The Autism Talk

On occasion, a parent will approach me and whisper in a hushed tone, "I think my child is autistic."

I turn on them and say without any whispering or muttering because I am no where near as fearful as they are, "If you think your child is autistic, they probably are."

Then the careful parent explains to me that they are thinking of having their child tested, but I'm sitting right there, and that's easy, so they're asking me what I think.

This is the speech I give them and I've given it enough times that I'm practically a pro. Ready?

There are three rings of autism: repetition, obsession, and misinterpretation of social cures. Then I ask them questions about the condition.

Does their child do things over and over?

They all say yes.

But then comes the important follow-up question. Is their child doing anything of a repetitive nature that is causing them harm? Are they picking at their skin until it bleeds? Are they pulling out their hair? Are they biting their nails until they bleed? Are they engaging in repetitive behavior so intensely that they are giving themselves repetitive strain injuries?

Most of the time, the answer the parent gives me is no. Their child is engaging in repetitive behavior that is not causing harm. They're playing with a fidget or they're saying the same thing over and over. Yes, the same joke over and over is tiresome, but it's not hurting anyone.

Then I move on to obsessive behavior. I ask how crazy their child goes after their obsession. Most importantly, does their child chase the thing they love without fear of consequences? Do they leave the house without permission? If they do, where do they go? What dangers are on the way? Do they steal for their obsession? Have you had run-ins with the police and how many?

Fortunately, the answer for this is usually quite reasonable as well. Their child is only watching Phantom of the Opera on repeat and that, though annoying, is still not hurting anybody... Until they start watching Grease (lol... I'm only joking. I just can't imagine a more difficult obsession than a child becoming obsessed with musicals).

Then I ask them if their child has any friends at school, if their child has people they talk to who seek them out and talk to them back, if their child is bullied, and if their child notices that they're being bullied.

Again, the answer is usually positive. They have a few friends.

Then the parent explains to me the difficulties their child is having and how tough things are for them. I'm listening, but I know I'm about to tell that concerned parent bad news.

When they are finished explaining, I tell them that they can tell all that they're telling me to a doctor, but the doctor is not going to be very interested.

"Your child is probably autistic from what you've told me, but aside from sympathizing with a child who is struggling, what are you expecting the doctor to do? Your child is not ripping their own skin apart, they aren't giving in to obsessive tendencies that lead to criminal behavior, and they have friends at school. What do you want the doctor to do?"

The parent's face falls. Putting the problem in that context has changed the way they were thinking about it. Then they say something about the value of a diagnosis.

I shake my head, "A lot of people are a little neuroatypical. Just because your child's brain is not a test book image of a perfectly developed brain, it doesn't mean that they can't live really good lives. A diagnosis is not going to change a lot about who they are, or what they can and cannot do."

I usually advise the parent to narrow the problems down to one or two of the most pressing problems and take those to the doctor. Medication, therapy, or behavioral intervention are some helpful options. One of those may be all their child really needs and to a family that has to pay for a pricey autism assessment, it may be more valuable to just chase the most pressing problem and address that first.

By this point in the conversation, the parent is feeling less optimistic than they were at the beginning when they were whispering, but I've saved another interesting aspect of autism to help them out.

I tell them that SPD is another tricky thing. I tell them that it is a sensory processing disorder. It means that the part of their child's brain that processes the sensations their body experiences (touch, taste, sight, smell, and sound) isn't perfect, so their child really does live in their own world. No one can know exactly what they experience because it isn't the same as the next person. Brain stems can be a little warped in all sorts of ways.

I tell them about people who have outrageous senses of smell. They can smell everything and scent is the bane of their existence. They smell perfume, detergent, pee, alcohol, body odor, chicken wings, and burnt toast. And everywhere they go, they have all these smells they have to fight.

Then I tell them about people who have problems with their ears and everything sounds like noise. You can put earplugs in, but my experience with earplugs is that while they block out unpleasant sounds, they also block out important sounds that help keep a person safe. They should be used sensibly.

Obviously, there are a lot of children who are picky eaters. In my experience, you aren't going to win this one. You can try to force unwanted food down a child's throat, and doctors have said that a person needs to try a new food 15 times before they'll like it (if they don't like it immediately). The way I have tackled this is by teaching that child that if they do not want to eat what everyone else is eating, then they have to cook for themselves. Depending on how bad their diet is, you can give them nutritional supplements, but going to war with them three times a day is going to ruin your life and theirs. So, be accommodating, and then give them a drink with 100% of their vitamin C requirements.

Next, we have sight. Sight is a weird one. It can mean that they don't like winter because the sight of clashing colors like red and green together fill them with the opposite of joy. It can also mean that they get the willies from a ton of tiny holes as one does with trypophobia. It can also mean that they find certain scenes in films disturbing that no one else finds disturbing. It's a whole thing.

Lastly, is touch. You can tell almost instantly when someone has a problem with touch by what they're wearing. If they prefer to wear almost the same thing all the time, that's due to their sensory processing disorder. It makes parents scream because wearing the same thing all the time makes parents look poor and children look like no one cares about them. Other aspects of this problem manifest when the weather is extreme one way or the other. The ASD kid is going to complain that they're uncomfortable more than any other kid, even though everyone is uncomfortable. The child with autism is more uncomfortable. They may also hate water, slime, mud, hair gel, and anything else that has an unusual texture or temperature.

Once I finish this aspect of my explanation to the parent, I've said enough. The parent is giving me a total play-by-play of their child's sensory preferences. I have already info-dumped on them, which is a very autistic thing to do, so I have to put my mask back on and let them info-dump on me. After all, autism is genetic, so if their child is autistic, there is a good chance they are too. If they go through with the assessment, they're probably going to figure it out.

"Does your child do this?"

The parent's face turns red. "I don't know, but I do that all the time."

Good luck, little parents.