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Dr. Temple Grandin's
"The Autistic Brain"
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I was brought up in the 1950’s and my mother and all the other mothers in the neighborhood used “teachable moments” to teach children correct behavior. When a social or manners mistake was made, Mother NEVER screamed “No” or “Stop it.” Instead, she calmly gave me the instruction of what I should do. Below are some examples.
In a day there are many “teachable moments.” At a hotel, I observed an excellent example of this. A little boy started to get on the elevator before the people in the elevator got off. His mom said, “You must wait for the other people to get out of the elevator before you get on.” She did not scream “No” when the child stepped forward towards the open elevator door. Instead, she calmly gave the instruction.
Wait for the Child to Respond
Teachable moments can also be used to encourage use of language. When a child has attained the ability to use a lot of words, he/she needs to be encouraged to use them. If the child wants juice, say “use your words.” WAIT FOR THE CHILD TO RESPOND. An autistic child’s brain processes information more slowly and he/she MUST BE GIVEN TIME TO RESPOND. The most common mistake that both parents and teachers make is to say the word before the child says it. There is a bad tendency to say the word too quickly. Give the child’s brain time to process the request. The processing speed of his/her brain may be like a computer with a slow internet connection. It takes longer for he/she to respond.
In kindergarten when I was age five, I remember an extremely frustrating moment where I was not given sufficient time to respond. The class assignment was to mark pictures when an object’s name began with B. I marked the suitcase picture as B for bag. The teacher marked it wrong and spoke so quickly that I could not explain that in our house suitcases were called bags. I could not respond quickly enough to tell her. If she had waited 2 or 3 seconds, I could have explained that I understood the B concept and explain why I marked certain pictures with a B.
The American Psychiatric Association is proposing to eliminate the Asperger and PDD-NOS diagnosis and merge them into autism spectrum disorder. This would occur when they publish the new diagnostic guidelines in the DSM-V. They are also proposing to create a new diagnosis called social communication disorder. The description of the symptoms for social communication disorder are similar to Asperger’s. Some of the features of social communication disorder are difficulty in social uses of verbal and non-verbal communication and social communication problems that have a detrimental effect on employment and social relationships. To be labeled autistic, the individual also has to have additional symptoms such as sensory problems, fixated interests or repetitive behavior. It is my opinion that social communication disorder is part of the social impairment continuum of the autism spectrum. I fear that many Aspies will be switched into this diagnosis when school districts get short on funding.
The changes in diagnostic criteria are probably going to cause the most problems for older, fully verbal children who have normal intelligence and are diagnosed in late childhood or adolescence. I have observed many individuals who have had a diagnosis that switches back and forth between ADHD and Aspergers. Another problem is that some individuals may get a diagnosis that will hold back their progress such as conduct disorder or oppositional defiant disorder.
Diagnosis with either the current DSMI-V or the proposed DSM-V is not precise like a diagnosis for bacterial infections where precise lab tests can be used. Psychiatric diagnostic labels were determined by both scientific studies and the opinion of committees sitting around conference room tables in hotels. Nobody debates the results of lab tests for a strep throat. Over the years, many psychiatric diagnoses have changed.
In conclusion, when individuals on the milder end of the autism spectrum are labeled, you must remember that the following words all mean the same thing. Asperger, Aspie, geek, nerd, mild autism, social communication disorder or socially awkward. The science clearly shows that the social problems on the autism spectrum are a true continuum. It is likely that some of the individuals who tell their stories in this book would be diagnosed as social communication disorder if DSM-V proposed criteria were used.