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Autism
is classified as a neurodevelopmental disorder that
manifests itself in markedly abnormal social interaction,
communication ability, patterns of interests, and patterns
of behavior.
Although
the specific etiology of autism is unknown, many researchers
suspect that autism results from genetically mediated
vulnerabilities to environmental triggers. And while there
is disagreement about the magnitude, nature, and mechanisms
for such environmental factors, researchers have found at
least seven major genes prevalent among individuals
diagnosed as autistic. Some estimate that autism occurs in
as many as one United States child in 166, however the
National Institute of Mental Health gives a more
conservative estimate of one in 1000. For families that
already have one autistic child, the odds of a second
autistic child may be as high as one in twenty. Diagnosis is
based on a list of psychiatric criteria, and a series of
standardized clinical tests may also be used.
Autism may not be physiologically obvious. A complete
physical and neurological evaluation will typically be part
of diagnosing autism. Some now speculate that autism is not
a single condition but a group of several distinct
conditions that manifest in similar ways.
By definition, autism must manifest delays in "social
interaction, language as used in social communication, or
symbolic or imaginative play," with "onset prior to age 3
years", according to the Diagnostic and Statistical Manual
of Mental Disorders. The ICD-10 also says that symptoms must
"manifest before the age of three years." There have been
large increases in the reported incidence of autism, for
reasons that are heavily debated by researchers in
psychology and related fields within the scientific
community.
Some children with autism have improved their social and
other skills to the point where they can fully participate
in mainstream education and social events, but there are
lingering concerns that an absolute cure from autism is
impossible with current technology. However, many autistic
children and adults who are able to communicate (at least in
writing) are opposed to attempts to cure their conditions,
and see such conditions as part of who they are.
History
The word
autism was first used in the English language by Swiss
psychiatrist Eugene Bleuler in a 1912 issue of the American
Journal of Insanity. It comes from the Greek word for
"self".
However, the classification of autism did not occur until
the middle of the twentieth century, when in 1943
psychiatrist Dr. Leo Kanner of the Johns Hopkins Hospital in
Baltimore reported on 11 child patients with striking
behavioral similarities, and introduced the label early
infantile autism. He suggested "autism" from the Greek αυτος
(autos), meaning "self", to describe the fact that the
children seemed to lack interest in other people. Although
Kanner's first paper on the subject was published in a (now
defunct) journal, The Nervous Child, almost every
characteristic he originally described is still regarded as
typical of the autistic spectrum of disorders.
At the same time an Austrian scientist, Dr. Hans Asperger,
described a different form of autism that became known as
Asperger's syndrome—but the widespread recognition of
Asperger's work was delayed by World War II in Germany, and
by the fact that his seminal paper wasn't translated into
English for almost 50 years. The majority of his work wasn't
widely read until 1997.
Thus these two conditions were described and are today
listed in the Diagnostic and Statistical Manual of Mental
Disorders DSM-IV-TR (fourth edition, text revision 1) as two
of the five pervasive developmental disorders (PDD), more
often referred to today as autism spectrum disorders (ASD).
All of these conditions are characterized by varying degrees
of difference in communication skills, social interactions,
and restricted, repetitive and stereotyped patterns of
behavior.
Few clinicians today solely use the DSM-IV criteria for
determining a diagnosis of autism, which are based on the
absence or delay of certain developmental milestones. Many
clinicians instead use an alternate means (or a combination
thereof) to more accurately determine a diagnosis.
Terminology
When referring to someone
diagnosed with autism, the term autistic is often
used. However, the term person with autism can be
used instead. This is referred to as
person-first terminology. The
autistic community generally prefers the term
autistic for reasons that are fairly controversial. This
article uses the term autistic.
Characteristics
There is a great diversity
in the skills and behaviors of individuals diagnosed as
autistic, and physicians will often arrive at different
conclusions about the appropriate diagnosis. Much of this is
due to the
sensory system of an autistic which is quite different
from the sensory system of other people, since certain
stimulations can affect an autistic differently than a
non-autistic, and the degree to which the sensory system is
affected varies wildly from one autistic person to another.
Nevertheless, professionals
within
pediatric care and development often look for early
indicators of autism in order to initiate treatment as early
as possible. However, some people do not believe in
treatment for autism, either because they do not believe
autism is a disorder or because they believe treatment can
do more harm than good.
Social development
Typically, developing
infants are social beings—early in life they do such things
as gaze at people, turn toward voices, grasp a finger, and
even smile. In contrast, most autistic children prefer
objects to faces and seem to have tremendous difficulty
learning to engage in the give-and-take of everyday human
interaction. Even in the first few months of life, many seem
indifferent to other people because they avoid eye contact
and do not interact with them as often as non-autistic
children.
Children with autism often
appear to prefer being alone to the company of others and
may passively accept such things as hugs and cuddling
without reciprocating, or resist attention altogether.
Later, they seldom seek comfort from others or respond to
parents' displays of anger or affection in a typical way.
Research has suggested that although autistic children are
attached to their parents, their expression of this
attachment is unusual and difficult to interpret. Parents
who looked forward to the joys of cuddling, teaching, and
playing with their child may feel crushed by this lack of
expected attachment behavior.
Children with autism often also appear to lack "theory of
mind", the ability to see things from another person's
perspective, a behavior cited as exclusive to human beings
above the age of five and, possibly, other higher primates
such as adult gorillas, chimpanzees and bonobos. Typical
5-year-olds can develop insights into other people's
different knowledge, feelings, and intentions,
interpretations based upon social cues (e.g., gestures,
facial expressions). An individual with autism seems to lack
these interpretation skills, an inability that leaves them
unable to predict or understand other people's actions. The
social alienation of autistic and Asperger's people can be
so intense from childhood that many of them have imaginary
friends as companionship. However, having an imaginary
friend is not necessarily a sign of autism and also occurs
in non-autistic children.
Although not universal, it
is common for autistic people to not regulate their
behavior. This can take the form of crying or verbal
outbursts that may seem out of proportion to the situation.
Individuals with autism generally prefer consistent routines
and environments; they may react negatively to changes in
them. It is not uncommon for these individuals to exhibit
aggression, increased levels of self-stimulatory behavior,
self-injury or extensive withdrawal in overwhelming
situations.
Sensory system
A key indicator to clinicians
making a proper assessment for autism would include looking
for symptoms much like those found in sensory integration
dysfunction. Children will exhibit problems coping with the
normal sensory input. Indicators of this disorder include
oversensitivity or underreactivity to touch, movement,
sights, or sounds; physical clumsiness or carelessness; poor
body awareness; a tendency to be easily distracted;
impulsive physical or verbal behavior; an activity level
that is unusually high or low; not unwinding or calming
oneself; difficulty learning new movements; difficulty in
making transitions from one situation to another; social
and/or emotional problems; delays in speech, language or
motor skills; specific learning difficulties/delays in
academic achievement.
One common example is an individual with autism hearing. A
person with Autism may have trouble hearing certain people
while other people are louder than usual. Or the person with
autism may be unable to filter out sounds in certain
situations, such as in a large crowd of people (see cocktail
party effect). However, this is perhaps the part of the
autism that tends to vary the most from person to person, so
these examples may not apply to every autistic.
It should be noted that sensory difficulties, although
reportedly common in autistics, are not part of the DSM-IV
diagnostic criteria for autistic disorder.
Communication difficulties
By age 3, typical children
have passed predictable language learning milestones; one of
the earliest is babbling. By the first birthday, a typical
toddler says words, turns when he or she hears his or her
name, points when he or she wants a toy, and when offered
something distasteful, makes it clear that the answer is
"no." Speech development in people with autism takes
different paths. Some remain mute throughout their lives
while being fully literate and able to communicate in other
ways—images, sign language, and typing are far more natural
to them. Some infants who later show signs of autism coo and
babble during the first few months of life, but stop soon
afterwards. Others may be delayed, developing language as
late as the teenage years. Still, inability to speak does
not mean that people with autism are unintelligent or
unaware. Once given appropriate accommodations, many will
happily converse for hours, and can often be found in online
chat rooms, discussion boards or websites and even using
communication devices at autism-community social events such
as Autreat.
Those who do speak often use language in unusual ways,
retaining features of earlier stages of language development
for long periods or throughout their lives. Some speak only
single words, while others repeat the same phrase over and
over. Some repeat what they hear, a condition called
echolalia. Sing-song repetitions in particular are a
calming, joyous activity that many autistic adults engage
in. Many people with autism have a strong tonal sense, and
can often understand spoken language. Some children may
exhibit only slight delays in language, or even seem to have
precocious language and unusually large vocabularies, but
have great difficulty in sustaining typical conversations.
The "give and take" of non-autistic conversation is hard for
them, although they often carry on a monologue on a favorite
subject, giving no one else an opportunity to comment. When
given the chance to converse with other autistics, they
comfortably do so in "parallel monologue"—taking turns
expressing views and information. Just as "neurotypicals"
(people without autism) have trouble understanding autistic
body languages, vocal tones, or phraseology, people with
autism similarly have trouble with such things in people
without autism. In particular, autistic language abilities
tend to be highly literal; people without autism often
inappropriately attribute hidden meaning to what people with
autism say or expect the person with autism to sense such
unstated meaning in their own words.
The body language of people with autism can be difficult for
other people to understand. Facial expressions, movements,
and gestures may be easily understood by some other people
with autism, but do not match those used by other people.
Also, their tone of voice has a much more subtle inflection
in reflecting their feelings, and the auditory system of a
person without autism often cannot sense the fluctuations.
What seems to non-autistic people like a high-pitched,
sing-song, or flat, robot-like voice is common in autistic
children. Some autistic children with relatively good
language skills speak like little adults, rather than
communicating at their current age level, which is one of
the things that can lead to problems.
Since non-autistic people
are often unfamiliar with the autistic
body language, and since autistic natural language may
not tend towards speech, autistic people often struggle to
let other people know what they need. As anybody might do in
such a situation, they may scream in frustration or resort
to grabbing what they want. While waiting for non-autistic
people to learn to communicate with them, people with autism
do whatever they can to get through to them. Communication
difficulties may contribute to autistic people becoming
socially anxious or depressed.
Repetitive behaviors
Although people with autism
usually appear physically normal and have good muscle
control, unusual repetitive motions, known as
self-stimulation or "stimming," may set them apart. These
behaviors might be extreme and highly apparent or more
subtle. Some children and older individuals spend a lot of
time repeatedly flapping their arms or wiggling their toes,
others suddenly freeze in position. As children, they might
spend hours lining up their cars and trains in a certain
way, not using them for pretend play. If someone
accidentally moves one of these toys, the child may be
tremendously upset. Autistic children often need, and
demand, absolute consistency in their environment. A slight
change in any routine—in mealtimes, dressing, taking a bath,
or going to school at a certain time and by the same
route—can be extremely disturbing. People with autism
sometimes have a persistent, intense preoccupation. For
example, the child might be obsessed with learning all about
vacuum cleaners, train schedules or lighthouses. Often they
show great interest in different languages, numbers, symbols
or science topics. Repetitive behaviors can also extend into
the spoken word as well. Perseveration of a single word or
phrase, even for a specific number of times can also become
a part of the child's daily routine.
Effects in education
Children with autism are
affected with these symptoms every day. These unusual
characteristics set them apart from the everyday normal
student. Because they have trouble understanding people’s
thoughts and feelings, they have trouble understanding what
their teacher may be telling them. They do not understand
that facial expressions and vocal variations hold meanings
and may misinterpret what emotion their instructor is
displaying. This inability to fully decipher the world
around them makes education stressful. Teachers need to be
aware of a student's disorder so that they are able to help
the student get the best out of the lessons being taught.
Some students learn better
with visual aids as they are better able to understand
material presented this way. Because of this, many teachers
create “visual schedules” for their autistic students. This
allows the student to know what is going on throughout the
day, so they know what to prepare for and what activity they
will be doing next. Some autistic children have trouble
going from one activity to the next, so this visual schedule
can help to reduce stress.
Research has shown that
working in pairs may be beneficial to autistic children.
Autistic students have problems in schools not only with
language and communication, but with socialization as well.
They feel self-conscious about themselves and many feel that
they will always be outcasts. By allowing them to work with
peers they can make friends, which in turn can help them
cope with the problems that arise. By doing so they can
become more integrated into the mainstream environment of
the classroom.
A teacher's aide can also be
useful to the student. The aide is able to give more
elaborate directions that the teacher may not have time to
explain to the autistic child. The aide can also facilitate
the autistic child in such a way as to allow them to stay at
a similar level to the rest of the class. This allows a
partially one-on-one lesson structure so that the child is
still able to stay in a normal classroom but be given the
extra help that they need.
There are many different
techniques that teachers can use to assist their students. A
teacher needs to become familiar with the child’s disorder
to know what will work best with that particular child.
Every child is going to be different and teachers have to be
able to adjust with every one of them.
Students with Autism
Spectrum Disorders typically have high levels of anxiety and
stress, particularly in social environments like school. If
a student exhibits aggressive or explosive behavior, it is
important for educational teams to recognize the impact of
stress and anxiety. Preparing students for new situations by
writing Social Stories can lower anxiety. Teaching social
and emotional concepts using systematic teaching approaches
such as The Incredible 5-Point Scale or other Cognitive
Behavioral strategies can increase a student's ability to
control excessive behavioral reactions.
DSM definition
Autism is defined in section
299.00 of the
Diagnostic and Statistical Manual of Mental Disorders
(DSM-IV) as:
- A total of six (or more)
items from (1), (2) and (3), with at least two from (1),
and one each from (2) and (3):
- qualitative impairment
in social interaction, as manifested by at least two of
the following:
- marked impairment in
the use of multiple nonverbal behaviors such as
eye-to-eye gaze, facial expression, body postures, and
gestures to regulate social interaction
- failure to develop
peer relationships appropriate to developmental level
- a lack of spontaneous
seeking to share enjoyment, interests, or achievements
with other people (e.g., by a lack of showing,
bringing, or pointing out objects of interest)
- lack of social or
emotional reciprocity
- qualitative impairments
in communication as manifested by at least one of the
following:
- delay in, or total
lack of, the development of spoken language (not
accompanied by an attempt to compensate through
alternative modes of communication such as gesture or
mime)
- in individuals with
adequate speech, marked impairment in the ability to
initiate or sustain a conversation with others
- stereotyped and
repetitive use of language or idiosyncratic language
- lack of varied,
spontaneous make-believe play or social imitative play
appropriate to developmental level
- restricted repetitive
and stereotyped patterns of behavior, interests, and
activities, as manifested by at least one of the
following:
- encompassing
preoccupation with one or more stereotyped and
restricted patterns of interest that is abnormal
either in intensity or focus
- apparently inflexible
adherence to specific, nonfunctional routines or
rituals
- stereotyped and
repetitive motor mannerisms (e.g., hand or finger
flapping or twisting, or complex whole-body movements)
- persistent
preoccupation with parts of objects
- Delays or abnormal
functioning in at least one of the following areas, with
onset prior to age 3 years: (1) social interaction, (2)
language as used in social communication, or (3) symbolic
or imaginative play.
- The disturbance is not
better accounted for by
Rett's Disorder or
Childhood Disintegrative Disorder.
The Diagnostic and
Statistical Manual's diagnostic criteria in general is
controversial for being vague and subjective. (See the
DSM cautionary statement.) The criteria for autism is
much more controversial and some clinicians today may ignore
it completely, instead solely relying on other methods for
determining the diagnosis.
Types of autism
Autism presents in a wide
degree, from those who are nearly
dysfunctional and apparently
mentally handicapped to those whose symptoms are mild or
remedied enough to appear unexceptional ("normal") to the
general public. In terms of both classification and therapy,
autistic individuals are often divided into those with an
IQ<80 referred to as having "low-functioning autism" (LFA),
while those with IQ>80 are referred to as having
"high-functioning autism" (HFA). Low and high functioning
are more generally applied to how well an individual can
accomplish activities of daily living, rather than to IQ.
The terms low and high functioning are controversial and not
all autistics accept these labels. Further, these two labels
are not currently used or accepted in autism literature.
This discrepancy can lead to
confusion among service providers who equate IQ with
functioning and may refuse to serve high-IQ autistic people
who are severely compromised in their ability to perform
daily living tasks, or may fail to recognize the
intellectual potential of many autistic people who are
considered LFA. For example, some professionals refuse to
recognize autistics who can speak or write as being autistic
at all, because they still think of autism as a
communication disorder so severe that no speech or writing
is possible.
As a consequence, many
"high-functioning" autistic persons, and autistic people
with a relatively high IQ,
are underdiagnosed, thus making the claim that "autism
implies retardation" self-fulfilling. The number of people
diagnosed with LFA is not rising quite as sharply as HFA,
indicating that at least part of the explanation for the
apparent rise is probably better diagnostics.
Asperger's and Kanner's
syndrome
In the current
Diagnostic and Statistical Manual of Mental Disorders
(DSM-IV-TR), the most significant difference between
Autistic Disorder (Kanner's) and Asperger's syndrome is that
a diagnosis of the former includes the observation of "[d]elays
or abnormal functioning in at least one of the following
areas, with onset prior to age 3 years: (1) social
interaction, (2) language as used in social communication,
or (3) symbolic or imaginative play[,]" while a diagnosis of Asperger's
syndrome observes "no clinically significant delay" in these
areas.
The DSM makes no mention of
level of intellectual functioning, but the fact that
Asperger's autistics as a group tend to perform better than
those with Kanner's autism has produced a popular conception
that Asperger's syndrome is synonymous with
"higher-functioning autism," or that it is a lesser disorder
than autism. There is also a popular but not necessarily
true conception that all autistic individuals with a high
level of intellectual functioning have Asperger's autism or
that both types are merely geeks with a medical label
attached. Also, autism has evolved in the public
understanding, but the popular identification of autism with
relatively severe cases as accurately depicted in Rain Man
has encouraged relatives of family members diagnosed in the
autistic spectrum to speak of their loved ones as having
Asperger's syndrome rather than autism.
Autism as a spectrum
disorder
Another
view of these disorders is that they are on a continuum
known as autistic spectrum disorders. A related continuum is
Sensory Integration Dysfunction, which is about how well we
integrate the information we receive from our senses.
Autism, Asperger's syndrome, and Sensory Integration
Dysfunction are all closely related and overlap.
There are two main manifestations of classical autism,
regressive autism and early infantile autism. Early
infantile autism is present at birth while regressive autism
begins before the age of 3 and often around 18 months.
Although this causes some controversy over when the
neurological differences involved in autism truly begin,
some believe that it is only a matter of when an
environmental toxin triggers the disorder. This triggering
could occur during gestation due to a toxin that enters the
mother's body and is transfered to the fetus. The triggering
could also occur after birth during the crucial early
nervous system development of the child due to a toxin
directly entering the child's body.
Increase in diagnoses of
autism.
There has been an explosion
worldwide in reported cases of autism over the last ten
years, which is largely reminiscent of increases in the
diagnosis of schizophrenia and multiple personality disorder
in the twentieth century. This has brought rise to a number
of different theories as to the nature of the sudden
increase.
Epidemiologists argue that the rise in diagnoses in the
United States is partly or entirely attributable to changes
in diagnostic criteria, reclassifications, public awareness,
and the incentive to receive federally mandated services. A
widely cited study from the M.I.N.D. Institute in California
(17 October 2002), claimed that the increase in autism is
real, even after those complicating factors are accounted
for (see reference in this section below).
Other researchers remain unconvinced (see references below),
including Dr. Chris Johnson, a professor of pediatrics at
the University of Texas Health Sciences Center at San
Antonio and cochair of the American Academy of Pediatrics
Autism Expert Panel, who says, "There is a chance we're
seeing a true rise, but right now I don't think anybody can
answer that question for sure." (Newsweek reference below).
The answer to this question has significant ramifications on
the direction of research, since a real increase would focus
more attention (and research funding) on the search for
environmental factors, while little or no real increase
would focus more attention to genetics. On the other hand,
it is conceivable that certain environmental factors
(vaccination, diet, societal changes) may have a particular
impact on people with a specific genetic constitution. There
is little public research on the effects of in vitro
fertilization on the number of incidences of autism.
One of the more popular theories is that there is a
connection between "geekdom" and autism. This is hinted, for
instance, by a Wired Magazine article in 2001 entitled "The
Geek Syndrome", which is a point argued by many in the
autism rights movement. This article, many professionals
assert, is just one example of the media's application of
mental disease labels to what is actually variant normal
behavior—they argue that shyness, lack of athletic ability
or social skills, and intellectual interests, even when they
seem unusual to others, are not in themselves signs of
autism or Asperger's syndrome. Others assert that it is
actually the medical profession which is applying mental
disease labels to children who in the past would have simply
been accepted as a little different or even labeled
'gifted'. See clinomorphism for further discussion of this
issue.
Due to the recent publicity surrounding autism and autistic
spectrum disorders, an increasing number of adults are
choosing to seek diagnoses of high-functioning autism or
Asperger's syndrome in light of symptoms they currently
experience or experienced during childhood. Since the cause
of autism is thought to be at least partly genetic, a
proportion of these adults seek their own diagnosis
specifically as follow-up to their children's diagnoses.
Because autism falls into the pervasive developmental
disorder category, strictly speaking, symptoms must have
been present in a given patient before age seven in order to
make a differential diagnosis.
Sociology
Due to the complexity of
autism, there are many facets of
sociology that need to be considered when discussing it,
such as the culture which has evolved from autistic persons
connecting and communicating with one another. In addition,
there are several subgroups forming within the autistic
community, sometimes in strong opposition to one another.
Community and politics
Much like many other
controversies in the world, the autistic community itself
has splintered off into several groups. Essentially, these
groups are those who seek a cure for autism, dubbed
pro-cure, those who do not desire a cure for autism and
as such resist it, dubbed anti-cure, and the many
people caught in the middle of the two. In recent history,
with scientists learning more about autism and possibly
coming closer to a cure, some members of the "anti-cure"
movement
sent a letter to the United Nations demanding to be
treated as a minority group rather than a group with a
mental disability or disease. Websites such as
autistics.org
present the view of the anti-cure group.
There are numerous resources
available for autistics from many groups. Due to the fact
that many autistics find it easier to communicate online
than in person, many of these resources are available
online. In addition, sometimes successful autistic adults in
a local community will help out children with autism, much
in the way a master would help out an apprentice, for
example.
2002 was declared Autism
Awareness Year in the United Kingdom—this idea was initiated
by Ivan and Charika Corea, parents of an autistic child,
Charin. Autism Awareness Year was led by the British
Institute of Brain Injured Children, Disabilities Trust,
National Autistic Society, Autism London and 800
organizations in the United Kingdom. It had the personal
backing of British Prime Minister Tony Blair and
parliamentarians of all parties in the Palace of
Westminster.
With the recent increases in autism recognition and new
approaches to educating and socializing autistics, an
autistic culture has begun to develop. Similar to deaf
culture, autistic culture is based in a belief that autism
is a unique way of being and not a disorder to be cured.
There are some commonalities which are specific to autism in
general as a culture, not just "autistic culture".
It is a common misperception that people with autism do not
marry; many do get married. Often, they marry another person
with autism, although this is not always the case. Many
times autistics are attracted to other autistics due to
shared interests or obsessions, but more often than not the
attraction is due to simple compatibility with personality
types, the same as is true for non-autistics. Autistics who
communicate have explained that companionship is as
important to autistics as it is to anyone else.
Multigenerational autistic families have also recently
become a bit more common.
The interests of autistic
people and so-called "geeks"
or "nerds"
can often overlap as autistic people can sometimes become
preoccupied with certain subjects, much like the variant
normal behavior geeks experience. However, in practice many
autistic people have difficulty with working in groups,
which impairs them even in the most "technical" of
situations.
Autistic adults
Some autistic adults are
able to work successfully in mainstream jobs, usually those
with high-functioning autism or Asperger's syndrome.
Nevertheless, communication and social problems often cause
difficulties in many areas of the autistic's life. Other
autistics are capable of employment in sheltered workshops
under the supervision of managers trained in working with
persons with disabilities. A nurturing environment at home,
at school, and later in job training and at work, helps
autistic people continue to learn and to develop throughout
their lives. Some argue that the internet allows autistic
individuals to communicate and form online communities, in
addition to being able to find occupations such as
independent consulting, which does generally not require
much human interaction offline.
In the
United States, the public schools' responsibility for
providing services ends when the autistic person is in their
20s, depending on each state. The family is then faced with
the challenge of finding living arrangements and employment
to match the particular needs of their adult child, as well
as the programs and facilities that can provide support
services to achieve these goals.
Autistic savants
The autistic savant
phenomenon is sometimes seen in autistic people. The term is
used to describe a person who is autistic and has extreme
talent in a certain area of study. Although there is a
common association between savants and autism (an
association created by the 1988 film Rain Man), most
autistic people are not savants. Mental calculators and fast
programming skills are the most common form. The famous
example is Daniel Tammet, the subject of the documentary
film The Brain Man (Kim Peek, one of the inspirations for
Dustin Hoffman's character in the film Rain Man, is not
autistic). "Bright Splinters of the Mind" is a book that
explores this issue further.
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