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978-1572305441

autism

Justin 37 music, even as

Justin 37 music, even as a baby, and as a young toddler he listened to his parents’ classical records for hours. The story of his growth and development has been a major focus of his father’s writings, a way of giving his child a voice. Today Hikari composes lovely music that is baroque-like, formal, and classical. The melodies are quite delicate and pristine, usually consisting of either solo piano or piano and flute. They are light and airy, without dark and brooding passages. His records have sold extremely well in Japan and around the world. Like Stephen Wiltshire’s paintings, his extraordinary perceptual memory and attention to acoustic detail have allowed his musical talents to blossom even as the capacity for social relationships and language remain limited. These savants illustrate in quite dramatic fashion that the flip side of a disability can, on occasion, release a skill or a gift that is beyond what most of us can accomplish. But to be amazed at the ability to calculate birthdays in the year 2050, to make meticulous drawings, or to divide astronomical numbers in one’s head misses the point. What is so fascinating is the more common experience of pleasure that perceptual detail arouses in children and adults with autism and AS. Justin’s acute perception of acoustic detail and Chris’s attention to visual stimuli aroused by the trees dancing in the wind are intensely pleasurable—they are experienced as true play. Without a fully developed capacity for imagination, people with ASD turn to the concrete world of perception and explore it in all its variety and in its sameness. The pleasure that it brings is no different from the pleasure experienced by typical children as they play with toys and dolls. Even the play of typical children has to be limited and fit into the daily course of life’s events. It is the ability to see, hear, and play with the intimate architecture of the world that is truly amazing. The rest of us can see this architecture too if we make a conscious decision to look. But we are rarely drawn to it as a natural affinity. We have to work at it. We have to turn away from language and from social relationships to see it. People with autism gravitate to it effortlessly. * * * What is going on in the brain that gives rise to these repetitive, stereotypic interests and activities? What neurological mechanisms are responsible? Several theories have been proposed, each with both merits and limitations. One is that people with ASD lack an understanding of

38 A MIND APART other people’s minds; they have a real difficulty understanding the beliefs, motivations, and emotions of other people. As a result, they might find the social world frightening and bewildering, as Sharon, an adult with some characteristics resembling AS, describes eloquently in Chapter 5. Social interactions are either meaningless or else unclear and ambiguous to children with ASD, which may lead to confusion and stress. This may be particularly true for children with AS or milder autism, because they are likely to be integrated into the social world, where they are constantly faced with their inability to understand communication and social discourse. According to this theory, people with autism turn to the perceptual and concrete as a refuge, a place where predictability is possible, where meaning does not depend on social context. In this explanation, the love of perceptual detail is secondary to loneliness and to the loss of the social world as a place of meaning. As a result, people with autism are given little choice but to develop an intense interest in perceptual detail. But this does not explain the genuine pleasure experienced by people with autism and AS when they engage in repetitive and stereotyped interests. We might also expect to see a nostalgia for the social world, a deep and profound longing for social relationships among people with autism, and this is rarely the case. People with AS in particular (and, I believe, even those with more severe autism) do want to be involved with other people and certainly want to develop meaningful relationships, but loneliness is not the terrible emotion for them as it is for typical adolescents. It does not rule their lives as it might for many other young people. Another theory proposes that people with autism have high levels of anxiety and arousal; they are irritable, sleep poorly, are overactive, and, like Justin, experience considerable anxiety as a natural consequence of their disorder. Their repetitive behaviors might act as a coping mechanism designed to soothe their anxiety and dampen their arousal. We know it’s common for those with ASD to have unusual fears—of certain sounds, rain, elevators—and to feel a lot of anxiety about impending changes in routine or the environment. And we can see examples of stereotypic behavior being used to soothe anxiety and lower arousal levels every day when we see mothers rocking fussy babies. So it makes sense that people with autism might be using their repetitive behaviors and rituals to cope with their anxiety and calm themselves down. Likewise, we see adults with Alzheimer’s disease use

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