Welcome to From the Spectrum Podcast. This is a podcast about autism. It is my
goal to explain what is autism. I intend to use a mixture of scientific literature,
personal experience, and opinion. With opinion, I will explain why I feel the
way I do and give examples. I will provide links to various references for each episode.
For each episode, we will discuss various aspects of autism. The From the Spectrum
podcast will mostly avoid causes of autism, and I will try avoiding the increases of
diagnoses of late. This is like playing tug of war with barbed wire, and I don't think I want to
travel down that path. For today's episode, we will spend time discussing symptoms of criteria
A from the DSM-5-TR. Remember episode one, these symptoms are crude and it tends to capture the
spectrum. In addition, I will provide personal examples, observations of others, and dialogue
from others. Remember, these symptoms are not exhaustive, neither by the DSM or the ones I
provide. Lastly, like reviewing criteria B, some of the word selection here makes it sound like
autistics need changed and moded to fit an acceptable phenotype. And to that, I want to say,
at times parsing this out is challenging because we are all unique and have a capacity for superpowers.
In other words, our behaviors and interests might not be acceptable to all. And now, A1, deficits
and social, emotional, reciprocity, in other words, back and forth. Ranging, for example,
from abnormal, abnormal in quotations here, abnormal social approach and failure of normal
back and forth conversation. Two, reduced sharing of interest, emotions or effect. To
failure to initiate or respond to social interactions. Okay, first, are you interesting? Do you see
the things we see? Do you have a wonderful ability to become captivated by a range of
whatever we are interested in? Do you have that ability? Please don't limit another person or force
them to do things that you think they ought to do so it eases whatever conflicting response you have
to the situation. Remember, some components from criteria B, those unique abilities, we can call
superpowers. I want to qualify my comment. I want to qualify it because humans in our internal
states are all on spectrums. I want you to say, don't change people just because. Help them become
them. Help them to understand their abilities and themselves as they are created, not as you think
they should be. Please check out Simon Baron Cohen and Temple Grandin on how to cultivate
autistic's incredible gifts. Because I am on this topic now, yes, Simon Baron Cohen and the actor
Sasha Baron Cohen are first cousins. Both Simon Baron Cohen and Temple Grandin, who is also autistic,
have a lifelong work of doing great things for autism. We know speech and language difficulties
align with autism. The why is less interesting to me. Sure things like the sensory processing
problems resulting in becoming overwhelmed, a lack of opportunity to develop social skills,
and a history of bad experiences, the breakage and choppage of speech and language, and so forth.
All of these are possible causes. It is known, autistic's with good speech and language still
have trouble with the back and forth of conversation. But remember, what we are experiencing inside
our brain is captivating and safe. Examples of A1 include, when and how to join a conversation.
This is me. I will walk up to two or more people and I have a purpose. I need something from one or
more of the people. It is challenging and awkward interfering that conversation. To extract what
we need. What I need. At times I can stand there and I suspect because maybe this is what people do,
the others think I'm there to join the conversation. Not likely. At times I can begin dialogue with
myself. Is now good time? Is there a break in the action to jump in? Am I interfering? Maybe I should
just come back. Or most likely I'm thinking and will do. I'll just figure it out myself. People
with autism become very self-sufficient. And often I can miss that opportunity to join the
conversation. It is complicating. When I was younger and still today, ending a phone conversation
is awkward. That standard back and forth. When is it over and when to hang up the phone? Overall,
the phone conversation at times is difficult to know when to talk. Now at 43 it is funny. And I
have experience with others capturing my awkwardness. And it is indeed funny. However, at different
stages, such as as a teenager, it is a different feeling. It is fascinating on different ages,
impact is different. The obvious challenges with back and forth and my typical monotone voice
introduces weird feelings. Another factor is the monotone voice. To me, I am loud. As a child and
adult, I have experience with appraisals calling me monotone. Most of my life, people thought I
said Brian when saying my name. The lack of annunciation and the monotone was a bad combination. I can
say that experience did not help me and my social desires or lack of. As an adult, has gotten much
easier for me. A known complication with socialness and autism is how unpredictable social context
in the world is. Already, we have built in protection whereby the brain is a prediction
machine. See Carl Deiseroth and Lisa Femin Barrett on this work. And the most crucial job of the
brain is keeping us safe. That is a bad combination to the autistic brain. The world around us is
already fast paced. But the unpredictableness of it is it. Now, just imagine multiple people in the
conversation, especially when the normal interaction is occurring. There is a little about that. It
seems fine. Keeping with the sensory processing theme, when multiple people are talking or multiple
conversations are occurring around us, even at normal volumes, sounds begin to blend. Eventually,
the sounds become similar to the late 60s Beatles track. When they started to experiment with blends
of noises and strange objects and instruments while flexing the pan and the speakers, the volume
left or right and the noises going up and down, it's very strange sound blends. That is a lot
going on. And this becomes exhausting. We need breaks. We need social isolation. And why not? They
never fell. So now I negotiate with myself. The unpredictableness and overwhelming sensory inputs
or that calm and exciting safety net of what is extremely interesting going on in my brain at
that time, those extreme fixated interest will always win. The propensity of the so-called
abnormal fixations and intensity is not difficult. This is preferred. Lastly, on this topic, you
can understand that indifference discussed in the first episode. I suspect we get stronger at
blocking out that outside world. When you think of the indifference to pain and temperature or
adverse reaction to certain touch or sounds, well likely that just interfered with what we are
doing inside and that extreme attention to our inner world, that dialogue and extreme interoceptive
capabilities. With a one, remember eco-lelea. It is hard to keep pace with the social back and
forth, especially when we get hitched on the word or phrase and understanding what it means. Now,
imagine multiple people around or in the conversation. That situation or our inner dialogue,
it is not complicated to understand our wise. I have noticed at times when speaking, I put my
hands out as if pushing on a wall. I just simply have my palms out facing away from me and facing
the world. This is me trying to slow down the outside world. It is a barrier so I can remain in
thought and dialogue with hopes. Only hopes my speech and language will not fail. Now, with
speaking, when I am speaking thoughts, I have a propensity to the blockage and broken speech. It is
difficult to merge everything into the same pace. The sensory processing comes at higher rates of
speed. Diceroth says it is a fire hose of information. When reading out loud, this is the
hardest. Reading to myself is already difficult. I transform everything into visual pictures and
movies if the context is interesting enough. So I am processing the visual system. Things like
the retina, the lateral geniculate, the occipital lobe, likely some hippocampal activation for the
memory, and then recruiting my broca and brinecki for the speech and language. Merging that speech
and language with the visual processing of words, the context of the story, and the memory, I still
have to execute the spoken words. That is a lot to think about. More social exhaustion. More needed
rest away from the social world. It is not uncommon I get hitched on a word. I know. But at that time,
the word looks too close to other words. That is a conundrum. The English language is pretentious
and lazy. For example, if you have a moment, or if you want to do it after the episode, go to
your search bar and type in biweekly. And look at the definition to biweekly. Another note about
social communication and interaction. I have no idea how much you know about a topic and how much
I should provide. In addition, I have no idea if you are even interested. Now, A2. Deficits and
nonverbal communicative behaviors used for social interaction. Ranging, for example, from poorly
integrated verbal and nonverbal communication to abnormal in eye contact and body language, or
deficits in understanding and use of gestures. Two, a lack of facial expressions and nonverbal
communication. Two things here. Well, three, that's a lot. But first, we already discussed, are you
interesting? And two, are you trying to mold us into something we are not when evaluating us
against that symptom? With that, I did not say don't help those that have obvious challenges
with communication and things like asking for help and learning how to engage to meet their needs
and wants. Be careful parsing that out. We already discussed the eye contact and the fire hose of
information. For me, eye contact while listening is much easier than when speaking. I want to give
an opinion. ABA therapy is delicate, whereby it is one human teaching another human. I think of
live the Kowski and the more knowledgeable other. But be careful. The ABA therapist is human. All
humans are subjective to their own here and now factors. And those can complicate the behaviorism
and the development. I recently heard while speaking about ABA that the goal ought to be to
help the person thrive in their environment, not to treat. You don't treat the autism. You just
help the person thrive in the environment. And I like that. Now with the verbal and nonverbal.
The overarching phenomenon is sustaining the appropriate and quotations, behaviors for
durations. It requires vast mental effort, a complete exhaustion of our metabolic energy. Hopefully,
as we are reviewing symptoms, you can understand how the anxiety is tracking alongside here. With
A2 and really all of criteria A, that loss of opportunity to build those social skills. A
significant source of our social skills comes from interacting, participating and observing. It is
not difficult to understand much of our ability comes from watching others, especially at young
ages. As a child, a teen or adult, people with autism miss this learning source. Think about how
your interest, autism or not, provides you comfort. The comfort in that nervous system. You can
sustain that topic. If you are speaking about a topic that you enjoy, it's easier. The interaction,
the more you have knowledge on the topic, it becomes much easier. With autism, this accelerates
those restricted type behaviors and makes something already difficult, like socialness, worse. Another
type of communication, students in class. For me, despite how hard I try, despite how much
deliberate effort I exert listening and following along and or while taking notes is always been
nearly impossible. Processing the sensations, following along with any visual thinking and keeping
up with the listening and note taking is a problem. Also, the challenges with spelling adds to the
trouble. I suspect as part of the speech and language problem, spelling is hard. For me,
spelling is hard. I simply cannot keep up while listening in a classroom and trying to take
notes. However, my listening skills and visualization of the things that I am processing, remember
that accelerated learning explained in the previous episode. This is superior for me. This is a
superpower. And lastly, A3. Deficits in developing, maintaining and understanding relationships.
Ranging, for example, from difficulties adjusting behavior to suit various social context to
difficulties in sharing imaginative play or in making friends to absence of interest and peers.
Other people, the outside world has a tough task with competing against our fixated and energetic
interest in mind. I cannot overstate this. As a child, eight or so, I was playing cops and robbers
with a peer. The peer was one year younger. The game was simple. The cop used the plastic handcuffs
to arrest the robber and the cop would take them to our make believe jail. I was the robber first
and I went to the jail. Easy task. Then we switched roles. The other child, being a child,
decided the robber wasn't going to jail and tried to escape. This isn't far off from child's play.
However, for me, that wasn't the rules and I got overwhelmed. How difficult was it to follow the
rules of the game? The plastic toys broke for my inability to understand it was just imaginative
play. I broke the toys. I broke the handcuffs while attached to the other child. I was trying to move
him to the jail area and was not budging from the simple rules. Fits like this was common. Another
example, in the 80s and 90s, the video games kind of emerged and took off. They were common for us.
I remember we played a lot of sports games. At that point, I could interact with children around my
neighborhood. We were fairly close. We would play sports games outside and inside on the video games.
I remember if my character was doing too good, if it was unrealistic, such as a baseball player
getting, let's say, 12 straight hits, he went 12 for his last 12, I would blow up. That couldn't
possibly be. That would throw me into fits and tantrums. I had troubles with maintaining the
video games and being able to interact on things like that. If you think about children at 8, 9, 10,
11, 12 even, and they have a character that they're controlling and this character is doing
unbelievably well. I think most children would capture that and enjoy that and try to maintain
that, keep that up. Me, on the other hand, I would take control of it and deliberately, let's say,
for the baseball player, make outs. I would get him out to regulate his, let's say, batting average
to a realistic range. That is what I preferred. I didn't want to have the character over-succeed
and make it unrealistic. I just couldn't understand that. And if you would think about how other
children would interact with that, that was tough. It presented a lot of problems with my
social interaction even, even with people I was close to at the time. Also as a child and like
the telephone problem, I have a history of being made fun of. But we should normalize this in a way.
Maybe as a child and teen, that is common situation. And maybe those pointing it out had a high
affinity for wanting that recognition, wanting to be known as the funny one. That I can understand.
As a child and still today, people can't interrupt or finish what I'm saying. If it is my
topic, I suspect maybe they are having a hard time keeping up. So there's some interruption. But
mostly, the trouble with formulating the thoughts into speech and language are broken. From the
previous episode, the CNT NAP2 gene is a common factor for speech and language. Now, a complete
contrast from what we were previously discussing. As I have aged, I have found myself severely
touched and moved with hearing things from others, such as in psychotherapy practice. I
genuinely care and can experience empathy. A lack of empathy from autistics is a misnomer. Look
for some links covering this. Empathy appears to be a general description. I don't know if this is a
good thing or confusing thing to break empathy down into several subtypes. Does this add to the
challenges of the human language? I'm not sure. However, with empathy, two subtypes, emotional
empathy and cognitive empathy. Emotional empathy is the ability to share another person's feelings.
And cognitive empathy is the capacity to understand such feelings. Now, with autism,
people with autism have a high ability for the emotional empathy and a low ability for the
cognitive empathy. And I can attest to this. I can understand this. Regardless of the subtypes,
scientists and humans, we like to break things down and to add to the language and definitions,
add more nouns, etc. So empathy has subtypes. Also later in my life, over the past five to
six years, I can find myself not bothered by seemingly small talk from strangers.
What helps is knowing these are short time scales. And I have an out. Knowing that this
is going to come to complete stop. And I will be able to move on. It's crucial.
To normalize this, I can't say I have a consistent deep relationship or friends.
Emotional or romantic relationships are extremely challenging and non existing.
I think those brief bouts of interaction, I do get supplements that void in my life.
Those little acute conversations act as supplements for those voids.
And before we end today, I want to review other symptoms.
Often it appears we are not paying attention. Not true. Our inner world is just safe.
We can still listen. Eyes, our vision, ears, or auditory. We are often passive in the passive
assertive spectrum. If assessed, this will likely be caught. This manifests from we don't persuade,
manipulate, or care much about your decisions. They're your decisions.
Often, at least a couple of times a week, and I've done this for decades, I wonder
how many hundreds of decisions we make per day. It's wild.
We give a perception of being rude or aggressive. Remember those items we covered about opportunity
and being direct. We have no gray areas. We see the objectives. Let's just get to it
while communicating. Also, marketing ourselves and talking about ourselves is awkward.
I never understood why a job interview would ask me why I'm a good candidate.
This is the worst possible question. Pull the answers of the candidates to know why this is
a bad question. We are often awkward in those interviews too. We don't do interviews well.
Before we end, I have a correction. Last episode, I said Leo Kanner published in pathology.
It is actually published in Nervous Child.
Leo's publishing falls in the pathology section of Nervous Child.
As we wrap up today's episode on criteria A, I ask you to understand how these symptoms
implicate our ability to socialize and build and maintain relationships. Also, how much criteria B
is a factor. It is okay to have criteria B. It is okay to live like B movie.
If you have questions, comments, concerns, criticism, or you just want to reach out,
please do. I would enjoy your conversation. You can email me at info.fromthespectrum.com.
Thank you for listening to From the Spectrum podcast.