Friday, February 13, 2009

Researchers pulling back the veil on adult autism


By Sharon Kirkey, Canwest News Service

Was the young doctor autistic?

He didn't think so: "I don't walk on tippytoes or get hypnotized by Wheel of Fortune," he explained.

But he did get upset when people didn't say what they mean. He loved math. "And then there's this odd thing I do with my hands and my nose when I'm excited and I think nobody's looking," he once wrote in the Canadian Medical Association Journal.

He thinks he may be on "some distant end" of the autism spectrum. At the other end are people like the man who organized his wife's CDs by the composer's date of birth and fell asleep on the floor during social events; his wife thought he was eccentric.

Or the office clerk who beat up a woman on his way to the bus stop one morning for the simple reason she was in his way. He was obsessed with not walking on the cracks between the tiles on the sidewalk.

Autism in children has never been more in the news. But few are talking about the adults, experts say, and few therapists are available to treat the illnesses in adults just as more are seeking help.

The official criteria for diagnosing autism spectrum disorders apply to children. Some adults only recognize autism in themselves when their child is diagnosed.

On the high-functioning end of autism is Asperger's disorder, "and that's the group that's coming to people's attention," says Dr. Deborah Elliott, assistant professor of psychiatry in the division of developmental disabilities at Queen's University in Kingston, Ont.

Even Asperger's is listed under the category "usually first diagnosed in infancy, childhood or adolescence" in psychiatry's official guidebook, the Diagnostic and Statistical Manual of Mental Disorders, and it was only in 1994 that the syndrome was added.

Adults with Asperger's have normal or above normal intelligence, but their social skills are disastrous. They avoid eye contact, have difficulty forming relationships and can't pick up on normal social cues, signs and facial expressions.

They may be able to get an advanced degree, but once employed they can't interact with their co-workers in a normal way. There's no normal coffee chit-chat, Elliott explains. They sometimes ask embarrassing questions and easily lose their tempers.

"A disagreement with a co-worker or a boss, or someone looked at them wrong, or it was a cloudy day instead of sunny like the weather man said, or you gave them the wrong sandwich," says Karen Rodman, founder and director of Families of Adults Affected by Asperger's syndrome, Inc., or FAAAS. "There's no rhyme or reason. And the problem is with everyone else around them. It's never their fault."

Some are diagnosed with social anxiety disorder, bipolar or depression. "You treat the depression but then you're left with somebody who still is a bit odd and eccentric," Elliott says. "That may be the first time they actually come to somebody's attention. Yes, he's depressed, but the reason he's depressed is because he can't develop relationships. Even though we've treated his depression, he's still stuck with disability."

Far more men than women are affected. Asperger's and high-functioning autism has been described as the extreme of male thinking, says Dr. Rutger Jan van der Gaag, a professor of clinical psychiatry at Radboud University Nijmegen in The Netherlands. "Very much detail, very little empathy."

Famous people from Isaac Newton to Einstein exhibit Asperger-like traits. "When you think of the rigidity and scrutiny you need to accomplish some of the big scientific achievements and inventions, if you're distracted by the beauty of life outside the lab, you're never going to have the perseverance to do so," van der Gaag says.

Many adults with autism recognize something is wrong, Elliott says. "They know they're not 'getting it.' They're not getting cues from people, they know they're being marginalized, they're aware they're different." But they often don't come to the attention of mental health experts until they're reprimanded at work for making an inappropriate comment, or charged with harassing or stalking.

"You can help them understand that they have a syndrome that makes them different," Elliott says. "That somehow relieves them from feeling that they're doing something terribly wrong."

Source: http://www.canada.com/Health/Researc...788/story.html

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