10 months ago



Zachary 53 was in fact a

Zachary 53 was in fact a literal, entirely egocentric, interpretation of death. The important part of Zachary’s interrogation of his mother was not the “What will happen to Grandma or Uncle Jim or Ferdinand Porsche?” question but the “Who will replace them?” question. More than anything else, I realized, Zachary was in fact terrified of change, of disruption in the order and coherence of his world. This was, in fact, the classic symptom of resistance to change, but because Zachary was so high functioning in terms of his language abilities, it appeared as a much more sophisticated anxiety about death and loss. My mistake was that I had paid too much attention to the first part of the repetitive questioning and too little to the second part about change and replacement. Zachary had taken an abstract concept like death and reduced it to its most concrete dimensions. Zachary’s language abilities allowed him to talk in a metaphysical way, but his ASD focused that concern on the immediate, literal consequences of death and the changes that it brings about. I had initially assumed that what concerned Zachary about death would be the same as it might be for a typical child. But I was wrong. The anxiety about death had to be interpreted through the prism of ASD, the distortion that the disorder imposes on a child’s experience of the world and the vicissitudes of change. In spite of myself, I found the whole conversation with Zachary amusing. So did his mother. We both found it funny that a nine-year-old child would have such an adult preoccupation and would express it in such a literal way. It made me remember a humorous scene from the novel Molloy by Samuel Beckett. Molloy is crippled and lives alone with his mother (whom we never meet). He likes to go to the beach and suck stones. He gathers sixteen stones and decides to place four in each of his pants pockets and the pockets of his overcoat. All his pockets are now full. His main problem is what to do with each stone as he finishes sucking it. He doesn’t want to suck the same stone twice before he has sucked all sixteen. He decides to put a stone in his left coat pocket after sucking it but soon realizes that all sixteen stones will end up in the same pocket, an unsatisfactory solution. His answer is to rotate the stones from pocket to pocket, replacing each stone from his coat pocket with one from his pants pocket. He goes on and on like this, trying to find a perfect solution to the problem of replacement. He cannot deviate from the ritual of sucking the sixteen stones in turn. But of course there is no perfect solution to this dilemma; that is the point. It’s a very funny episode but profound at the same time. The problem of replacing stones, which is silly at first, takes on a more conceptual, slightly sinis-

54 A MIND APART ter, and grotesque meaning through the device of repetition. Molloy’s speech is a monologue on the problem of replacement. By going through his litany of repetitive questioning, Zachary too was engaging in a monologue about replacement, grappling with the problem of change. Only instead of stones, we were talking about people. The anxiety and fear about change experienced by Zachary is just as profound in its own way as the more conceptually sophisticated experience articulated by Beckett, who can appreciate the absurdity of trying to achieve exact replacement perhaps better than Zachary. But the point is that these are universal experiences, accessible to all. Both expressions come from the same impulse. Death can be funny. Zachary does not know this, though; he is too focused on the literal consequences. In many ways the resistance to change that is experienced by children with PDD is like the nostalgia for a perfect world that we all feel; nostalgia for the time before the fall, when everything was plentiful and at peace. That perfect world can be the innocence of our own childhood, when there was a structure to the world, an order—one knew where to find things. That time and place is now lost forever (did it ever really exist?). No doubt, nostalgia is just our own resistance to change dressed up to be more respectable. * * * Now that I felt I understood the content of his fear and the meaning of the obsession with death, the form it took also made sense. The repetitive questioning was a coping mechanism for Zachary, a mechanism not uncommonly used by highly verbal children with ASD. Typical children use other, probably more effective coping mechanisms. All children, at one time or another, experience the same worries as Zachary, but they can articulate them in some fashion. The very act of articulation and naming, the bringing of language to a complex problem, often serves to reduce the resistance to change. We are able to modulate our anxiety level for ourselves using language. We tell ourselves, in thought, that the world is not ordered, it is not perfect, nostalgia can be boring after a while. Perhaps language gives us this ability to put in perspective what makes us anxious, to look into the future and to anticipate a new order, to imagine a new way of dealing with change. Of course, the anxiety may return momentarily, but we can for the most part deal with it, sometimes by telling ourselves lies. Due to their language deficiencies, children with PDD cannot ver-

New Zealand Autism Spectrum Disorder Guideline - Ministry of Health
Autism Spectrum Disorders: Pervasive ... - New Avenues
"From Albert Einstein to Napoleon Dynamite: Diagnosing Autism ...
Autism Spectrum Disorders (ASD) - The Meadows Center for ...
Reaching and Teaching Students with Autism Spectrum Disorders
Early Intervention for children with Autism Spectrum Disorder
Developmental outcomes in young children with Autism and ...
A Journey with Autism - CARD USF - University of South Florida
Building Bridges: Dental Care for Patients with Autism -
Children with Autism Spectrum Disorder A Guide for Eligibility ...
Six New Things About Autism That Will Influence the Future
Nursing of Autism Spectrum Disorder - Springer Publishing
How the Brain Thinks in Autism: Implications for Language Intervention
A Parent's Guide to Autism Spectrum Disorder - NIMH - National ...
Education and Training in Autism and Developmental Disabilities
Education and Training in Autism and Developmental Disabilities
Unstrange Minds Remapping the World of Autism - AUTEA
Therapies for Children With Autism Spectrum Disorders
a handbook for parents of children with autism spectrum disorders
Evidence-Based Practices for Children and Adolescents with Autism ...
Future of Autism Spectrum Disorders - Biochemistry 118
Treatment Perspectives in Autistic Disorder
Jones/Ottley Powerpoint - Oklahoma Autism Network
7th Annual International Meeting For Autism Research ... - Confex
Autism: A Neurologists View - University of Pittsburgh Department of ...