Guest Editorial

A u t i s m :
A Personal Insight

B y  T e m ple G r a n d i n , P h D

W hen I wa s 3, I had a ll the sy mptoms of autism— no speech, tantrums, self-stimulatory behavior, and no interest in social interaction. Today I am an associate professor of animal science at Colorado State University. How did I get to my current position? I had a great early education, and I was not allowed to just sit in a corner and stim. When I stimmed, by either dribbling sand through my hands or rocking, I could shut off the sounds that hurt my ears. To me, the school bell ringing was like a dentist’s drill hitting a nerve.

Instead, I was intellectually stimulated at school and at home. My speech teacher stretched out hard consonant sounds, such as the “c” in cup, to help me hear them. I had acute hearing but I could not hear auditory detail. If adults spoke slowly I understood them, but when they spoke too fast their words turned to gibberish. I thought adults had a special “grown-up” language. To prevent me from tuning out and shutting out the world, my mother hired a nanny who played constant turn-taking games with my sister and me.

It is extremely important to develop an autistic person’s talents. Skills are usually uneven and the emphasis needs to be on building them up so they can be turned into employable skills. My talent in art showed up at an early age, and painting and drawing were encouraged by those around me.

This talent in art was later channelled into my first professional career as a designer of cattle-handling facilities. Half the cattle in the United States are handled in facilities that I have designed.

Medication

Despite having excellent support, high anxiety and nervousness were a tremendous problem for me in my adolescence and early adulthood. When the hormones started flowing during p u b e r t y, the anxiety attacks started. It was like being in a constant state of stage fright. My nervous system was ready to fight a lion, even though there was no lion to fight.

In my case, anxiety worsened with age. By the time I got into my late 20s, my nerves were tearing me apart. I also had worsening problems with colitis and headaches.

Antidepressant medication saved me. A small 50 mg dose of Tofranil made the anxiety go away. My problems were biological, not psychological. To reduce the side effects, I switched to Norpramin at the same 50 mg dose. Anxiety would come and go in cycles, and I resisted the urge to increase the dose; I just waited for the cycle to pass. More information on my experience with medication is in my book, Thinking in Pictures (New York: Vintage Press, 1995). Since being treated, I have talked to many other people who have been helped by low doses of Prozac, Paxil, or Zoloft.

Problems at Work

At autism conferences, I have also met many talented people with Asperger’s disorder or high-functioning autism who have college educations, but not jobs. There are, however, ways for these individuals to make a successful transition from school to employment.

People with autism thrive in the structured environment of college, but a college degree does not guarantee employment. People on the spectrum should be encouraged to major in a field where jobs are readily available. For example, there are few jobs in history but many in library sciences. Engineering, drafting, and computer science are three areas where people with high-functioning autism or Asperger’s disorder tend to excel.

Two of the biggest on-the-job issues for people with these conditions are sensory overload and having too many things going on at once. Many people on the spectrum cannot tolerate the normal noisy work environment of office cubicles or factories. Fluorescent lighting c annot be tolerated by some a u t i s t i c / A s p e r g e r ’s persons because they can see the 60-cycles-p e r-second flicker. A simple way to solve this problem is to use a 100-watt incandescent lamp to overpower the fluorescent light. Another way to avoid these problems is to do freelance work from home, which makes it possible to avoid sensory overload in the workplace. Freelance work also helps minimize the social problems that people might encounter in a typical workplace.

Mentors and Meaningful Work

For many high-functioning people on the spectrum, mentors can play an important role in the development of skills that can lead to meaningful work, and more social interaction. During my high school years and throughout early adulthood different people served as mentors, helping me to develop an interest in science and motivating me. Although high school was torture and was the worst part of my life, I was able to take refuge in Mr. Carlock’s science lab. It was a haven where I could do interesting projects and develop my skills.

There is no way I could have been made into a perfect social person. For me, developing my drawing talents and using them to do meaningful work has made my life fulfilling and enjoyable. When I go to autism conferences, the happy people on the spectrum have challenging work; the unhappy ones are the ones that have either no jobs or dead-end jobs.

Work can provide needed social contact. Some of the happiest people on the autism/Asperger’s disorder I have talked to are those in the computer field. In a typical case, a parent was a computer programmer and the child started learning computers at about 10 years of age. I talked to several successful programmers who are on the spectrum, and one of them said she was happy at work because she was with “her own people.”

Many people in the computer field may have a mild variant of autism spec trum signs. Simon Baron-Cohen, MD, a researcher in England, found that there are significantly more engineers in the family histories of people on the spectrum. This is true for me. My grandfather was a Massachusetts Instit ute of Technology-t rained eng inee r who was the coinventor of the automatic pilot for airplanes. My first cousin’s son designs circuit boards, and I have other cousins who are scientists and mathematicians.

Besides work, hobbies can make life worthwhile. Shared interests in hobbies, ranging from collecting flags to breeding fancy show chickens, can provide social contact.The most unhappy people on the autism/Asperger’s disorder spectrum spend hours complaining in Internet chat rooms and have a pessimistic view of life. They have no hobby or meaningful employment. Few people are interested in pessimistic ramblings on the Internet. H o w e v e r, many people are interested in skills and hobbies like drawing, computer programming, or orchid raising.

A person on the spectrum can then sell his or her skill, not p e r s o n a l i t y. I spent three years learning how to design cattle facilities. To make up for my social deficiencies, I had to make myself the best artist I could be. Not just average, but the best. I then made a portfolio of drawings that I could show potential clients. When I first started my business, people thought I was weird, but when I opened my portfolio and showed my drawings, people were impressed with my skills.

Tips for Physicians

Physicians can keep adults on the spectrum high-functioning by encouraging the development of talent areas and by finding mentors. The visual thinkers will be good at drafting and designing, and the more verbal, non-visual Asperger’s people will be good at accounting and computer programming.

Talents can still be developed in adulthood. For example, I learned drafting in my late 20s. Mentors will be drawn to talent, and they can be found in the most unexpected places. A mentor who could teach computer programming may be a next-door neighbor who works for the telephone company or a person at church.

In conclusion, physicians
need to treat anxiety problems and encourage the development of skills that other people will value. If this is achieved, more people with autism/ A s p e r g e r ’s disorder will be supported so that they can live meaningful and fulfilled lives.