An interview with Dr. Tony Attwood, Ph.D. AS/ASD expert
In a previous article for Autism Parenting Magazine, I addressed erasing the prejudice of violence associated with individuals on the autism spectrum. Although it is important to erase that growing prejudice, I mentioned that it would be negligent not to discuss the possibility of special interests (which is a symptom of Autism Spectrum Disorder (ASD)) becoming a clinical concern. In the previous article we touched on special interests that might cross a clinical line and said as an autism specialist and professional counselor, I urge parents to be vigilant of the special interests a spectrum child engages in approaching those teen/tween years. A second interview with Dr. Tony Attwood focused on the Spectrum Teen’s development of core self and dating relationships and the correlation with intense special interests.
Another interest of clinical concern can be in the area of pornography. Remember what makes the interest a clinical concern is the intensity and focus placed on the activity. The article by John Elder Robison in a blog for Psychology Today discusses how pornography can develop into a deeper issue for Asperger’s syndrome (AS)/ASD persons and how theory of mind, developmental delay and immaturity, coupled with feelings of rejection, isolation, and curiosity can become problematic as an interest. Dr. Attwood further explained that spectrum teens or young adults may not seek advice from parents and turn to pornography as a guidebook for romance of what females want in a dating relationship. Add to that a neurotypical (NT) population fascinated with books such as Fifty Shades of Gray and there is a reasonable expectation for confusion in the Aspie/ASD teen on relationships modeling.
Dr. Attwood: “Often times a teenager looking for romance or a relationship with a female may collect pornography and view it as a documentary as what women want. What is in pornography is not realistic and represents extremes and this can lead to issues of legalities. If a 18-19 year old ASD male who emotionally maybe 5-10 years younger in his thinking is collecting photographs and pornographic movies of all extremes as if he collecting data is rebuffed by girls his own age, may find a younger girl who may be 14 or 15 who may find having a relationship with an older guy as desirable could be in a dangerous position if he thinks that what she wants in a dating relationship has been demonstrated in the photographs and films he has been collecting.”
Dr. Attwood further explained that the AS person is often not aware that downloading images of younger girls is a federal crime, yet the legal recourse would be the same despite the person having AS and functioning emotionally three to five behind his peers.
At Mind and Hearts: A Psychology Clinic for Autism Spectrum Conditions, Dr. Garnett (Founder and Director), Dr. Attwood and trained professionals on the Mind and Hearts team work with teens and adults who are struggling with pornography (and other relational issues) as a special interest and realize that is often a cry for help for instruction in the art of relationships. At the clinic these individuals receive education about friendships and romantic relationships in a program called Beyond Friendship. Dr. Attwood explains that often times spectrum youth are isolated and do not have positive peers or role models to guide through this time of adolescence but they are in desperate need of education and personal support. They work with spectrum teens in a group setting with one to two chosen NT peers who have been trained to help guide them through relational issues. Parents of the teens are also given information on guiding discussions with their child about their own romantic experiences to help develop positive and healthy relationships. Peer development in this group with role-play experiences, guidance, and support then steers them away from the negative influences they may be receiving with their own “research” into the world of pornography and give them information they are actually seeking.
Spectrum Teens find it difficult to ask for information whether it be about relationships or about themselves. Spectrum Teens often are looking for a peer group to accept them and include them. Even if a person on the spectrum is undiagnosed, there is a sense that something about them is different than their peers. When an Aspie comes to believe something, it becomes a “truth” to them. Dr. Attwood and I discussed the neural pathway in which AS persons can become entrenched into a belief that they should be the opposite gender, and this is a different issue than what we think we know about Transgender or Transsexual issues. This combination of AS/ASD wiring and gender identity needs to be handled with care. Because gender reassignment surgery is a permanent solution to what may be a three to five year phase, it is important to address.
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For those Dr. Attwood refers to as “genuinely feeling they are transgender” would state that since childhood they had attraction or thoughts about feeling like the opposite gender. For those with AS/ASD, the belief that they are truly the opposite gender and their social issues would disappear if they could become the opposite gender stems from what he calls Psychological Archeology. Children begin to form that concept of self in childhood. Dr. Attwood defined this as, “Do you like who you are, or are you comfortable with who you are or others perceive you to be.” For NT children there is a wealth of knowledge that is this concept is being built upon, family, community, peers, etc. A strong component of that is how peer groups and those closest to you in your community treat you and view you. For Aspies, they tend to base this on the criticisms of peer and feelings of inferiority. Dr. Attwood said developmentally between the age of six to eight years of age children are beginning to pick up on differences and what being different means. At this age children are picking up on being included or excluded and how others are treating them in light of perceived differences. AS/ASD persons may or may not be diagnosed at this age since the average age of milder autism (formerly called Asperger’s) was ages eight to eleven. However, Dr. Attwood said that boys are finding at this young age that girls tend to be nicer and friendlier to them than boys in their peer group. So the seed is planted that perhaps if I was a girl, this would “fix” things. They may befriend more girls and begin to adopt more feminine mannerisms. Once this occurs, boys in this peer group will begin to distance themselves further and exclude them for their lack of masculine qualities. The boys don’t accept me, but the girls do, maybe I was meant to be a girl. Young AS/ASD girls may not be “girly girl” and maybe not even “tomboy” but they do not seem to fit in with what the other girls their age are doing. The AS/ASD girls pick up the girls are being mean to me and leaving me out or excluding me because I do not like the same things that they do. Some girls may be more tom-boyish or masculine which is generally a little more accepted in society (a feminine boy usually gets a more derogative name like “gay” or “sissy”). The AS/ASD girls find that being with the NT girls is more stressful than the boys. The boys are more inclusive and I would rather be doing what they are doing anyway. A feedback loop is created that reinforces the gender questioning so as each approaches puberty, the thoughts can become that perhaps I am not this gender but the other gender.
In adolescence the desire to be accepted is strong. As AS/ASD persons are entering middle and high school peers begin to distance themselves and they wonder: Where do I fit? Where do I find acceptance? When a mainstream person makes a gender change and it called a hero or applauded for the courage to make this change, someone confused about their identity, wondering what they feel different, and feel like this change could gain acceptance of a peer group, this a perfect storm for what is called Gender Dysphoria in the ICD. Aspies also tend to be five to six years behind their peers in developing romantic attraction and may believe they are asexual or bisexual because they have not had any experiences in the area of romantic type relationships. Celibacy is often seen as safe, and many on the spectrum live happy fulfilled lives celibate.
As a mother, clinician, and autism advocate, this is why I am adamant about sharing a child’s diagnosis of Asperger’s/Autism Spectrum Disorder with them at a young age. Many time parents feel like this label will stigmatize them or do more harm than good. Many parents tell me “it is just a label and I do not want he/she to think there is anything wrong with them.” As a parent, I understand. However, Dr. Attwood and I agree that by not sharing the label and keeping it hidden can denote shame. We want persons on the spectrum to see their wiring as a difference and understand the challenges and strengths of their wiring. Tweens/teens will naturally begin to feel their differences. As Temple Grandin says, “Different not less than.” As parents when we talk openly in our home about the spectrum and some of the differences we can help prepare our children for these conflicting feelings and understand how the treatment of NT peers can affect their identity development and how they build relationships with peers and those of the opposite sex.
This article was featured in Issue 46 – The Time for Acceptance