978-1572305441

50 A MIND APART
avoid it as much as possible. Indeed, “resistance to change” was one of
the core symptoms of autism described by Leo Kanner more than fifty
years ago. Children with ASD want things in their personal environment
to remain the same—always. So do most typical children, but the
odd thing about resistance to change is that for children with ASD the
anxiety is not about major changes in a child’s life (like changing
schools or moving to a new house) but rather about more trivial
changes—painting the bedroom a different color, buying a new car, taking
a different route to school, or hanging new curtains in the living
room. Changes such as these can precipitate terrible anxiety and frantic
attempts to make things return to the way they were before. The birth of
a sibling or the death of the family pet often passes unnoticed or is endured
with seeming poise and equanimity. But the changes that Zachary
was concerned about were not necessarily trivial; he was concerned
about his grandmother’s death and about death in a more general sense.
This was not resistance to trivial changes in his life. This was like an existential
crisis, so unlike other children with ASD. I did not understand
what was going on.
When a new symptom is difficult to understand, it’s frequently best
to go back to the child’s developmental history to look for clues that the
symptom was already present but in an attenuated or covert form at an
earlier point in development. In this case, it made sense to see if the
current anxiety was part of a more general tendency for anxiety in
Zachary’s developmental history. I decided to go over his early history
again and to look for anxieties that were perhaps not apparent at first.
* * *
I reviewed everything I knew about Zachary to try to understand
the origin of this anxiety about death. Of course I had known him only
since he was age six, but I did have information about his earlier development.
Zachary’s mother first became concerned with him at around
ten months of age, when he stopped making sounds. Eventually he developed
speech and was talking in sentences by thirty months. After
that his speech progressed appropriately, except that he had a funny
way of talking; he sounded a lot like Ringo Starr. Even at that young an
age, though, it was difficult to have a conversation with Zachary. It was
true that his grammar and vocabulary were mostly age appropriate, but
he only wanted to talk about Thomas the Tank Engine and bumblebees.
He would not respond to other questions, preferring instead to remain