Neurotransmitters Flow in this Autism Mind

Jitterbugging with Co-Eds

The original Oski "Jitterbugged with co-eds"

LOL

Flat Effect in Autism - What it Means

Flat affect refers to a reduced emotional expressiveness, often seen in autism, which is linked to atypical neural processing and connectivity in brain regions responsible for emotion processing and expression. [read in more detail]

PlainSpeak: Flat affect means showing little to no emotion on the face or in speech, often seen in autism, due to differences in how the brain processes and shows emotions. [ Read in more detail in plain language]

Stanford Neurodiversity Design Thinking Workshop

I was part of a 7 week Stanford Neurodiversity Design Workshop led by Dr Lawrence Fung. An effort at at multi stakeholder design thinking towards solutions for neurodiverse individuals. Today was the final presentation by each group on their ideas.

Leo Kanner and Autism

Leo Kanner was an Austrian-American psychiatrist and one of the pioneers in the study of child psychiatry. He is most famous for his work on autism, having first described the condition in 1943 in a paper titled Autistic Disturbances of Affective Contact, which laid the foundation for how autism was understood for decades. Kanner is considered the first to systematically identify autism as a distinct syndrome, setting it apart from other mental health conditions.

How Did Kanner Stumble Across Autism?

Kanner's interest in autism began during his work as the first director of the children's psychiatric clinic at Johns Hopkins University. In the late 1930s, a series of parents brought their children to him, describing behaviors that didn't fit into existing psychiatric categories of the time. These children displayed profound difficulties in social interaction, communication, and exhibited repetitive, rigid behaviors. Kanner noticed that these characteristics were markedly different from those seen in other developmental disorders.

In 1943, after studying 11 children who shared similar traits, Kanner published his landmark paper, where he described autism as a unique condition of "innate inability to form the usual, biologically provided affective contact with people." He coined the term "early infantile autism" and laid out the core features, including a preference for aloneness, an "obsessive insistence on sameness," and difficulty in communication.

Kanner’s View of Autism: Lifelong but With Potential for Improvement

Kanner viewed autism as a rare and distinct developmental disorder, and he initially believed it was a lifelong condition. In his early work, he described autism as appearing in infancy and persisting into adulthood, characterized by difficulties in social interaction, communication, and rigid, repetitive behaviors. He did, however, leave some room for optimism, believing that with the right interventions, some children could make significant improvements in certain areas, especially in social skills and communication.

While Kanner saw autism as enduring throughout life, he thought that early and intensive interventions could lead to varying degrees of progress. His belief that autism was a lifelong condition has been supported by modern research, though today we recognize a broader spectrum of experiences in autistic individuals, with some needing more support than others over their lifespan.

Patient Number 1: Donald Triplett

The first child Kanner ever diagnosed with autism was Donald Triplett, referred to as "Case 1" in Kanner’s 1943 paper. Donald, born in 1933 in Mississippi, exhibited behaviors that puzzled his parents. From an early age, he showed an unusual ability to memorize facts and numbers, yet he was emotionally detached, didn’t play with other children, and had trouble communicating in socially conventional ways. His parents described him as being “self-sufficient” and “aloof.” He had an extraordinary memory, could recite the 25th chapter of the Book of Matthew, and was fascinated with numbers, especially multiplication.

Donald’s behaviors intrigued Kanner, and he became the first documented case of what Kanner described as "early infantile autism." Kanner noted Donald’s repetitive behaviors, his insistence on sameness, and his remarkable memory, features that became part of the diagnostic criteria for autism.

Donald Triplett’s Life After Diagnosis

Donald Triplett went on to live a relatively independent and fulfilling life in his hometown of Forest, Mississippi. Unlike many children diagnosed with autism in the early days, who were often institutionalized, Donald returned to his community after spending time in an institution and successfully integrated into everyday life. He was supported by his family and community, and he developed passions for golf, travel, and automobiles. He worked lifelong at the Forest Bank, owned by his family. His remarkable story was chronicled in The Atlantic article “Autism’s First Child,” which brought public attention to his life and his role in the history of autism. Donald Passed away in 2023 at the age of 83

Kanner's Legacy

Leo Kanner’s work was revolutionary in identifying autism as a distinct clinical diagnosis. His early descriptions laid the groundwork for the field of autism research, even though his initial views, particularly those about the role of parenting, were later discredited. Kanner’s belief that autism was a lifelong condition but with the possibility for improvement has been validated by modern research. Today, the understanding of autism is much broader, recognizing a spectrum of abilities and challenges that persist across an individual’s life.

Mentions

Student Feedback on Autism Decal.

What interests you about this class

A friend of mine works with kids with autism and I would like to educate myself more on this topic so that I can be more well versed in this subject area when i talk to them. I would like to learn about pretty much anything yall find most important, im just a dude ryba learn as much as possible.
It is interesting to learn about the spectrum of autism and how individuals cope with certain levels of the spectrum.
I am interested in learning more about adults with autism and the kind of support needed and barriers experienced later on in life. I also know a little about who women and girls are less likely to be diagnosed with autism until later on in life due to the way ASD is gendered, but I am curious to learn more about that.
I hope to build my awareness and knowledge of autism so that I can better understand and be an ally to those around me. I feel that autism is often stigmatized as a disability, and I want to learn more about how we can combat this thinking. I want to learn what symptoms and behaviors are associated with autism.
- I am interested on how I can be more cognizant of those on the spectrum. Additionally, as an intended disability studies minor, I want to learn more about personal stories by listening to guest speakers etc.
I am very interested in taking this course because of my interest in better understanding disabilities on many levels. I am aiming to pursue a career in disability research but believe heavily in the importance of understanding disabilities on a personal / social level before having the right to study them on a molecular / neurological level.
As being on the spectrum, I want to learn more about the condition and maybe provide some insight into the daily life of an autistic person.
I want to learn more about the autism spectrum, and what it looks like to proactively involved.
more information about life with autism and advantages or disadvantages
As a Psychology major, I find that I haven't actually learned much about autism in my classes, although I've learned about mood disorders, intellectual disabilities, and learning disorders. So, I'd like to learn more about the realities of autism and treatment options available.
I would like to get a more holistic view about autism from different disciplines as well as hear from the guest speakers!
why they have tendency too hyperfixate. how to navigate social situations with them.
I've seen autism depicted in media, and am curious to see if their depictions are accurate, and i just want to understand and be able to empathize more with people who do have autism.
I've always wanted to take a class focused on Autism, and I came to know of this class through Obama's Instagram ;) I would like to learn more about Autism through the perspective of someone with Autism. I also would like to learn more about the biological basis behind autism. Overall, I am most excited to meet more people and hear everyone's various experiences.
Just want to gain some general understanding about Autism to be able to broaden my sensitivity to and understanding of the needs of neurodiverse people :)
I'd like to hear about what it's like to be autistic from someone who has autism and how to be a helpful ally.
I am pursuing the disability studies minor and would like to educate myself more around the topic of disability. I think this will be a great way to know more about autism as we are taught very little about it in school.
I would like to meet other people on the spectrum, hear there stories / experience and have a safe place to share my own.
I'm interested in this course because I've learned a couple of things about the autism spectrum from my child development and psychology classes, but not a significant amount, and I guess I've just realized recently that I'm relatively ignorant on the subject. I'd like to change that. I don't have anything specific in mind to learn more about but I'm very excited to learn more!
I would love to learn more about autism alongside disability justice. I took a city planning for disability course a while back and it was very valuable and I learned a lot!
I would like to educate myself about people with autism. I took a course with professor Hinshaw and it was really interesting and I would like to learn more about Autism.
I joined this class because I have a family member who was recently diagnosed and I wanted to learn as much as I could about Autism Spectrum Disorder so that I could support that family member. I'm interested in learning about family dynamics and learn more about the current research on ASD.
I would like to better understand autism and learn how I can positively impact the community.
I have a twin brother who was diagnosed with ASD in the 5th grade. From this course I want to learn more about ASD in hopes to better understand my brother. My brother is considered "high functioning", so I'm really curious how doctors diagnose someone with Autism and how they decide if they're low/high functioning. My brother has also struggled with IEP accommodations growing up, so I would like to know how disability programs work at public schools and how schools decide if a student qualifies for IEP/DSP accommodations.
I study neurodevelopment with relevance to ASD. I would like to learn more about ASD from perspectives beyond my research area, particularly disability rights/advocacy and intersectionality. I am hoping to have a better understanding of how I as a researcher can interact with the autism community in a positive way that doesn’t cause harm. I’m hoping this class will give me the space to think about ways to center the interests and needs of folks with autism in my research and beyond.
It’s felt like talking about autism was taboo, but I really want to understand what the experience is and how to support folks who may have autism.

Stanford Neurodiversity Summit

I'll be speaking on Oct 20 morning session.

Registration Link

https://www.eventbrite.com/e/stanford-neurodiversity-summit-tickets-115366333810

Climate Change!!

4pm 9/11/20

Air Quality due to the Wildfires.

Creative Workarounds and Silver Linings

https://www.neuronav.org/post/creative-workarounds-and-silver-linings

A reflection for the NeuroNav newsletter

Science Fiction or What

The smoky air from the Mendocino County wildfires 100 miles away, hovering above the bay area. CA

1pm

12p

11am - is it lightening up?

10:30am - Red mixed with gray clouds

10am: A distinct orange, tending to orange-red

9:30am: Yellow Orange Skies

7am - dark grey skies. light ash fall

An Explanation

https://www.berkeleyside.com/2020/09/09/its-not-the-end-of-the-world-despite-appearances-to-the-contrary-in-berkeley?fbclid=IwAR2dDrT-ziGY8GJt-NYBPEsBQ7kXDNieYNW3o8chEnwF3BixJHbOkPZPNo8

— is caused by smoke from the over 300,000-acre August Complex fires burning in Mendocino and neighboring counties.

The Bay Area is directly downwind from the fires and strong winds are pushing smoke about 5,000 feet up in the air through a process called “turbulent mixing.” Or, as NWS meteorologist Drew Peterson put it: “It’s kind of like if there’s a pile of dust, and someone took a leaf blower to it and flung it all up into the air.”

The sky is orange because longer wavelength light (reds and oranges) are able to push through smoke particulates, whereas shorter wavelengths (blues and purples) are filtered out. And it has gotten progressively darker since (the largely invisible) sunrise. According to the National Weather Service, as the winds weaken, gravity takes over as the primary vertical transport of the smoke. “Suspended smoke will descend closer to the surface and could lead to darker skies and worsening air quality today,” the agency posted on Twitter, adding, “This is beyond the scope of our models so we rely on your reports!”

Berkeleyans have been sharing dramatic photo on social media since they woke up — describing the view as a “nuclear winter” or the “Twilight Zone.”

The good news — and boy do we need good news on an eerie day like today — is that the air quality is actually pretty good in Berkeley. According to the Bay Area Air Quality Management District monitor at the Aquatic Park, it was at the yellow, “moderate” level (79 MP2.5) by the 7 a.m. count.

Journey to Stats and R

So Begins Stats2 and R

rrrrrrrr,,,,

Collaborating on Anxiety in Neurodiversity

Over the summer, I was part of a Stanford Rebuilt Project - NDGifts (Neuro diversity, Giving Individuals full team success.). It was a collaborative effort by around 72 people from across the world. It is the idea of helping employers better understand ND so that ND folks also become part of the employment landscape. I wrote the section on Anxiety as Comorbidity of the 81 page report.

Launch Event on 9/3/20 (From 0:52 mins) - on Youtube
Link to the Report: My section starts on Page 50

I actually heard about this project from another recent Berkeley graduate, Cole, who is also part of this project. It’s been an unusual summer sitting at home, with rampant cabin fever.

There were many areas that Tiffany laid out that we could get involved in and frankly I was feeling a little overwhelmed at the beginning. I already deal with a lot of anxiety and this summer of pandemic has not been kind to many of us autistics in some ways and it has felt very oppressive and suffocating.

So I thought, why not take on the topic of anxiety as a co-morbidity and write on it. Writing can be cathartic and therapeutic as well as informational for others, and I have written on mental health in autism before.

Other topics I was interested in writing about was how neurodiversity is defined, how it is represented in the media and the whole special education system which is a mess with gatekeeping at every level. Had lots of thoughts on many of these things. Of course it's absolutely unrealistic to take on writing so many. So I focused on the anxiety part. But was able to add inputs to other different areas in the meetings.

Tiffany was also super helpful in funneling a lot of research articles my way as I was trying to set up the remote login to the Berkeley library system to access research materials. So that was super helpful.

Sometimes the hardest part is to get started and Nicole was really great on that and she outlined a nice framework to work within. It was great working with Nicole.

So the section is a combination of literature review of existing research and incorporating personal experiences to give it a human angle, that there are real people at the end of it reflecting liv’d experiences.

I think mental health is something that people have not quite understood, a kind of fuzzy logic. Sometimes it seems like the newest buzzword, to be used almost like a fashion accessory, which saddens me as it dilutes the needs of those who really have to liv with it.

Everyone also seems to assume that Mental health is a stand alone condition. So if you have autism, it must preclude anxiety. I think what we are trying to say is that anxiety is a very real thing, a very real co-existing condition, a very real comorbidity of neurodivergence.

If you think about it, Mental health is inevitable after years of feeling different, that you don’t belong, and being excluded. The nature of the neurodiversity itself, whether it's autism or ADHD or dyslexia or dysgraphia, can itself be a source of anxiety as can environmental factors and societal attitudes. We go into explaining these in the report. It does not matter if the disability is very visible like in my case or invisible as in the case of many others, each has different anxieties around it.

I have both learned from and enjoyed writing this section as well as reviewing and providing feedback to other sections.

I think one of the surprising ironies of this pandemic, or rather its bright lights, is that zoom has been able to connect us to people from around the world. It was amazing to hear different perspectives across times zones and across continents. So we were zooming and working off the same google drive and it did not matter that we were literally crossing physical oceans.

As an autistic I have a huge personal stake in seeing improvements across the board for our community. I tentatively attended the first meeting and found an important area was being targeted, getting employers to understand what neurodiversity was about.

You see, you can implement all kinds of laws to mandate equitable access to employment, but laws will not translate to anything as long as employers feel uncertain and uncomfortable about what they are dealing with.

It's no use just telling employers that they need to be doing this for the greater good because everyone needs to be included. They will always find a workaround to not go into unknown employee territory if they don’t understand what accommodations can look like or that there can actually be advantages to them. Neurodiversity is a huge spectrum which can make it seem overwhelming but it can also be a spectrum of un thought of skill sets that can be harnessed.

I had another stake in this project in that some faces in the neurodiversity populations such as autistics with higher support needs, are less visible even to general society, and therefore less visible to employers as well. For instance, I’m not the image of what you imagine a college going autistic would look like. But why should individuals like me be a rarity in the college world and hence the employment world. I wanted to give a voice to this population as well, that we exist and have skills to contribute too. And we can create win-win situations.

It stands to reason therefore that as potential employers learn about neurodiversity, they will become more amenable to including all of neurodiversity in the employment arena. We can help employers get over this fear of the unknown and find out that perhaps we are all not so different after all. I believe this project is a step in expanding understanding and kind of demystifying neurodiversity.

Simple really, from my point of view as an autistic. All of us, whether abled or disabled want to be contributing members of society. We all need to wake up to something meaningful every day.

Anxiety as Comorbidity By Nicole Seaward & Hari Srinivasan

Anxiety as Comorbidity in Neurodiversity

By Nicole Seaward & Hari Srinivasan

Reviewed by Kamel Webster

Overview of Anxiety

Anxiety is a universal human experience that triggers the impulses to fight, flee, or freeze. Symptoms of anxiety include “persistent feelings of restlessness, irritability, difficulty concentrating, sleep disturbance, fatigue, nausea, diarrhea, and muscle cramps” (Bandelow, Michaelis, & Wedekind, 2017). Anxiety is the result of both biological and environmental factors. “Childhood adversity, stress, or trauma” contribute to the development of anxiety disorders with the age of onset being around eleven (Bandelow, Michaelis, & Wedekind, 2017). Anxiety can be extremely intense and result in illness and lost time at work or from school. Chronic, pervasive anxiety is often characterized by excessive worry, rumination, and anticipatory anxiety. This generally results in avoidance behavior which reinforces anxious feelings (Riordan & Singhal, 2018) and can impact one’s participation in daily life. While optimal anxiety increases performance, too much can have a detrimental impact, and when left untreated, anxiety can cause significant functional impairments (Riordan & Singhal, 2018). When one is experiencing anxiety, the state of arousal can be so distracting that learning and memory are negatively affected (Riordan & Singhal, 2018). Furthermore, anxiety can disrupt relationships as well as social development (Riordan & Singhal, 2018). Common treatments for anxiety include both therapy and pharmacological treatments. It is important to identify and treat severe anxiety, but also to recognize the occasional benefits of anxiety in its milder forms.

Autism Spectrum Disorder (ASD)

Anxiety is common in those who are autistic as a result of sensory sensitivities, societal expectations, disclosure, and camouflaging. The illustration by Halim, Richdale, & Uljarević (2018) below provides a succinct overview of the many causes of anxiety in autistics. Estimates of the co-occurrence of anxiety and autism range from 40% (Rosen et al., 2018) to 48% (Smith, Ollendick, & White, 2019). Furthermore, research has shown that the added presence of anxiety can significantly impact quality of life (Smith, Ollendick, & White, 2019). Autistics prefer routines and when one is disrupted this can cause significant stress to the individual. Therefore, the management of the “intolerance of uncertainty” is an important factor in addressing anxiety in autistics. (Hwang et al., 2019).

In addition to the factors noted above, there are various ways in which the social environment can cause or exacerbate anxiety in autistic individuals. One of the authors of this section, Hari Srinivasan, has autism, ADHD and Dysgraphia. He can testify to the pressure of constantly trying to fit into “normal” societal expectations beginning in childhood. Since the societal “normal” itself is ill-defined, it is akin to chasing a moving target which is a constant source of stress. The result is constantly facing gatekeeping at every step, be it in education, social opportunities and in the field of employment. Autism can be both visible and invisible both of which can contribute to anxiety in their own way. For instance, Srinivasan’s autistic traits, with atypical body mannerisms and limited speech, are very visible. Therefore, disabilityrelated stigma may exist, whether overt or subtle, from employers and co-workers from the start. Those with an invisible form of autism face the dilemma of trying to camouflage their autism or disclosing their disability in order to avail of the ADA accommodations; either choice contributing to anxiety. In addition, a common misconception is that autism somehow magically disappears in adulthood, when in reality, years of therapy have only served to ‘mask’ some of the more overt atypical mannerisms. This means that anxiety associated with being autistic continues into adulthood though the intensity of anxiety may well depend on an individual's physiology and resilience.

Untreated anxiety will negatively impact entering the workforce, sustaining employment and enjoying the quality of life one expects from productive employment. Another author of this section, Nicole Seaward experienced autistic burnout after too many years of camouflaging and trying to fit in as “normal” in the workplace. Seaward experienced daily panic attacks and anxiety related to work that eventually became too much and she temporarily lost many of her executive functioning skills making independent living difficult and working impossible. Autistic burnout is still a new term and is characterized by “chronic exhaustion, loss of skills, and reduced tolerance to stimulus” (Raymaker et al., 2020, p. 136). Autistic burnout has serious consequences that can be reduced when the proper supports are in place and the individual no longer feels the need to hide their autistic traits (Raymaker et al., 2020).

Attention Deficit Hyperactivity Disorder (ADHD)

ADHD presents varying degrees of challenges in the areas of hyperactivity, inattention, impulsivity, concentration, productivity, memory, and focus. Comorbid and ‘hidden impairments’ are common among those with ADHD, including anxiety (Adamou et al. 2013). In fact, nearly 25% of children diagnosed with ADHD had some form of anxiety disorder (Bilgiç et al., 2013). Many of the challenges associated with ADHD “generate anxiety-provoking situations” (Bilgiç et al., 2013). Individuals with ADHD may struggle to maintain their focus which can impact task completion. Their memory might be poor due to being distracted while intaking information and learning. In other studies, a physiological link has shown that anxiety in the ADHD population correlates with lower neural activity or poor performance with visuospatial working memory tasks (Meer et al., 2017).

Srinivasan points to his experience of ADHD as a cause of anxiety. In his case, ADHD can mean an impulsive fidgeting body, which society does not regard as an appropriate social mannerism. There are also some internal conflicts when ADHD is combined with autism - ADHD can mean a certain need for newness (easily bored) which conflicts with “sameness” that the Autism desires. Depending on the situation, environment and topic, attention itself can go from hyper focus to inattention. The level of body activity too can go from hyperactive to hypoactive. Having to navigate the terrain of a potentially unaccepting social or workplace environment on top of the uncertainty of your own body reaction creates for constant anxiety laden scenarios which affect productivity

Dyslexia

Anxiety is often higher in dyslexic individuals due to the near constant challenges related to learning, subsequent feelings of inadequacy, and fear of failure (Carroll & Iles, 2006). Dyslexia is marked by challenges with writing and reading, along with functioning memory, processing speed, organization, and time management. As a result of these challenges, dyslexics are associated with “depression, anxiety, lower self-esteem, and often, behavioral problems” (Livingston, Siegel, & Ribary, 2018). Weak reading skills can contribute to lower academic achievement which has shown to lead to an increase in levels of social anxiety (Carroll & Iles, 2006). Negative emotions from living with dyslexia can contribute to “lower self-efficacy and competency relating to work, and increased work anxiety” (Livingston, Siegel, & Ribery, 2018, p.126). The challenges of dyslexia start in the early years of education, continue into adulthood and can impact success in the workplace.

Dysgraphia

Dysgraphia can be developmental or acquired through injury and is characterized by difficulty with the physical act of writing or typing due to challenges with fine motor skills (Tafti & Abdolrahmani, 2014). Difficulty with gripping a writing utensil, typing written words, discerning units of language (especially new words), and managing working memory contribute to frustration and low self-esteem (McCloskey & Rapp, 2017). Furthermore, when an individual is focused entirely on writing words, they are not fully able to concentrate on learning and therefore can fall behind. The experiences of repeated failures, bullying, and loneliness associated with dysgraphia are tied to increased levels of anxiety (Biotteau et al., 2019). As mentioned above, feelings of anxiety lead to avoidance behaviors and this can result in the dysgraphic individual opting out of experiences that will increase their education and chances of engaging in fulfilling employment.

Srinivasan offers an explanation of his experience of dysgraphia as related to motor apraxia, motor memory, motor planning issues and even dysregulation in the ability to form a body schema. There is more to writing than just the ability to grip and pick up a pen or pencil and scribble on paper. There is a lot of motor planning involved, in what direction the hand should move, by how much, at what angle, the font size, and the spacing. These tiny adjustments can be hard for a person with poor fine motor skills. A whole sequence of movements go into writing each letter. A poor body schema means the brain is constantly trying to keep track of where the hand is in space and time on top of the other tasks involved. For a typical person, these movements are embedded in their motor memory, making the writing task automatic, but motor apraxia and poor body schema means that such sequences of motor movements take much longer or do not make it into the motor memory. So, the act of writing itself ends up as a laborious task of having to motor plan all over again each time and distracts from the attention and thinking processes. Srinivasan can see the letters in his head but is never quite sure if he will be able to pen it on paper, which leads to tremendous anxiety. He says his motor instinct is to write his name, as that is an activity he was made to do over and over again in his special education years. When compared to writing, the act of typing, though it has its own challenges, seems a relatively easier motor task, as it requires the press of just a single key for each letter most of the time.

All neurodivergent individuals are unique, though anxiety seems to be common to many of them (Tafti & Abdolrahmani, 2014). Individuals may not be aware that their work performance or behavior is being impacted by anxiety. Deficits in social interactions and transitions are a challenge for many who are neurodivergent and may further contribute to anxiety. There is also a great deal of stigma with neurodiversity, which creates anxiety around disclosure and impacts emotional health (Livingston, Siegel, & Ribery, 2018). By understanding and accepting the challenges associated with neurodivergence and working to increase self-advocacy, employers can reduce employees’ stress and anxiety. The goal is an accepting, welcoming environment, creating a win-win for both employers and neurodivergent employees.

Life’s challenges include facing the uncertainty of societal expectations, in addition to dealing with autism’s core features, such as sensory sensitivity, repetitive behaviors and sameness behaviors, and other less discussed issues like lack of a body schema and poor fine motor skills in Srinivasan’s case. He feels that anxiety is a very real and often unacknowledged comorbidity of neurodivergence, though the intensity of anxiety may depend on an individual’s diagnosis and resilience. While anxiety management and coping techniques can be useful, helping employers understand neurodiversity and create an accepting workplace may do even more to develop resilient employees. The neurodivergent mind, when nurtured in the right environment, has much to offer in the workplace, including creativity and innovation