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1. An autist without wheelchair

a. The autistic person is not mentally retarded

Before talking about autism, we must know what we are talking about, because if we hear sometimes that the definition of autism has changed, this is completely false, and the problem is actually the difference between the definition of autism from media and its actual definition.

In his book « Comprendre les personnes autistes de haut niveau », Peter Vermeulen, author of many books on autism, explains that in the chapter 1, called “When autism is not like autism “.

The word autism is almost 70 years old since Leo Kanner and Hans Asperger used it for the first time to describe children and teenagers in their clinic.
Yet something does not correspond to the idea that we have of autism. Although Leo Kanner and Hans Asperger described children with different levels of intelligence, the word “autism” seems to mostly describe a severely disabled child, with not only autism, but also a clear mental deficiency.

If you ask people about what autism is, they do not usually give a description of autism, but of a combination of autism and mental handicap. They consider the following characteristics as typical autism: social isolation, little or no spoken language, surprising repetitive behavior (motor stereotypies) and resistance to change. The”autistic” type is a child who “refuses or avoids contact with others, has no eye contact, do not speak and are constantly turning small wheel”.

However, most of these characteristics are more connected with mental disability than with autism.
How autistic children play, talk or just do not talk, engage relationships with others, avoid relationships and, in fact, do not play, is a result of their autism combined with their mental disability. They are doubly handicapped. The term autism is not enough to realize what these children suffer. It is as if the term “blindness” was used to refer to people who are blind with motor disabilities. Being blind would mean about not being able to see or walk. A blind person without a wheelchair, would no longer be blind …
Sometimes autism is not visible, as if it “was not observable.” These are people with autism with normal intelligence or above intelligence.
Autism can be associated with all levels of intelligence, and therefore there are people with autism WITH intellectual disabilities and other WITHOUT.
(…)
Epidemiological studies have shown that the number of people with autism may be higher than previously estimated. The figures vary between 35% and 70%. Increasingly it is estimated that about the half part of people with autism do not have any intellectual disabilities.
(…)
“Instead of autistic persons of the same age who are less gifted, individuals with autism without mental retardation use their intelligence to compensate for their deficits. They are trying to survive in a world that is not made for them. ‘
(…) To find out how they are supposed to behave in certain situations, they very often use “scripts” or scenarios and involve calculations, formulas and rules.
Hans Asperger had also noticed that, and in 1944, he wrote:
« Normal children acquire social habits they need unconsciously, they learn instinctively. It is these instinctive relationships that are altered (in autistic children). Said bluntly: they are intelligent automata. The social adaptation must go through the intellect. In fact, they even must learn everything through the intellect. »

Later in the book, an interesting quote from Leo Kanner, that, I believe, in fact defines autism in itself:

« The knowledge of the world of the child with autism is mainly formed through personal experience and is not the result of learning from others. Obviously, the performance of autistic individuals often become extremely original and delicious. »

b. DSM-IV

DSM CRITERIA FOR AUTISTIC DISORDER (DSM-IV)

A. 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):



(1) qualitative impairment in social interaction, as manifested by at least two of the following:
(a) 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
(b) failure to develop peer relationships appropriate to developmental level
( c ) 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)
(d) lack of social or emotional reciprocity

(2) qualitative impairments in communication, as manifested by at least one of the following:
(a) 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)
(b) in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
( c ) stereotyped and repetitive use of language or idiosyncratic language
(d) lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level.

(3) restricted, repetitive, and stereotyped patterns of behavior, interests, and activities as manifested by at least one of the following:
(a) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
(b) apparently inflexible adherence to specific, nonfunctional routines or rituals
( c ) stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting or complex whole-body movements)
(d) persistent precoccupation with parts of objects

B. 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,
(3) symbolic or imaginative play.

C. The disturbance is not better accounted for by Rett’s disorder or childhood disintegrative disorder.

DSM CRITERIA FOR ASPERGER’S DISORDER (OR ASPERGER SYNDROME) (DSM IV)

A. Qualitative impairment in social interaction,
as manifested by at least two of the following:
1) marked impairment in the use of multiple nonverbal behaviours such
as eye-to-eye gaze, facial expression, body postures, and gestures
to regulate social interaction;
2) failure to develop peer relationships appropriate to developmental
level;
3) a lack of spontaneous seeking to share enjoyment, interests or
achievments with other people (eg: by a lack of showing, bringing,
or pointing out objects of interest to other people);
4) lack of social or emotional reciprocity.

B. Restricted repetitive and stereotyped patterns of behaviour, interests,
and activities, as manifested by at least one of the following:



1) encompassing preoccupation with one or more stereotyped and
restricted patterns of interest that is abnormal either in intensity
or focus;
2) apparently inflexible adherence to specific, nonfunctional routines
or rituals;
3) stereotyped and repetitive motor mannerisms (eg: hand or finger
flapping or twisting, or complex whole-body movements);
4) persistent preoccupation with parts of objects

C. The disturbance causes clinically significant impairment in social,
occupational, or other important areas of functioning.



D. There is no clinically significant general delay in language
(eg: single words used by age 2 years, communicative phrases used by
age 3 years).



E. There is no clinically significant delay in cognitive development or in
the development of age-appropriate self-help skills, adaptive behaviour
(other than social interaction), and curiosity about the environment in
childhood.



F. Criteria are not met for another specific Pervasive Developmental
Disorder, or Schizophrenia.