Autistic

I would have missed World Autism Awareness Day if I hadn’t been reading an online edition of the British newspaper The Guardian. That day is set on April 2 with many activities, including a “light it up blue” campaign, where landmark buildings put up blue lights, usually outlining the structure. The list of such “blue buildings” is growing, like the Empire State in New York, CN Tower in Toronto, the Leaning Tower of Pisa and the White House in Washington (for the first time ever, apparently; so that’s one positive news coming from the Trump administration).

We’re surrounded by autistics, and yet we remain painfully unaware of what it means to be autistic. It’s not easy because the medical establishment is also still finding their way around the many conditions that we generically lump together as “special children,” many of whom will grow up and take their place in society, without people ever using the term “special adults.” Debates continue, even on language—people with autism or autistics? Disorder, disease or variation on behavior?

Here’s where we are with the medical classifications:

Down’s syndrome (the old term is “Mongoloidism”) is different from autism. ADHD (attention deficit hyperactivity disorder) is different from autism. But people with Down’s syndrome, and people with ADHD can also be autistic.

In 2013 the American Psychiatric Association issued a DSM-5, the latest of its Diagnostic and Statistical Manual of Mental Disorders with the category “Autism Spectrum Disorder” (ASD), which now incorporates a previously separate category, Asperger’s syndrome.

Autism spectrum

While the medical people continue their research and discussions over the terminologies, millions of families live with their special children, and autistics. Autistics do represent a large segment of the population, the US Centers for Disease Control and Prevention estimating, in 2014, that one out of 68 children are autistic. The rates are higher in boys (one in 42) than in girls (one in 189).

The term “spectrum” is appropriate given the wide variation among people who are autistic. Many function quite well in society, even finding certain job niches where some of the characteristics of autism are actually an advantage.

Here are some of the symptoms of autism:

Repetition of certain behaviors, sometimes accompanied by a fixation on certain objects or parts of an object—for example, wheels on a toy, or the whirling blades of an electric fan. Adult autistics will sometimes be attached to the same style of clothing for years.

Long-term intense interest in certain topics or details, which can also mean speaking at great length about the topic, without realizing people are not interested. There’s a misconception that all autistics are “savants,” meaning, a genius-level skill with music, math (able, for example, to tell what day of the week June 12, 1896 was). The estimate is that only 10 percent of autistics are savants; but most have what are called “splinter skills,” that is, proficiency with a particular field that they are intensely attached to.

Problems relating to people socially because of difficulties with understanding another person’s viewpoint (which can include not allowing other people to speak) or other people’s actions. Autistics may also have little or inconsistent eye contact with people, and facial expressions may not match what they may be saying.

Autistics can become easily distressed in a new unfamiliar environment, and may be sensitive to light and noise. In extreme cases, autistics are unable to communicate verbally. Frustration with this inability to communicate, or the distress from new environments or distressing stimuli can lead to such behaviors as head-banging, and meltdown, which looks like a temper tantrum but is different in the sense that the autistic is unable to control or understand his or her emotions.

I’m sure that as you read through some of these signs you probably recognize them, maybe with surprise, as being present in some close friends, relatives, a former professor. . . or even yourself. Contrary to popular misconceptions, you can’t easily tell who is autistic simply by external appearances.

As I said earlier, many autistics, people with Asperger’s particularly, are able to get jobs and become successful in their work, without realizing they are autistic. Not surprisingly, autistics find their niches in work that requires close attention to detail and that involves more individual work and less social interactions. There can, therefore, be a perfect fit for autistics and laboratory research, or information tech jobs involving numbers and data crunching.

I mentioned professors earlier, which might be surprising; but think of the “nerdy” professors in universities, who might actually be autistic, doing very well at research and writing, but with awkwardness when it comes to social relationships and problems with communicating (yes, ironically, with teaching, but that’s still forgiven in universities).

It’s so well and good for those on the high-functioning end of the spectrum, but many other autistics will not be able to get into and survive in mainstream schools, and face many hurdles as they try to get jobs because of their difficulty relating to people, and to society. Again, I should clarify autistics can have tremendous empathy, but are unable to understand social rules about expressing emotions.

Meltdowns

Earlier this year in one of those places with lots of electronic games, I ran into an acquaintance from many years who now lives in a province in southern Luzon. She was carrying a toddler and she told me: “Special child, I think autistic, but I can’t get an appointment with the pediatricians. Such long waiting periods.”

She sighed as she described how she had lost one yaya (nanny) after another, and how she was taking a break with the autistic child.

I realized she was not aware that these electronic game places are the worst places for an autistic, with their lights and sounds and crowds. Pity the autistic in the Philippines where our public places have never-ending assaults on our senses. Homes are not necessarily better with karaoke and TV and computer games.

Bewildered, the autistic child (and occasional adult) will have a meltdown, which people then equate with a temper tantrum. The crowds stare at the parent with looks that accuse them of neglect, abuse or both. The appropriate response is to help the distraught parents or caregivers to find a quiet place where the autistic can calm down and be comforted.

We lack professionals who can deal with autism and facilities to help care for the autistics. Meanwhile, we’ll have to rev up the awareness campaigns that will include such basics as dealing with a meltdown. Might we aim for a “light it up blue” campaign with some buildings and malls in 2018?

Attempts at political correctness—using terms like “people with autism” and avoiding “autistic”—may have been counterproductive, adding to the stigma around the condition and propagating ignorance.

In the Philippines, autism awareness week is set, by a presidential order, in the third week of January.

mtan@inquirer.com.ph