Expert: Catherine Ridenour - 3/15/2008

Question
My daughter is 17 years old. As a young child she seemed painfully shy. In preschool she would clench to my leg and cry when dropping her off. This lasted for the first month and a half. I just figured she was shy. The teacher said my daughter would not socialize with the other children and preferred to play alone. She also just thought my daughter was shy as she didn't show any developmental difficulties. She was very smart. My daughter was in a private Christian School until the 6th grade. She never did make any real friends even though all the kids in her class were the same kids that started with her in preschool. After I realized that this school would not confront any behavior or learning difficulty problems I decided to take her out and put her in public school. I held her back in 6th grade because I felt she was VERY immature for her age and the only thing she had difficulty in was math. She is now in 10th grade and is still very immature. She still calls me mommy. She freaks out if anything is not in her normal routine. She does everything in a certain order. Until just a few months ago she would not leave my side in the store for fear she would get lost. She doesn't comprehend simple instructions. I thought maybe because she was too sheltered as a child in a small school, But my son is doing fine(he is 15). I had asked the school if they thought maybe a learning disability, but she makes straight A's & B's. She still wants toys (stuffed animals and trinkets) for Christmas. When she is angry she throws temper tantrums and makes this growling noise. She hardly ever smiles unless you make her laugh or she is happy about getting something. Always has had a mean look on her face since she was a baby. Doesn't show affection or real emotions. When she does speak, her language is a bit choppy almost like a 9 or ten year old would speak. There are a lot of other things I find unusual, but I know this is already very long. I really don't now where to go for help. Everyone at the school seems to think she is just shy because she does very well in school and is quiet.

Answer
Hi Carol,

I would say you are looking at a young woman with undiagnosed high-functioning autism (HFA)or Asperger's syndrome (AS).

Getting lost easily is common for people with these disorders. They have difficulty orienting themselves in space. Every new place has to be learned by rote. I'm betting she has trouble riding a bicycle too, yes? Be warned, learning to drive will be a challenge as well. She will be able to do it but I would wait until she's about 20.

Emotional delay is one of the hallmarks of either condition. She truly is emotionally younger than her body. Many people with AS continue to mature, emotionally, they are just 3-5 years behind. By the time she was 20, my daughter was emotionally about 16.

Most AS and HFA people have difficulty feeling any emotion until it reaches great intensity. So they seem to go from peaceful to furious in a half second. She needs to be directly taught to recognize the sensations in her body that precede a meltdown. Talk about the tight stomach, clenched fists, hot face and other sensations that should tell her she is becoming angry. Teach her a technique to diffuse the anger before the outburst. Some people count to 10, some do deep breathing, some simply verbalize the feelings, "I am becoming angry because I am frustrated with this puzzle."

I want to recommend a book to you about helping her find a career path. "Developing Talents: Careers for Individuals with Asperger Syndrome and High-Functioning Autism" by Temple Grandin, Kate Duffy, and Tony Attwood .  Whether she receives a diagnosis or not, she will confront many difficulties in the work world because of it.

Don't hesitate to send her to a nearby college if she wants to go. Many HFA and AS individuals thrive in the academic world. They are able to specialize in their field of interest and the academic demands are usually very clearly defined. She will meet more people like herself there than she ever met in public school. It will also give her more time to mature before tackling a career. Also read the book "Ask and Tell" edited by Stephen Shore about when/how to reveal one's diagnosis to colleges and/or employers.

I think some speech therapy would be helpful simply because it would be nice for her to sound as intelligent as she truly is. It is unfortunate how quickly we pigeonhole someone who has strange speech patterns as "not smart."

I hope this has been helpful. Check out these web sites for more information:

http://www.neurodiversity.com/main.html (many links to books, articles and resources)

http://www.patientcenters.com/autism/news/resources.html (books and resources)

http://www.ninds.nih.gov/disorders/asperger/asperger.htm (the definitions and
government links)

http://www.autism.org/ (many links to information)

Best wishes,
Catherine