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978-1572305441

autism

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Justin 35<br />

a nuisance, especially because it is pursued with such intensity that it<br />

severely hampers family life. Parents cannot wait for hours while the<br />

child opens and closes the garage doors with the electric openers. I<br />

knew one couple who was, to say the least, annoyed when an enormous<br />

heating bill arrived in the mail, thanks to their son, who loved the<br />

sound of the furnace so much that he played with the setting on the<br />

thermostat. He made the furnace come on at regular and frequent intervals,<br />

even in the heat of summer, and each time it did, the sounds<br />

brought him great pleasure and excitement.<br />

But as with Stephen, sometimes the interests can seem quite<br />

charming, and in those circumstances parents may take great pleasure<br />

in their child’s preoccupations. I vividly remember little Chris, although<br />

I saw him only once since he lived far away. He was a lovely boy with<br />

short dark hair and big green eyes. The family lived out in the country<br />

by the banks of a small river. Along the river were tall aspen trees that<br />

could be seen from the backyard of the house. Chris became very excited<br />

whenever he watched the wind blow through the trees. The<br />

branches swayed, the leaves rustled and shimmered in the sunlight.<br />

Chris would stand there in his backyard, flap his arms, and make humming<br />

sounds. He loved to watch the trees move in the wind. Then he<br />

and his mother would hold hands and dance, because, as Chris said,<br />

“the trees are dancing.”<br />

Whether or not these eccentric interests and preoccupations should<br />

be eliminated is a common question and one without a definite answer.<br />

To eliminate them entirely may not be possible or even desirable as they<br />

represent true play activities, and play is essential to the development of<br />

communication and social skills, especially if the play can be extended<br />

to include other children. Sometimes, however, these interests and preoccupations<br />

are experienced as intrusive and troublesome by the child,<br />

almost like the obsessions seen in obsessive–compulsive disorder (OCD).<br />

When that occurs, treatment with medication is certainly indicated.<br />

There is good evidence that the selective serotonin reuptake inhibitors<br />

(SSRIs) are effective for the rituals and obsessions in OCD and more<br />

generally for symptoms of anxiety in children with autism and AS.<br />

When the interest is troublesome or intrusive, it is important to<br />

limit the pursuit of that interest to a time and place that does not interfere<br />

too much with the family or other people. Often the activity can be<br />

limited to the child’s bedroom or else pursued away from people outside<br />

the family. This can be done by setting aside a certain time each day<br />

when the child is allowed to pursue his interests without interference

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