Imagine being ‘lost for words’ most of the time, when conversation is expected.
Imagine speech being indecipherable among background noise.
Imagine being unable to distinguish between a smile and a grimace.
Imagine constantly being unable to recognise people without the use of context (the environment you expect to see them in, their hair cut and colour or body shape).
Imagine having a poor memory for people, places and events.
Imagine being me.
I didn’t realise for a long time that this was different from other people’s experiences because I didn’t know what it was like to be anyone else.
When I received a diagnosis of autism, I became aware that at the core of this diagnosis was social communication impairment1. There are plenty of social theories about why people with autism experience social communication impairment, often centring on impaired understanding of emotions and the ability to attribute mental states (intentions, knowledge and beliefs) to others but none of them completely explained my experience.
Then I started to read about differences in information processing (refer also to previous blog post on Autism and Sensitivity) such as pragmatic language impairment, prosopagnosia, auditory processing delays and differences in types of memory. That was when I really began to understand the extent of my differences. I will follow with a brief description of each condition and its relationship to autism.
Pragmatic language impairment is strongly associated with the social communication impairments of autism2;3. It refers to difficulties such as recognizing social cues, problems understanding and engaging in ‘small talk’ and giving conversational responses that are socially inappropriate2.
Prosopagnosia is a ‘condition in which one can correctly label objects but cannot distinguish among faces’4. There are similarities in anatomical brain differences that attribute to prosopagnosia in people with autism4. I found this personal account of autism (aspergers) and prosopagnosia that describes it well. Abnormalities in face processing (the way the brain processes information regarding faces) are commonly seen in people with autism and are likely have consequences of difficulties with identity recognition and emotion recognition4.
Auditory processing refers to the way the brain interprets sound (speech and non-speech stimuli). There is extensive evidence for atypical processing of auditory information in people with autism5. These differences include pitch perception, hypersensitivity to loudness and prosody perception5. There is also preliminary evidence for impaired processing of auditory information in background noise in people with autism with many personal accounts of this difficulty5.
Autobiographical memory comprises both personally experienced events and self-related information. Episodic autobiographical memory has been shown to be impaired in autism while other memory systems are typical6.
These were some of the clues that made me realise that I experienced each and every one of the information processing differences listed above:
- The day I was able to recognise someone I hardly knew by the sound of their voice alone (with their back turned to me, in a quiet room where I didn’t expect to meet them) but at the same time being aware that I am regularly unable to recognize people I know well by their facial features especially in environments that I do not expect to see them.
- Giving a happy response in a conversation until I realise too late that the person I am with is actually angry or crying.
- Having to rely on subtitles while watching TV to ‘hear’ what the characters are saying. I love subtitles.
- Having to constantly ask people to repeat themselves because I haven’t heard what they have said even though all my hearing tests came back normal. Permanently looking confused during conversations in crowded noisy places and often nodding my head in agreement unaware of what I am actually responding too.
- Often forgetting to ask about key events or shared experiences in people’s lives, due to forgetting about them (either in that moment or permanently).
- Being completely unable to think of anything appropriate to say in a conversation, even while frantically searching my brain for something relevant, resulting in many prolonged awkward silences.
- Sometimes desperately filling awkward silences with random pieces of information that were not relevant to what was previously said.
- Being told by others that I have been referred to as ‘odd’ or being told directly that I am odd.
- Social anxiety +++ Can you really blame me for that?
There are so many more different things about me and there are reasons why I am different with quantifiable evidence to back it up. Trying hard (which believe me I do) and practising a lot won’t ever make me as talented as you at socialising. Memorizing and retrieving scripts such as ‘How was your weekend?’ or ‘How is your child going at school?’ can only go so far. It’s not my fault, it just is. My strengths lie elsewhere.
Imagine being able to empathise with difference everywhere, to avoid blame and to appreciate things about other people that no one else noticed.
Imagine having an amazing memory for the written word, to read words, to spell words, to pronounce words, to express how I feel in writing better than most.
Imagine being able to focus intensely on topics that interest me, allowing me to become very knowledgeable in those areas.
Imagine being me.
- American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013.
- Reisinger, L.M. Cornish, K.M. Fombonne, E. Diagnostic differentiation of autism spectrum disorders and pragmatic language impairment. Journal of Autism and Developmental Disorders 2011; 41:1694-1704
- Gibson, J. Adams, C, Lockton, E. Green, J. Social communication disorder outside autism? A diagnostic classification approach to delineating pragmatic language impairment, high functioning autism and specific language impairment. Journal of Child Psychology and Psychiatry 2013; 54(11):1186-1197
- Sasson, N.J. The development of face processing in autism. Journal of Autism and Developmental Disorders 2006; 36(3):381-394
- O’Connor, K. Auditory processing in autism spectrum disorder: A review. Neuroscience and Biobehavioral Reviews 2012; 36:836-854
- Crane, L and Goddard, L. Episodic and semantic autobiographical memory in adults with autism spectrum disorders. Journal of Autism and Developmental Disorders 2008; 38:498-506