Yet more harms of wokeness and tabula rasa dogma. Female behavior is seen as the default, and male behavior is a disorder:
That's not autism: It's simply a brainy, introverted boy
"In its milder form, especially among preschool- and kindergarten-age boys, it is tough to distinguish between early signs of autism spectrum disorder and indications that we have on our hands a young boy who is a budding intellectual, is more interested in studying objects than hanging out with friends, overvalues logic, is socially awkward unless interacting with others who share identical interests or is in a leadership role, learns best when obsessed with a topic, and is overly businesslike and serious in how he socializes. The picture gets even more complicated during the toddler years, when normal, crude assertions of willfulness, tantrums, and lapses in verbal mastery when highly emotional are in full swing...
True autism is a potentially very disabling neurological condition. Roy Richard Grinker, in his acclaimed book “Unstrange Minds,” masterfully documents the challenges he faced raising Isabel, his autistic daughter. At age two, she only made passing eye contact, rarely initiated interactions, and had trouble responding to her name in a consistent fashion. Her play often took the form of rote activities such as drawing the same picture repeatedly or rewinding a DVD to watch the same film clip over and over. Unless awakened each morning with the same utterance, “Get up! Get up!” Isabel became quite agitated. She tended to be very literal and concrete in her language comprehension. Expressions like “I’m so tired I could die” left her apprehensive about actual death. By age five, Isabel remained almost completely nonverbal.
When the signs of autism spectrum disorder are clear, as in Isabel’s case, early detection and intervention are essential to bolster verbal communication and social skills. The brain is simply more malleable when children are young...
However, the earlier an evaluation is conducted, the greater the risk of a false diagnosis. Many toddlers can be autistic-like in their behavior when they are stressed. Sometimes the procedures used by experts to evaluate toddlers generate the sort of stress that leads a struggling, but otherwise normally developing, toddler to behavior that is autistic-like.
Nobody has made this point more clearly than the late Dr. Stanley Greenspan, the internationally recognized child psychiatrist who developed the popular Floortime approach to treating autism spectrum disordered kids. In his web-based radio show several years before his death in April 2010, he cited an alarming statistic. Of the two hundred autism assessment programs his team surveyed across the country, many of which were located in prestigious medical centers, only 10 percent emphasized the need to observe a child along with a parent or guardian for more than ten minutes as they spontaneously interacted together. He tended to observe children playing with a parent for forty-five minutes or more, waiting for choice points to engage a child to determine if he or she was capable of more sustained eye contact, elaborate verbalizations, or shared emotional reactions. Dr. Greenspan believed that these conditions of safety and sensitive interaction were essential in order to obtain an accurate reading of a child’s true verbal and social skills.
For a sizable percentage of toddlers who don’t transition well to new surroundings, freeze up with strangers, or temporarily dread being apart from a parent, the formal nature of a structured autism assessment can lead to their becoming mute, hiding under a table, avoiding eye contact, hand flapping, or exhibiting any number of other self-soothing behaviors that get misinterpreted as autistic-like. Trained professionals are supposed to conduct autism assessments in a standardized way. This is clinical jargon for being fairly neutral in one’s approach to the child. This might involve an examiner assuming a seating position that requires a child to turn his or her head ninety degrees to directly look at the examiner when his or her name is called. If the child fails to look up and make direct eye contact with the examiner after his or her name is called aloud several times, the child is considered to be exhibiting autism red-zone behavior. Yet many distressed or slow-to-warm toddlers will only respond to their name if an unfamiliar adult strives to be warm, engaging, and nonthreatening—not just neutral.
It is these autistic-like situational reactions of struggling toddlers during formal testing conditions that make a false diagnosis a real possibility. A 2007 University of North Carolina at Chapel Hill study found that over 30 percent of children diagnosed as autistic at age two no longer fit the diagnosis at age four. Several years ago, data supplied by parents of over seventy-eight thousand three- to seventeen-year-olds, as part of a National Survey of Children’s Health, discovered that nearly 40 percent had a previous, but not a current, diagnosis of autism spectrum disorder.
There are other reasons why a sizable percentage of toddlers get erroneously diagnosed with autism spectrum disorder. Up to one in five two-year-olds are late talkers. They fall below the fifty-word expressive-vocabulary threshold and appear incapable of stringing together two- and three-word phrases. This sort of irregular language development is one of the hallmarks of early autism. Yet it is notoriously difficult to distinguish between toddlers with autism spectrum disorder and those who are afflicted with delayed language development. The situation is further complicated by the fact that toddlers with delayed language development tend to share other features in common with autism spectrum children. Scientific findings at the famed Yale Child Study Center have shown that toddlers with delayed language development are almost identical to their autism spectrum disordered counterparts in their use of eye contact to gauge social interactions, the range of sounds and words they produce, and the emotional give-and-take they are capable of. Consequently, many toddlers who simply don’t meet standard benchmarks for how quickly language should be acquired and social interactions mastered are in the autism red zone.
Expanding autistic phenomena to include picky eating and tantrums only amounts to more confusion when applied to toddlers. The percentage of young children in the United States with poor appetites and picky eating habits is so high that experts writing in the journal Pediatrics in 2007 commented, “It could reasonably be said that eating-behavior problems are a normal feature of toddler life.” Tantrums also are surprisingly frequent and intense during the toddler years. Dr. Gina Mireault, a behavioral sciences professor at Johnson State College in Vermont, studied children from three separate local preschools. She discerned that toddlers had tantrums, on average, once every few days. Almost a third of the parents surveyed considered their child’s tantrum behavior to be distressing or disturbing.
With the push to screen for and detect autism spectrum disorder at progressively younger ages, the risk is greater that late-talking, picky-eating, tantrum-throwing, transition-resistant toddlers will be misperceived as potentially autistic—especially if an evaluation is conducted in which the child is not sensitively engaged and put at ease. The risk is more acute, as I will soon illustrate, if this toddler is likely to develop into an introverted, cognitively gifted boy who tends to be single-minded and willful in his approach to life learning. Even more basic than that, if we don’t have a firm grasp of gender differences in how young children communicate and socialize, we can mistake traditional masculine behavior for high-functioning autism.
A book I return to every so often is Eleanor Maccoby’s “The Two Sexes.” Her descriptions of boys’ and girls’ different speech styles jive with what I see daily in my office. She maintains, and I agree, that boys’ speech, on average, tends to be more egoistic than girls’. Boys are more apt to brag, interrupt, and talk over others, and ignore commands or suggestions. They are more inclined to grandstand and “hold court,” trying to impress listeners with all that they know. They seem to be less socially attuned than girls. They are less likely to scan the faces and body language of others for cues on whether they should stop talking and start listening—for basic social sensitivity reasons.
Simon Baron-Cohen, the Cambridge University professor who popularized the extreme-male-brain theory of autism, would say that boys’ speech is more egoistic because, overall, boys tend to be less empathic than girls. He backs this up with abundant scientific evidence. Putting yourself in someone else’s shoes to figure out what they might be feeling comes more naturally to girls. Girls are simply more inclined to read a person’s facial expressions in order to make sure that they are coming across sensitively. Faces tend to be sources of social feedback for girls in ways that they are not for boys. Dr. Baron-Cohen’s research team has discovered that even at birth, female infants will look longer at faces than male infants and prolong mutual eye gazing.
Many boys just get perplexed when you try to empathize with them...
for many boys, grasping the literal content of their verbalizations matters more than “feeling understood.” Appearing attentive, asking probing questions, and reflecting back what someone is saying may be the empathic glue that cements a friendship for the average female. However, for the average male, following along with and responding to the literal content of what they are saying is what’s deemed valuable. A friend is someone who shares your interests and with whom you can have detailed discussions about these interests.
Watch boys at a sleepover and you’ll quickly realize that they need a joint activity to buttress social interaction and verbal dialogue. If that joint activity is a videogame like Red Dead Redemption, the discussion will be peppered with pragmatic exchanges of information about how best to tame horses, free someone who has been kidnapped, or locate animal pelts. Without a joint activity that taps into their preexisting knowledge about that activity, boys are often at a loss for discussion. There are long silences. Eye contact is avoided. Bodies become more wiggly.
Watch girls at a sleepover and any shared activity they engage in is often secondary to the pleasure they seem to derive from just hanging out and talking.
The stereotype of boys as logical, inflexible, and businesslike in their communication habits is more than just a stereotype. A recent massive study out of the University of Florida involving fifty-four hundred children in the United States ages eight to sixteen indicates that twice as many boys as girls fit this thinking-type temperament. Conversely, twice as many girls as boys fit the feeling-type temperament— tactful, friendly, compassionate, and preferring emotion over logic.
Many boys feel compelled to be logical and exact in their use of language. They withdraw and shut down around people who use language more loosely. A glaring example of this was shown to me recently by a fourteen-year-old client named Jordan. His parents brought him in for therapy because he was racking up school detentions for being rude to teachers. Jordan secretly confessed to me that his English teacher must be dumb because she referred to certain assignments as “homework” when she allowed them to be completed in class. She should have renamed them “schoolwork,” he said, because they were being completed at school. In twenty-five years of therapy practice, I’ve never known a girl to make such a comment.
As educated people, we don’t want to believe in overarching differences in communication styles between the sexes. When I was in college in the 1980s and ’90s, “essentialism” was a dirty word. To believe that males and females might be different in essential ways was akin to admitting that you were unenlightened. There’s still a pervasive sense in our culture that to be educated is to be gender-blind, and there is something of a taboo against voicing aloud explanations for a child’s behavior in terms of his or her gender...
It’s this public discomfort with discussing children’s gendered behavior that gets many traditionally masculine boys inappropriately labeled as high-functioning autistic. Poor eye contact, long-winded monologues about one’s new favorite topic, being overly serious and businesslike, appearing uninterested in other’s facial expressions, and restricting friendships to those who share one’s interests, may all be signs of Asperger’s syndrome or high-functioning autism. However, these same traits typify boys who are traditionally masculine in their behavior. Parents somehow have to ask the uncomfortable question in the doctor’s office: Is he high-functioning autistic or really a more masculine-identified boy? If it’s the latter, what a boy may need is some combination of acceptance and personal and professional help to finesse his social skills over time—not an incorrect diagnosis and unnecessary medical treatment...
When highly restricted interests are shared with relatively little spontaneity and enthusiasm, in ways that fail to entice children to come hither to listen and play—this is when we should suspect autism spectrum disorder. The same is true when a kid talks without interruption about a very technical topic, such as dinosaur names or bus schedules, seemingly indifferent to whether the listener congratulates him for his encyclopedic knowledge or is peeved by the lecture...
Autism spectrum disordered children tend to hold steadfast to their odd topics of interest over time and not readily substitute one for another.
One of the drawbacks to early screening and detection of high-functioning autism is that small children’s cognitive development isn’t sufficiently mature enough to judge what their sense of humor is like. Often it is a sense of humor that separates true cases of mild autism from mental giftedness. Mildly autistic kids often don’t really comprehend irony, sarcasm, and absurdity. Mentally gifted kids, on the other hand, often thrive on irony, sarcasm, and absurdity...
Highly intelligent boys who happen to be introverted by temperament are probably the subpopulation of kids who are most likely to be erroneously labeled autistic. In her provocatively titled Psychology Today article “Revenge of the Introvert,” Laurie Helgoe, a self-described card-carrying introvert, captures a key personality characteristic of introverts: “[They] like to think before responding—many prefer to think out what they want to say in advance—and seek facts before expressing opinions.” Introverted, highly intelligent boys may appear vacant and nonresponsive when asked a question like “What is your favorite animal?” Yet in their minds, they may be deeply and actively processing copious amounts of information on types and defining features of animals and zeroing in on precise words to use to articulate their complex thoughts. Thirty seconds, a minute, or even more time may pass before an answer is supplied. In the meantime, the listener might wonder if the boy is deaf or completely self-absorbed.
According to Laurie Helgoe: “Introverts seek time alone because they want time alone.” Brainy, introverted boys may cherish and look forward to alone time, which allows them the opportunity to indulge their intellectual appetites full throttle, amassing knowledge through reading or Internet searches. Solitude creates the time and space they need to totally immerse themselves in their preferred interests. They may get more turned on by studying ideas, pursuing science projects, or by solving math problems than by conversing with people.
In our extroverted culture, where being a “team player” and a “people person” are seen as linchpins of normalcy, the notion that a brainy, introverted boy might legitimately prefer the world of ideas over the world of people is hard for most people to accept. Parents of such boys may feel terribly uneasy about their tendency to want to be alone and try to push their sons to be sociable and to make more friends. But if you get to know such boys, they would much rather be alone reading, writing, or pursuing projects that stimulate their intellect than be socializing with peers who are not their intellectual equals. However, once they come into contact with a kindred spirit, someone who is a true intellectual equal with whom they can share the fullness of their ideas, that person just might become a lifelong friend. Around such kindred spirits, brainy, introverted boys can perk up and appear more extroverted and outgoing, wanting to talk as well as to listen. With people who share their interests, especially people who possess equal or greater knowledge in these areas, brainy, introverted boys can display quite normal social skills.
I’d like to engage the reader in a thought-provoking exercise. I’m going to list a collection of behaviors. As you peruse them, ask yourself if these behaviors are indicative of typical willful male toddlers or of possible autism at this age. Remember, the toddler years are from approximately age one to three.
Doesn’t look when you call their name, even if they seem to hear other sounds
Doesn’t look you in the eye much or at all
Doesn’t notice when you enter or leave a room
Seems to be in their own world
Doesn’t look where you do or follow your finger when you point to something
Leads you by the hand to tell you what they want
Can’t do simple things you ask them to do
Has a lot of tantrums
Prefers to play alone
Wants to always hold a certain object, such as a flashlight Doesn’t play with toys in the usual way
It may surprise the reader to learn that I obtained this list of behaviors from a Consumer Reports health-related article titled “What Are the Symptoms of Autism?” If this exercise left you thinking that these behaviors might be characteristic of both willful male toddlers and autistic children, that’s commendable. This means that you have more than a passing familiarity with early childhood development. It also means that you are keenly aware of how toddler issues can get misconstrued as autistic tendencies.
The glee on the faces of toddlers upon discovering that they can propel themselves away from caregivers and into the world beyond— with the power of their own limbs—says it all. During the first year of life, they were relatively helpless. They were at the complete mercy of caregivers to gauge what they needed. Now their fast-evolving fine-and gross-motor abilities are being put to full use in exploring their surroundings. There is fire in their bellies. They insist on having personal control over what they get to see, hear, touch, smell, and taste and for how long. This is what developmental psychologists call the “need for autonomy” that kicks in during toddlerhood. The word parents tend to use is “willfulness.” There is a world of sensory delight out there for toddlers to discover and sample, and they want nothing to get in their way.
Male toddlers advance at a faster rate than the opposite sex in their gross-motor development and visual-spatial skills. The science is there. Generally speaking, boys are more physically capable of exploring their environments than girls. When they do, objects are likely to be the object of their exploration. Little boys, especially those with strong visual-spatial intelligence, can appear as though they’ve entered a trance when they stare at, squeeze, lick, toss and fetch, arrange, stack, and knock down blocks—only to do it all over again. We forget how immersion in an activity, and repetition of it, can lead to an experience of mastery. Lining up trains in identical order, making the same sounds, and pulling them with the same force can rekindle the same feeling of mastery that was felt the first time this activity went well. Not all repetitiveness and needs for sameness speak to autistic tendencies. When a toddler appears driven to use his body effectively in the accomplishment of a task and to further an experience of mastery, it’s unlikely that he’s on the spectrum no matter how repetitive the task becomes—particularly if that toddler shows self-pride and wants others to share in the excitement of it all, even in quiet and subdued ways.
Boys’ level of engrossment in discovering and manipulating objects can lead them to be oblivious to their surroundings. They may not look up when their name is called. They may appear unconcerned whether you’re in the room or not. Self-absorption while studying objects is expectable behavior for male toddlers, especially for those on the upper end of the bell curve on visual-spatial intelligence.
Parents and educators shouldn’t assume the worst when male toddlers play alone. Research shows that boys are far more likely to engage in solitary play than girls at this age. Many little boys are satisfied playing alone or quietly alongside someone else, lining up toy trains, stacking blocks, or engaging in a range of sensorimotor play activities. It is not until about age four or five that boys are involved in associative play to the same extent as girls. That’s the kind of play where there’s verbal interaction and give-and-take exchanges of toys and ideas.
The difference between a relatively typical male toddler immersed in solitary object play and one who shows early signs of autistic behavior can be subtle. Typically developing male toddlers are more apt to experience periodic separation anxiety. They suddenly wonder where Mommy is. Needing Mommy in these moments takes precedence over the activity in which they were absorbed. Sometimes visually checking in and receiving a reassuring glance back from Mommy is enough. Sometimes more is needed, like approaching her for a hug or a pat on the back. This inspires confidence that Mom will be available if and when needed. The toddler can then go across the room and pick up where he left off playing. This “emotional pit stop” behavior is less apparent with toddlers on the spectrum.
Mentally gifted boys are often perfectionists. Their projects need to be done just right, and they will continue to work on a project until it is exactly what they want...
Tantrums during the toddler years are, of course, commonplace. Under normal family circumstances, when a toddler’s maturation is right on schedule, parents can expect a tantrum from their three-to five-year-old once every few days. That was the conclusion of Dr. Gina Mireault’s study, cited earlier. Her research also revealed that the reason top ranked by parents as triggering a toddler’s tantrum is this: “Denial of a request/not getting his or her way.” Most tantrums are triggered by parents directly confronting kids’ assertions of autonomy or by kids’ need to have personal control over what they get to see, hear, touch, smell, and taste, and for how long. Tantrums can be exacerbated by fatigue and hunger. Toddlers have different temperaments, and this influences the frequency, intensity, and duration of tantrums. But in general, tantrums occur because a toddler is denied ice cream before dinner, for example, or is prevented from grabbing Grandma’s expensive Moorcroft pottery dish or insists on watching one more show when it’s bedtime—or any such expectable parental challenge to their need to prolong a pleasurable activity or independently exercise sensorimotor mastery.
The tantrums of autism spectrum kids are less likely to be of the autonomy-assertion or mastery-seeking variety. Their tantrums more often than not reflect sensory overload. They may scream and writhe around on the floor because they are in physical pain due to their nervous system being bombarded by an intolerable level of stimulation. The sights and sounds at the mall when their family is shopping for holiday gifts may put them over the top. The buzz from and brightness of overhead lights might be a trigger. Rituals and routines are relied on to keep sensory stimulation at manageable levels. Tantrums may signal a need to keep a ritual or routine exactly the way it was to protect the kid from sensory overload.
Sometimes what appears to be an autistic-like tantrum is really what Dr. Stanley Greenspan, the world-renowned child psychiatrist, calls “sensory craving.” This applies to toddlers whose ability to self-regulate their feelings while they’re in the act of exploring their environments is underdeveloped...
A child wants more sensory input, but doesn’t know how to do it in an organized social way.
These are toddlers who Dr. Greenspan thinks need abundant “sensory meaningful” interactions with parents and care providers to help them become more self-composed over time. This could amount to matching the child’s energy and activity level in a fun airplane-ride game. Scooping him up, asking him to point his fist in the direction in which he wants to be flown, with a thumbs-up for faster and a thumbs-down for slower, would be an example of a sensory-meaningful interaction that still honors his need for autonomy.
Temper outbursts and quirky behavior around food preferences are widespread among autism spectrum children. But the same can be said of toddlers in general. It’s important to have a sense of perspective regarding the pervasiveness of toddlers’ habit of latching onto preferred foods and rejecting new offerings. A survey of more than three thousand households with infants and toddlers conducted by nutrition experts at the University of Tennessee–Knoxville indicates that a whopping 50 percent of two-year-olds are considered picky eaters by their caregivers. These nutritionists believe the numbers are so high because mothers are not persistent enough in introducing new foods in ways that ensure they’ll eventually be eaten: “When offering a new food, mothers need to provide many more repeated exposures (e.g., eight to 15 times) to enhance acceptance of that food than they currently do.”
Let’s call this the “eight-to-fifteen-times rule.” If a toddler reacts with revulsion, aggressively throwing dishes on the floor or refusing to eat each time a new food item is introduced after eight to fifteen separate attempts, chances are that he or she is a picky eater. This is particularly true if, in the process, the parent stayed calm and conveyed confidence that the new food item was good to eat—not being too insistent on the one hand, or tentative, on the other.
But certainly not all picky eaters are that way because they are on the spectrum. Autism spectrum children who are picky eaters often have odd food preferences, such as only eating foods that are yellow-colored. Their reactions after repeated exposure to new foods frequently remain acute or become even more blustery. It’s not about power struggles and control. A new food item may literally assault their senses. The smell, look, and texture of that food may induce a type of sensory revulsion and disgust. They can’t be around it. Either it goes or the kid does—perhaps agitatedly running off.
The younger in age a kid is when professionals screen for milder forms of autism, the greater the risk a struggling kid will be misperceived as a disordered one. A vast number of toddlers present in the doctor’s office with a hodgepodge of social and emotional difficulties, such as poor eye contact, overactivity and underactivity, tantrums, picky eating, quirky interests, or social awkwardness. These phenomena need not be seen as telltale signs of autism spectrum disorder. Sometimes they are merely evidence of a perfect storm of off-beat events in social and emotional development mixed with difficult personality traits—with the upshot that the kid, for the time being, is very out of sorts.
When we mistake a brainy, introverted boy for an autism spectrum disordered one, we devalue his mental gifts. We view his ability to become wholeheartedly engrossed in a topic as a symptom that needs to be stamped out, rather than a form of intellectualism that needs to be cultivated."
