Thinking in Pictures: My Life with Autism by Temple Grandin Page B

stared at his and appeared to be afraid of it. He didn't know what to do, because in the past he had eaten ice cream with a spoon.
    Another serious problem for people with Kanner's syndrome is lack of common sense. They can easily learn how to get on a bus to go to school, but have no idea what to do if something interrupts the routine. Any disruption of routine causes a panic attack, anxiety, or a flight response, unless the person is taught what to do when something goes wrong. Rigid thinking makes it difficult to teach people with Kanner-type autism the subtleties of socially appropriate behavior. For example, at an autism meeting, a young man with Kanner's syndrome walked up to every person and asked, “Where are your earrings?” Kanner autistics need to be told in a clear simple way what is appropriate and inappropriate social behavior.
    Uta Frith, a researcher at the MRC Cognitive Development Unit in London, has found that some people with Kanner's syndrome are unable to imagine what another person is thinking. She developed a “theory of mind” test to determine the extent of the problem. For example, Joe, Dick, and a person with autism are sitting at a table. Joe places a candy bar in a box and shuts the lid. The telephone rings, and Dick leaves the room to answer the phone. While Dick is gone, Joe eats the candy bar and puts a pen in the box. The autistic person who is watching is asked, “What does Dick think is in the box?” Many people with autism will give the wrong answer and say “a pen.” They are not able to figure out that Dick, who is now outside the room, thinks that the box still contains a candy bar.
    People with Asperger's syndrome, who tend to be far less handicapped than people with Kanner-type autism, can usually pass this test and generally perform better on tests of flexible problem-solving than Kanner's syndrome autistics. In fact, many Asperger individuals never get formally diagnosed, and they often hold jobs and live independently. Children with Asperger's syndrome have more normal speech development and much better cognitive skills than those with classic Kanner's. Another label for Asperger's syndrome is “high-functioning autism.” One noticeable difference between Kanner's and Asperger's syndromes is that Asperger children are often clumsy. The diagnosis of Asperger's is often confused with PDD, a label that is applied to children with mild symptoms which are not quite serious enough to call for one of the other labels.
    Children diagnosed as having disintegrative disorder start to develop normal speech and social behavior and then regress and lose their speech after age two. Many of them never regain their speech, and they have difficulty learning simple household chores. These individuals are also referred to as having low-functioning autism, and they require supervised living arrangements for their entire lives. Some children with disintegrative disorder improve and become high-functioning, but overall, children in this category are likely to remain low-functioning. There is a large group of children labeled autistic who start to develop normally and then regress and lose their speech before age two. These early regressives sometimes have a better prognosis than late regressives. Those who never learn to talk usually have severe neurological impairments that show up on routine tests. They are also more likely to have epilepsy than Kanner or Asperger children. Individuals who are low-functioning often have very poor ability to understand spoken words. Kanner, Asperger, and PDD children and adults usually have a much better ability to understand speech.
    Children in all of the diagnostic categories benefit from placement in a good educational program. Prognosis is improved if intensive education is started before age three. I finally learned to speak at three and a half, after a year of intensive speech therapy. Children who regress at eighteen to twenty-four months of age respond