After years of working with autistic boys, Simon Taylor questions the efficacy of diagnosing mental disorders in children.
I love kids. I want to be a father so much I’d even trade my iPhone for a uterus.
This desire was a major motivator behind my work with children with autism and Asperger’s syndrome during university. Throughout my psychology studies I got a job with a reputable autism care centre. I was one of two males working there out of about forty staff. The job required me to visit family homes to administer one-on-one behavioural therapy in their living rooms. I’d look after kids as young as two and as old as nine. I fed, taught and refrained from stealing those adorable little critters.
It was fulfilling and meaningful work that I continued for over three years. During that time, my understanding and attitude towards the diagnosis of Autism Spectrum Disorder (ASD) changed in a dramatic way.
The most poignant of the many catalysts was my time with 4-year-old Jason. I best recall us playing with his Thomas the Tank Engine train set in between bouts of learning exercises. Jason would quote the television series and make up his own hilarious stories, narrated in silly voices. My favourite was his Fat Controller impression. He had the accent down and all.
Alas when it came time to pack the toys away, Jason’s charm was wiped out from his disposition by a wave of tantrums. Lunging, scratching, whaling, biting. Chairs would fly across the room when play time was over.
The care centre’s instructed response to these behaviours was called overcorrection. As a psychological consequence for Jason overreacting, therapists had to give the instructions “Stand up” and “Sit down” over and over again. These two commands would be repeated for at least 10 minutes regardless of Jason’s response. The hardest part was ignoring his sobs and pleas as he forced himself to follow the relentless task.
I hated overcorrection. It didn’t make sense to me but I was new to the job at this point and didn’t feel confident enough to even question it.
During the height of one of Jason’s emotional meltdowns one day, after months of therapy, I began yet another overcorrection. The moment I began to speak, Jason leaped back crying, put his hands over his ears and screamed, “I’M NOT A DOG, I’M A BOY!”
As tears streamed down my face, I found myself questioning the whole system.
The truth is autism is in fashion. Many children are being diagnosed with ASD for a number of symptoms. The process is complex given that ASD can be diagnosed based on varying symptom combinations. When a disorder is defined in such broad terms it becomes easier to make it fit with any child, in the absence of neurological testing.
Autistic symptoms, in essence, are normal behaviours in abnormal proportions. For this reason it is difficult to determine where the cut-off is. For example, criteria like how much yelling a child has to do before being deemed autistic is subjective to the point of being almost arbitrary. Part of the issue is that sometimes the academic outlook is that if a child can’t sit still in a classroom, then there is something wrong with them.
Ten years ago ADD or ADHD was in vogue. Now it’s autism. Sure, many children do have mental disorders, but it seems to me that personality can be misconstrued as pathology.
I’ve visited many family homes during my autism work. I’ve seen the lingering grief in parents’ faces as they look upon their child, forever labelled as disordered. Diagnostic labels are a helpful tool for healing and adapting to the mental challenges that a child may experience. Yet in some cases, I saw this label perpetuating a ‘sick child’ framework that prevented their natural personality from being recognised and embraced.
I still visit Jason now, four years on, even after his parents’ decision to discontinue therapy when he turned five. No one outside the family seems to notice his autism. He’s treated as a normal developing boy. For me, however, Jason’s unremitting ability to move people with his charisma and powerful words is something else. It’s better than normal.
Photo: Lance Neilson/Flickr