INSIDE VIEW OF AUTISM
Temple Grandin, Ph.D.
Colorado State University
Fort Collins, CO 80523, USA
I am a 44-year-old autistic woman who has a successful
international career designing livestock equipment. I completed
my Ph.D. in Animal Science at the University of Illinois in Urbana
and I am now an Assistant Professor of Animal Science at Colorado
State University. Early intervention at age 2 1/2 helped me overcome
Two of the subjects covered in this chapter are
the frustration of not being able to speak and
sensory problems. My senses were oversensitive to loud noise
and touch. Loud noise hurt my ears and I withdrew from touch to
avoid over-whelming sensation.
I built a squeezing machine which helped me to
calm my nerves and to tolerate touching. At puberty, horrible anxiety
attacks started and they became worse with age. Antidepressant
medication relieved the anxiety. In the last section of the chapter
directing my fixations into constructive activities and a career
will be discussed along with the importance of a mentor. My skill
and deficit areas are covered in detail. All my thinking is visual,
like videos played in my imagination. Even abstract concepts such
as getting along with other people are visualized through the use
of door imagery.
LACK OF SPEECH
Not being able to speak was utter frustration.
If adults spoke directly to me I could understand everything they
said, but I could not get my words out. It was like a big stutter.
If I was placed in a slight stress situation, words would sometimes
overcome the barrier and come out. My speech therapist knew how
to intrude into my world. She would hold me by my chin and made
me look in her eyes and say "ball." At age three, "ball"
came out "bah," said with great stress. If the therapist
pushed too hard I threw a tantrum, and if she did not intrude far
enough no progress was made. My mother and teachers wondered why
I screamed. Screaming was the only way I could communicate. Often
I would logically think to myself, "I am going to scream now
because I want to tell somebody I don't want to do something."
It is interesting that my speech resembled the
stressed speech in young children who have had tumors removed from
the cerebellum. Rekate, Grubb, Aram, Hahn, and Ratcheson (1985)
found that cancer surgeries that lesioned the vermus, deep nuclei,
and both hemispheres of the cerebellum caused temporary speech loss
in normal children. Vowel sounds were the first to(1) return, and
receptive speech was normal. Courchesne, Yeung-Courchesne, Press,
Hesselink, and Jernigan (1988) reported that 14 out of 18 high-
to moderate- functioning autistics had undersized cerebellar vermal
lobules VI and VII. Bauman and Kemper (1985) and Ritvo et al. (1986)
also discovered that brains from autistics had lower than normal
Purkinje cell counts in the cerebellum. In my own case an MRI scan
revealed cerebellar abnormalities. I am unable to tandem walk (the
standard "walk the line" test done by the police for drunken
drivers). I end up toppling sideways, but my reactions are normal
for other simple motor tests of cerebellar dysfunction.
Vestibular stimulation can sometimes stimulate
speech in autistic children. Slowly swinging a child on a swing
can sometimes help initiate speech (Ray, King, & Grandin, 1988).
Certain types of smooth, coordinated movements are difficult for
me, even though I appear normal to the casual observer. For example,
when I operate hydraulic equipment that has a series of levers,
I can operate one lever at a time perfectly. Coordinating the movement
of two or three levers at once is impossible. This may explain why
I do not readily learn a musical instrument, even though I have
innate musical talent for pitch and melody. The only musical instrument
I mastered is whistling with my mouth.
RHYTHM AND MUSIC
Throughout elementary school my speech was still
not completely normal. Often it took me longer than other children
to start getting my words out. Singing, however was easy. I have
perfect pitch and I can effortlessly hum back the tune of a song
I have heard only once or twice.
I still have many problems with rhythm. I can
clap out a rhythm by myself, but I am unable to synchronize my rhythm
with somebody else's rhythm. At a concert I am unable to clap in
time with the music with the rest of the people. A lack of rhythm
during autistic piano playing is noted by Park and Youderian (1974).
Rhythm problems may be related to some autistic speech problems.
Normal babies move in synchronization with adult speech (Condon
& Sander, 1974). Autistics fail to do this. Condon (1985) also
found that autistics and, to a lesser extent, dyslexics and stutterers
have a defective orienting response. One ear hears a sound sooner
that the other. The asynchrony between ears is some- times over
one second. This may help explain certain speech problems. People
still accuse me of interrupting. Due to a faulty rhythm sense, it
is difficult to determine when I should break into a conversation.
Following the rhythmic ebb and rise of a conversation is difficult.
My hearing is like having a hearing aid with the
volume control stuck on "super loud." It is like an open
microphone that picks up everything. I have two choices: turn the
mike on and get deluged with sound, or shut it off. Mother reported
that sometimes I acted like I was deaf. Hearing tests indicated
that my hearing was normal. I can't modulate incoming auditory stimulation.
Many autistics have problems with modulating sensory input (Ornitz,
1985). They either overreact or under-react. Ornitz (1985) suggests
that some cognitive deficits could be caused by distorted sensory
input. Autistics also have profound abnormalities in the neurological
mechanisms that control the capacity to shift attention between
different stimuli (Courchesne, 1989).
I am unable to talk on the phone in a noisy office
or airport. Everybody else can use the phones in a noisy environment,
but I can't. If I try to screen out the background noise, I also
screen out the phone. A friend of mine, a high-functioning autistic,
was unable to hear a conversation in a relatively quiet hotel lobby.
She has the same problem I have, except worse.
Autistics must be protected from noises that bother
them. Sudden loud noises hurt my ears like a dentist's drill hitting
a nerve. A gifted, autistic man from Portugal wrote, "I jumped
out of my skin when animals made noises" (White & White,
1987). An autistic child will cover his ears because certain sounds
hurt. It is like an excessive startle reaction. A sudden noise (even
a relatively faint one) will often make my heart race. Cerebellar
abnormalities may play a role in increased sound sensitivity. Research
on rats indicates that the vermus of the cerebellum modulates sensory
input (Crispino & Bullock, 1984). Stimulation of the cerebellum
with an electrode will make a cat hypersensitive to sound and touch
I still dislike places with confusing noise, such
as shopping malls. High-pitched continuous noises such as bathroom
vent fans or hair dryers are annoying. I can shut down my hearing
and withdraw from most noise, but certain frequencies cannot be
shut out. It is impossible for an autistic child to concentrate
in a classroom if he is bombarded with noises that blast through
his brain like a jet engine. High, shrill noises were the worst.
A low rumble has no effect, but an exploding firecracker hurts my
ears. As a child, my governess used to punish me by popping a paper
bag. The sudden, loud noise was torture.
Even now, I still have problems with tuning out.
I will be listening to a favorite song on the radio, and then realize
I missed half of it. My hearing just shuts off. In college, I had
to constantly keep taking notes to prevent tuning out. The young
man from Portugal also wrote that carrying on a conversation was
very difficult. The other person's voice faded in and out like a
distant radio station (White & White, 1987).
I often misbehaved in church, because the petticoats
itched and scratched. Sunday clothes felt different than everyday
clothes. Most people adapt to the feeling of different types of
clothing in a few minutes. Even now, I avoid wearing new types of
underwear. It takes me three to four days to fully adapt to new
As a child in church, skirts and stockings drove
me crazy. My legs hurt during the cold winter when I wore a skirt.
The problem was the change from pants all week to a skirt on Sunday.
If I had worn skirts all the time, I would not have been able to
tolerate pants. Today I buy clothes that feel similar. My parents
had no idea why I behaved so badly. A few simple changes in clothes
would have improved my behavior.
Some tactile sensitivities can be desensitized.
Encouraging a child to rub the skin with different cloth textures
often helps. The nerve endings on my skin were supersensitive. Stimuli
that were insignificant to most people were like Chinese water torture.
Ayres (1979) lists many good suggestions on methods to desensitize
the tactile system.
In my book Emergence: Labeled Autistic
(Grandin & Scariano, 1986), I describe craving pressure stimulation.
It was an approach-avoid situation. I wanted to feel the good feeling
of being hugged, but when people hugged me the stimuli washed over
me like a tidal wave. When I was five years old, I used to daydream
about a mechanical device I could get into that would apply comforting
pressure. Being able to control the device was very important. I
had to be able to stop the stimulation when it became too intense.
When people hugged me, I stiffened and pulled away to avoid the
all- engulfing tidal wave of stimulation. The stiffening up and
flinching was like a wild animal pulling away. As a child, I used
to like to get under the sofa cushions and have my sister sit on
them. At various Autism conferences, I have had 30 or 40 parents
tell me that their autistic child seeks deep pressure stimuli. Research
by Schopler (1965) indicated that autistic children prefer (proximal)
sensory stimulation such as touching, tasting, and smelling to distal
sensory stimulation such as hearing or seeing.
At age 18 I built a squeezing machine. This device
is completely lined with foam rubber, and the user has complete
control over the duration and amount of pressure applied. A complete
description of the machine is in Grandin (1983, 1984), and Grandin
and Scariano (1986). The machine pro- vides comforting pressure
to large areas of the body.
It took me a long time to learn to accept the
feeling of being held and not try to pull away from it. Reports
in the literature indicate that autistics lack empathy (Bemporad,
1979; Volkmar & Cohen, 1985). I feel that the lack of empathy
may be partially due to a lack of comforting tactual input.
One day about 12 years ago, a Siamese cat's reaction
to me changed after I had used the squeeze machine. This cat used
to run from me, but after using the machine, I learned to pet the
cat more gently and he decided to stay with me. I had to be comforted
myself before I could give comfort to the cat (Grandin, 1984).
I have found from my own experiences with the
squeeze machine that I almost never feel aggressive after using
it. In order to learn to relate to people better, I first had to
learn how to receive comfort from the soothing pressure of the squeeze
machine. Twelve years ago I wrote, "I realize that unless I
can accept the squeeze machine I will never be able to bestow love
on another human being" (Grandin, 1984). During my work with
livestock, I find that touching the animals increases my empathy
for them. Touching and stroking the cattle makes me feel gentle
towards them. The squeeze machine also had a calming effect on my
Squeeze machines have been in use in clinics working
with autistic and hyperactive children (Figures 6-1 and 6-2). Lorna
King, an occupational therapist in Phoenix, Arizona, reports that
it has a calming effect on hyperactive behavior. Therapists have
found that deep pressure stimulation has a calming effect (Ayres,,
1979). Both animal and human studies have shown that pressure stimulation
reduces nervous system arousal (Kumazawa, 1963; Melzack, Konrad,
& Dubrobsky, 1969; Takagi & Kobagasi, 1956). Pressure on
the sides of the body will induce relaxation in pigs (Grandin, Dodman,
& Shuster, 1989).
ANXIETY AT PUBERTY
As a child I was hyperactive,
but I did not feel "nervous" until I reached puberty.
At puberty, my behavior took a bad turn for the worse. Gillberg
and Schaumann (1981) describe behavior deterioration at puberty
in many autistics. Shortly after my first menstrual period, the
started. The feeling was like a constant feeling of stage fright
all the time. When people ask me what it is like I say, "Just
imagine how you felt when you did something really anxiety provoking,
such as your first public speaking engagement.
Now just imagine if you felt that way most of
the time for no reason." I had a pounding heart, sweaty palms,
and restless movements. The "nerves" were almost like
hypersensitivity rather than anxiety.
It was like my brain was running at 200 miles an hour, instead of
60 miles an hour. Librium and Valium provided no relief. The "nerves"
followed a daily cycle and were worse in the late afternoon and
early evening. They subsided late at night and early in the morning.
The constant nervousness would go in cycles, with a tendency to
be worse in the spring and fall. The "nerves" also subsided
Sometimes the "nerves" would manifest
themselves in other forms. For weeks I had horrible bouts of colitis.
When the colitis attacks were active, the feeling of "stage-fright"
nerves went away.
I was desperate for relief. At a carnival I discovered
that riding on the Rotor ride provided temporary relief. Intense
pressure and vestibular stimulation calmed my nerves. Bhatara, Clark,
Arnold, Gunsett, and Smeltzer (1981) have found that spinning in
a chair twice each week reduces hyperactivity in young children.
While visiting my aunt's ranch, I observed that
cattle being handled in a squeeze chute sometimes relaxed after
the pressure was applied. A few days later I tried the cattle squeeze
chute, and it provided relief for several hours. The squeeze machine
was modeled after a squeeze chute used on cattle. It had two functions:
(1) to help relax my "nerves" and (2) to provide the comforting
feeling of being held. Prior to building the squeeze machine, the
only other way I could get relief was strenuous exercise or manual
labor. Research with autistics and mentally retarded clients has
shown that vigorous exercise can decrease stereotypies and disruptive
behavior (McGimsey & Favell, 1988; Walters & Walters, 1980).
There are two other ways to fight the nerves: fixate on an intense
activity, or withdraw and try to minimize outside stimulation. Fixating
on one thing had a calming effect. When I was livestock editor for
the Arizona Farmer Ranchman, I used to write three articles in one
night. While I was typing furiously I felt calmer. I was the most
nervous when I had nothing to do.
With age, the nerves got worse. Eight years ago,
I had a stressful eye operation that triggered the worst bout of
"nerves" in my life. I started waking up in the middle
of the night with my heart pounding and obsessive thoughts about
In the next section, I am going to describe my
experiences with medication.
There are many Autism subtypes, and a medication that works for
me may be useless for another case. Parents of autistic children
should obtain medical advice from professionals who are knowledgeable
of the latest medical research.
I read in the medical library that antidepressant
drugs such as Tofranil (Imipramine) were effective for treating
patients with endogenous anxiety and panic (Sheehan, Beh, Ballenger,
& Jacobsen, 1980). The symptoms described in this paper sounded
like my symptoms, so I decided to try Tofranil. Fifty mg of Tofranil
at bedtime worked like magic. Within a week, the feelings of nervousness
started to go away. After being on Tofranil for four years I switched
to 50 mg Norpramin (desipramine), which has fewer side effects.
These pills have changed my life. Colitis and other stress-related
health problems were cured.
Dr. Paul Hardy in Boston has found that Tofranil
and Prozac (fluoxetine) are both effective for treating certain
high-functioning autistic adolescents and adults. Both Dr. Hardy
and Dr. John Ratey (personal communication, 1989) have learned that
very small doses of these drugs must be used. These doses are usually
much lower than the dose prescribed for depression.
Too high a dose can cause agitation, aggression, or excitement,
and too low a dose will have no effect. My "nerve" attacks
would go in cycles, and I have had relapses while on the drug. It
took will power to stick with the 50 mg dose and let the relapse
subside on its own.
Taking the medicine is like adjusting the idle
screw on a car's carburetor. Before taking the drug, the engine
was racing all the time. Now it runs at normal speed. I no longer
fixate, and I am no longer "driven." Prozac and Anafranil
(clomipramine) have been very effective in autistics who have obsessive-compulsive
symptoms or obsessive thoughts which race through their heads.
The effective doses for Prozac have ranged from two 20 mg capsules
per week to 40 mg per day. Too high a dose will cause agitation
and excitement. If an autistic person becomes agitated the dose
should be lowered. Other promising drugs for aggressive autistic
adolescents and adults are beta blockers. Beta blockers greatly
reduce aggressive behavior (Ratey et al., 1987).
During the eight years I have been taking antidepressants,
there has been a steady improvement in my speech, sociability, and
posture. The change was so gradual that I did not notice it. Even
though I felt relief from the "nerves" immediately, it
takes time to unlearn old behavior patterns.
Within the last year, I had an opportunity to
visit an old friend who had known me before I started taking antidepressants.
My friend, Billie Hart, told me I was a completely different person.
She said I used to walk and sit in a hunched-over position and now
my posture is straight. Eye contact had improved and I no longer
shifted around in my chair. I was also surprised to learn that I
no longer seemed to be out of breath all the time, and I had stopped
Various people I have met at Autism meetings have
seen steady improvement in my speech and mannerisms throughout the
eight-year period I have taken the medicines. My old friend, Lorna
King, also noticed many changes. "Your speech used to seem
pressured, coming in almost explosive bursts. Your old tendency
to perseverate is gone" (Grandin & Scariano, 1986).
I had a odd lack of awareness of my oddities of
speech and mannerisms until I looked at videotapes. I think videotapes
could be used to help many high-functioning autistics with speech
and social skills.
There is much that can be learned from family
history. During my travels to Autism conferences, I have found many
families with affective disorder in the family history. The relationship
between Autism and affective disorder has also been reported in
the literature (Gillberg & Schaumann, 1981). Family histories
of high-functioning autistics often contain giftedness,
anxiety or panic
allergies, and learning disorders. In many of the families I
have interviewed the disorders were never formally diagnosed, but
careful questioning revealed them.
My own family history contains nervousness and
anxiety on both sides. My grandmother has mild depression, and Tofranil
has also worked wonders for her. She is also very sensitive to loud
noise. She told me that when she was a little girl, the sound of
coal going down the chute was torture. My sister is bothered by
confusing noise from several sources. On my father's side there
is explosive temper, perseveration on one topic, extreme nervousness,
and food allergies. Both sides of my family contain artists. There
are also signs of immune system abnormalities in myself and my siblings.
I had shingles in my thirties, and my brother had them at age four.
My sister had serious ear infections similar to the ear infections
in many young autistics. My dad, brother , and myself all have eczema.
SENSORY DEPRIVATION SYMPTOMS
Animals placed in an environment that severely
restricts sensory input develop many autistic symptoms such as stereotyped
(Grandin, 1984). Why would an autistic and a lion in a barren
concrete zoo cage have some of the same symptoms?
From my own experience I would like to suggest
a possible answer. Since incoming auditory and tactile stimulation
often overwhelmed me, I may have created a self-imposed sensory
restriction by withdrawing from input that was too intense. Mother
told me that when I was a baby I stiffened and pulled away. By pulling
away, I did not receive the comforting tactile input that is required
for normal development. Animal studies show that sensory restriction
in puppies and baby rats has a very detrimental effect on brain
Puppies raised in a barren kennel become hyper-excitable,
and their EEGs (brain waves) still contain signs of overarousal
six months after removal from the kennel (Melzack & Burns, 1965).
Autistic children also have a desynchronized EEG, which indicates
high arousal (Hutt, Hutt, Lee, & Ounstead, 1965). Trimming the
whiskers on baby rats causes the parts of the brain that receive
input from the whiskers to become oversensitive (Simons & Land,
1987). The abnormality is relatively permanent; the brain areas
are still abnormal after the whiskers grow back. Some autistics
also have overactive brain metabolism (Rumsey et al., 1985).
I often wonder, if I had received more tactile
stimulation as a child would I have been less "hyper"
as an adult? Handling baby rats produces less emotional adults who
are more willing to explore a maze (Denenbert, Morton, Kline, &
Grota, 1962; Ehrlich, 1959). Tactile stimulation is extremely important
for babies and aids their development (Casler, 1965). Therapists
have found that children who withdraw from comforting tactile stimulation
can learn to enjoy it if their skin is carefully desensitized. Rubbing
the skin with different cloth textures often helps. Deep pressure
stimulation also reduces the urge to pull away.
I was born with sensory
problems (due to cerebellar abnormalities), but perhaps secondary
neurological damage is caused by withdrawal from touching. Autopsies
of five autistic brains indicated that cerebellar abnormalities
occur during fetal development, and many areas of the limbic systems
were immature and abnormal (Bauman, 1989). The limbic system does
not fully mature until two years after birth. Maybe withdrawal from
touching made some behavior problems worse. In my book, I describe
stupid " bathroom" fixations that got me into a lot of
trouble. An interesting paper by McCray (1978) shows a link between
a lack of tactual stimulation and excessive masturbation. Masturbation
stopped when the children received more affection and hugging. Perhaps
the "bathroom" fixation would never have occurred if I
could have enjoyed affection and hugging.
Lately there has been a lot of publicity about
holding therapy, where an autistic child is forcibly held and hugged
until he stops resisting. If this had been done to me I would have
found it highly aversive and stressful. Several parents of autistic
children have told me that a gentler form of holding therapy is
effective and it improved eye contact, language, and sociability.
Powers and Thorworth (1985) report a similar result. Perhaps it
would be beneficial if autistic babies were gently stroked when
they pulled away. My reaction was like a wild animal. At first touching
was aversive, and then it became pleasant. In my opinion, tactual
defensiveness should be broken down slowly, like taming an animal.
If a baby could be desensitized and learn to enjoy comforting tactile
input, possible future behavior problems could be reduced.
Today I have a successful career designing livestock
equipment because my high school science teacher, Mr. Carlock, used
my fixation on cattle chutes to motivate me to study psychology
and science. He also taught me how to use the scientific indexes.
This knowledge enabled me to find out about Tofranil.
While the school psychologist wanted to take my squeeze machine
away, Mr. Carlock encouraged me to read scientific journals so I
could learn why the machine had a relaxing effect. When I moved
out to Arizona to go to graduate school, I went out to the feedlots
to study the reactions of the cattle in squeeze chutes. This was
the beginning of my career.
Today I travel all over the world designing stockyards
and chutes for major meat-packing firms. I am a recognized leader
in my field and have written over 100 technical and scientific papers
on livestock handling (Grandin, 1987). If the psychologists had
been successful in taking away my squeeze machine, maybe I would
be sitting somewhere rotting in front of a TV instead of writing
Some of the most successful high-functioning autistics
have directed childhood fixations into careers (Bemporad, 1979;
Grandin & Scariano, 1968; Kanner, 1971). When Kanner (1971)
followed up his original 11 cases, there were two major successes.
The most successful person turned a childhood fixation on numbers
into a bank teller's job. The farmer who reared him found goals
for his number fixation; he told him he could count the corn rows
if he plowed the field.
Many of my fixations initially had a sensory basis.
In the fourth grade, I was attracted to election posters because
I liked the feeling of wearing the posters like a sandwich man.
Occupational therapists have found that a weighted vest will often
Even though the poster fixation started out with
a sensory basis, I became interested in the election. My teachers
should have taken advantage of my poster fixation to stimulate and
interest in social studies. Calculating electoral college points
would have motivated me to study math. Reading could have been motivated
by having me read newspaper articles about the people on the posters.
If a child is interested in vacuum cleaners, then use a vacuum-cleaner
instruction book as a text.
Another one of my fixations was automatic glass
sliding doors. Initially I was attracted to the doors because I
liked the sensation of watching them move back and forth. Then gradually
the doors took on other meanings, which I will talk about in the
next section. In a high-functioning adolescent, and interest in
sliding doors could be used to stimulate science interests. if my
teacher had challenged me to learn how the electronic box that opened
the door worked, I would have dived head first into electronics.
Fixations can be tremendous motivators. Teachers need to use fixations
to motivate instead of trying to stamp them out. A narrow, fixated
interest needs to be broadened into constructive activities. The
principle can also be used with lower- functioning children; Simons
and Sabine (1987) list many good examples.
Fixations need to be differentiated from stereotypies,
such as hand flapping or rocking. A fixation is an interest in something
external, such as airplanes, radio, or sliding doors. Engaging in
stereotypic behavior for long periods of time may be damaging to
the nervous system. In one experiment, pigs in a barren pen that
engaged in large amounts of stereotyped rooting on each other had
abnormal dendritic growth in the somatosensory cortex (Grandin,
All my thinking is visual. When I think about
abstract concepts such as getting along with people I use visual
images such as the sliding glass door. Relationships must be approached
carefully otherwise the sliding door could be shattered. Visualization
to describe abstract concepts is also described by Park and Youderian
(1974). As a young child I had visualizations to help me understand
the Lord's Prayer. The "power and the glory" were high-tension
electric towers and a blazing rainbow sun. The word "trespass"
was visualized as a "No Trespassing" sign on the neighbor's
tree. Some parts of the prayer were simply incomprehensible. The
only non-visual thoughts I have are of music. Today I no longer
use sliding doors to understand personal relationships, but I still
have to relate a particular relationship with something I have read
- for example, the fight between Jane and Joe was like the U.S.
and Canada squabbling over the trade agreement. Almost all my memories
relate to visual images of specific events. If somebody says the
word "cat," my images are of individual cats I have known
or read about. I do not think about a generalized cat.
My career as a designer of livestock facilities
maximizes my talent areas and minimizes my deficits. I still have
problems handling long strings of verbal information. If directions
from a gas station contain more than three steps, I have to write
them down. Statistics are extremely difficult because I am unable
to hold one piece of information in my mind while I do the next
step. Algebra is almost impossible, because I can't make a visual
image and I mix up steps in the sequence. To learn statistics I
had to sit down with a tutor and write down the directions for doing
each test. Every time I do a t-test or a chi-square, I have to use
the notes. I have no problem understanding the principles of statistics,
because I can see the normal or skewed distributions in my head.
The problem is I cannot remember the sequence for doing the calculations.
I can put a regression line on a graph full of dots visually. The
first time I tried it, I was off only a few degrees. I also have
many dyslexic traits, such as reversing numbers and mixing up similar-sounding
words such as "over" and "other." Right and
left are also mixed up.
Visual thinking is an asset for an equipment designer.
I am able to "see" how all parts of a project will fit
together and see potential problems. It never ceases to amaze me
how architects and engineers can make so many stupid mistakes in
buildings. The disastrous accident where the catwalks at the Hyatt
Regency fell and killed 100 people was caused by visualization errors.
All the calculations were correct, but the architect's original
design was impossible to build. Further visualization errors made
during construction resulted in doubling the load on poorly designed
fasteners. Academic requirements probably keep many visual thinkers
out of these professions. Designing a piece of equipment with a
sequential mind may be just as difficult for an engineer as statistics
equations are for me. The sequential thinker can't see the whole.
I have observed many incidents in industry where a brilliant maintenance
man with a high school education designs a piece of equipment after
all the Ph.D. engineers have failed. He may be an unrecognized visual
thinker. There may be two basic kinds of thinking, visual and sequential.
Farah (1989) concluded that "thinking in images is distinct
from thinking in language." I have also had the opportunity
to interview brilliant people who have very little visual thought.
One professor told me that facts just come out of his mind instantly.
To retrieve facts, I have to read them off a visualized page of
a book or "play a video" of some previous event.
There is however, one area of visualization I
am poor in. I often fail to recognize faces until I have known a
person for a long time. This sometimes causes social problems, because
I sometimes don't respond to an acquaintance because I fail to recognize
Einstein was a visual thinker who failed his high school language
requirement and relied on visual methods of study ((Holton, 1971-1972).
The theory of relativity was based on visual imagery of moving boxcars
and riding on light beams. At an Autism meeting I had the opportunity
to visit some of Einstein's relatives. His family history has a
high incidence of Autism, dyslexia, food allergies, giftedness,
and musical talent. Einstein himself had many autistic traits. An
astute reader can find them in Einstein and Einstein (1987) and
In my own family history, my grandfather on my
mother's side was co-inventor of the automatic pilot for airplanes,
and on my father's side my great-grandfather was a maverick who
started the largest corporate wheat farm in the world. My two sisters
and one brother are all visual thinkers. One sister is dyslexic
and is brilliant in the art of decorating houses. My brother can
build anything but had problems with calculus when he tried to major
in engineering. He is now a very successful banker and did well
in all other subjects in college. My youngest sister is a sculptress
and did well in school. My mother and grandparents on the mother's
side were all good at higher math, and many people on my mother's
side were well-known for intellect.
Drawing elaborate drawings of steel and concrete
livestock stockyards is easy (Figure 6-3). I am able to visualize
a motion picture of the finished facility in my imagination. However,
drawing realistic human faces is very difficult. Figure 6-4 illustrates
a buffalo-handling facility I designed. Since it was a government
low-bid contract, every piece of steel had to be visualized and
drawn on 26 sheets of detailed drawings. I am very proud of this
job because I was able to accurately visualize everything prior
to construction except for one little ladder. When I was a child,
my parents and teachers encouraged my artistic talent. It is important
to nurture talents.
Discussions with other high-functioning autistics
have revealed visual methods of thinking on tasks that are often
considered non-visual. A brilliant autistic computer programmer
told me that he visualized the program tree in his mind and then
just filled in the code on each branch. A gifted autistic composer
told me that he made "sound pictures."
I was good at building things, but when I first
started working with drawings it took time to learn how the lines
on a drawing related to the picture in my imagination. When I built
a house for my aunt and uncle, I had difficulty learning the relationship
between symbolic markings on the drawings and the actual construction.
The house was built before I learned drafting. Now I can instantly
translate a drawing into a mental image of a finished structure.
While agonizing over the house plans, I was able to pull up pictures
out of my memory of a house addition that was built when I was eight.
Mental images from my childhood memory helped me install windows,
light switches, and plumbing. I replayed the "videos"
in my imagination.
Studies have shown that when autistic
savants become less fixated and more social they lose their
savant skills such as card counting, calendar calculation, or art
skills (Rimland & Fein, 1988). Since I started taking the medication
I have lost my fixation, but I have not lost my visualization skill.
Some of my best work has been done while on the medication.
My opinion is that savants lose their skill because
they lose the fixated attention. Card counting (shown in the Rain
Man movie) is no mystery to me. I think savants visualize the cards
being dealt onto a table in a pattern, like a series of clocks or
a Persian rug pattern. To tell which cards are still in the deck,
they simply look at their patterns. The only thing that prevents
me from card counting or calendar calculation is that I no longer
have the concentration to hold a visual image completely steady
for a long period of time. I speculate that socialized savants still
retain their visualization skills. I still have the perfect pitch
skill, even though I don't use it. If I had greater concentration,
I could sing back much longer songs after hearing them once.
In my own case the strongest visual images are
of things that evoked strong emotions, such as important big jobs.
These memories never fade and they remain accurate. However, I was
unable to recall visual images of the houses on a frequently traveled
road until I made an effort to attend to them. A strong visual image
contains all details, and it can be rotated and made to move like
a movie. Weaker images are like slightly out-of-focus pictures or
may have details missing. For example, in a meat-packing plant I
can accurately visualize the piece of equipment I designed but I
am unable to remember things I do not attend to, such as the ceiling
over the equipment, bathrooms, stairways, offices, and other areas
of little or not interest. Memories of items of moderate interest
grow hazy with time.
I tried a little memory experiment at one of my
jobs. After being away from the plant for 30 days, I tried recalling
a part of the plant that I had attended to poorly, and another part
I had attended to intently. I had not designed either of these places.
The first place was the plant conference room, and the other was
the entrance to the room that housed my equipment. I was able to
draw a fairly accurate map of the office, but I made major mistakes
on conference-room furniture and ceiling covering. The room I visualized
was plain and lacked detail. On the other hand, I visualized the
entrance door to the equipment room very accurately, but made a
slight mistake on the door-handle style. The visualized door had
much greater detail than the visualized conference room. The conference
room was not attended to even though I negotiated with the plant
managers in that room.
Talents need to be nurtured and broadened out
into something useful. Nadia, a well-known autistic case, drew wonderful
perspective pictures as a child (Seifel, 1977). When she gained
rudimentary social skills, she stopped drawing. Possibly the talent
could have been revived with encouragement from teachers. Seifel
(1977) describes how Nadia drew pictures on napkins and waste papers.
She needed proper drawing equipment. Treffert (1989) reported on
several savants who did not lose their savant skills when they became
more social. Use of savant skills was encouraged.
At the age of 28, my drafting drastically improved
after I observed a talented draftsman named David. Building the
house taught me how to understand blueprints, but now I had to learn
to draw them. When I started drawing livestock facilities I used
David's drawings as models. I had to "pretend" I was David.
After buying a drafting pencil just like David's, I laid some of
his drawings out and then proceeded to draw a loading ramp for cattle.
I just copied his style, like a savant playing music, except my
ramp was a different design. When it was finished I couldn't believe
I had done it.
DEFICITS AND ABILITIES
Five years ago I took a series of tests to determine
my abilities and handicaps. On the Hiskey Nebraska Spatial Reasoning
test, my performance was at the top of the norms. On the Woodcock-Johnson
Spatial Relations test, I only got an average score because it was
a timed speed test. I am not a fast thinker; it takes time for the
visual image to form. When I survey a site for equipment at a meat-packing
plant, it takes 20 to 30 minutes of staring at the building to fully
imprint the site in my memory. Once this is done, I have a "video"
I can play back when I am working on the drawing. When I draw, the
image of the new piece of equipment gradually emerges. As my experience
increased, I needed fewer measurements to properly survey a job.
On many remodeling jobs, the plant engineer often measures a whole
bunch of stuff that is going to be torn out. He can't visualize
what the building will look like when parts of it are torn out and
a new part is added.
As a child I got scores of 120 and 137 on the
Wechsler. I had superior scores in Memory for Sentences, Picture
Vocabulary, and Antonyms-Synonyms on the Woodcock-Johnson. On Memory
for Numbers I beat the test by repeating the numbers out loud. I
have an extremely poor long-term memory for things such as phone
numbers unless I can convert them to visual images. For example,
the number 65 is retirement age, and I imagine somebody in Sun City,
Arizona. If I am unable to take notes I cannot remember what people
tell me unless I translate the verbal information to visual pictures.
Recently I was listening to a taped medical lecture while driving.
To remember information such as the drug doses discussed on the
tape I had to create a picture to stand for the dose. For example,
300mg is a football field with shoes on it. The shoes remind me
that the number is 300 feet, not yards.
I got a second-grade score on the Woodcock-Johnson
Blending subtest where I had to identify slowly sounded-out words.
The Visual Auditory Learning subtest was another disaster. I had
to memorize the meaning of arbitrary symbols, such as a triangle
means "horse," and read a sentence composed of symbols.
I could only learn the ones where I was able to make a picture for
each symbol. For example, I imagined the triangle as a flag carried
by a horse and rider.
Foreign languages were almost impossible. Concept
Formation was another test with fourth-grade results. The name of
this test really irks me, because I am good at forming concepts
in the real world. My ability to visualize broad unifying concepts
from hundreds of journal articles has enabled me to outguess the
"experts" on many livestock subjects. The test involved
picking out a concept such as "large, yellow" and then
finding it in another set of cards. The problem was, I could not
hold the concept in my mind while I looked at the other cards. If
I had been allowed to write the concept down, I would have done
learning to read
Mother was my salvation for reading. I would have
never learned to read by the method that requires memorization of
hundreds of words. Words are too abstract to be remembered. She
taught me with old-fashioned phonics. After I laboriously learned
all the sounds, I was able to sound out words. To motivate me, she
read a page and then stopped in an exciting part. I had to read
the next sentence. Gradually she read less and less. Mrs. David
W. Eastham in Canada taught her autistic son to read in a similar
manner, using some Montessori methods. Many teachers thought the
boy was retarded. He learned to communicate by typing, and he wrote
beautiful poetry. Douglas Biklen at Syracuse University has taught
some nonverbal autistic people to write fluently on the typewriter.
To prevent perseveration on a single key and key targeting mistakes
the person's wrist is supported by another person.
A visualized-reading method developed by Miller
and Miller (1971) would also have been helpful. To learn verbs,
each word has letters drawn to look like the action. For example,
"fall" would have letters falling over, and "run"
would have letters that looked like runners. This method needs to
be further developed for learning speech sounds. Learning the sounds
would have been much easier if I had a picture of a choo-choo train
for "ch" and a cat for hard "c" sound. For long
and short vowels, long "a" could be represented by a picture
of somebody praying. This card could be used for both "pr"
and long "a" by having a circle around "pr"
on one card and the "a" on another.
At first, reading out loud was the only way I
could read. Today, when I read silently, I use a combination of
instant visualization and sounding words. For example, this phrase
from a magazine - "stop several pedestrians on a city street"
- was instantly seen as moving pictures. Sentences that contain
more abstract words like "apparent" or "incumbent"
are sounded out phonetically.
As a child, I often talked out loud because it
made my thoughts more "concrete" and "real."
Today, when I am alone designing, I will talk out loud about the
design. Talking activates more brain regions than just thinking.
"A skilled and imaginative teacher prepared
to enjoy and be challenged by the child seems repeatedly to have
been a deciding factor in the success and educational placement
of high-functioning, autistic children" (Newson, Dawson, &
Everard, 1982). Bemporod (1979) also brings forth the mentor concept.
My mentor in high school was Mr. Carlock, my high school science
teacher. Structured behavior modification methods that work with
small children are often useless with a high-functioning older child
with normal intelligence.
I was lucky to get headed on the right path after
college. Three other high-functioning autistics were not so fortunate.
One man has a Ph.D. in math and he sits at home. He needed somebody
to steer him into an appropriate job. Teaching math did not work
out; he should have obtained a research position that required less
interaction with people. The other lady has a degree in history
and now works doing a boring telephone-sales job. She needs a job
where she can fully utilize her talents. she al so needs a mentor
to help her find an appropriate job and help open doors for her.
Both these people needed support after college, and they did not
receive it. The third man did well in high school and he also sits
at home. He has a real knack for library research. If some interested
person worked with him, he could work for a newspaper researching
background information for stories. All three of these people need
jobs where they can make maximum use of their talents and minimize
Another autistic lady I know was lucky. She landed
a graphic-arts job where she was able to put her visualization talents
to good use. Her morale was also boosted when her paintings received
recognition and were purchased by a local bank. Her success with
the paintings also opened up many social doors. In my own case,
many social doors opened after I made scenery for the college talent
show. I was still considered a nerd, but now I was a "neat"
nerd. People respect talent even if they think you are "weird."
People became interested in me after they saw my drawings and pictures
of my jobs. I made myself an expert in a specialized area.
High-functioning autistics will probably never
really fit in with the social whirl. My life is my work. If a high-
functioning autistic gets an interesting job, he or she will have
a fulfilling life. I spend most Friday and Saturday nights writing
papers and drawing. Almost all my social contacts are with livestock
people or people interested in Autism. Like the Newson et al. (1982)
subjects, I prefer factual, non-fictional reading materials. I have
little interest in novels with complicated interpersonal relationships.
When I do read novels, I prefer straightforward stories that occur
in interesting places with lots of description.
The mentor needs to be somebody who can provide
support on several different fronts. Employment is only one area.
Many high-functioning autistics need to learn about budgeting money,
how to make claims on health insurance, and nutritional counseling.
As the person becomes more and more independent the mentor can be
phased out, but the mentor may still be needed if the autistic loses
his job or has some other crisis.
WHO HELPED ME RECOVER
Many people ask me, "How did you manage to
recover?" I was extremely lucky to have the right people working
with me at the right time. At age two, I had all the typical autistic
symptoms. In 1949, most doctors did not know what Autism
was, but fortunately a wise neurologist recommended "normal
therapy" instead of an institution. I was referred to a speech
therapist who ran a special nursery school in her home. The speech
therapist was the most important professional in my life. At age
three, my mother hired a governess who kept me and my sister constantly
occupied. My day consisted of structured activities such as skating,
swinging, and painting. The activities were structured, but I was
given limited opportunities for choice. For example, on one day
I could choose between building a snowman or sledding. She actually
participated in all the activities. She also conducted musical activities,
and we marched around the piano with toy drums. My sensory problems
were not handled well. I would have really benefited if I had had
an occupational therapist trained in sensory
I went to a normal elementary school with older,
experienced teachers and small classes. Mother was another important
person who helped my recovery. She worked very closely with the
school. She used techniques that are used today in the most successful
mainstreaming programs to integrate me into the classroom. The day
before I went to school, she and the teacher explained to the other
children that they needed to help me.
As discussed earlier, puberty was a real problem
time. I got kicked out of high school for fighting. I then moved
on to a small country boarding school for gifted children with emotional
problems. The director was an innovative man and considered a "lone
wolf" by his psychologist colleagues. This is where I met Mr.
Carlock. Another extremely helpful person was Ann, my aunt. I visited
her ranch during the summer.
In high school and college, the people that helped
me the most were the creative, unconventional thinkers. The more
traditional professionals such as the school psychologist were actually
harmful. They were too busy trying to psychoanalyze me and take
away my squeeze machine. Later when I became interested in meat-packing
plants, Tom Rohrer, the manager of the local meat-packing plant,
took an interest in me. For three years I visited his plant once
a week and learned the industry. My very first design job was in
his plant. I want to emphasize the importance of a gradual transition
from the world of school to the world of work. The packing plant
visits were made while I was still in college. People with Autism
need to be gradually introduced to a job before they graduate. The
autistics I discussed earlier could have excellent careers if they
had a local businessperson take an interest in them.
During my travels I have observed many different
programs. It is my opinion that effective programs for young children
have certain common denominators that are similar regardless of
theoretical basis. Early, intense intervention improves the prognosis.
Passive approaches don't work. My governess was sometimes mean,
but her intense, structured intervention prevented me from withdrawing.
She and my mother just used their good instincts. Good programs
do a variety of activities and use more than one approach. A good
little children's program should include flexible behavior modification,
speech therapy, exercise, sensory treatment (activities that stimulate
the vestibular system and tactile desensitization), musical activities,
contact with nor mal children, and lots of love. The effectiveness
of different types of programs is going to vary from case to case.
A program that is effective for one case may be less effective for
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