Today we have a special Guest Post from Katherine Fowler, my good friend and go-to girl for Autistic Spectrum Disorders (ASD) – take it away, Katherine!
It is a great honour to be asked to do a guest post here, on ASD (aka my favourite topic in all the world). So, without further ado…
DISCLAIMER: This blog post is designed for writers of fiction. If you are concerned that you or someone you know has symptoms of mental health problems, please see your doctor.
What is ASD?
ASD, or autism spectrum disorders, cover a wide range of developmental disorders, ranging from full-blown classic autism, to the catchily named PDD-NOS (pervasive developmental disorder, not otherwise specified). As the word “spectrum” suggests, there is a huge difference between those at the far ends of the scale. And, with such a diverse range of symptoms, even those placed in the same spot along the scale may come across very differently.
For simplicity’s sake, let’s divide the spectrum into three.
Autism is defined by the ‘triad of impairments’, or in other words, three main families of symptoms. Whilst these are often described as distinct families, the links between them are strong and, ultimately, they feed off of each other. These triad of impairments are:
Social and emotional difficulties
People with autism struggle to interact socially with others. Problems with empathy, and understanding the viewpoints of others (often referred to as “theory of mind”) mean that it can be hard for those on the spectrum to make and sustain friendships.
ASD tends to go hand in hand with mood disorders such as depression and anxiety, due largely to problems with socialising, leading to loneliness and social anxiety. As people with autism also tend to struggle to understand and regulate their own emotions and reactions to the world around them, they may also come across as volatile, over-dramatic or over-sensitive. This tends to be due to their inabilities to process and understand their feelings, but can often come across as being “a bit of a drama queen”.
Language and communication
Autistic people can struggle with communication and conversation. Eye contact feels awkward and unnatural, and so those with ASD tend to avoid meeting another person’s gaze if possible. Combined with awkward body language, and autistic people may come across as stand-offish, bored or uninterested. This is, normally, not the case.
Autistic people also tend to take things very literally, with jokes and sarcasm often not registering or being taken as deadly serious. This can easily, and commonly, lead to misunderstandings and hurt feelings.
Those on the spectrum tend to have very rigid views and interests. The world is normally seen in black and white, rather than shades of grey. Autistic people tend to have a few very obsessive interests, rather than a wider range of general interests.
This rigidity spreads into everyday life, as well as just in extra-curricular interests. Routine is key to those on the spectrum, and when a routine is suddenly thrown off-kilter this can often lead to feelings of anxiety and distress. Change, similarly, tends to lead to upsets, as this will, by very definition, affect the familiar day-to-day life that those with ASD find so reassuring.
Asperger’s Syndrome is a form of autism, characterised by high levels of cognitive ability. There is a great deal of debate amongst the scientific and medical communities as to whether this is truly different from high-functioning autism (those at the most able end of the autism spectrum). Those who believe the two conditions are distinct cite an increased level of clumsiness in those with Asperger’s, alongside no delay in the onset of speech and other forms of communication (those with classic autism tend to start speaking and communicating later than the “average” child). More than any other form of autism, those with Asperger’s are known for above average levels of intelligence, sometimes even bordering on genius.
PDD-NOS tends to be used as a catch-all term for those who display autistic behaviours and symptoms alongside clinical impairment, without fulfilling the full diagnostic criteria for autism (or Asperger’s). For example, someone who clearly ticks the boxes of two of the triad of impairments, but doesn’t quite reach the third.
As already mentioned, all of these symptoms come on a spectrum, and nothing I say is true of every person with a diagnosis of autism. Those with ASD are known for lacking imagination, however I know of autistic people who are successful fiction writers. Those with ASD are known for struggling socially, and being loners, and yet there are those with large groups of friends, partners, spouses. There are those with autism whose communication skills are so limited they never speak a word, whilst others will go through a mainstream school environment and go on to University. Everyone is different.
Ask anybody about the portrayal of ASD in film and television, and the title that comes to mind is Rain Man. Rain Man tells the tale of Charlie Babbitt (Tom Cruise) and his roadtrip across America with his autistic brother Raymond (Dustin Hoffman).
At times, Rain Man does a superb job of portraying the severe end of the autistic spectrum. For example in this scene, Raymond’s need for pattern and routine are clearly established, as are his anxieties and problems with communication.
Where Rain Man falls down is in regards to the social and emotional difficulties seen in ASD. Whilst Raymond does have the occasional emotional outburst – the most memorable being in a scene where his brother tries to take him on a plane, something that terrifies him and leads to a meltdown – there are also many scenes where this aspect of autism is overlooked in favour of The Plot.
Later on in the film, Charlie tries to exploit his brother’s memory and observation skills by taking him to a casino, hoping to win big money with the help of Raymond’s ability to spot patterns in the cards. The casino is loud and busy, something that is very much emphasised in the film’s direction; however, Raymond shows little concern for this. He is also happy to sit around a cramped card table, spectators crowded over his shoulders and loud conversations all around him. This does not affect his concentration or provoke any additional feelings of anxiety. For the vast majority of autistic individuals, loud and busy environments tend to be very anxiety-provoking, due to the very common inability to process a bombardment of stimulation to the senses.
Instead, the film plays up the trope of the “idiot savant”, a common pitfall in fictional characters with ASD. Whilst there are autistic people who do show exceptional skills in areas such as memory, even when they may be highly disabled in others areas of cognition, this is not as common as the media leads us to believe. The exceptional intelligence, etc. that is the trademark of “Hollywood” autism is actually far more commonly seen in those at the higher end of the spectrum, who are capable of functioning adequately in every day society.
Another character that lends himself to ASD is Sherlock Holmes. The latest incarnation, written by Stephen Moffat and Mark Gatiss and portrayed by Benedict Cumberbatch, has garnered a great deal of discussion as to whether or not he is meant to have Asperger’s – although the debate can be found to go back to the time of Arthur Conan Doyle and his original Holmes. For the current incarnation, the writers’ intentions seem unclear, with both Moffat and Gatiss refusing to definitively say whether they feel Sherlock has the syndrome. In the series 2 episode The Hounds of Baskerville, Lestrade and Watson joke about “having the same faces back together” appealing to Sherlock’s “Asperger’s”, but this one jokey line of dialogue does not constitute proof of the writers’ intentions.
Sherlock does at times display several elements of Asperger’s. However, these displays are erratic and contradictory. It is made clear that he struggles to understand human behaviour and social interaction – for example, his ridiculously over the top apologies to John (again, in The Hounds of Baskerville) after they argue. However, at other times, he uses a very intimate knowledge of human behaviour to trick others into assisting him (the best example being his “relationship” with Janine throughout series 3, or his way of gaining entry into Irene Adler’s home in the series 2 episode A Scandal in Belgravia).
His range of interests is small, and obsessive, but doesn’t quite hit the “austistic” mark (obsessions so great that all conversations are forced back to it, and strong mental anguish felt if forced to abandon these interests). And whilst Sherlock does come across as mostly antisocial, he doesn’t have the awkward sense to him that so often comes across in those with Asperger’s. He allows a Christmas party in his flat without complaint, and even allows and gets excited by visitors that bring work. Whilst it is common for those with Asperger’s, or high functioning autism, to wear a “normal mask”, Sherlock wears his just a little too well at times.
Da Vinci’s Demons is a sadly underrated show, probably because of its late night slot on an obscure satellite channel with quite frankly terrible CGI. However, it is the very definition of a hidden gem, and, whether on purpose or not, the character of Leonardo da Vinci has been written with all the hallmarks of a sufferer of Asperger’s Syndrome.
Leonardo brings the savant without the Hollywood idiot. He lives a solitary life, or at least as solitary as circumstance allows, and clearly finds company more of an irritant than a pleasure. He fixates on certain ideas obsessively, to the constant frustration of his small group of friends (or, more accurately, followers and acquaintances), and to the point where he can zone out from anything else that is happening around him. This is often done to the considerable detriment of the work he has been commissioned to carry out by the Medici family. He is prone to sudden outbursts of anger or violence, most commonly when faced with communication barriers, and he finds himself unable to understand why the people around him are behaving as they are.
The scene above highlights several of these key Asperger’s traits. Notice Leonardo’s single-minded fixation on his current obsession (namely breaking into the Vatican’s Secret Archives), and how he only joins in the conversation around him when it is directly relevant to what he wants to discuss. Jokes that make others laugh go straight over his head. The way he thanks the man hiding them feels awkward, as though he only says it because he knows he should, rather than with any real feeling. And when his friend Zo tries to broach his personal space to try and pull him from his obsession, the reaction is immediate and strongly negative.
(I should probably state here that Series 2 of Da Vinci’s Demons has begun in America but as a law-abiding British citizen, I won’t be watching until it comes to the UK in April. So there is a chance that the new season ruins everything I have just written above. If so, forgive me and pretend this never happened.)
Editor’s Note 26/03/14: In response to this article, Tom Riley, who plays Leonardo on Da Vinci’s Demons, commented on Twitter that he portrays the character with ASD and researched for accuracy with people on the spectrum.
If you are writing a character with an ASD, the triad of impairments need to be at the forefront of your mind. If you focus on the socially awkward, but give them a wide range of hobbies and interests and a deep understanding of the human psyche, then you’ve probably got somebody who’s shy or, at most, socially phobic. Focus on the struggles with empathy, understanding and emotional regulation, but give your character a wide social circle, and you’ve got someone who, sure, may have low levels of emotional intelligence, but is far from autistic. Or, as is the most common pitfall when bringing ASD to the page or the screen, if you only focus on the obsessions and rituals, without the social aspects of autism, then you’re probably going to end up closer to OCD.
As well as a well-rounded autistic character, with clear signs of all three impairment areas, I would also love to see more “every day” characters with ASD. The “idiot savant” has been done to death, and tends to give the impression that ASD = low intelligence/requiring institutionalisation or constant care. Those with ASD who live ordinary lives, go to work, get married and have children are constantly overlooked. ASD can be, and often are, invisible. It would be good to shine a light on them.
Footnote: I decided against talking about The Curious Incident of the Dog in the Night Time here, as I wanted to keep the focus on TV/film. However, if you do want an example of an expertly written character with autism, I cannot recommend the book enough. I’ve yet to see the stage play, though, so cannot vouch for that.
Katherine Fowler has a background in psychology, and a Masters degree in developmental disorders. She chose to focus on autistic spectrum disorders throughout her studies. She has worked with autistic children and teens in school, social and research settings for over 7 years.
She also blogs book reviews, and anything else that comes into her head, over at her Hodge Podge of Miscellany.