Autism: A Different Face

You had a beautiful daughter who seemed like a normal toddler. You saw nothing different about her. She is your daughter and you love her unconditionally. The only thing you could think of is that her speech was delayed but this was quickly fixed by speech therapy and she learnt to read at a normal speed. She was confident and never had a fear of strangers, which put you in a lot of uncomfortable positions but also created ones which you laughed at. Despite this, when she got to school age, she always found it difficult to connect with her peers. It seemed wherever she went she would rub people up the wrong way by always taking a joke too far. Even when she wasn’t rude, her peers would find her weird. She didn’t have any interest in popular trends such as fidget spinners or fashionable clothes. This led to a lot of bullying. Despite this, she would always believe the best in people. You tried to explain to her that people aren’t always good but she couldn’t understand people’s ulterior motives. She got hurt a lot. To manage this, you tried to tell her to fit in, such as sitting still or having her hair a certain way but the bullying continued for a long time.

You’re very proud of your daughter now. She is incredibly studious and spends hours doing schoolwork. Sometimes it is difficult to distract her from the long list of things she has to do and can get distressed when she is unwillingly pulled away from it. The only thing that can distract her is music. She loves playing her trumpet and can get lost in practice for hours. She is naturally gifted at these things, but sometimes it doesn’t translate into other situations such as exams, but you don’t understand why.

Your also grateful for the social life your daughter has now. She has friends which she goes out with. However, when she has a falling out with her friends, it tends to be explosive and she has to move on to a new group of people. She also has some odd habits. For instance, while you’re in the car driving to drop her off somewhere, she talks to herself. You ask her what she is doing and she tells you she is rehearsing what is going to happen and what she is going to say. She can spend hours doing this. You ask her why and she tells you it helps relieve the anxiety around people. You remind her she doesn’t have to go but she wants to because she likes people, just sometimes she can get overwhelmed by having to read everyone’s moods. Her old characteristics remain of making inappropriate jokes, but her friends mostly laugh at these as they understand that this is just her and she doesn’t mean it.

However, there are definitely things that annoy you. Her fixation on the schoolwork means that other tasks are put to the side-line. Even with her fixation, she often struggles to organise the right books to take into school. This causes her to get even more anxious, as she has to follow school rules to the letter and cannot be punished under any circumstances. She struggles to clean her room or to do basic house chores such as washing up. This gets to the extent that she has a meltdown when asked to do it. You don’t understand why she struggles with such simple tasks. She also struggles with changes in the home. The last time you did some spring cleaning, you attempted to change the furniture in the kitchen and she started crying though she couldn’t explain why to you. You merely marked her as materialistic and moved on. You thought that having a tough stance on her would improve the situation, but this never seemed to make a difference. She also has little annoying habbits that come out, particularly while sitting at the dinner table such as jiggling her leg under the dinner table or coming out with random phrases. The most annoying one is when she quacks like duck for no obvious reason. You know she can control them so you don’t understand why she continues to do it, particularly when it infuriates you.

On top of this, your daughter got diagnosed with PTSD two years ago from the bullying she faced. You partially think she is being overemotional, but then you see how withdrawn she has become. You see your once happy child emotionally broken from what they used to say to her. She avoids things that remind her of the situation, the saddest one her abandonment of dance. You realise that how she saw it was different to how you saw it and that she honestly never meant to be a target. She spends most of her time in bed, particularly if she has had a long day at school which has led to her feeling overwhelmed. She doesn’t know how to deal with the sensory overload school provides her with. Often, she comes into your bedroom at night because she experiences thanatophobia. Nightmares also keep her awake, where she is helpless and cannot change the inevitable. You’re worried about her, particularly about her eating. She is a fussy eater any way, not wanting to eat spicy food or certain food combinations, but there are some days where she won’t eat at all because she is too stressed. The doctors have told you she is fine because she is a healthy weight, but she is clearly not fine. On top of this, she seems to pick scabs excessively. You know everyone picks scabs but this seems different. She has no control over how to stop. You don’t know what to do. Sending her back to therapy is an option but while it does help, it only works to a limited extent and for a short period of time. It agonises you not to know how to help. The doctors have already given her antidepressants, but there is nothing beyond that they can do.

You decide to take her back to the doctors, this time for a second opinion with a different doctor. The woman talks to both of you about her symptoms. She asks whether your daughter has been screened for autism. You are shocked and tell her that’s impossible; your daughter is too social to be autistic. Furthermore, she doesn’t have any special interests, is too creative and has never been aggressive to anyone in her life. She is eighteen, someone would have mentioned it before if she was! The doctor sighs. She says that autism can take different shapes in different people, some less understood than others.

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