Sexual Dimorphism in Autism

Autism occurs 4 times more often in males. Such sexual dimorphism isn’t uncommon–after all, women are more likely to get depression, and men are more likely to be left-handed–but in many cases we don’t really know why (or, really, how).

In the case of autism, there might now be a clue in the way proteins are regulated. As it turns out, proteins in women’s brains are more tightly regulated by a process called phosphorylation than they are in men’s brains–and this includes a large number of proteins associated with autism.

It actually makes a lot of sense for women’s brains to be more protected than men’s, since women have had the bulk of the responsibility of taking care of the offspring. This is also why men tend to get much sicker than women when they get sick. Women’s bodies are designed to be more resilient and to have more stamina than men’s, and this resilience goes all the way down to the level of molecular biology.

(Not) Getting Disability

I’ve been trying to get disability for a few years now. I cannot seem to hold down a job for more than a few months, and it all boils down to my autism. Anything remotely social, and everyone turns against me sooner or later. In addition, I have problems with my hips and feet that prevent me from doing physical labor.¬† So you would think I would be a shoo-in.

After being turned down, then contesting it and being turned down again, I went before a judge–and got turned down again. The good thing about going before a judge is that I was able to get details as to why I got turned down.

It turns out that you apparently cannot have pain caused by doing physical things, but can only have pain that is constant in order to get disability for pain. If you walk in without a walker, a wheelchair, or a cane, forget it.

It also turns out that my intelligence and Ph.D. count against me. While the judge did determine that I could not do any job that would require my education, that education still counted against me. Also, because I can apparently sit and read, or sit and watch T.V., or sit and play video games (I’m not sure where that came from, since I don’t play many video games, and I don’t play often, but it was listed), I’m capable of “paying attention.” Never mind the details of that. I have to read with a pen and paper nearby in order to write things down as they occur to me as I read. It’s not uninterrupted reading. To do the best reading, I have to go someplace with a little background noise to create enough of a distraction that I don’t distract myself. T.V. comes with commercials, during which time I’m up and doing something, or I’m reading.

The judge also did not take into consideration the fact that I was able to get a Ph.D. because I was focusing on my obsession at the time. Of course autistics do well with their obsessions. The problem is that people think, “If you can focus on your obsessions, you can focus on other things.” Unfortunately, that’s simply not at all how it works.

When I work, I get distracted all the time. I have to have paper and pen close by in order to write things down so that I can get it out of my head, or I obsess over it and can’t get my work done. The problem is that when people see that, they think I’m “goofing off.” But it’s a necessary part of my process.

There was also the issue of my memory. My exceptional long-term memory counted against me, and the judge had mixed information from the neurologist and two psychologists who diagnosed me, so he basically determined I don’t have issues with short term memory. Oddly, while the neurologist explicitly told us that I have short term memory amnesia, this didn’t end up in my official diagnosis. If you’re not autistic, having terrible short term memory and excellent long term memory makes no sense. People don’t really differentiate between the two. But having bad short term memory affects executive function and planning and how one learns.

Also, being married, having kids, helping take care of the kids, cooking, and shopping on my own all counted against me. Yes, my ability to spend a half hour shopping in a store, where I can ignore most of the people there while concentrating on finding the food I need, is apparently equivalent to spending 8 hours actively interacting with people. Also, feeding my kids when I eat and otherwise letting them play and watch T.V. when I’m at home is equally equivalent to working a full time job. Being married means I have someone who helps me–and yet, this somehow counts against me.

The judge also counted against me that I didn’t do any followup therapy or medical diagnoses, or get medication for my anxiety. Never mind that I have a hard time getting myself to make appointments, etc. precisely because of my anxiety. I hate going to the doctor, I hate taking medication, and it all makes me extremely anxious. But he didn’t ask me why I didn’t do any followup, so he doesn’t know these things. He just assumes that because he always has insurance, I can pay for everything all the time. And he just assumes that because he can make appointments, it’s easy for me to do so. It’s not. I went several years with a cataract in my left eye before I was able to get myself to make the appointment to get the surgery.

In the end, the judge’s conclusion was that I was capable of doing either assembly work or packaging. When I asked whether or not he would hire me for such a job given my resume, he said that wasn’t relevant. But of course, we all know what the answer to that is. The only places where I could theoretically work would never hire me with my resume. If I don’t put my full education on my application, I lied on my application, and they could fire me. If I do put my full education on my application, they won’t hire me in the first place. So I’m stuck between my autism and my education.

The good news is that I am currently working. It requires me to stand for at least 6 hours a day, and at least half the time I’m surrounded by a lot of people. And it doesn’t pay much, though it’s better than minimum wage, and they have great insurance. My feet are in constant pain, and severe pain periodically shoots through my hips, but I don’t have a choice, so I have to just suffer.

I suffer because nobody wants to believe me. They have no experience of my world, and so don’t really believe such a world exists. I’m not sure how to convince them it does.

The Uncanny Valley

There is a phenomenon familiar to those who make animated films and robots known as “the uncanny valley.” We are generally comfortable with animation that looks like the old Loony Toons cartoons, and we are comfortable with much of the extremely life-like animation we are starting to see in contemporary movies, but there is a place in between where people feel sort of creeped-out by the fact that the animation is almost realistic, but not quite. This in between place is the uncanny valley.

I have often wondered why people have such a negative reaction to me and many verbal autistics. With my education, I shouldn’t have such a hard time finding and keeping a job. In short interactions, I can appear non-autistic, I can be quite funny, maybe even a bit charming. But I seem to wear on people. I don’t suffer fools lightly, and my bluntness can certainly make people not like me. I generally try to avoid certain topics, especially at work, but even when I do my best to avoid topics that set me off on a rant, or on a lecture, and even when I’m doing my best to be funny and charming, I still find people become increasingly standoffish over time.

I believe what is happening is that people are feeling the uncanny valley when they experience my behaviors over the long term. That is what is making people uncomfortable and wanting to avoid me. There are days when I just can’t pretend, and I’m sure that on those days, the uncanny valley is being felt by others to a higher degree.

The problem, in other words, is that I’m human, but not quite human enough.

I suspect, too, that we autistics feel much the same way toward neurotypicals. In my case, though, while I felt that way much of my life, I stopped feeling that way once I realized I was autistic myself. Realizing that neurotypicals can’t help their behaviors, and no longer wishing I could fix them all and make them better, more rational, more creative thinkers, helped me realize that they were all simply different, not worse. It was a lesson in humility, to be sure.

In many ways, it’s easier for people to simply look to the non-verbal autistics and feel sorry for them and want to cure autism. They are foreign enough that it’s easy to not feel fully uncomfortable–or, perhaps, to feel sufficiently uncomfortable that wanting to get rid of them all is itself a comfortable way of thinking.

Autism is a different way of being in the world and a different way of thinking. In many people, it can be combined with other issues to become disabling. We all know that. But many of the issues people like my son and me (who are diagnosed with autism I and II, respectively) face involve the way we’re treated by neurotypicals, and the environments into which we are thrown. With the right environment, many of us aren’t disabled at all. I mean, we don’t call a fish on land disabled because it cannot walk. It’s simply not in the right environment. Even mudskippers cannot move around on land even as well as a snake. It would be absurd to call a mudskipper a disabled cheetah.

Image result for mudskipper

Perhaps if we understand that we are all feeling the uncanny valley when we are interacting with neurodivergent people, we can come to a better understanding of each other. We can come to respect those who experience the world in different ways, perhaps even come to appreciate the fact that there are people in the world who are different from ourselves, who think differently, who experience things differently, and therefore will necessarily make different kinds of contributions to the world than we could.

LGBTQ and Autism

I keep coming across this connection between autism and an increased likelihood of being LGBTQ, but I haven’t written about it until now because, well, it hasn’t been personalized yet. My wife has a gay best friend–they have been friends since they were 14–but he’s not autistic. I always figured that homosexuality didn’t bother me in the least because I was so secure in my own heterosexuality. Which, again, points to why I haven’t really written about this issue. With a few exceptions, such as here.

Yet, it would be a dereliction of my duty as a blogger of all things autism if I were to leave it aside. Thus, I refer you to this article: Dual Spectrums. It’s worth a read, because it discusses the very high correlation between autism and fluid gender and sexuality.

I believe that one of the traits of autism involves a failure to “see”hierarchies and boundaries in the world. For the same reasons I tend to treat the CEO and the custodian the same and for the same reasons I’m a polymath, there are those for whom the boundaries of gender and/or sexuality have dissolved. I have argued that autistics tend not to be racist, and this tendency is also related, I think.

It also may simply be that we are oblivious to social pressures and are thus free to be ourselves, more or less.

Of course, we are looking for a single reason, we’re almost certainly going to be wrong.

On Consent

There have been several times where I have noticed that children with high-functioning autism have a difficult time stopping what they are doing when someone withdraws their consent.

Let’s say that an autistic child is playing around with another child. Let’s say they are wrestling around, and the autistic child is on top of the other child, and the other child is yelling for him to get off. I have noticed that it usually requires a third party to get the autistic child to stop what they are doing, or for the other child to actually resort to physically pushing him off or even hitting him to get him to stop.

After noticing it in other autistic children, I noticed it in my own son. Daniel doesn’t know when to take “No” for an answer, that when people tell him to stop doing something, he should stop doing it. He doesn’t seem to hear the person refusing or withdrawing their consent. As a consequence, I have been making¬† a particular effort to help him understand that you always need the other person’s consent if you’re going to do something with them. This may include something as simple as having a conversation, but it may involve play as well. And, when he gets much older, it will definitely have to include sex, to say the least. The last thing anyone wants is for their child to make that mistake.

The good news is that after only two weeks of talking to Daniel about consent and not continuing to do things after he was asked to stop doing them, this morning on the drive to school his sister asked him to stop making some noise he was making, and he actually stopped, saying, “OK. I’ll stop.” I immediately thanked him for doing so.

When I was a child, my mother would often accuse me of being “argumentative and aggravative.” I think to a great extent those two tendencies–which I have found to be not uncommon among autistics–are part of that issue of consent. Someone who is aggravating another is continuing to do what they are doing beyond the point where the person has asked the person to stop. The one doing the aggravating may not stop because they are trying to annoy the other on purpose, or they may not stop because the request just isn’t registering properly. If it’s the latter case, you can teach the person that when people ask you to stop, the rule is that you stop.

There are perhaps few lessons as important as this one to teach, whether your child is autistic or not.

Adult Diagnosis: Now What?

Once I diagnosed myself with autism, I wanted a formal diagnosis. Many people have wondered why you would want a diagnosis when you’re already an adult.

I can only speak for myself. I have my Ph.D. in the humanities, so I have read a great many philosophers (I read a great many philosophers prior to getting my degree, which was among the reasons I wanted a Ph.D. in the humanities), and if there is a common thread among the philosophers, it is that you need to get to know yourself. To “know yourself”–as written at the Temple of Apollo at Delphi (home of the Oracle at Delphi)–you have to think long and hard about yourself and your place in the world. I add to this having contemporary biological, evolutionary, psychological, neurological, and sociological knowledge about yourself as well. So to me, knowing whether or not I was autistic would allow me to better know myself.

Using the knowledge to better understand oneself means that you use that knowledge to better oneself, to understand one’s place in society, to clarify your past actions. It doesn’t mean you’ll suddenly be able to “fix” yourself; rather, it means you’ll have greater clarity about who you are and why you do the things you do.

That, I think, is what people ought to do with an adult diagnosis. But I know for a fact that that’s not always what happens. I know of someone who suspected her husband was on the spectrum. She started sharing information about Asperger’s with him, and he became convinced he was autistic. As a result, he started using it as an excuse for everything, to excuse everything he did. They ended up getting a divorce.

Too many people cannot seem to tell the difference between having a reason for something and having an excuse for something. Autism is a reason I may fail to notice you trying to greet me in a public place, but it’s no excuse to be rude. Knowing that my autism may make me less attentive to people immediately in front of me, I can make more of an effort to focus on whoever may be closer by, which will make it more likely I will notice when someone is trying to greet me.

There are of course other things I cannot help, such as my short term memory amnesia. Knowing about that won’t help me, but it most certainly does help others understand why it is that I can remember volumes of information while being simultaneously unable to remember your name right after you told it to me. Throughout the years I have been with my wife, I have told her that if she wants me to do something or get more than three items from the store, she will need to write it down. She thought that was ridiculous given how prodigious my long term memory is. When she heard the doctor diagnose me with short term amnesia, though, she finally understood what I had been telling her all these years was true. Now I get lists.

My diagnosis has, I believe, strengthened my marriage somewhat by my wife having a better understanding of some of the things I do and say (and don’t do and don’t say). I’m sure some of it is still annoying, but at least there’s some understanding there of it. And if something gets to annoying, I really do try to change what I’m doing, etc.

I also believe my diagnosis has helped me with my scholarship. I have published several peer reviewed articles on spontaneous order theory–a theory of economics and sociology–and I assumed like everyone else that people were fundamentally the same in their thinking, with slight variations in IQ or between men and women. However, I now know that not to be the case at all. The idea of neurodiversity suggests a much more complex system, a more deeply heterogeneous social system, than most people realize. This neurodiversity is what makes human society so dynamic and creative. The lack of it in other social species it what keeps them relatively stagnant in comparison.

My diagnosis, then, has had a significant impact on the way I think of myself and on the way I think about social issues. When you begin to realize that so many important people in the past and present were on the autism spectrum, and that autism is over-represented among creative people, you start thinking about creativity and social evolution quite differently. You also think about the importance of autism in society differently.

I’m not sure I would have written this blog if only my son were diagnosed with autism. I do not think I would have obsessively learned all I have learned about autism without my being autistic myself, so I certainly wouldn’t have had the depth and breadth of topics as I have had here.

In any case, I’m glad I was diagnosed. I suspect it has weakened some relationships from people who are likely sick of hearing me talk about autism all the time. I also suspect those people miss my talking about topics they found interesting. But it has also strengthened a few relationships. I know myself much better than I did before, and I think I understand the world a little better as well. Which is probably no coincidence. Know yourself, know the world.

Is ADHD Really Anxiety?

There are a few traits that are almost completely co-morbid with autism: chronic anxiety and ADD/ADHD. If you have autism, you have anxiety and attention problems.

Autism, though, isn’t the only thing where anxiety and attention problems are co-morbid. The same is true of post-traumatic stress disorder (PTSD). When you have PTSD, you are in a state of constant anxiety and constant hyper-vigilance. Hyper-vigilance means you are constantly actively keeping close tabs on the environment. Your attention is drawn to every little thing, to anything you catch out of the corner of your eye.

This hyper-vigilance sounds an awful lot like ADD/ADHD. Hyper-vigilance is actually how I would describe my ADD. It’s not that I have a hard time paying attention–rather, I have a hard time not paying attention to literally everything around me. To the person I’m directly in front of, it’s going to appear that I am having a hard time paying them attention, though.

If we understand ADD/ADHD as hyper-vigilance, this could then easily explain why many with ADD/ADHD can pay close attention to video games, for example. After all, many video games simulate conditions in which hyper-vigilance is needed to succeed.

Obsessive focus on an area of interest could also be understood as hyper-vigilance. Hyper-vigilance will also require hyper-focus if and when the “danger” is located. When there is no actual danger, that hyper-focus could manifest itself in a variety of other ways, including obsessive interests.

Hyper-vigilance comes out of anxiety, and we autistics are full of anxiety. In our case, the anxiety stems from our constantly being bombarded by sensory input. We’re overstimulated, and oftentimes that stimulation doesn’t get integrated well. It should not be surprising if an intense environment should result in hyper-vigilance within that environment. Anxiety is the intermediary.

While I myself do not use any kind of medication, and we do not use medication on our son, I do understand why some might want to medicate themselves or their children. The typical medication is for ADD/ADHD–things like Ritalin–because that’s the most problematic behavior. However, if my suspicions are correct, we are very much treating the symptoms of anxiety rather than dealing with the deeper cause–the anxiety itself.

Since we cannot rewire the brain, we cannot treat the ultimate cause (and we with autism probably wouldn’t want to do that, anyway, since that wiring is part of who we are as human beings), but anti-anxiety medications may go a long way toward eliminating at least the co-morbidity of ADD/ADHD. They would also likely alleviate some of our social issues, which stem from that anxiety.

The general rise in ADD/ADHD and the high prevalence of it in the U.S. can, I believe, based on this thesis, be traced to the fact that our school system is making our children far more anxious than ever before. But that’s a whole other set of issues. I will say, though, that rather than putting more children on Ritalin and related drugs or anti-anxiety medications, perhaps if our schools treated students as ends in themselves rather than as means to achieve testing outcomes to make administrators look good and justify their 6-digit salaries, there wouldn’t be nearly as many children with ADD/ADHD.