Expert: Catherine Ridenour - 8/30/2007

Question
i have a 20 year old cousin that i think might have autism.. she used to have all the common symptoms for autism as a child..such as not being able to communicate with others or wondering eyes... she lives in Iran and my aunt has taken her to many doctors and psychiatrists and nothing seems to work for her.. she goes to college and can be independent..but when it comes to socializing she can be abnormal..she often dreams about non-existing stories and tells them to others...she lies about many things just to get anyone's attention..she's not capable of making friends and keeping them because of the abnormal things she says or does...if she gets mad at someone she doesn't care who would be around she will say or do inappropriate things...my aunt is trying and has tried everything out there but there seems noting there to be able to help her...she still has sign like not being able to look in  person eyes while talking or echoing her own words and phrases..
my question to you is that does she really have autism and if she does how do U think she could be treated..she lives in Iran Tehran..but aunt would probably take her anywhere to treat it?

Answer
Hello Samira,

First, let me apologize for not knowing anything about the state of medical care in Iran or the resources available to someone with a disability like autism. I will be able to tell you about autism but not about where to get help in her country.

There are no cures for autism. Some medications can help some people. Recently, Risperdal has been approved for autism. However, it can have some significant side effects. Those who have attention deficit disorder benefit from medication for that and those with severe anxiety often take anti-depressants or anti-anxiety medications.

It sounds like your cousin has high-functioning autism or Asperger's syndrome. Both of these conditions affect a person's ability to function socially. I use the analogy that these people are socially deaf. They do not hear tone of voice, understand body language or facial expressions or catch on to the many non-verbal cues we all send each other during communication. Just like someone who is deaf, they can learn some of the words by direct teaching but they will never "speak the language" like someone who can hear it normally. Just as we do not expect a deaf person to hear us or speak normally, we have to accept that the autistic will never function like the rest of us, socially. We have to adapt.

Hopefully, she is specializing in her strongest abilities at college. For many, art, music, computers or math, are places where they excel. She should continue to get an education as it is her key to living as normally as possible.

However, everyone should realize that her social function will always be different. It is unlikely she would have success in marriage. I know the culture expects most women to fulfill this traditional role. But, it would be unwise to put her in that situation.

Most treatment for autism is focused on helping children learn the rules of social interaction. As she is now an adult, most of the treatment would no longer be appropriate.

People with HFA or AS learn well, they just don't generalize. The "right thing to do" in one situation does not transfer to another when the circumstances are different. They have to learn it all over again. Over time, they can build up a set of behaviors that work most of the time, but any new situation will cause them to revert to autistic behavior. Again, the people around her need to understand this and be forgiving. She is not trying to be inappropriate she just can't be something she is not.

The last thing I think it would be helpful for everyone to know is that emotions tend to sneak up on people with autism. They don't know they are getting angry until they are so angry the lash out. Helping her recognise the feelings associated with getting frustrated and then methods to deal with it.

I hope this has been helpful.

Best wishes,
Catherine