I AamA father of an autistic daughter and a molecular biologist. When my daughter was diagnosed as being on the autism spectrum, I began an in-depth study of genetic components of autism. I believe that every autistic individual has gifts and need...

I love the optimism of your research but the way you’re describing it here is reminiscent of the misconception that autism = savant. When you say that every autistic individual has gifts are you also speaking of extremely low functioning individuals as well? If so, what kinds of gifts does your research show are present in these individuals?

You point out the misconception that autism = savant. It does not. Savants are a small part of cognitive strengths that can be identified, developed and nurtured in autistic people. Every autistic individual likely has unusual positive traits. Low functioning autistic people struggle with the extreme of autism. What is unknown, but has been identified in “low functioning individuals,” is that their physical and social “low functioning” can occur with a surprisingly alert cognitivity. The underlying gifts of struggling people are unknown but to dismiss cognitive abilities because life is an extreme struggle would be wrong.

Do you know anything about premature babies and why they would be more likely to have autism?

Environmental traumatic events like premature birth or traumatic brain injury and PTSD can precipitate autism and autistic traits. When this occurs it is quite likely that the individuals have an underlying propensity for autism carried in their genetic heritage. This does not mean they would have autism following a “normal” birth. Traumatic events on top of an underlying precondition that otherwise might be normal can precipitate autism.

This is interesting because my autistic son caught meningitis at one day old. This was 19 years ago. He is a high functioning autistic but we haven't discovered any special talents yet! We always wondered if the meningitis may have been a factor.

We will never know the relationship between his meningitis and his autism diagnosis. There are a couple of possible explanations but it is all speculation. Special gifts or traits are often very hard to identify. The most successful path to discovering special abilities is to follow his own interests. Special interests are usually identified early on when young autistic children hyper focus or perseverate on topics, toys or interests. These sometimes are simply seen as habits and sometimes never really revealed until they are challenged as might occur in the work place where they have an ability that others don’t. In Silicon Valley this takes the form of creativity and being able to see relationships between seemingly disparate ideas or topics.

What gifts has your daughter discovered?

We learned early on that one of the calming things that we introduced our daughter to was polyphonic music as in Scarlatti and Bach. Her favorites later moved to Mozart and Tchaikovsky. This led to her learning piano at the age of 5. Three of the teachers she had claimed that she was gifted and indeed she enjoyed playing the difficult pieces of Liszt. Sadly, for unknown reason, in high school she dropped the piano, possibly because it wasn’t “cool”.

From day one, after her adoption, she was fascinated with the glasses her parents wore. She sketched from an early age, hundred, possibly thousands of bespectacled people and animals. This all led to an outstanding ability to draw and paint with excellent control of colors. She is today a successful artists and has sold much of her work.

Thank you for doing this AMA. Did you begin your research into autism after you were retired or was this a part of your career once your daughter was born? Additionally, did you publish any of your findings in peer-reviewed journals and if so what were some of your conclusions? How were they received by the greater community doing autism research?

My daughter was born 43 years ago and I have been following the autism research data for 25 years. Publications are limited to a chapter in a book by Scott Barry Kaufman. The book is entitled Twice Exceptional. I covered the subject of the overlap between twice exceptional and the identical traits in autistic children. I am not certain of the sales of the book. I am presently writing a book on autistic traits, the education of autistic students and the topic of the tragedy of girls and women on the spectrum.

What one piece of wisdom came hard to you that you wish you had known early in your daughter's life? How would that have helped both you and your daughter?

The most confusing thing for me about my daughter’s behavior was appreciating her struggle with extreme sensory issues. I remember walking out the front door to see my daughter suddenly rise from the sandbox and come rushing towards me with her hands over her ears, screaming at the top of her voice. When she got to me, I almost fell over as she jumped into my arms. Ten seconds later a military jet flew over at 500 hundred feet with a deafening sound. I believe she heard it coming long before an NT person would and was able most likely to feel the sound vibrations in her feet and hands in the sandbox.

Hypersensitivities are pervasive in all children with autism. We later learned she had food texture sensitivities, clothing sensitivities, touch/feel sensitivities and others, all of which created unusual behaviors that puzzled us as parents.

I believe that most of us who excel in the computer industry must fall somewhere into the spectrum to be able to tolerate and even enjoy the unusual mental activities we do every day. Is there any point for people like us to obtain a formal diagnosis or should we just self-diagnose as a peculiar but high-functioning individual?

I strongly encourage you to seek out a diagnosis if that is your inclination. If the diagnosis is positive you have an important piece of personal information that may have represented a puzzle for you. There is nothing wrong with self-diagnosing or indeed researching the various traits and aspects for those with autism. I encourage you to follow your curiosity.

My son has certain skills or abilities that we encourage to develop. The problem comes when you have to deal with standards and common cores in school. He excels in art but had problems in physical education, and because he is in constant movement, and looks healthy, teachers tend to dismiss his problems. It is very frustrating for him to have lower grades when he’s done his best. How would you adapt school curriculums so that high functioning autistic children can be happy and less frustrated in the early years of their education?

Standards and common cores are built for “normal” children in school these days. Modern thinking and neurodiversity believe that it is impossible to define normal. Your son clashes with school because he is wired differently. One of the most common traits of autism is poor motor skills that impact everything from throwing a ball to writing script.

Adapting school curriculum should start with recognizing that many people learn differently and that standard testing fails to measure subjects learned and understood. I would suggest you attempt to understand his best learning styles, possibly with the help of a counselor, and then approach the teachers and advocate for teaching and evaluating accordingly.

What are the similarities between autism and adhd? There seem to be many similarities along with stark differences. Why is this? Thanks for being a hero for neurodiversity.

Indeed, there are many similarities between ADHD and autism. For the most part they are seen in similar traits such as hyperactivity and inability to focus. We understand less about genetic activity and ADHD than we do about autism. Many autistic individuals also carry a diagnosis of ADHD and many ADHD people have obvious autistic traits. It is likely that there is some genetic similarity between the two conditions. Many of the behavioral burdens one lives with tend to improve with age. This comes from the normal maturation process which we know can be delayed in autism.

Hi, I'm a psychiatrist who has autism and adhd myself. Right now there are already a few genes that can be tested for, that are related to the presence of autism. These are only a few of the many that exist, if I understand it correctly.

Do you think that, with time, more and more genes will be uncovered, making genetic testing to diagnose autism viable? And if yes, how many years/decades would it take?

You are correct, the number of genes that can be tested for is really only a handful. Those are genes that constitute large changes in the DNA like mutation, deletion and duplication. This type of gene change, for the most part, occurs in about 30% of autism. 50% of autism cases originate from a large polygenic pool of thousands of genes. It will be far easier to identify large modifications of DNA than to measure hundreds or thousands of small changes.

I would guess that we should have another handful of genes available for testing for autism in the next 10 years or so. Theoretically we will have the ability to measure the genetic load of autism risk genes. It will take some time to measure the small changes in autism risk genes.

Thanks for your reply, this is extremely interesting to read for me. For example, I wonder about the applicability for my patients in clinical practice.

I've never been good with statistics - does this mean that 30% of people with autism, and mainly those with low functioning autism, will test "positive" on the current genetic testing?

Because of the few tests that we have identifying large changes, it is quite possible the testing would be negative. Likewise, when we do have more tests for large mutations I would expect to find more positive results from low functioning individuals.

I know this question is a bit ubiquitous, but how do you think autistic individuals of varying degrees can optimally cope with NT's, or with other autistics? I'm curious about how this "gift" can be applied in certain aspects.

A large group of autistic people learn how to deal with the world of NTs. I am reminded here of the tragic struggle girls and women have in dealing with their autism and the world around them. Girls learn at an early age to camouflage their autism and mimic NTs. They become so skilled that they can defy multiple attempts by professionals to identify autism.

Coping with NTs and the world around them is something most autistics learn however to varying degrees. Many autistic people believe they are most at home and relaxed living on their own. A solo lifestyle is most common in autism. Similarly many autistic individuals search out and find nonstressful relationships with other autistic individuals.

During your studies have you found it true that a lot of us are trans and more likely to be trans then neurotypical people

I’m on a lot of trans subreddits(due to me being trans) and someone mentioned that it’s more common for autistic people do you believe this/is it true?

What a timely question. It was reported this month in the highly respected journal, Nature, that the incidence of autistic trans/non-binary people is higher than in neurotypicals. Therefore, I do believe it is true. At this very moment I am researching this topic for a chapter in my forthcoming book.

My 4 yold nephew is nonverbal. He is going to therapy several times a week, what are the chances that he'll just start communicating?

Many young autistic children are nonverbal. It is critical to mention here that many people make the mistake of thinking that nonverbal children do not see, hear or understand all that is happening around them and in particular what is being said about them. It is highly likely there is a very active understanding person inside that understands all the is going on outside.

Many people become verbal as they grow older. Some who become verbal can become nonverbal again under stress.

I venture a guess that he will, like many, become verbal. I suggest you read the epic story of Carly Fleishmann in her autobiography Carly’s Voice.

what do you mean by “gifts”, what does this include?

what are the methods for diagnosing autism?

In autism the brain is basically wired differently than in neurotypicals. The genes that cause autism are responsible for the wiring of the brain. Gifts in autism are special attributes or traits that confer exceptionality. Exceptionality includes unusual abilities that can be intellectual, creative, sensory such as visual or hearing and many others. These are best exemplified by traits that gave us the music from Mozart and the theory of relativity from Albert Einstein. All children with autism have traits of exceptionality that need to be identified. These need to be nurtured, supported and encouraged.When this occurs one finds the exceptional creativity coming from the companies of Silicon Valley.

The methods for diagnosing autism are defined by the Psychiatric Diagnostic Manual “DSM-5”. In the manual one will find a list of conditions that are tested for that allows a diagnostician to identify autism.

Are people with synesthesia (for example) more often that not autistic?

You are asking a question of prevalence and statistics. I do not know the numbers but it is well known that a large number of autistic individual have synesthesia. It is also known that many people with synesthesia have many autistic traits with and without diagnosis.

Our eldest is diagnosed on the ASD and is high functioning. He receives regular ABA and has made incredible strides.

One thing we noticed early on after his diagnosis, was that certain foods really exacerbated his headbanging behavior (particularly food with corn in it). Has any research been done on the effect foods have on ASD behavior?

Nearly all children on the spectrum have hypersensitivities. One or many senses can be involved and most all unusual behaviors result from trying to compensate for sensory overload. Certain foods autistic find intolerable. This is because of texture, taste, smell or sound. My daughter refuses to eat potato chips because it sounds like overly loud thunder.

There is a good body of literature indicating that many autistic children have digestion issues. The reason for this is multifactorial. Some people are intolerant to certain foods creating indigestion or allergic-like responses. Many children have been treated for digestive issues with a wholesome diet and probiotics. On the subject of foods I recommend the book by Dr Janet Lintala, The Un-Prescription for Autism.

How would you assess the difference between oversensitivity and resistance to change/new experience? Having worked with a handful of clients doing feeding therapy to try new foods, I often find that a majority of declined foods are enjoyed quickly after a few instances of consumption. This leads me to think that for many foods, there is negatively reinforced declining food behavior which generalizes to contexts beyond exposure to overstimulating features of the food.

Most autistics are indeed resistant to change and new experiences. An autistic individual deals with environmental sensory overload. The usual mechanism for coping with too much going on around them is to try to keep everything in the environment as stable as possible. If nothing changes their anxiety with sensory overload tends to ameliorate. Changing the environment will often result in an outburst from boys or internalizing the stress in girls. New food is a change.

Do you think that people on the spectrum could serve in the military in non-combat roles? (Cyber, intelligence, etc)

I’ve heard that people on the spectrum are very good at picking up patterns and can be very good with computers (sorry if that’s an ignorant comment).

An excellent question and not at all an ignorant comment. There is no question about the ability of autistic people to make valuable contribution in the service of the military.

The best example of this is a special unit established by Israeli IDF. They have built an entire military unit of autistic individuals who contribute to intelligence, military strategy and computer science. Many members of this group are specifically assigned where the analysis of random events potentially has underlying patterns that can be easily identified by autistic people. There is a major role for autistic people in the military.

I am a teenager and I think I am probably autistic. Are there any books you can suggest to help me see the benefits? I am good at faking it but my parents see through that now and I will be tested soon but I would love some ideas for books to give me hope for a positive future! 

To answer your question I like the following books. A book about autism heroes titled "Different Like Me” by Jennifer Elder. Two books by Temple Grandin are very good, "The Autistic Brain" and "Thinking In Pictures". "Uniquely Human" by Barry Prizant.

I have 2 blogs on my website that discuss autism in girls and women along with a list of books that I like. www.AllWaysAutistic.com

Is there any definitive cause? Excess testosterone levels in the womb, age of the father, etc?

If testosterone related, can this be coming from semen? Would less or no sex during pregnancy help prevent an issue?

The condition of autism is entirely genetic whether early onset in infancy or later in life. The genes carrying the risk for autism number in the 1000s. Those genes have been in human heritage for millions of years. This group of genes has undergone evolutionary selection because they impart advantages to society. There are mutations that occur following fertilization that precipitate often severe autism. There have been theories regarding testosterone and explanations of some autistic traits thought to be based on testosterone. Nothing with regards to testosterone has been proven.

The condition of autism is entirely genetic whether early onset in infancy or later in life.

This isn't true. Environmental conditions like pre-natal valporic acid exposure and TBI's may also result in autism. Autism isn't a pathology, it's a behavioral description. Part of the reason so many large data sets are awful is because of the pathological heterogeneity of the psychiatric description.

There's really not thousands of genes that impart autistic symptoms either. As mentioned before, autism is NOT pathologically defined and as such GWAS studies end up tagging genes that have nothing to do with the actual symptomology of autism.

Are you making efforts to push for a pathological definition of autism?

This group of genes has undergone evolutionary selection because they impart advantages to society.

That's a pretty bold statement, what specific advantages has autism imparted on "society"?

Are there any neurological, electrical, or chemical processes which are unique to autism?

In what areas of focus is autism research under/over served?

Is the brain the mind, or are they separate entities?

Can you describe what autism is?

From a molecular perspective, what mechanisms create autistic symptomology?

Can autism be cured? Should it be cured?

How has the definition of autism changed since it's inception?

If we assume that nearly all function starts in the cerebellum and the neocortex works as a "social sense" organ, is it fair to think of autism as a sensory disability rather than a psychological one?

In no way am I attempting to argue that autism is a pathological condition nor is it defined as such. GWAS studies indeed tag genes that have no apparent contribution to symptomology of autism. Presently it is hard to make conclusions from those tags. Evolutionary selection of autism is a bold statement. It can be argued that unusual social behavior and sensory sensitivities provided individual with abilities to see and hear a threatening environment. In primitive society that conferred a benefit to the group as a whole.

There are substantial neurological differences in the cortex of autistic people. These are variable and widespread. They all relate to differences in neurotransmission in the brain.

Autism cannot be cured and is a lifelong condition. There is no argument for curing autism and it cannot be rationalized. The brain is wired differently; that is something you cannot change.

Autism carries significant sensory abilities and disabilities among other traits. Most all psychological problems come not from autism but from struggling to deal with sensory overload and social pressures of being different.