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Kids and adolescents with ADHD often struggle to keep their emotions in check. ADHD has also been linked to sleep disorders, which is one of the reasons a team of German researchers sought to determine how sleep influences the consolidation and processing of emotional memories.

Brain imaging studies have shown that ADHD alters the structure and functions of areas of the brain important to processing emotions, like the prefrontal cortex, the amygdala and the hippocampus. Scientists have speculated that a disrupted connection between these areas of the brain could contribute to a patient’s day-to-day emotions.

Among healthy children and adults, sleep facilitates the processing of emotional stimuli, so the researchers wanted to see if there were processing differences between healthy study subjects and participants with ADHD. For their study, researchers led by Alexander Prehn-Kristensen of University Hospital Schleswig-Holstein analyzed the emotional memory processing of 16 children with ADHD, 16 healthy children and 20 healthy adults.

In the study, the participants were shown photos that were either emotionally negative, like a snake or growling bear, or emotionally neutral, like an umbrella or lamp. Previous research has shown that emotionally charged images usually have a greater brain response, and are more likely to be remembered.

“During daytime, people suffering from ADHD often have problems focusing on the relevant information and ignoring irrelevant information. Here, we wanted to look whether the described daytime problem in contrasting between relevant and irrelevant information is also observable during sleep,” says study author Alexander Prehn-Kristensen, study researcher from Christian-Albrecht-university in Kiel, Germany in an email response.

All the participants were shown the photos in the evening and had their sleep monitored by the researchers using electroencephalogram (EEG) measurements to track brain activity. The next day, the participants were tested on their recollection of the emotion-inducing images.

The healthy kids without ADHD were better able to recall the images compared to the kids with ADHD and even the healthy adults. These kids had higher activity in the frontal region of their brain and could remember the emotional images better than the neutral ones. Emotional experiences are typically easier to remember than neutral memories.

Prehn-Kristensen says more research is necessary before any therapeutic or clinical conclusions should be drawn. Since the children’s memories were observed in an artificial context, they cannot presume these results carry over to day-to-day memory experiences. However, they do shed light on how brain activity issues during sleep could be responsible for emotional processing for kids with ADHD.

The study is published in the journal PLOS ONE.

Article source: http://healthland.time.com/2013/05/30/for-kids-with-adhd-sleep-disturbances-may-interfere-with-emotional-memories/

These problems can be even worse when there are other psychological issues in the family, according to the report, which was published online May 27 and in the June print issue of the journal Pediatrics.

During deployments, preschoolers could become anxious and withdraw. Children between 5 and 17 years old also are at greater risk for emotional and behavioral problems, the report said. And the situation can get worse when kids’ parents are on extended deployments.

Meanwhile, the AAP advised that parents or caregivers who remain at home also are under greater stress. This could, in turn, affect the mental health and well-being of children.

Because half of all children of active-duty military service members are taken care of by nonmilitary pediatricians before, during and after deployment, the AAP emphasized that all health care providers must recognize the mental-health needs of their patients with deployed parents, and those of other family members.

“By understanding the military family and the stressful experiences of parental wartime deployment, all pediatricians—both active duty and civilian—and other health care providers can be the front line in caring for U.S. military children and their families,” report co-author Dr. Benjamin Siegel said in an AAP news release.

“In the past 10 years, more than 2 million children in the U.S. have experienced the emotional and stressful event of being separated from a loved one deployed for active duty,” report co-author Dr. Beth Ellen Davis said in the release. “Most children cope and adapt quite well, but all children experience a heightened sense of fear and worry during a parent’s deployment. It’s important for pediatricians caring for these families to be aware of their family’s situation so they can guide them appropriately.”

More information: Visit the U.S. National Institutes of Health for more about military family health.

Journal reference: Pediatrics

Health News Copyright © 2013 HealthDay. All rights reserved.

Article source: http://medicalxpress.com/news/2013-05-military-families-mental-health.html

David H. Lewis / Getty Images

Who doesn’t want a pristine lawn free of annoying weeds and bugs? But some of those pest-fighting strategies may come with a price — to your health.

A new study published in the journal Neurology, found that pesticides, which have already been linked to a range of health complications from allergies to lower IQ levels, may also play a role in the development of Parkinson’s.

Parkinson’s is a neurological disease in which motor nerves in the brain lose their ability to function, leading to uncontrolled movements, tremors and difficulty walking and speaking. While genes play some role in the condition, more research is connecting lifestyle and environmental factors to a higher risk of disease.

In the latest review, the researchers reviewed 104 studies that analyzed exposure to pesticides and solvents that kill weeds, fungus, rodents and bug,s, and the risk of Parkinson’s disease. The trials measured things such as whether the participants lived in close proximity to farms or other agricultural plots that use a higher volume of such chemicals, the likelihood of well water consumption, rural living and various occupations that put an individual at a greater or lower risk of exposure.

They found that exposure to bug and weed killers and solvents was linked to a 33% to 80% greater risk of developing Parkinson’s disease. In some studies, individuals who came in contact with the weed killer paraquat or the fungicides maneb and mancozeb were twice as likely to develop Parkinson’s.

Unfortunately, the trials did not all address how the participants were exposed, so the scientists could not determine if certain routes, such as inhaling the chemicals, was more dangerous than absorbing them through the skin. The investigation did conclude, however, that risk appears to increase the longer people are exposed. But more studies are needed to figure out whether there is a threshold for when the chemicals become most harmful to the brain.

The scientists also acknowledge that some of the data is conflicting; while the studies they analyzed showed a strong association between solvents and well water and a higher risk of Parkinson’s, the same elevated risk didn’t appear for insecticides.

Despite that, the results add to growing research about how exposure to environmental factors may play a role in diseases such as Parkinson’s. “I think the study is actually a big advance in our research knowledge of the relation between chemical exposures and the basic neurological injuries,” Dr. Arch Carson of the University of Texas School of Public Health in Houston told MedPage Today. “This report is the first to show that there is a positive relationship between not only insecticides and herbicides but also some other solvent chemicals to which many people are exposed and the development of Parkinson’s syndrome.”

Uncovering and understanding these links could not only help to prevent some cases of disease, but also lead to more targeted ways of intervening with effective treatments.

Article source: http://healthland.time.com/2013/05/28/study-links-exposure-to-bug-and-weed-killers-and-higher-risk-for-parkinsons/

Drummer Lee Rigby died from multiple stab wounds after being attacked outside Woolwich barracks last Wednesday – AP

The brutal killing of Drummer Lee Rigby on the streets of Woolwich has raised serious questions about the safety of our soldiers at home, and how such violence could affect their recovery from the psychological toll of war. Rigby served in Afghanistan in 2009.

On tour, soldiers face repeated exposure to death and trauma. Their return home is supposed to offer safety and a time to recuperate from the stressful nature of their tours. Events like Rigby’s murder could shatter that sense of safety for some.

Post-traumatic stress disorder (PTSD) is a severe reaction that some people develop after being attacked or sexually assaulted, for example, or witnessing such events.

While most soldiers return home without showing psychological problems, current research shows that up to 18% may show signs of a psychological problem and almost 3% will show signs of PTSD.

So of the 9,500 British soldiers who have been deployed to Afghanistan, almost 285 are likely to suffer from PTSD and up to 1,700 may suffer from another psychological health problem, such as depression.

They will re-live terrifying memories of their duties. They may question decisions they made, feel strong emotions such as anger, guilt and shame, and feel hyper-alert and aroused, have difficulty winding down and relaxing and may feel as though they are constantly full of adrenalin.

Helping soldiers re-adjust is a priority. If soldiers face danger at home, their risk of re-adjusting and re-integrating with their families diminishes and we are faced with a potentially increasing incidence of PTSD as well as problems in helping them to overcome this debilitating problem.

The current treatments recommended for PTSD by the National Institute for Clinical Health and Excellence work best when the people seeking treatment are experiencing safety: when there is no longer ongoing threat in their home environment.

Trauma-focused cognitive behavioural therapy, the primary treatment of choice for PTSD, requires that people with PTSD do not have ongoing threat in their environment when they come for treatment.

So violence at home adds another stressful dimension for returning soldiers. Simon Wessely’s group at King’s College London found that stressful events at home, such as the death or serious illness of a relative, problems with children or serious financial problems, were linked to PTSD and other psychological problems in soldiers who had returned from Afghanistan.

Research I conducted at King’s College London found that problems with memory, such as the ability to remember a list of words, affected how well people with PTSD responded to cognitive behavioural therapy.

Violence risks serious injury and head trauma, which undoubtedly affects memory functioning and the ability to respond to effective psychological interventions.

For all these reasons, it is imperative that we prioritise the safety of our soldiers when they return home. Soldiers need to know that they are no longer on the battlefield when they leave places like Afghanistan.

There is nothing to be done now to bring Lee Rigby back, but public support in the face of violence will help our soldiers feel safe. This in turn will ensure they are being helped to maintain their mental health.

Editor’s note: This article originally stated that 2,850 soldiers deployed to Afghanistan were statistically likely to suffer from PTSD. This was incorrect, and has been amended to 285.

Follow us: @MailOnline on Twitter | DailyMail on Facebook

Article source: http://theconversation.com/making-soldiers-safe-at-home-is-essential-for-mental-health-14655

The results were presented at the annual meeting of the American Psychiatric Association and represent growing excitement about ketamine’s potential. The study included 72 patients who had previously failed to respond to at least two other medications. After receiving a single intravenous (IV) dose of ketamine, 64% of patients reported fewer depression symptoms within one day compared to 28% of those given midazolam — an anesthetic drug that was used as a control.

“[This research] reports the largest controlled evaluation of the antidepressant effects of ketamine to date,” says Dr. John Krystal, professor of psychiatry at Yale, who published the first study in 2000 suggesting that ketamine could quickly lift depression, but was not associated with this trial.

Antidepressants typically take weeks to improve mood — and that’s a time when people with the disorder are at an especially high risk of suicide. “Among people who respond to antidepressants, it takes on average 7 weeks to produce this response,” Krystal says, “When simply getting through a single day can be difficult, waiting 7 weeks to get better can be daunting.” Ketamine— and similar drugs currently being tested by pharmaceutical companies could help relieve suffering faster and potentially reduce the suicide risk associated with the mood disorder.

And because the doses used were lower than those taken by clubbers or used in anesthesia, most patients didn’t have the extreme experiences of “out of body” sensations or profoundly distorted perceptions of reality.  “Nobody freaked out,” says Murrough, adding that most described the experience of the infusion as being similar to having had a few drinks. About 10%, however, did have some dissociative effects.  “One patient [reported] wondering whether time still existed during the infusion,” he says.

The results are especially noteworthy because ketamine was compared to another anesthetic with similar psychoactive effects, not just a placebo. Such comparisons are important because drugs that result in highly noticeable responses like sedation also tend to have strong placebo effects. Researchers had argued that without such a comparison, it would be difficult to tell whether ketamine was actually relieving depression.

“This design was elegant because midazolam briefly made patients feel better, but did not produce a real antidepressant effect,” Krystal says, “In contrast, ketamine produced the robust antidepressant effects that have been observed in every study of ketamine since our initial preliminary observations.  This is the first direct evidence that the antidepressant effects of ketamine are specific, increasing our confidence in importance of this clinical observations.”

Since the study has not been published, however, the results have not yet been subject to peer review. But Krystal and others are encouraged by the apparently lasting effects of the drug; the study showed that seven days after the infusion, 46% of those who received ketamine were still experiencing significant relief— compared to just 18% of those who received the midazolam.

The findings also follow about half a dozen smaller trials that tested the drug for depression or bipolar disorder. Murrough and his colleagues also published a study last year in Biological Psychiatry that could pave the way for broader use of the drug. In that analysis, his team examined whether ketamine could be used repeatedly for longer term results, perhaps as a replacement for, or addition to, electroconvulsive therapy (ECT). In that study, 24 patients with treatment-resistant depression who were not taking any other medications received several daily doses of ketamine; after 12 days, 71% of the patients showed a 50% reduction in depression symptoms, with relief typically coming within 2 hours of the treatment.  On average, the patients who responded remained well for 18 days following the last infusion.

But because ketamine distorts consciousness, it likely would not be practical as a daily medication, as Prozac is currently used. In cases of profoundly disabling depression, however, it might be helpful if given several days a week, the way ECT is now prescribed.  While ECT is the best existing treatment for cases of depression that do not respond to medication and therapy, the stimulation can interfere with memory and it requires general anesthesia. Murrough envisions ketamine could be administered in conjunction with talk therapy and in combination with other medications to try to maintain recovery.

In fact, since ketamine is already FDA-approved, some clinicians have started to offer infusions to their patients, but that’s not a practice that Murrough condones. “There are physicians carrying out this procedure in nearly every major American city,” Krystal notes, “[But] I think that ketamine infusion is still an experimental procedure.”

Indeed, Krystal’s colleagues recently reported some significant negative side effects in his trial of using ketamine to treat obsessive-compulsive disorder (OCD). Two of three participants who had OCD, who did not have current depression but had suffered from it in the past, developed new symptoms the day after ketamine treatment, which included suicidal thoughts, anxiety and severe distress.

The researchers agree that while promising, ketamine-based therapy is probably still best conducted in an experimental setting— but that any clinicians who use it outside of research must, at the very minimum, carefully monitor patients. Krystal is planning to urge the National Institute on Mental Health to collect more data on all patients currently being treated for mental illness with ketamine. “The largest study of repeated ketamine administration ever published has only 24 patients in it,” he says, “This is an extremely thin and somewhat risky evidence-base to launch a national treatment program.”

With more data, however, researchers may become more confident in how best— and safely— to use the drug. And the latest study is an important first step toward that goal. “It seems that a new antidepressant approach has been identified that may expand the scope of effective antidepressant treatment,” Krystal says, “We look forward to larger and more definitive clinical trials that will help to determine whether more patients will be effectively treated through this mechanism and whether the possibility of rapid improvements in depression substantially reduces the burden of this disease.”

Article source: http://healthland.time.com/2013/05/22/club-drug-ketamine-lifts-depression-in-hours/

Minister for Mental Health Mark Butler said the $247 million in Federal Government funding would allow Headspace to broaden its service to deliver nine early psychosis youth services across Australia to support young people with more complex mental illnesses.

“Initially, four ‘hubs’ will be established, building to nine over a three year period, with at least one located in each state and territory. The initial four sites will be located in: western Sydney; south-east Melbourne; western Adelaide; and north-east Perth, with two to be up and running by July 1.

“These sites will act as service ‘hubs’ and will be a key element of Headspace’s growing network across Australia,” Butler said.

Butler said State and Territory Governments would be important to the delivery of the EPPIC initiative and he would continue to work with the all jurisdictions on how they could contribute.

“If State and Territory Governments are able to commit their own resources, this initiative can be scaled up in their jurisdictions,” he said.

The sites will deliver the services based on the EPPIC model of care which has been championed by the 2010 Australian of the Year, Professor Patrick McGorry.

Professor McGorry said the decision to channel early psychosis care through the national Headspace platform was a welcomed breakthrough in mental health reform.

“It will allow young Australians with early psychosis in every state and territory to access expert 21st century care for the first time,” he said.
“Young people and their families will now be able to access specialist care for early psychosis in optimistic stigma-free environments and in a more holistic evidence informed and comprehensive way.

“This strategic partnership between EPPIC and Headspace represents a significant stage in building a national system of youth mental health care and realising the potential of young Australians to flourish and contribute.”

The model includes: 24 hour home based care and assessment; community education and awareness programs; easy access to acute and sub-acute services; continuing care case management; mobile outreach; medical and psychological interventions; functional recovery, group, family and peer support programs; workforce development; and youth participation.

Headspace CEO Chris Tanti said the announcement would see a “once-in-a-generation change” in the way young people with serious, but less common, mental health issues were supported in our community.

“Headspace has been providing mental health support in a youth friendly environment since 2006. Young people trust Headspace and recognise it as an accessible and safe place to get help for their problems.

Article source: http://www.probonoaustralia.com.au/news/2013/05/mental-health-gets-final-reform-funding

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ADHD has been linked to struggles with drugs and alcohol, less schooling and more arrests, but the latest study shows it may also contribute to problems with weight as well.

In the study published in Pediatrics, researchers connected the impulsive behavior that can characterize attention deficit-hyerpeactivity disorder (ADHD) with the over-eating that contributes to calorie-overload.

In the 33-year study that tracked boys with ADHD into adulthood, men who were hyperactive as children were twice as likely to have higher body-mass index (BMI) readings and rates of obesity than men who didn’t have the condition as children. Of men diagnosed with ADHD as kids, 41% were obese compared to 22% of men who didn’t have ADHD as children. The average rate of obesity for men in this age group was 24%.

The researchers say they did not set out to explore the relationship between ADHD and weight; the study was actually designed to investigate new insights into brain structures differences among people with ADHD. But in 2003, when researchers received a grant to perform brain MRI scans on the men to evaluate their psychiatric health, many of the study participants were too large to fit in the scanner. “One of these gentlemen really wanted to help out, but we had to squeeze him in, inch by inch,” says Dr. Francisco Xavier Castellanos, the study’s senior author and a professor of child and adolescent psychiatry at New York University’s Langone Medical Center.

For practical reasons, the scientists began asking the men for height and weight measurements to see if they would fit inside the MRI machine, which has a diameter of about 2 feet. They found that nearly three times as many men from the childhood hyperactivity group couldn’t fit in the scanner — 17 men compared to six who did not have the disorder. Intrigued, they decided to systematically collect data on the men’s weight.

“There had been suggestions in the past that ADHD might be related to obesity,” says Castellanos. “There were a lot of checks to make sure this was not due to other conditions. We were able to confirm that this risk seemed really related to childhood diagnosis of ADHD.”

The study controlled for factors including depression, anxiety, drug and alcohol abuse, along with education and socioeconomic status, all of which have also been associated in other studies with obesity. But even though the childhood ADHD group had a median income that was $50,000 lower than that of the men in the control group, this economic factor did not appear to be driving the association between ADHD and obesity.

It’s not entirely clear why the disorder, which can make focusing and concentrating on tasks more difficult, would lead men with the disorder to weigh so much more than their peers. But the researchers suspect that impulsivity and poor decision-making skills played a role. “We live in a society with super-sized amounts of food,” says Castellanos. “If someone has less than the average amount of self-control because of the ADHD, they are less able to withstand the temptations of food.”

The results suggest that among the other behavioral issues that children with ADHD may face, including problems with drugs and alcohol, maintaining a healthy weight might be an additional concern, since obesity is associated with a host of other chronic conditions such as diabetes and heart disease. Keeping calories in check can be a challenge for even the most determined person, but these findings hint that weight might be a particularly frustrating struggle for those with ADHD.

Article source: http://healthland.time.com/2013/05/20/adhd-may-prime-boys-for-obesity/

Although the prevalence, early onset and effect on society make childhood mental problems a major public health issue, only 21 percent of affected children get treatment because of a shortage of pediatric sub-specialists and child and adolescent psychiatrists, according to the American Academy of Child Adolescent Psychiatry.

“Our current health care system does not meet the needs of these children,” Martin J. Drell, the group’s president, said last week in a statement about the problem.

Making matters worse, fewer medical students are opting for careers in children’s mental health, while the current crop of professionals is aging out of the workforce. The dearth of providers means troubled youngsters in underserved rural and urban areas are less likely to get timely care.

“Children with serious medical conditions should not have where they live determine what kind of health care services they receive,” said Thomas K. McInerny, president of the American Academy of Pediatrics.

The CDC report, “Mental Health Surveillance Among Children,” summarizes federal data and research from 2005 through 2011 to provide the agency’s first comprehensive snapshot of the nation’s emotionally troubled youths.

One recent study found that from 1997 to 2010, the rate of hospital stays among children for mood disorders increased from 10 to 17 admissions per 10,000 people.

Another study, which analyzed insurance claims, found a 24 percent increase in inpatient mental health and substance abuse admissions for children from 2007 to 2010. The report also found that the use of psychotropic drugs by teens had increased over the same period.

Greater awareness of mental health issues by doctors and parents, increased poverty stemming from the Great Recession and possible environmental factors could be playing a part in the increases, said Ruth Perou, child development studies team leader at the CDC.

The report arrived one week after National Children’s Mental Health Awareness Day on May 9 and as President Obama prepares to host a June 3 mental health summit at the White House in response to recent efforts to halt gun violence.

The report found that suicide was more prevalent among boys than girls and among non-
Hispanic whites and non-
Hispanics of other races than it was among non-Hispanic blacks and Hispanic children.

Among children who died by suicide, the report found that nearly 30 percent made their intent known before the act and that 35.5 percent had a diagnosed mental disorder when they died. More than one in four childhood suicide victims were being treated for a mental disorder when they died, and 21 percent had made a previous suicide attempt.

Attention-deficit hyperactivity disorder was the most commonly diagnosed problem reported by parents. It affects about 7 percent of children ages 3 to 17, or about 4.2 million, Perou said. About 2.2 million children in that age group — about 3.5 percent — have behavioral or conduct problems, while nearly 2 million, or 3 percent, have anxiety issues, she said.

An additional 1.2 million children ages 3 to 17, or about 2.1 percent, suffer from depression, while 678,000, or just over 1.1 percent, suffer from autism, she said. Tourette’s syndrome affects 99,000, about two-tenths of 1 percent of children in this age group.

An estimated 40 percent of children diagnosed with one disorder have multiple mental health disorders, some of which can be linked to childhood criminal behavior, substance abuse and other risky behaviors. Among adolescents ages 12 through 17, nearly 5 percent, or 1.2 million, battle an illicit-drug-use disorder, Perou said.

About 1 million, or 4.2 percent, deal with alcohol abuse disorder, and 691,000, or 2.8 percent of adolescents, have cigarette dependence, she said.

— McClatchy-Tribune

Article source: http://www.washingtonpost.com/politics/cdc-says-20-percent-of-us-children-have-mental-health-disorders/2013/05/19/8c316b42-c0b3-11e2-8bd8-2788030e6b44_story.html

Released Thursday, the report represents the government’s first comprehensive look at mental disorders in children. It focuses on diagnoses in six areas: attention-deficit/hyperactivity disorder (ADHD), behavioral or

The most common mental disorder among children aged 3 through 17 is ADHD. Nearly 7 percent—about one in 15 children—in that age group have a current diagnosis, according to the report from the U.S. Centers for Disease Control and Prevention.

For other disorders, 3.5 percent of children currently have behavioral or conduct problems, 3 percent suffer from anxiety, about 2 percent have depression and about 1 percent have autism. About two children out of 1,000 aged 6 to 17 have Tourette Syndrome.

Among teens, about 5 percent had abused or were dependent on illegal drugs within the past year. More than 4 percent were abusers of alcohol, and nearly 3 percent reported being regular cigarette smokers.

The report, which supplements the May 17 issue of the CDC’s Morbidity and Mortality Weekly Report, also noted gender differences in mental disorders.

“Boys are more likely than girls to have most of the disorders overall,” said Ruth Perou, the team leader for child development studies at the CDC.

Boys specifically are more prone to ADHD, behavioral or conduct problems, autism spectrum disorders, anxiety and Tourette syndrome, and are more likely to be smokers than girls, Perou said. They’re also more likely to die by suicide.

“On the other hand, girls are more likely to have depression or an alcohol-use disorder,” she said.

Although this is the first time the CDC has tried to compile prevalence estimates for some of the most common mental disorders in a single report, the agency has long tracked rates of many of these illnesses through population surveys.

“We are seeing increases across the board in a lot of mental disorders,” Perou said. Some of the biggest jumps have been in ADHD and autism. “We don’t know if it’s due to greater awareness, or if these conditions actually are going up,” she said.

Perou said that is a question they will try to answer as they continue to track children’s mental disorders going forward.

“The good news is that mental disorders are diagnosable and treatable,” she said. “If we act early, we can really make a huge difference in children’s live and in families’ lives overall.”

More information: To find out more about children’s mental health, head to the U.S. National Institute for Mental Health.

Journal reference:

Morbidity and Mortality Weekly Report

Health News Copyright © 2013 HealthDay. All rights reserved.

Article source: http://medicalxpress.com/news/2013-05-kids-mental-health-disorder-cdc.html

What most concerns you about the way we work with autistic children today?

I’m really concerned about getting people on the higher end of the spectrum good jobs. Autism is a very diverse disorder ranging from someone who remains nonverbal with a very severe handicap to mild autism. And really, half the people in Silicon Valley have got some mild autism.

But I’m seeing too many kids today that are really talented and on the high end of the spectrum kind of going nowhere because their skills haven’t been developed. They haven’t learned how to work. When I was 13, I had a sewing job and when I was 15, I cleaned horse stalls.

Do you think the label of autism is hurting these kids, making them feel they are limited in a way that someone without the diagnosis might not be?

I think sometimes parents and teachers fail to stretch kids. My mother had a very good sense of how to stretch me just slightly outside my comfort zone. No surprises. You can’t chuck them in the deep end of the pool, that doesn’t work but she kind of just knew, you know, to get me to do things, like serve hors d’oeuvres at my mother’s parties and just bow and shake hands with the guests.

You write a bit about the controversy over how to define autism and how it has changed over the years in psychiatry’s diagnostic book, the DSM.

It’s not like having a diagnosis for tuberculosis. In fact, when I worked on the [part of the book about the] history of the DSM and I saw how it was laid out, how it changed over the years, it’s really pretty shocking. It’s probably half-based in science and half-based in doctors sitting around a conference room table in a hotel squabbling.

Do you think there is more autism now than there used to be or are we just better at recognizing it?

I think on the mild end of the spectrum most of it’s increased detection because I’ve worked with so many folks my age that I know are on the spectrum that are undiagnosed. And I think there’s some mental retardation—what used to be labeled mental retardation— that has gotten labeled autism. But I think there’s some actual severe autism that actually has increased.

Sensory issues, like being disturbed by sudden, loud noises or itchy clothing are a big part of your experience as an autistic person. Why do you think sensory issues have not received as much study as other aspects of autism?

I think that’s extremely important. They’re all extremely variable from nuisances to being completely debilitating and they can affect all levels of the spectrum. One kid will have a sensitivity problem with the flicker of fluorescent lights and you can get that problem in some dyslexics, [and in] some [with] ADHD, or a kid might have a problem with loud noise like in the cafeteria, or he might have problems with scratchy clothes. It’s extremely variable.

Do you think sensory issues are at the root of what makes autistic people different?

I think the core criterion is the social awkwardness, but the sensory issues are a serious problem in many, many cases of autism and they make it impossible to operate in the environment where you’re supposed to be social. How can you be social if you can’t tolerate those five TVs that are in that bar?

Are the social problems a consequence of kids tuning out very early on because they are overwhelmed?

That might contribute to it [and] I think my top priority for research is sensory. We need to find some good treatments.

What helps you to cope?

My problems are sort of more on a nuisance level. I can’t stand scratchy clothes, I’ve got to have soft kinds of cotton against my skin and I don’t know why some 100% cotton t-shirts itch and others don’t, it has something to do with the weave. I make sure I wash all the underwear that goes against my skin before I wear it, however I wear it inside out.

And then on noise sensitivity, one of the best ways to try and desensitize that is to have a child initiate the sound. Like one of the bad ones is the buzzer on the scoreboard in the gym so have a child go in the gym and turn it on, maybe with headphones on first, then gradually take the headphones off and he initiates the sound — that helps. Start the sound really faint[ly] and then gradually make it louder. That’s another thing you can do.

Tell me about what it’s like to be a visual thinker.

My mind sort of works like a search engine. You ask me something and I start seeing pictures. Why don’t you ask me a key word, something that’s not in the hotel room and not something common like house or car and I’ll tell you how my mind accesses the information?

How about a thermometer?

I’m seeing a big thermometer that we had outside our window of my childhood house. I’m seeing a thermometer that a poster has been painted to show how much money has been given to United Way. Now that’s got me off the subject of thermometers and now I’m thinking about charities and each one of those things is coming up as a picture.

You had your brain scanned, which must be a pretty scary and difficult experience.

I’ve been in scanners a whole bunch of times and they do give you earplugs since it’s quite noisy, but getting the pictures is just really fascinating.

The scan done out in Utah showed that in the parietal area of my brain, [much of it has been taken over by a large fluid filled cavity], my math department’s full of cerebral spinal fluid. That would account for [my] being bad in math. Then I also have some huge gigantic visual circuits. That would explain my visual thinking.

Of course, that I really found fascinating. The fusiform gyrus, the circuits involved with face recognition — those [were] abnormal and then another finding was that my amygdala, the fear center, was much larger than normal and that probably explains why I was so anxious and had so many panic attacks, although now I control them with anti-depressants.

You have often pointed out the strengths of the autistic mind, while many people focus only on deficits.

There definitely are some strengths. You see, there’s a point where mild autism is just a personality variation. There’s no black and white dividing line between autism and non-autism from the mild end of the spectrum. And some people on the mild end of the spectrum have extreme talent areas in things like computer programming, mathematics, art, design, graphics, writing skills, and I’m a big believer on building on the child’s strengths.

Do you think if people try to get rid of “autistic genes” those talents would be lost?

You’ve got to think about it. Who do you think made the first stone spear? It certainly wasn’t the social yakkity yaks around the campfire and you wouldn’t even have a recording device to record this conversation on if there wasn’t somebody mildly on the autism spectrum that invented it.

Article source: http://healthland.time.com/2013/05/16/qa-temple-grandin-on-the-autistic-brain/