly becomes capable of making choices and participating in life.

But why? It's still the same guy.

Or, let's say you've got an Aspie kid in school. He's had speech all his life, but he's got "behavior problems"--let's say, he freaks out towards the end of the day because the noise and the lights and the other kids are just getting to him. (I call that a stress problem, but whatever.) So he goes in for neuropsych testing. And one little number can change everything. Let's say he scores an 85 on his IQ test--low normal, still enough for Asperger's, but enough to make people assume he'll never amount to much. He gets stuck in a special ed class. His teachers know his IQ; they don't try to challenge him all that much; maybe they spend a lot of time trying to extinguish his "behaviors" instead of teaching him. But let's say he scores wildly high--150, maybe. Now they've got a whole new persepctive on him. He must be bored, because he's gifted. Suddenly he gets all these choices--enrichment programs, gifted/talented, maybe even a skipped grade.

Why? What is so important about IQ? And does IQ really predict outcomes, or is it that IQ predicts how you're treated, and how you're treated predicts outcomes?

You have to remember that IQ is often times quite meaningless for autistic people. I'm "only" Asperger's, and I still have such a large gap between my highest and lowest subscores that my overall IQ doesn't say much about me at all. The only reason people know I am not mentally retarded is that I have a big vocabulary and I'm good at school. If those two factors were taken out, they'd assume mild MR immediately. (And that, in fact, is where I function in daily life--with exceptions for strengths).

If you have a high IQ, you're assumed to be functioning at that level in every area.
If you have a low one, you're assumed to be functioning at that level in every area.
Huge fallacy. Huge problem, especially for autistic people.

I had my IQ tested last year. As a direct result, I was allowed a chance at college. If I'd tested lower, I might have been given a job coach and a McDonald's uniform--regardless of the fact that McDonald's (and many other entry level jobs, excluding a few that involve sorting and organization) would be one of the worst possible positions for me and my skill set, however you measured the IQ.

I wonder how many other people, who could have gone to college and specialized in what they were good at, have been pigeonholed because they're not good at IQ tests? I got lucky. I "proved" that I was capable. What if you can't "prove" it to the people who insist that IQ defines what you can do?

You just cannot deal with an autistic person based on their IQ alone, primarily, or even as an important factor. IQ doesn't say much about us. It's often hard to measure, and it reflects our abilities even less than it does for the average person because most autistic people have really jagged skill profiles. It's not uncommon to be able to do math three grades above level and reading three grades below, or be able to write a book but not cook a meal, or be able to ace a physics class but not hold a job as a cashier.

And yet they still categorize us by IQ. Do we threaten them, with our unwillingness to fit into categories?

Have a high IQ? You're fine. You're just not being given the opportunity to express it. You're a genius, really. What you have to say is worth listening to. If you're non-verbal with a high IQ, that's even better--let's make a TV documentary on it! Suddenly, with a high IQ, you're a person.

With a low IQ, you're a problem. You need to have your behaviors extinguished. You need to be medicated and watched over and have your choices curtailed "for your own good". You're a burden to your family. You'll probably "NEVER LIVE A NORMAL LIFE".

(What, pray, is so attractive about a normal life anyway?)

It's even leaking into the autism community. People are either trying to say that all autistic people "really" have high IQs. Or they're trying to say that people with low IQs are "not really autistic", or else that people with high IQs aren't really autistic, but Asperger's, and thus completely different from "those mentally retarded people over there". Or they try to divorce autism from mental retardation, as though people with both had two different brains. Worst of all, there's people who are so glad they're "high-functioning" that they attempt to disassociate themselves from anyone who isn't--especially evident in statements like, "Well, I don't need a cure, because autism makes me intelligent and talented; but that non-verbal guy over there hasn't got any really good skills like I've got. We should try to figure out how we can turn him into an Aspie." They talk about diapers and self-injury and aides like it's self-evident that if you have those things, your life must be horrible.

I hate that kind of bigotry. People's brains are not supposed to be messed with against their will. Period. People are supposed to be treated with respect. People should not be written off. And people do not deserve to be stuffed into categories based on their IQ scores.

The scattered skills, where you can't predict someone's ability in one area by looking at his average, are common with autism--and some of those skills are not even measurable on most or all IQ tests. One low skill can mask a lot of other high skills--suddenly, when you accommodate for that, the other high skills start showing up. You see a version of the same thing when you test kids with learning disability, short-term memory problems, etc. Somebody could be getting failing grades in school because he has dyslexia--which doesn't impair his ability to learn science or history, but prevents him from getting the information on science and history into his head in the first place. Accommodate for the dyslexia--some version of auditory teaching plus extra reading lessons--and suddenly he's showing his true skills in the other areas.

If you treat somebody with a low IQ as "somebody with a low IQ", you're probably not going to let him use the talents he's got. Either that, or you'll call him a savant as a way of saying the talents are meaningless. (True savants are rare; and from what I can tell, the accusation that they're uncreative is quite far off the mark anyway.)

You may be able to say that some non-verbal people "really" have high IQs, but I bet those IQs are even more meaningless to them than mine is to me. Assuming that an autistic with a high IQ can function as well as a neurotypical person with that IQ is a great way to say, "Hey, you're just being lazy. Stop it. You don't need any help." I don't know how many times I've heard, "If you're so smart, why don't you just do X?" where X is some skill that falls into my very low range...

If you've got a high IQ, there's rather a danger of not getting the help you need, because of the assumption that all your skills fall near that level, like a neurotypical person's would. And if you've got a low one, there's a great danger of being underestimated, having your talents ignored, so that you never get the opportunity to develop them.

If non-verbal people are like the average autistic person (admittedly, "average autistic" is somewhat of an oxymoron), then they'll have similar skill profiles--scattered all over the place, undefinable by an overall IQ even if it could be properly measured. The only thing I could safely say about someone who doesn't use language is that he's bad at using, or at least producing, language. The rest is all still up in the air.

You can't make assumptions about autistic people, and you can't categorize them by their IQ scores and still have the categories mean anything more than how good those people are at taking IQ tests. You have to take them on a case by case basis. If you're a professional, you have to find out what they're good at, what they're bad at, and what you can do to help them free up the strengths. I get extra time on tests because I have inefficient working memory, slow processing speed, and impaired concentration. I also get lessons in how to improve organization, to create external order so that I'll be able to work with what I've got. Otherwise, those things would hold me back and not let me show off my skills on other areas. A lot of the teaching you do with autistic people is to grab hold of what they're good at doing, whatever it is, and use it.

Some autistic people are less independent than others. Some need more help. I'm not denying that. I'm just really leery of assuming that you could put autistic people in boxes at all, even if you could somehow measure their "true" IQ.

Apr. 5th, 2009

Indeterminate Form

I have a different sort of empathy.

I don't understand other peoples' feelings very well; it's hard to detect what they're thinking. I also don't copy other peoples' emotions--I'm not happy just because they're happy, or sad because they're sad.

I don't even really form strong emotional attachments. Out of sight, out of mind. No real desire to socialize. If we have common interests, or you know interesting things I'd like to learn, fine; if not, boring--no offense, really; it's just not something I'm into, however much most people want to socialize. I'm one of the few autistic people I know who are more asocial than alienated.

But I do care a great deal. I feel an odd sort of empathy when I read a news article about someone being mistreated; when my mom lost her job; when my friend broke up with her boyfriend. It feels the same way as when I see a mistake in an essay or a botched equation in my homework, only more intense--like something's wrong, and it has to be fixed. I can't stand leaving a mistake in an essay. I can't stand leaving a mistake in the world.

My reaction to seeing someone suffer is wanting to fix it, wanting to find a solution. As I've become more mature, I've come to realize that a solution can't always be found; that sometimes your solution is indeterminate. Especially, you can't solve death.

In those cases, I've memorized some responses that seem to give people some support for their emotional pain, even if I can't fix their situation--sitting with them, listening, bringing them food. Food is traditional for comfort in our culture, so it isn't just a way to make sure they eat (though it's that, too). It's kind of odd that I didn't learn this stuff earlier. I always used to think you could just say something magical and make them feel like they would feel if it never happened. It happens in the movies. People who are hurting have some big issue, and then somebody says something that makes them see things in a whole new way and be completely OK again. But you can't do that in real life. Real life is indeterminate.

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