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SPECIAL REPORT: AUTISM

Although Autism, Asperger's Run in Families, Therapy Makes a Difference

March 12, 2001|ROSIE MESTEL | TIMES MEDICAL WRITER

It's not unusual for a parent of a child newly diagnosed with autism to recall a strange uncle who always lived alone, was painfully awkward with people and had an obsessive interest in bicycles.

Or, for that matter, for that parent to look sideways at his or her spouse with sudden recognition. The lack of eye contact. The rigid need for routine. An all-consuming hobby. That hatred of social gatherings. They are all traits of autism and Asperger's, a milder form of the condition.

Scientists now know that autism and Asperger's syndrome run in families.

Today, awareness about autism is so high that a child with the condition is likely to get diagnosed, sooner or later. That wasn't the case in earlier decades--especially for those on the milder end of the spectrum. And though it may seem useless to get a label such as "mild autism" in adulthood, it can also be helpful.

Understanding that one, or one's spouse, has a mild kind of autism can lead to finding ways to deal with conflicts common in such marriages, says Tony Attwood, a clinical psychologist in Queensland, Australia. Such conflicts arise, for instance, because people with autism have great difficulty understanding the nuances of social communication--nods, smiles and tone of voice.

Therapy can help--but people with autism and Asperger's are far more likely to benefit from cognitive behavior therapy than from generic "tell me about your feelings" therapy, says Attwood. Cognitive behavior therapy helps people reexamine their attitudes and build new skills for coping.

"The therapy that says 'how do you feel about . . .?' falls flat on our ears," says Liane Holliday Willey, author of a book about Asperger's, "Pretending to Be Normal." Willey and her daughter both have Asperger's syndrome. "We use logic and intellect to find solutions," she says.

There are support groups for people with Asperger's and their spouses. In L.A., a dozen or so people with Asperger's and high-functioning autism--members of a support group called Adults Gathering, United and Autistic--meet regularly to talk about the strain associated with being different in this highly social world.

Spouses of people with Asperger's can also glean support from one another through a group set up by Cape Cod resident Karen Rodman, whose husband has Asperger's syndrome: Families of Adults Afflicted with Asperger's Syndrome, P.O. Box 514, Centerville, MA 02632, http://www.faaas.org. Dealing with Asperger's in a marriage can be terribly difficult, Rodman says.

Many people with Asperger's syndrome do not marry, but of those who do, Attwood sees two patterns that seem more successful.

"One is: They choose someone who's very similar. They're both entomologists. They met at university. And their view of a good time is going to Africa looking at beetles." In other words, the marriage works because the kind of interest that can consume a person with Asperger's is shared by the partner.

"Or sometimes," says Attwood, "they take a partner--usually it's the wife--who is very, very socially skilled. And she scripts her spouse in many ways--'When your aunt comes to dinner, don't tell the joke about the priest and the prostitute because she's a Catholic'--acts, in other words, as a counterbalance to his social difficulties."

For instance, "Jill" (an Altadena resident who prefers that her real name not be used) helps her engineer husband "Pete" with such social scripts--reminding him over the phone, for example, to praise his younger daughter for an achievement in school.

And--pragmatically--she writes her husband lists of the things she needs to make her happy. "I've told him I need things. I need you to go walking with me sometimes. To hold my hand sometimes. To read books with me sometimes. To look at the mountains and go, 'Ooh, aren't they pretty.' And he does it."

They've devised ways for Pete to keep close to each of his daughters. With the oldest, he goes to movies. With the youngest, he does soccer. With the middle girl, though, nothing needs manufacturing: "Ann" has Asperger's too. They both love computers, and whatever they do just seems to happen, says Jill.

One day, Jill, Pete and Ann went for a walk, and Pete--remembering his script--stopped and exclaimed at the beauty of the moon. Ann turned to her dad and asked him what on earth he was saying, why on earth would he say something like that.

"I don't get it either," whispered Pete, "but it works."

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