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4 months ago

978-1572305441

autism

Frankie 167 This she did

Frankie 167 This she did attentively and with great enthusiasm. Now her mother had no trouble getting Heather to go to school. She woke up and got ready for school without incident. Broken twigs still attracted her attention, but there was no resistance at the entrance to the school, no hanging on to the doors as she was being pulled into class. Each day, she worked industriously on her cards, and when they were all done she handed them out to all the children in the class. She was beaming with pride, and of course the other children were thrilled to get these early Easter cards—it was, after all, just March. The teacher was a little apprehensive as to what Heather could work on next, but it turned out that after Easter there is Mother’s Day, Father’s Day, and so on. In fact the greeting card industry has arranged it so that there are holidays needing cards all year long! What luck! All this activity put Heather in a better mood, and she was quite happy in class—no more hiding under the desk, making funny noises, being abrasive and difficult with the teacher or her teacher’s aide. In fact, she was in such a good mood that she was able to make real progress in reading and basic arithmetic, a major accomplishment that year. * * * Harry walked into the office one day rather proudly, bearing the picture of a fish on his T-shirt. I asked him if he liked fish. “Oh, yes,” he said, “very much.” Did he own fish at home? “Oh, yes, we have a fiftygallon tank with lots of fish,” he said. What was his favorite fish? “A puffer fish,” he said. What kind was it? I asked. “Puffer fish live in the tropical and subtropical parts of the Atlantic, Indian, and Pacific Oceans. There are about one hundred twenty species of puffer fish,” he replied, not quite answering my question but leaving me impressed with his knowledge of fish. Harry was fifteen years old. He had dark hair down to his shoulders that often covered his eyes. He would look at me with his head down, not quite, but almost, avoiding eye contact. He always wore T-shirts with pictures of tropical fish stenciled on them. He loved animals, especially scaly ones, and he knew an extraordinary amount about the history and breeding of various fish and reptiles. He had at least fifty stuffed reptiles, dinosaurs, and fish covering his bed. They all had to be arranged in perfect order before he went to sleep. While this was very cute, it was perhaps a little inappropriate for a teenager. In fact, his classmates teased him quite mercilessly for his immaturity.

168 A MIND APART Harry was originally referred to me with a diagnosis of “nonverbal learning disability.” This label refers to children with good reading and language skills but poor academic achievement in math, poor fine and gross motor coordination, and poor drawing skills. Nonverbal learning disabilities contrast with the classic dyslexia type of reading disability, where the children show poor academic achievement in reading, phonics, and (often but not always) mathematics in spite of good overall intelligence and an adequate opportunity for learning. The problem was that as time went on, Harry was falling farther and farther behind his classmates in the more difficult subjects in high school. The main problem now was one of organization; he could not work independently, wandered around the classroom, could not start his homework, felt easily overwhelmed by projects. He was also more and more isolated from his peers and was unhappy about the fact that they were all going out with girls and he was left alone at home with his parents and the fish tank! Harry, in fact, behaved in ways consistent with AS; the learning disability was just part of the problem. His early history noted that he was always isolated, tended to play by himself and avoid inviting his parents into his play, had poor conversation skills, was never very chatty, and was fascinated with animals. He used to line up his stuffed toys from his bedroom into the living room and down the stairs into the basement. He was, however, able to read at three years of age. His mother remembers him reading from his father’s textbooks (he was an accountant) by the time he was five. He loved to read and even to this day loves chapter books, though they are often of an immature variety designed to appeal to younger readers. He did well in school until grade four, then started to have problems with math. A psychological assessment revealed the classic profile of a nonverbal learning disability, and he started to receive some extra help. But by high school he was finding it more and more difficult to keep up not only in math but in all his subjects. The difficulty was especially evident in subjects that required lots of homework and independent study projects. It is not uncommon for children with AS to get a diagnosis of nonverbal learning disability. The two overlap but are not identical. Nonverbal learning disability is a diagnosis based on performance on academic tests and overall intelligence; it does not involve problems with social skills or communication or obsessive interests. Many children with AS have this cognitive profile, but not all do. In addition,

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