Lee's Summit R-7 School District: The Concerns Regarding School Assessments for Educational Autism
This is happening a lot in Lee's Summit. At one point it was happening 50% of the time. When I last checked there were 250 students in the district with a medical diagnosis of autism and only 98 had an educational diagnosis.
From the Article The Concerns Regarding School Assessments for Educational Autism
Please read the rest. Here is a portion that I find significant.
I recently assessed a teenager and diagnosed him with Asperger’s Syndrome. Within the past year two psychologists for different purposes (hospital and disability determination) also diagnosed him with Asperger’s Syndrome. Yet the school believed that he did not fit the criteria for educational autism based on their assessment. He was failing every subject and having behavioral and social difficulties. No other explanation was given for the problems in school and he was denied special services. Due to a predictable problem he was suspended from school and is now, ironically, receiving services. We are not sure what will happen when he returns to school.
Monday, November 11, 2013
Saturday, November 9, 2013
Missouri School District Faces Second Federal Lawsuit in Two Years - Yahoo News
Missouri School District Faces Second Federal Lawsuit in Two Years - Yahoo News
The Republic School District in southwest Missouri is facing its second lawsuit in federal court in four years over a special education student. The Springfield News-Leader reports the Hansen family won a case against the school district after four years of litigation stating their son needed individualized attention since the fifth grade.
The federal lawsuit litigated in June 2009 that he had conduct and personality disorders that required the school district to adapt to his needs for an education. Eventually, he got four hours of individualized tutoring which helped improve his grades.
Since the lawsuit was settled in 2010, the family moved away. It was also reported the family had more than $27,000 in legal costs paid by the district. Republic itself spent over $60,000 in legal fees.
Another lawsuit was brought against the school district in federal court alleging another pupil's rights were violated. A girl and her family are suing Republic Schools over multiple rape allegations by a boy on middle school grounds. Plaintiffs say they have DNA evidence and juvenile court records to back up their claims. Republic schools have denied the accusations. The current litigation received national media attention from the likes of CBS News .
That makes two lawsuits in federal court in a two-year period for Republic Schools regarding special needs children. Even though the recent lawsuit is just beginning, there clearly is something wrong in the once proud school system. Added to these lawsuits was a controversy over the past year regarding the banning of two books from the high school's library. That issue also received national attention.
The $87,000 in legal fees could easily pay for two or three teachers to help kids learn. It could also go towards improved curricula or funding for special education programs. Instead, it went to fees to clean up a mess that administrators and leaders in the Republic School District created themselves. The next school board election in Republic will be very interesting to watch.
What's even worse is that both students' lives were changed forever. No one should have to endure the humiliation of these kids who were just trying to be normal kids. This is America where no one should be treated as a second-class citizen. How we treat the future of this country today will largely effect how the next generation of leaders will work with citizens to better their communities.
For some children who attended schools in Republic, their lives 10 years from now will be irrevocably altered by men and women who were trained to protect them. Instead, they were ignored.
William Browning, a lifelong Missouri resident, writes about local and state issues for the Yahoo! Contributor Network. Born in St. Louis, Browning earned his bachelor's degree in English from the University of Missouri. He currently resides in Branson.
Thursday, November 7, 2013
A Parent's Guide to Evidence-Based Practice and Autism - West Palm Beach Asperger & Education | Examiner.com
A Parent's Guide to Evidence-Based Practice and Autism - West Palm Beach Asperger & Education | Examiner.com
Autism is a disorder with no known cause or cure. Parents of children with ASD will understandably pursue interventions and treatments that offer the possibility of helping their child, particularly if they are perceived as unlikely to have any adverse effects. Unfortunately, families are often exposed to unsubstantiated, pseudoscientific theories, and related clinical practices that are ineffective and compete with validated treatments, or that have the potential to result in physical, emotional, or financial harm. The time, effort, and financial resources spent on ineffective treatments can create an additional burden on families. As a result, parents, caregivers, advocates, and educators everywhere are eager for credible, research-based information on the most effective treatments for autism spectrum disorders (ASD). To address this need, the National Autism Center has released its newest manual, A Parent's Guide to Evidence-Based Practice and Autism, to help parents and caregivers differentiate empirically validated treatment approaches from treatments that are unproven and/or potentially ineffective.
The 134-page manual focuses on helping parents as they make decisions about how to best help children with ASD reach their full potential. It begins with a review of the autism spectrum, symptoms, and co-occurring conditions, and identifies and describes effective treatments. Other topics include the importance of professional judgment, the role of family preferences and values in the decision-making process, and factors to consider when choosing a team of professionals to help their child.
“Finding information about autism is easy. It is much more difficult to find reliable information that has withstood the rigors of science, is comprehensive in scope, and is accessible and easy to read,” saidHanna C. Rue, Ph.D., BCBA-D, Director of Evidence-based Practice for the National Autism Center and one of the manual’s authors. “Even for a trained professional, sorting through the clutter to find information that is most relevant to a child’s needs is a complicated and challenging process.”
One of the most distinctive and important features of this manual is that it was co-authored by professionals and parents of children with autism. “As professionals, we think about treatment from an entirely different perspective than a parent,” Dr. Rue comments. “We felt it was critical that the parent experience be reflected in every aspect of the manual.”
The manual is the latest in a series of publications by the National Autism Center. Visit the Center’s website to download a free copy, watch a video, or learn more.
About the National Autism Center
The National Autism Center is May Institute’s Center for the Promotion of Evidence-based Practice.It is dedicated to serving children and adolescents with Autism Spectrum Disorders(ASD) by providing reliable information, promoting best practices, and offering comprehensiveresources for families, practitioners, and communities.
An advocate for evidence-based treatment approaches, the National Autism Center identifies effective programming and shares practical information with families about how to respond to the challenges they face. The Center also conducts applied research and develops training and service models for practitioners. Finally, the Center works to shape public policy concerning ASD and its treatment through the development and dissemination of National Standards of Practice.
Lee A. Wilkinson, PhD, CCBT, NCSP is author of the award-winning book, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools, published by Jessica Kingsley Publishers.
Dr. Wilkinson can be reached at BestPracticeAutism.com.
Unusual Fears and Phobias in Children with ASD - West Palm Beach Autism & Education | Examiner.com
Unusual Fears and Phobias in Children with ASD - West Palm Beach Autism & Education | Examiner.com
Anxiety Disorders are a frequent co-occurring (comorbid) problem for children and youth with ASD. Although prevalence rates vary from 11% to 84%, most studies indicate that approximately one-half of children with ASD meet criteria for at least one anxiety disorder. Of all types of anxiety disorders, specific phobia is the most common, with prevalence estimates ranging from 31% to 64%. In contrast, estimates of phobias in children in the general population range from 5% to 18%.
Unusual fears have long been recognized as a feature ofautism. In fact, 70 years ago, Leo Kanner wrote in his initial account of autism that “loud noises and moving objects” are “reacted to with horror” and things like “tricycles, swings, elevators, vacuum cleaners, running water, gas burners, mechanical toys, egg beaters, even the wind could on occasions bring about a major panic.” We now know that children with autism perceive, experience, and respond to the world very differently than children without autism. Experiences that may be tolerable for most typical children might be frightening, disturbing, or irritating for a child with ASD. Children with autism may also be unresponsive to other experiences (e.g., insensitive to pain), may not show stranger or separation anxiety, and may be seemingly unaware of obvious dangers (e.g., running into traffic).
Research
Previous research examining the types and frequencies of fears in children with autism have found odd and intense fears in approximately 40% of children with autism, whereas unusual fears were present in only 0–5% of children without autism, including children with a learning disability, language disorder, ADHD, intellectual disability, and typical development. Studies also indicate that while some of the most common fears for children with autism and typical development overlap, children with autism have frequent fears that were not amongst the most frequently reported for typical children. These include fear of thunderstorms, large crowds, and closed spaces.
A large scale study reported in Research in Autism Spectrum Disorders investigated unusual fears in a sample of 1033 children ages 1-16 with autism. The purpose of the study was to categorize and determine specific types of unusual fears in children with autism as well as identify variables related to the presence or absence of these fears. Unusual fears were reported in 421 (40.8%) of the 1033 children with autism. A total of 487 unusual fears were reported, representing 92 different fears. The most common unusual fear was fear of toilets, accounting for 11.7% of the unusual fears. For children with unusual fears, 60.0% had one fear, 27.6% had two, 10.2% had three, 1.9% had four, and one child had five fears. Unusual fears fell into 14 categories. More than half of the 421 children with unusual fears had fears of mechanical things, heights, and/or weather. The most common category was fear of mechanical things, which accounted for 23.8% of the types of fears reported. For children with unusual fears, 71.1% had fears in only one category, 21.9% in two categories, 6.7% in three categories, and 0.3% in four categories. Many children also had common childhood fears and phobias (including fear of dogs, bugs, spiders, snakes, the dark, doctors, barbers, monsters, people in costumes, mechanical toys, sleeping alone, fire, and swimming), which increased the overall proportion of children with autism who had intense fears and phobias to more than 50%.
Categories and Frequency of Unusual Fears
The most frequently reported categories of unusual fears were:
- Mechanical things (Blenders, can openers, cassette players, ceiling fans, clothes, dryers, drills, electric toothbrushes, exhaust fans, hair dryers, hand dryers, leaf blowers, toilets, vacuum cleaners, washing machines, water fountains, wheelchairs, windshield wipers)
- Heights (Elevators, escalators, heights, steps)
- Weather (Cloudy weather, natural disasters such as floods, droughts, hurricanes, tornadoes), rain, thunderstorms, wind)
- Non-mechanical things (Balloons, black television screen, buttons, clam shells, crayons, dolls, drains, electrical outlets, eyes on toys garden hose, glass tabletops, glow in dark stars, gum under table, hair in bathtub, lights, mole on person’s face, moon, shadows, strings, stuffed animals, swinging or rocking things, tall things, things on ceiling, vent on house)
- Places (Bathroom, bedroom, certain house or restaurant, closed or small spaces, garage, large or open space, room with doors unlocked or open)
- Worries Dying (e.g., bone breaking through chest, car accident, drowned, eaten by fleas, heart attack, murdered, natural disaster, poisoned, spleen exploding, world ending), germs or contamination, running out of certain foods, running out of gas, something falling over, swallowing something when did not, toilet overflowing, tree falling on house)
- Visual media (Characters in or segments of movies, television shows, commercials, computer games)
Types and Frequency of Unusual Fears
Unusual fears reported by parents fell into two categories: (1) uncommon fears not typically reported in children in the general population or in children with specific phobias and (2) fears that have been reported in studies of children without autism but which were considered unusual by parents because of their intensity, obsessiveness, irrationality, or interference with functioning. Of the total number reported, the most common unusual fears in three or more children with autism were:
- Toilets
- Elevators
- Vacuum cleaners
- Thunderstorms
- Tornadoes
- Heights
- Worry dying (e.g., bone breaking through chest, car accident, drowned, eaten by fleas, heart attack, murdered, natural disaster, poisoned, sick, spleen exploding, or world ending)
- Visual media (characters in or segments of movies, television shows, commercials, or computer games)
Associated variables
Children with and without unusual fears did not differ in age, IQ level, mental age, autism severity, race or parent occupation. Of all the demographic variables, only female gender was associated with the presence or absence of unusual fears. More girls had unusual fears (48.8%) than did boys (39.1%). This is consistent with the earlier studies indicating that girls with autism had more fears than boys and with general population studies showing that girls had more fears and higher fear survey scores than boys. The finding that children with and without unusual fears did not differ in age suggests that unlike most typical children, those with autism may not outgrow unusual fears. Likewise, the findings regarding autism severity and parent occupation suggest that the presence of unusual and intense fears may be present across SES and the entire autism spectrum. The authors note that the lack of demographic differences in the study may suggest a neurobiological basis for fears overriding developmental and environmental influences.
Conclusion and Implications
Research suggests that it is critical to assess for unusual and intense fears in children with ASD because they are common in this population and can interfere significantly with functioning. Specific fears and phobias have been cited as frequent anxiety triggers/stressors for children with ASD. The impact of anxiety includes personal distress in children, parents, and siblings, increase in challenging behavior and stereotyped behaviors, restriction of activities/opportunities and negative impact on quality of life for child and family. For example, children with autism may avoid necessary life situations (e.g., refusing to go to school because there may be a fire drill) or be in a constant state of anxiety and unable to function optimally because of their fears.
Identification of specific fears and phobias in children with ASD can help educators and interventionists improve programs and services for this group of students. This information may be especially useful for clinicians, particularly those utilizing CBT as a treatment approach for children and youth with ASD. There is evidence to suggest that the interventions used to treat intense fears and phobias in children without autism (exposure, desensitization, modeling, shaping, and reinforcement) might also be effective for children who have autism. Lastly, further research is needed to investigate why some specific unusual fears are common to autism but not the general population. As more individuals with ASD communicate about their fears and reasons for their idiosyncrasies, we may come to a better understanding of autism and its symptoms.
Mayes, S. D., Calhoun, S. L., Aggarwal, R., Baker, C., Mathapati, S., Molitoris, S., & Mayes, R. D. (2013). Unusual fears in children with autism. Research in Autism Spectrum Disorders, 7, 151–158.
Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child, 2, 217–250.
Lee A. Wilkinson, PhD, CCBT, NCSP is author of the award-winning book, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools, published by Jessica Kingsley Publishers.
Comorbid Psychiatric Conditions in Autism Spectrum Disorder (ASD) - West Palm Beach Autism & Education | Examiner.com
Comorbid Psychiatric Conditions in Autism Spectrum Disorder (ASD) - West Palm Beach Autism & Education | Examiner.com
Children with ASD frequently have co-occurring (comorbid) psychiatric conditions, with estimates as high as 70 to 84 percent. A Comorbid disorder is defined as a disorder that co-exists or co-occurs with another diagnosis so that both share a primary focus of clinical and educational attention. Research indicates that children with ASD have a high risk for meeting criteria for other disorders, such as Attention Deficit/Hyperactivity Disorder (ADHD), disruptive behavior disorders, mood, and anxiety disorders, all which contribute to overall impairment.
A study published in the Annals of General Psychiatryexamined which psychiatric disorders are more frequently associated with higher functioning ASD. The authors conducted a systematic literature search to identify clinical studies that assessed psychiatric comorbidities in individuals with high functioning autism ASD. They also searched references from recent reviews and other reports identified by this search strategy, and selected those we judged relevant.
Internalizing Problems
Several studies reported an association between ASD and internalizing symptoms, in particular, anxiety, depression, and bipolar disorder. A bidirectional association has been identified between internalizing disorders and autistic symptoms. For example, both a higher prevalence of anxiety disorders has been found in ASD and a higher rate of autistic traits has been reported in youths with mood and anxiety disorders. Another study showed that individuals with ASD displayed more social anxiety symptoms compared to healthy control individuals, even if these symptoms were clinically overlapping with the characteristic social problems typical of ASD. Research also suggests that adolescents and young adults with ASD show a higher prevalence of bipolar disorders as compared to controls.
Depression is one of the most common comorbid syndromes observed in individuals with ASD, particularly higher functioning youth. An evaluation of psychiatric comorbidity in young adults with AS revealed that 70% had experienced at least one episode of major depression and 50% reported recurrent major depression. Although another documented association is with Obsessive-Compulsive Disorder (OCD), it is difficult to determine whether observed obsessive-repetitive behaviors are an expression of a separate, comorbid OCD, or an integral part of the core symptoms of AS. An additional study investigated the presence of DSM-IV- defined bipolar disorder in adolescents and young adults with ASD and found that adolescents and young adults with ASD show a higher prevalence of bipolar disorders as compared to controls.
Externalizing Problems
An association between ASD and Attention-Deficit Hyperactivity Disorder (ADHD) and other externalizing disorders such as disruptive behavior and conduct disorders has been reported. For example, a study of comorbid psychiatric disorders in children with ASD found that approximately 71% of cases had a least one comorbid psychiatric disorder, with the most common comorbidities being social anxiety (29%), ADHD (28%), and Oppositional Defiant Disorder (28%). One of the most controversial comorbidities in children with ASD is the co-occurrence of Attention Deficit Hyperactivity Disorder (ADHD). Although there continues to a debate about ADHD comorbidity in ASD, research, practice and theoretical models suggest that comorbidity between these disorders is relevant and occurs frequently. For example, a study comparing the rate and type of psychiatric comorbidity in children and adolescents with ASD found that the most common disorder was ADHD. Although the previous DSM-IV-TR hierarchical rules prohibited the concurrent diagnosis of ASD/PDD and ADHD, there is a relatively high frequency of impulsivity and inattention in children with higher functioning ASD. In fact, ADHD is a relatively common initial diagnosis in young children with ASD. Some researchers have suggested that a subgroup of individuals on the autism spectrum also has ADHD.
Other Comorbidities
Tourette Syndrome (TS) and other tic disorders have been found to be a comorbid condition in many children with ASD. A Swedish study showed that 20% of all school-age children with ASD met the full criteria for TS. Although the association between autism and seizure disorder is not as yet firmly established, there appears to be a higher incidence of seizures in children with autism compared to the general population. The comorbidity of ASD and psychotic disorders has also been examined. A study of children with ASD who were referred for psychotic behavior and given a diagnosis of schizophrenia showed that when psychotic behaviors were the presenting symptoms, depression and not schizophrenia, was the likely diagnosis. Thus, individuals with ASD may present with characteristics that could lead to a misdiagnosis of schizophrenia and other psychotic disorders.
Conclusion
Children and youth with ASD frequently have comorbid psychiatric conditions, with rates significantly higher than would be expected from the general population. The most common co-occurring diagnoses are anxiety and depression, attention problems, and disruptive behavior disorders. The core symptoms of ASD can often mask the symptoms of a comorbid condition. Thus, the current challenge for practitioners is to determine if the symptoms observed in ASD are part of the same dimension (e.g., the autism spectrum) or whether they represent another psychiatric disorder. Further research should include longitudinal studies to examine whether individuals with ASD have an increased risk or a constitutive predisposition to develop psychiatric disorders or whether the incidence of onset is similar to normal population. Although assessment tools are limited,comorbid problems should be assessed whenever significant behavioral issues (e.g., inattention, mood instability, anxiety, sleep disturbance, aggression) become evident or when major changes in behavior are reported. Coexisting disorders should also be carefully investigated when severe or worsening symptoms are present that are not responding to traditional methods of intervention.
Mazzone et al.: Psychiatric comorbidities in asperger syndrome and high functioning autism: diagnostic challenges. Annals of General Psychiatry 2012 11:16. doi:10.1186/1744-859X-11-16
Lee A. Wilkinson, PhD, CCBT, NCSP is author of the award-winning book, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools, published by Jessica Kingsley Publishers.
If you enjoy reading my articles, you can click on "subscribe" at the top of the page to receive notice when new ones are published. You can also follow me at http://bestpracticeautism.com.
Risk Factors for Bullying Among Children with ASD - West Palm Beach Autism & Education | Examiner.com
Risk Factors for Bullying Among Children with ASD - West Palm Beach Autism & Education | Examiner.com
Studies exploring bullying in special educationpopulations have reported higher rates of peer victimization among students with special needs. Although children with disabilities have been found to be at an increased risk of bullying, there are limited studies investigating predictors or “risk factors” of bullying involvement in children with autism spectrum disorder (ASD). Identifying children with ASD who are at greatest risk of involvement in bullying has important implications for clinicians, teachers, and parents who are interested in preventing bullying and promoting effective coping strategies among children who are bullied.
A study published in the journal Autism examined child and school characteristics that may place children with ASD at risk of being involved in bullying. Participants were 1221 parents of children aged 6-15 years with a current diagnosis of ASD selected from a national web-based registry. Parents completed a survey dedicated to the school and bullying experiences of their child, and analyses conducted to identify child and school risk factors for involvement as victim, bully, or bully–victim. Additional analyses examined the risk of bullying involvement based on the amount of time spent in general education classrooms.
The researchers hypothesized that higher functioning children with ASD would be at increased risk of victimization, as would children who spent more time in an inclusive educational setting. It was also hypothesized that children who present with more comorbid (co-occurring) psychiatric conditions (e.g., attention deficit hyperactivity disorder (ADHD), depression, anxiety, obsessive compulsive disorder (OCD), social anxiety, oppositional defiant disorder (ODD), learning disorders, intellectual disability) and a high number of autistic traits would be at additional risk.
Results
The results indicated that overall, 63% of children with ASD had been victimized in their lifetime, and 38% had been victimized in the past month. In addition, 19.9% had bullied others in their lifetime, with 9.3% bullying others in the past month. Of these, 63% were bully–victims, that is, they had been both victim and perpetrator in the past month. Children diagnosed with high functioning ASD, attending a public school or a school with a general education population, were at the greatest risk of being victimized in the past month. Children with comorbid conditions and a high level of autistic traits were the most likely to be victims, bullies, and bully–victims. Lastly, children in full inclusion classrooms were more likely to be victimized than those who spend the majority of their time in special education settings.
Conclusion and Implications
The findings from the current study confirm that children across the autism spectrum are at increased risk of being bullied when compared to their typically developing peers, with children who are the highest functioning, and the most involved in general education schools and classrooms, being at the greatest risk. Several previously identified predictors of bullying behaviors among a general education population were also observed in this study, including the presence of co-occurring psychiatric conditions and difficulty making friends. The researchers note that although children with special needs in inclusion settings have been shown to benefit from increased interactions with typically developing children, it appears that they are still at risk of being isolated within the classroom and subsequently being bullied. Thus, children who spend a great deal of time in less protected, general education settings with typical peers may be at greatest risk of being bullied. The study also provides evidence that children with the greatest impairments are being protected by spending all or most of their time in special education settings
The decision of whether or not to include students with ASD continues to be a subject of debate among principals, teachers, parents, and often students themselves. Inclusion with typically developing peers is important for a child with ASD as peers provide the best models for language and social skills. However, inclusive education alone is insufficient. When children with ASD are included, it is imperative that schools ensure that they receive the supports they need to thrive at school while also protecting them from bullying. Moreover, the development and implementation of school bullying policies and inclusion programs must take into account the special vulnerability of this group of children, which can include staff and teachers being trained in identifying children who may be at additional risk of victimization. Clinicians and school-based mental health professionals (e.g., school psychologists) should also familiarize themselves with the risk factors and psychological symptoms commonly associated with bullying involvement. For example, symptom severity should be assessed and comorbid problems identified whenever significant behavioral issues (e.g., inattention, mood instability, anxiety, sleep disturbance, aggression) become evident. Finally, future research studies should focus on developing appropriate supports for children with ASD placed in inclusive settings.
Risk factors for bullying among children with autism spectrum disorders. Benjamin Zablotsky, Catherine P Bradshaw, Connie M Anderson and Paul Law. Autism published online 30 July 2013. DOI: 10.1177/1362361313477920
Lee A. Wilkinson, PhD, CCBT, NCSP is author of the award-winning book, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools, published by Jessica Kingsley Publishers.
If you enjoy reading my articles, you can click on "subscribe" at the top of the page to receive notice when new ones are published. You can also follow me at http://bestpracticeautism.com.
Friday, November 1, 2013
Aspergers Syndrome and Depression: the masking effect
Aspergers Syndrome and Depression: the masking effect
In the first part of this series on autism spectrum disorder (ASD) and depression, I offered a broad description of how depression operates (click here for that post). This time around I’d like to get into more specifics.
What makes depression so dangerous for someone on the spectrum is that it can actually hide behind autistic traits. My fear is that too few people realize: depression and ASD have several features in common, creating a kind of “masking effect”. A trait commonly associated with ASD can in some cases be depression masquerading as that trait, thus allowing it go undetected.
In my own life, I’ve found 3 features that ASD and depression have in common: absolute, black and white thinking; repetitive/obsessive thoughts; and, finally, intense feelings of alienation.
To better understand the interplay between ASD and depression, let’s take a closer look a these traits.
I. Absolute, black and white thinking.
My mind seeks out patterns. I think it helps provide me with a sense of stability, but there’s also an element of play involved. Just looking around and identifying patterns in different facets of the world, it’s something I enjoy.
One thing I’ve noticed: in order to hold patterns in my mind, be it with small things like a film, or big concepts like human behavior, I generally think in broad absolutes. Good, bad; right, wrong. Patterns are easier to establish if I can group things into easily identifiable categories; so, possibly for this reason, I am a fairly rigid thinker. Not rigid in a bad way; I just find that I habitually think in very black and white terms as a way of navigating the world. It’s how I see things, and for the most part, it works for me. “This factor should always work this way. This other factor should always work that way.” It can lead to conceptual ruts, but again, it works pretty well for the most part.
I’m on the spectrum, and I think this habit is an outgrowth of my neurological differences. The problem I’ve run into is that depression is also characterized by very absolute, black and white thinking. And because of this, I can have a difficult time identifying the onset of a depressive state.
Many people describe depression as a feeling…a kind of numb sadness that creates a physical sensation of fatigue. And while that is true, I think this feeling is a symptom, not the core factor. To me, depression is first and foremost a pattern of negative thoughts. Thoughts that frame the world as meaningless…that make ones life feel damaged beyond repair. It’s the thought patterns that drive this bleak world view and create a powerful sense of futility
Depression is effective at creating a sense of hopelessness precisely because it utilizes rigid, black and white categories. “My life is pointless. The world is meaningless. Nothing will ever change,” and so on. These rigid absolutes can control ones perceptions and make it very hard to see any light at the end of the tunnel.
As a result, someone on the spectrum can transition from their normal thought patterns into a depressive state without realizing it…and it can also be invisible to others, due to the similarities in these thought patterns.
2. Repetitive/obsessive thoughts.
Depressive thoughts tend to be black and white in nature, but they can also be brutally repetitive, to the point of obsession. Endlessly repeating thoughts about hopelessness, thoughts about the need to die: depression can be a relentless mental treadmill that repeats the same dire thoughts on a never ending loop.
When I was depressed, anything and everything from my daily life went under the depressive microscope: “this is pointless, this serves no purpose.” Everything I did, saw, was completely drained of meaning by these negative observations. I also applied this negativity to the bigger picture of life itself: people, the world, the universe; all of the broad categories that make up existence went into the mental grinder of depression. Mentally, it was exhausting, but I continued to think the same thoughts, over and over.
Asperger’s/ASD can also be characterized by obsessive thoughts. When I’m not depressed, I spend most of my day dwelling on whatever my current obsessive interest is. It can be a book, a theory, a hobby. For me, obsessive interests aren’t a bad thing…it’s just the way that I engage with the world.
Once again, these similarities can make it very hard to see the arrival of depression. My thoughts do not go through some radical shift. Obsessive thoughts about my interests become obsessive thoughts about hopelessness. The topic changes…but the overall thought pattern stays exactly the same.
It’s the masking effect, allowing depression to hide behind autistic traits like a parasite.
3. Feelings of alienation.
This one is self explanatory, but it’s worth focusing on since the feelings of alienation with both depression and ASD can be eerily similar.
If you look at personal stories from folks on the spectrum, they often share a common theme: feeling like an alien around others. I know that I struggle with social pragmatics, and during interactions, it can definitely feel like being in a land where the customs are strange and I don’t speak the language.
I have a hard time perceiving non-verbal communication and, as a result of this, I experienced significant delays with basic social milestones when I was growing up.
To make matters worse, I could see other kids interacting with ease, making connections. The world seemed like it was designed specifically for them, for other people; I didn’t seem to have a place in their world. Put all of these factors together- confusion during social interactions; the resulting social delays; loneliness- and you’re left with a powerful sense of alienation. By the time I was a teenager, this feeling was just a normal part of my every day life. I put a lot of effort into observing others, trying interpret the social realm…even before I was depressed, I felt like an alien visitor hiding behind a human mask.
Depression similarly creates a feeling of being on the “outside” of the world. What basically happens as a person sinks into depression is that the mind attempts to let go of life. It wants to fully detach itself from a world that has caused it so much pain and confusion. It’s a frightening state of being that leaves one with the impression…just like with Aspergers…that the world is a place for other people, not for you.
I remember being at the grocery store one day. This was during a particularly bleak time in my life. And I basically became trapped inside of the store, because I could no longer remember why I was there. My mind just blanked out. I roamed around, trying to recall what I needed. I walked up and down aisles. I sat on benches, tried to wait out the confusion. But everything felt so incredibly pointless that I couldn’t articulate what I might need or why I was even there. I just stared at soup cans and apples and the wheels on shopping carts and thought about how everything here was just shapes, empty of content. Meaningless. The people wandering past seemed like wind-up toys bobbling through ridiculous tasks. “They’re just shapes buying shapes,” I thought. I was overwhelmed with a sense that the world was something very far away…and it was as world for the wind-up toys, not for me.
I never bought anything that day; eventually, I just went home. It was something that happened from time to time. I would find myself “lost” in familiar places due to the lethargy and mental confusion of depression.
The interplay between Asperger’s and depression can be a constant, subtle thing. Subtract depression and social interactions still feel very confusing, strange. Subtract Asperger’s and depression still makes the world feel like it’s drifting away. Put the two together and you get a perfect storm for alienation and emotional detachment.
Once again, the transition to a depressive state can be invisible, due to these similarities. If you’re accustomed to feeling odd around people, the sense of being “outside” of the world caused by depression just seems like a natural fit.
Conclusion
At the age of 30- after nearly a decade of social isolation- I spoke with a psychologist. I was diagnosed with both Asperger’s Syndrome and clinical depression. We began the process of discussing, distinguishing and untangling the two factors from one another. The idea of going to therapy was something I hated, but I can safely say: it was necessary. I wasn’t going to survive on my own. It was ultimately a beneficial, constructive process, and I do feel that with something like depression, professional help is the best way to go.
Two diagnoses and multiple traits have been discussed here, but the take-away is pretty straightforward: as a result of the similarities described above, a potentially lethal mood disorder can hide behind the neurological differences of the autism spectrum. Hopefully, the more we talk about this- and the more personal stories we share- the more we will better understand these issues and create solutions. In future posts, I’ll discuss some of the techniques that helped me to balance ASD and depression.
[Note: these observations are based on my personal experiences with these issues. Autistic traits can and do vary from person to person; and depression can manifest in different ways, depending on the person. Learning to differentiate depression and ASD will require knowing the individual, and understanding their unique personality and needs. I'm on the spectrum, but I can't speak for others and I am not a mental health professional; this post is intended as a starting point for thinking about these issues. And to clarify: the DSM VI was recently released, with changes to spectrum terminology; for the time being, I am using the terms Aspergers and ASD interchangeably.]
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