Do autistic people have feelings

Autism - Disease or Character Trait?

When the sun is shining, John likes to stay in the room. It bothers him when everything glitters and reflects. It also bothers him if it's loud or if a stranger is sitting next to him on the bus. John is autistic. "He cannot write, cannot speak and cannot understand everything," says Monika Scheele-Knight, John's mother. "You could say he's like a one or two year old kid."

When John was three years old, doctors diagnosed him with early childhood autism. People with this form of autism hardly develop gestures and facial expressions and have problems understanding feelings. Many obsessively stick to the same, recurring rituals, to fixed paths or daily routines.

Rainer Döhle is also autistic. He was already an adult when he was diagnosed with Asperger's Syndrome - a form of autism that is not associated with speech or mental impairment. "But my testimony always said: He has no access to the class community," he says. "I just never understood how friendship works and was always happy when I was left alone and I could read." The diagnosis of "Asperger's Syndrome" was a great relief for him - finally there was an explanation for the difficulties in dealing with other people. Today Rainer Döhle sits on the board of Aspies e.V., the largest German self-help association for autistic people. He works as a translator and is an author at Wikipedia. "I'm gifted and have special interests in geography and history. Sometimes I spend hours writing lists about regents or capitals. But now I can use that constructively."

From gifted to mentally impaired

While some autistic people never learn to speak, others get noticed early on by their chosen language. Some are motorically inept, others draw for hours - there are the mentally impaired autistic people as well as those with the extraordinary number memory. However, they all usually always show the same, recurring behavior patterns and have similar difficulties in interacting with others.

While a few years ago it was thought that the different forms of autism were qualitatively different conditions, each with different causes, we now know from many studies that they differ more gradually.

"Autism is qualitatively nothing different than Asperger's Syndrome," explains Sven Bölte, head of the "Autism Spectrum Disorders" research group at the Karolinska Institute in Stockholm. "Both forms of autism tend to differ in the severity of their symptoms." Autism researchers therefore speak of autism spectrum disorders today, which they attribute to a different type of neurological development. What exactly is atypical in the development of the brain and nervous system in autistic people is unclear.

The British author and autistic Daniel Tammet holds the European record for reciting the number pi by heart with 22,514 digits

An extreme variant of the male brain?

From brain scans, for example, we know that autistic people show less activity in brain regions that are responsible for processing feelings and language or for remembering faces. Instead, there is more activity where objects are processed and details of a system are recognized.

The British autism researcher Simon Baron-Cohen therefore takes the view that autistic people have an extreme variant of the male brain. In a study, he measured the level of so-called prenatal testosterone in the amniotic fluid of pregnant women, which influences brain development. "When we examined the children after they were born, we found that the higher the level of prenatal testosterone, the more the children later showed autistic traits - and the more interested they were in systems."

In the film "Rain Man" Dustin Hoffman plays the autistic Raymond

The brains of autistic people also differ from typical brains by a different distribution of the docking points for the messenger substances dopamine and serotonin - which, among other things, play a role in controlling fear and motivation. Studies at the University of Freiburg show that communication between neurons in the brains of autistic people is impaired, and genes and genetic changes have also been discovered in connection with autism.

However, these often only explain a few autistic symptoms, for example impaired language ability. They appear only in a few examined people or are also found in healthy people or in non-autistic people with intellectual disorder, attention deficit disorder or epilepsy.

Environmental factors influence autism risk

Sven Bölte explains that this is probably why other factors play a role in the development of autism in addition to genetics. "A Danish study looked at the connection between autism and viral infections during pregnancy. It was found that the child's risk of autism increased from one to two percent if the mother had such an infection during pregnancy."

Certain medications taken during pregnancy, childbirth complications, and even environmental toxins or air pollution are possible risk factors for autism. However: "These factors are not equally at risk for everyone. The development of autism can be a rather complex interplay."

Diagnosis of autism remains subjective

Psychiatrists and neurologists therefore still decide what autism is primarily on the basis of observable behavior: the same, recurring behaviors, problems in social interaction. It remains a subjective assessment. Moreover, the more complex the picture that geneticists, epidemiologists and neuroscientists paint of autism, the more blurred the criteria for what autism is - and what is not.

"At the moment we are observing such a 'fraying'. We no longer know: Where is the end of the spectrum?", Criticizes Inge Kamp-Becker, head of child and adolescent psychiatry at the University of Marburg. "Many studies show, however, that autism is more of a characteristic, that there are autistic traits that are also found in the normal population and even more together with other disorders. But what exactly autism is is becoming increasingly unclear."

Autistic people often have trouble getting in touch with other people

Diagnostically, the line between healthy and sick is usually drawn where autistic behavior means that someone cannot perform everyday tasks independently and where there is a need for help.

The borderline, however, is fluid. And in autism research, too, according to Sven Bölte, the question - illness or character trait - remains undecided for the time being: "There is nothing wrong with saying that all people vary in their social skills. And if we move into a range of very If you have less pronounced social behavior, we are in the area of ​​autism. On the other hand, there would be people who are very communicative and social. It is not unthinkable that you will come there. "

But? "Many researchers - including myself - are not sure whether this shift is not there after all, whether the development in autism does not differ qualitatively from other disorders and from typical neuronal development. I have my opinion 20 to 30 times changed because it's just difficult. "

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    Author: Carla Bleiker