Saturday, January 19, 2008

Autism Disorder and Impulse Control

There are many puzzling features of autism. Hence the puzzle symbol for autism. Some of the mystery is being removed as our daily news brings us reports of new studies mapping the genetic and biological basis of autism. But even those areas are just beginning to be explored and while we are living through an Autism Knowledge Revolution there is much which remains unexplained and mysterious. Impulse control is one of those unexplained mysteries.

Even 10 years after Conor was diagnosed with Autism Disorder I am still startled by the impulses which suddenly seize Conor, and I mean seize literally, turning gentle acts of affection into potentially injurious and even dangerous acts of violence. Conor is very affectionate, tactile and observant. He likes to place his hands on either side of Dad's scruffy bearded face and study my face. But some times, suddenly, his hands dig painfully into my face. Sometimes he will grab my throat. Conor has also suddenly grabbed his mother by the hair and snapped her head and neck. Walking arm in arm downtown Fredericton, as we often do on weekends, he will occasionally grab by arm forcefully.

We have never thought for even a second that Conor intentionally tries to injure. I do not believe he has control during these instances. An impulse appears to overcome him suddenly and often is not preceded by any apparent triggering environmental stimuli. Conor simply appears physically seized by a powerful impulse.

I do not know what causes these seizure like impulses. I realize that my description of these events may sound like they are epileptic seizures and Conor's pediatrician may well confirm that lay person's guess. I know that there are many articles commenting on comorbidity of autism and epilepsy. Putting a new name on them may well be helpful in leading to other literature and understanding but I suspect that the behavior itself when it happens will always be startling and mysterious.

8 comments:

jypsy said...

Have you explored the concept discussed here (and here)as an explanation? I have always seen a strong similarity between many of Alex's (and other autistics') actions and Tourettes.

Unknown said...

jypsy

The "concepts" you referred me to don't really explain anything. Conor's surges or seizures are obviously the result of internal processes. I am more interested in understanding why they occur, or as part of what phenomenon, then just reading someone's philosophical approach to them.

Sometimes when Conor has one of his surges his eyes roll back in his head, what does the concept you referenced have to do with that phenomenon? What does the concept tell me when he suddenly grabs my arm pinching it with enough force to cause bruising? Or his own arms, legs etc? Or when he suddenly grabs his mother's hair and snaps her head back quickly? These are serious matters not philosophical meanderings.

Lisa Jo Rudy said...

Harold - I'm trying to explore the question of comorbidity, and am guessing you have delved more deeply than I. It SEEMS that autism is comorbid with a great number of issues - epilepsy, gastrointestinal issues, bip9lar disorder and sleep problems to name just a few...

In your research, have you come across any studies that not only note the comorbidities but also discuss WHY such issues exist?

Let me know!

Best,

Lisa Rudy (autism.about.com)

Maya M said...

I think that, indeed, Conor's pediatrician has a say here - or rather a neurologist to whom he could send you.
I guess it could be helpful that you have mentioned particular circumstances when these reactions occur (e.g. during walks in not quite familiar environment).
Is it a rule that Conor directs these reactions to you and Mrs. Doherty, or he grabs random objects also?
It just came to me that if you, his parents, are the preferred targets, then he maybe feels that he is losing control and tries to reach for help.
Of course I cannot really know anything about this, just a guess.

Unknown said...

maya m

I don't characterize his actions as "preferred", they are, in my view not intentional in any way. Conor's mom and dad are recipients because we are with him more than any other people. And we are in close proximity and involved with him.

Conor is in full control when he places his hands on my face affectionately. I have seen the look that comes over his face, the surge that overwhelms him, when he suddenly grabs my face forcefully and painfully.

The actions of which I speak are not intentional. That is my observation based on 12 years of living with and interacting with him as an involved father.

Unknown said...

Lisa Jo

I have never researched comorbidity per se. I think that is an interesting subject for you to pursue, although it will probably be a very large subject to cover.

Anonymous said...

Hello. My daughter is almost 4 years old and she has almost EXACTLY these same impulses. I do not believe her intentions are to hurt anyone...in fact, I don't think she has intentions! I too have witnessed daily the look in her eyes that suddenly changes, I can almost hear the gears churning, there's the look that says "Don't" but the hands grab, and hit and pinch anyway. Emma is such a sweet girl. Very caring and observant too.

Anonymous said...

I completely understand the idea of impulsive "seizures". My son is 10 and has finally been diagnosed with Aspberger's with his severe ADHD. Each day is a "draw of the hat" how that day or each moment in that day is going to go concerning my son's behavior, impulse and inappropriate behaviors. Many time things just happen for no apparent trigger, and most times we can go a couple weeks, with out any extreme distructive actions. But then one day he'll wake up and that whole day is just unbelieveably stressful and wild. He will have NO sense of appropriateness or awareness of his actions or how wild and subdomesticate they are. Anyway I don't know what can be done to help him or the situation but I wanted to state for you and others that there are people raising and living the same difficulties.