Problem Child: Confessions of an Aspie

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In my own case, my worried mother knew something was drastically wrong with me because at age two and a half I could not speak and had constant tantrums. An adult diagnosed with autism who has limited speech or no speech is also outside the realm of normal variation; there exists a true medical disorder. Osborne has the same reservations I do about the DSM. Some of the listed mental disorders are the names of personality traits.

At what point, after all, does a variation in personality become a true neurological disorder such as severe depression, bipolar disorder, schizophrenia, anxiety, or obsessive-compulsive disorder?

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When does moody become manic depressive? When does feeling blue become depressed? When does being fussy about cleanliness slip over into obsessive-compulsive disorder?

The consensus of articles I have reviewed on brain research, including the use of imaging to discover the characteristics of serious disorders, is that even genuine disorders deserving a medical diagnosis are on a continuum with the normal. John Ratey and Catherine Johnson write in The Shadow Syndrome Bantam Books, that traits associated with severe disorders are observed, in milder versions, in many so-called neurotypical people.

Thus, I have seen Aspergerlike traits in family members of people with autism: a father who is a computer programmer with poor social skills, an eccentric uncle, and other family members with depression or anxiety. Small cells are packed tightly in these immature parts of the brain, signifying true immature development, not damage or atrophy.

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The situation is reversed for the amygdala, a part of the brain that processes emotion. But a British study by Matt Howard and his colleagues showed that high-functioning autistics had a larger abnormal amygdala. A third study, by Mehmet Haznedar and Monte Buchsbaum, showed no differences.

Problem Child: Confessions of an Aspie

Possibly the differences among these studies could be explained by differences in the criteria used to diagnose the subjects. Also, a brain autopsy is more accurate than a brain scan on a living person. But the question remains: When does a difference in the size of a certain brain region become an abnormality, instead of just a normal variation? It is likely that brain scan results from this normal cross section of the public could be closely correlated with tests that evaluate sociability and social skills. Conducting this experiment on the general public would show that normal brain variation could be measured.

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Out of the hypothetical people from a large corporation whose brains were scanned, the technical people in the computer department would probably show less activation in their amygdalas compared to the highly social salesman in the marketing department. I told her that before all the labels were used, her child might well have been diagnosed as gifted. Both Osborne and I are concerned about medicalizing what may be a normal variation in personality. Mel Levine, a professor of pediatrics at the University of North Carolina and nationally known author and consultant on learning disorders, who said that American psychiatry seems unable to conceive of healthy eccentricity or complex individuality.

Daryl Blonder Discusses his Memoir "Problem Child: Confessions of an Aspie"

Instead, psychiatrists have evolved an elaborate coding system, which, he fears, gives them undue control over families. I wonder what would have happened to great geniuses in the past if they had been labeled with a disability. Jefferson is described as pacing back and forth and constantly singing under his breath. His lifelong tinkering with his mansion Monticello was an Aspergerish obsession, and he loved mechanical devices, constructing and using elaborate dumbwaiters.

Gould was much weirder than Jefferson, and, as he grew older, his obsessions worsened. He was an intense hypochondriac, for example, and collected hotel keys. In many ways a child who never grew up, Gould had an odd, stiff gait. In my own case, a brain scan indicated that my cerebellum was 20 percent smaller than normal; this would explain my own problems with balance.

People with great abilities in one area often are poor in another. Einstein had a brain abnormality that some researchers think made his genius possible. According to Sandra Witelson, a researcher at McMaster University in Ontario, Canada, the parts of his brain that processed visual and mathematical thought were fused together. He was in the right environment to express his genius, however; today, he might be shunted through the special education system. One computer programmer at a university was obsessed with clocks and time; he had drifted from odd job to odd job until he found an employer who understood his eccentricities and recognized his talents.

One man was so sensitive to sound that he experienced the ringing of a cell phone as excruciating. These extreme sensitivities make functioning in a normal workplace uncomfortable or even painful. I might mention that my own problems with sound and touch sensitivity were mild compared to some of those described by Osborne. Fortunately, some problems with sensory oversensitivity can be reduced through special diets, medication, auditory training, or special glasses.

Osborne correctly asserts that far too many young children are given medication, but he sometimes ignores the biological problems that medication can help. For example, obsessions and anxieties often worsen with age; many high-functioning people in their late 20s or early 30s experience crippling anxiety that can sabotage their jobs. In my late 20s, my anxiety steadily worsened. I had panic attacks for no reason and woke up at night with my heart pounding. I resisted the idea of taking medication until , when I read an article in the Archives of General Psychiatry by David Sheehan and his colleagues about endogenous anxiety.

They discussed the use of tricyclic antidepressants for treating anxiety, and their list of symptoms described me. Antidepressants saved me; I would not have functioned well after age 30 without them. All my stress-related illnesses were cured; my debilitating headaches and colitis stopped.

I became a reluctant believer in biochemistry. Being a child of the s may have helped me, because the structured lifestyle taught me social rules. Since I do not have much innate social instinct to guide me, I had to rely on logic to learn how to behave. Fortunately, I was brought up in an environment where I was taught very clear standards of right and wrong. If he is brought up in an environment with no such opportunity, he may end up a disillusioned loner, mad at the world.

Exploring further, beyond our individual environments, in the last chapter of American Normal Osborne discusses what are called culture-bound syndromes. For example, why do American women get anorexia nervosa but women in indigenous cultures do not? I am drawn to this concept. Extremes in biological variation can manifest themselves in different ways in different environments. Genetically, people can be either high or low anxiety; I feel that my own nervous system was designed to be vigilant for danger.

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Depending upon the environment, an urban person with high anxiety might become a hypochondriac, but in a native society he might become a great lookout who could spot dangerous animals. Perhaps the low-anxiety low-fear person might be a criminal in one environment and a courageous war hero in another. When they are startled by sudden noises or other surprises, they go into a trance, utter obscenities, and imitate any silly behavior they see or are asked to do—for example, hopping up and down like a grasshopper. They do not mind being latahs, and no attempt is made to cure them.

The Dayaks live in a decorous culture, and playing games with latahs provides an outlet for their intense emotions. The biology may be similar, but culture may determine how it is expressed. Recently, we have learned a lot about this kind of complex interaction between biology and environment. Abused children with a gene that directs a high level of expression for a particular brain enzyme known as monamine oxidase A MAOA were less likely to become antisocial and violent. This suggests that both groups of children, if raised in a nurturing environment, would be likely to become good citizens, but if abused as children, those with one genotype were more likely to become good citizens than those with a different genotype.

Both genes and the environment affect what we become. It is equality that is [viewed as] normal, not genius. Osborne is a journalist who has written frequently for the New York Times and Slate. This program is free and open to the public. For more information, please contact the Library at Nearby Places. Back to the Groton Patch. The views expressed in this post are the author's own. Want to post on Patch?

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