Expert: Trey McGowan - 4/7/2008

Question
My son is 18 and has recently dropped out of school due to severe concentration difficulties.  He says his mind constantly replays images, conversations etc non-stop without his ability to control them.  We are beginning to consider that he has some form of autism/asperger's/pdd-nos due to his eccentric ways and incredibly poor social skills.  He fits many of the symptoms which have been there since toddler age - poor coordination, obsessive and very limited interests, lack of interactivity but with a very high IQ.  He is currently under the care of a psychiatric health unit but has been treated unsuccessfully for anxiety, schitzophrenia and lately OCD.  His main concern is the concentration issue.  I did read an article recently that many PDD people think visually (which he does) and true thinking ability may not fully develop until late adolescence thus bringing about uncontrollable thinking etc.  What do you think?

Answer
Hi there, Graeme!

Manic episodes are not an uncommon symptom of Asperger's Syndrome and other ASDs, and those bring with them the infamous 'racing thoughts', which you are describing pretty much to a 'T' here. As you mentioned (or rather, as your son did) it can be extremely difficult to concentrate when they are going on.

I have not actually looked into the development of 'visual thinking', so I can't exactly be sure on just how it runs with ASD as opposed to the 'normal' trains of thought. I do, however, know that my actual mode of thinking, I.E. in a lot of pictures and sensations, has not really changed through my life, so the 'visual thinking' is very accurate in my case (and no doubt for others). However, you say that 'true thinking' doesn't develop. What exactly is meant in this case by 'true thinking'? It makes it sound as if everyone has the same method of thinking. Which, to be quite honest, I disagree with. Even neurotypical people can tell you that they think of things in a lot of different ways: visually, sense-based, impressions, words, numbers, black-and-white or color... I think that the actual mode of thinking tends to be in a general pattern, but that the words 'true thinking' don't apply so much because there is no 'normalized' mode of thought.

The best way to treat the concentration issues would be to treat it as if he is ADHD. That's not to say that he needs to be on medication (although they have sometimes shown success rates), but that if he *is* Asperger's and undiagnosed, the pair express themselves in extremely similar ways, and indeed may be related or interconnected. Because of this, treatment and methods for ADHD can be helpful for those with Asperger's. As a matter of fact, my doctor suggested that I try low doses of caffeine (AKA cups of coffee) to help with my focusing skills, and while it might be psychosomatic, it did indeed seem to help. I am not a doctor, and I would not dare prescribe anything (even harmless substances), but I *can* at least suggest that 'what could a cup hurt?'. Although obviously, don't have them drunk too close to bedtime. Sleeping issues are another common problem with ASDs, and so why potentially make them worse?

If he is showing a lot of signs, many autism groups have information pertaining to Adult Autism. It may well be that you can find one of them locally to do an evaluation, and if this is part of the issue with your son, get some special education aid to get him his GED at the very least. There are a lot of jobs out there that suit autistic individuals, and getting the education necessary for them will help him continue in life. Not to mention getting the diagnosis will hopefully help get some life skills that might be necessary to keep going with it all!

I wish you both the best. Questions, comments, follow-ups, whatever, can be sent here! I'm about!

Trey