There’s been a fair amount of discussion of the new/proposed autism criteria around the web, and particularly on tumblr. I’m glad we’re finally talking about them, since my original opinion on them was that they were fine. Not great, not terrible, probably not going to exclude anyone, and just sort of…meh.
A few people on tumblr have rightfully pointed out that the criteria are actually moving even further away from the lived experience of autism towards useless constructs of what autistic behaviour does/should look like according to allistic researchers. This is hugely problematic, if for no other reason than it’s scientifically unsound. Accordingly, I’ve been thinking about what I would prefer criteria to look like. This is what I have so far. All constructive criticism and commentary is very much welcome, since I think that the diagnostic criteria for autism should be autistic-defined as a broad group–we’re effectively deciding who gets to be in our group with us.
Apologies for the wonky formatting. WordPress was not happy with my beautiful tiered bullets.
A. Differences in perception (at least 3)
1. Sensory defensiveness (ie, complaints or avoidance of any of the following: loud noises or places, bright lights, textures (food or object/clothing), tastes, smells, touch)
2. Sensory seeking (ie, stims or stimming behaviour such as rocking, flapping, finger flicking, hair twirling, spinning objects, etc or actively desiring any of the following: deep pressure or touch, vestibular sensation [swings, spinning in any context, etc], specific smells, tastes, or textures)
3. Auditory processing difficulties
4. Unusual, awkward, or delayed motor skills, or asymmetry between gross and fine motor skills (ie, clumsy but with strong fine motor skills, good gross motor skills with poor hand-writing or table skills)
5. A reduced or lack of conscious awareness and/or use of allistic (not autistic) nonverbal behaviour and communication such as facial expression, gesture, and posture.
This criterion should not exclude persons who have learnt to read or otherwise comprehend nonverbal behaviour by rote learning, particularly adults. Intentional learning to overcome an inherent difficulty in comprehension is supportive of this criterion. It should also not exclude persons who have been taught to use nonverbals to be less visibly different. In such cases, internal report of difficulty should take precedence over apparent behaviour.
B. Differences in cognition (at least 3, one of which must be 1 or 2)
1. Difficulty in beginning or ending (at least 1):
-Perseverative thoughts or behaviours
-Needing prompts (visual, verbal, hand-over-hand, etc) to begin or finish a task
-Difficulties planning complex activities
-Catatonia
-Difficulty switching between activities
-Lack of apparent startle response
2. Difficulty in using language (at least 1):
-Problems with pronoun use that are developmentally inappropriate
-A reduced or lack of awareness of tone in self (ie, speaks in a monotone, childish, or otherwise unusual manner) and/or others (ie, does not perceive sarcasm or follow implied prompts, responds to rhetorical statements and questions in earnest)
-A reduced or lack of awareness of volume (ie, speaks too loud or too quietly for the situation)
-No functional language use
-Echolalia
-Mutism in some or all situations
3. At least one special interest in a topic that is unusual for any combination of intensity (ie, does not want to learn/talk about anything else, collects all information about the topic) or subject matter (ie, unusual, obscure, or not considered age appropriate). Topics may be age appropriate and/or common (such as a popular television show or book), but the intensity of interest and/or specific behaviour (such as collecting or organising information as the primary focus) should be taken into account.
4. Asymmetry of cognitive skills
5. Talents in pattern recognition, including music, mathematics, specific language structures, puzzles, and art.
6. A tendency to focus on details instead of the broader picture, across contexts.
C. These differences cause impairment and/or distress in at least one context (ie, school, work, home), which may be variable over time.
D. Symptoms should be present in early childhood, but may not be noticable until social demands outpace compensatory skills, at any age
I’ve been thinking about inertia and perseveration lately. I thought I’d been thinking about depression and my own early signs of a life-long sprint from black clouds, but apparently the part of my brain that ruminates without my knowledge was busy at work on something altogether separate.
I’ve talked about inertia before–I should probably start using a tag for it and the other things I mention regularly. And I’ve talked about perseveration, and how I think it’s a useful, adaptive process in working through executive function difficulties (see the link to rumination).
A quick recap: inertia is the tendency to keep doing what you’re doing rather than change paths (with a nod to Newtonian physics for the basic concept), and perseveration is going over something endlessly, either because it provides comfort, stimulation, or a solution to a problem or otherwise fills some need.
I think they are the same thing, or facets of a larger single thing. And I think that thing is at the heart of difficulties in choice making in autism spectrum disorders and at least partially to do with why concrete plans are necessary. I’m not sure if it is part of the larger executive function or a related but separate thing.
Inertia has negative connotations, at least for me. Inertia is continuing to do something that isn’t really great for me (like not eat or not sleep) because it is easier than the alternative (procuring food or getting ready for bed–which usually entails saying goodbye to Kitty, something I loathe). Inertia means staying in bad jobs because it is easier than finding new ones. Inertia means multiple degrees in a field which doesn’t hold a career or major interest to me, because considering a change took too much thought and spoons to be done at a pace that would have allowed me to change.
Perseveration has a mixed connotation. Perseveration is going over and over songs until I know them by heart and can sing them pitch, tone, and word perfectly. Perseveration is almost always thinking about one of the few topics I am especially interested in, like autism or MBT. Perseveration is the way my brain works to process complex information by letting it tumble around and then finding notable, interesting things in what that information sticks to inside my head. Perseveration is eating the same food for three, four, five days in a row all. the. time.
Both are the inability to change topics or actions without a strong desire to do so. That desire can be internally or externally motivated, emotionally or physically motivated.
This inability to move off a single track can make it difficult to impossible to make decisions and choices. I know that the DSM is too strictly categorized for this to ever happen, but perhaps autism should be considered partially an anxiety disorder.
I wanted to buy a computer–a laptop. I researched laptops for months, learning about screen types and the inner workings of a machine, learning about various OSes and interfaces. I learned what my price range would need to be to get something like what I wanted (a tablet with the ability to write directly on the screen). And then I didn’t do anything. I knew what I wanted, but I was absolutely paralyzed by the idea that as soon as I made a choice a better, cheaper, more awesome choice would appear and thus be unavailable to me. I finally bought my laptop only because it was on woot that day and the price was about half what I’d been prepared to pay previously. I needed that external limitation to make a decision: woot is only one item per day and there is no guarentee the item will ever turn up again, the price is drastically lower than anywhere else online, and there is a limited number of units available–but you can’t tell how many until it’s sold out. I’ve had this laptop for about two years now and I suspect I would still be dithering about getting the BEST LAPTOP EVAR had I not been constrained by this.
Having choices makes choosing extremely difficult when you tend towards this style of thinking. The more choices I have, the more likely I am to fall back into the holding pattern of inertia and just not choose. When I am hungry, I need to have explicit options rather than an open ended “what do you want?” because the latter will only lead to frustration and upset. (Kitty, in her wisdom, knew this years and years ago and tolerated my saying over and over that I hated planning meals and that it made food unappealing, and to her I apologize again for being a shit. She was completely right and knew me better than I knew myself at the time.) Having a schedule means I actually get things done. Without, I am likely to spend all day online, playing games or looking at tumblr.
Unfortunately, none of these things allows me to write coherent blog posts sometimes!
This might be a little bit dense at the start for most of my friends, but I found it so fascinating I have to link anyway. It’s a summary of a recently published study on empathy responses in mice. Basically, if a mouse sees (or, to a lesser extent, hears or smells) another mouse respond with fear to an environment, it will likely respond similarly. If the mice are siblings or mates, they are even more likely to respond. Further, the scientists doing the study had a few ideas about where this empathetic response would be located in the brain and performed genetic and pharmacological knockouts on the mice–and they were right about two of their three hypotheses. Via knockouts, they were essentially able to make sociopathic mice–mice who feel no empathy for others.
So basically, they made the Brain.
No subtitles or captions, I’m afraid, but a lot of what is spoken is either illustrated or written down in the course of the video.
My name is Ali, though sometimes it's Eliot.
I have many tumblrs, which you are welcome to also visit:
The Polite Yeti - My personal tumblr, full of silliness.
Fuck Yeah, Kate Miller-Heidke - the only active Kate fan site, which is baffling.
The Branden Rose - the only active Monster Blood Tattoo fansite, which is less baffling.
I also have a semi-successful etsy shop, which you should visit, below.
Please buy things from me:
A brief history: