Week 12
Autism and Childhood Schizophrenia
We were introduced in Week 11 to atypical autism or the autistic savant, an individual who is autistic but has a special talent on a selected area. In the case of Johnny Bear, he was able to remember conversations he had overheard and them repeat them verbatim, mimicking the speaker's voice. Other than this, Johnny showed signs of retardation and autism.

This time we look at autism again along with the onset of schizophrenia in a child. The onset of schizophrenia usually occurs between the late teens and mid-30s. It is rare that it occurs in pre-adolescence although cases involving 5 and 6 years olds have been reported. When diagnosing a child, it is difficult to pinpoint as severe a disorder as schizophrenia, and medical practitioners are more likely to see the symptoms as typical of more common disorders in childhood. When it comes to schizophrenia, children do not have as complex and elaborate delusions (false beliefs) and hallucinations (false sensory perceptions) as adults, but visual hallucinations are more common. Such is the case in this week's selection Silent Snow, Secret Snow.

Autism is brought into the equation because the patient tends to become more emotionally attached to their own fantasies or imagination than to the real world. This attachment to one's fantasies leads to impairment in social interaction, communication and patterns of interest. We see this week the tremendous desire of Paul to escape the realities of confronting his illness and how easily he escapes into his hallucination and imaginative world.

Our story deals with a young boy who suffers from childhood schizophrenia. The DSM-IV outlines the following symptoms for schizophrenia:
  • prominent hallucinations
  • prominent delusions
  • disorganized speech
  • grossly disorganized behavior
  • negative symptoms (an absence of emotional dynamics or rigid body postures)
  • disturbances in work, interpersonal relationships or self-care
  • communication disorders, pervasive developmental disorders, attention-deficit/hyperactivity disorder
  • or stereotypic movement disorder do not provide a better diagnosis

Our story also deals with autism. The DSM-IV outlines the following symptoms:

  • impairment in nonverbal communication such as eye-to-eye gazes
  • failure in developing peer relationships
  • lack of sharing enjoyment in life with others
  • lack of social reciprocity
  • delay in or lack of spoken language
  • impairment in initiating or sustaining conversations
  • repetitive language
  • an abnormal preoccupation in one or more restricted patterns of interest
  • adheres rigidly to routines or rituals
  • repetitive motor mannerisms such as finger tapping or twisting

There is no case study for autism or childhood schizophrenia.

On to our reading passage.

    1. Paul thinks, "How silly all this was. As if it had anything to do with his throat! Or his heart of his lungs!" What does this tell us about Paul's knowledge of his symptoms? What does this tell us of his knowledge that he has a disorder?
    2. What emotions are Paul feeling when he thinks "...it was all a nuisance, this necessity for resistance, this necessity for attention: it was as if one had been stood up on a brilliantly lighted stage, under a great round blaze of spotlight; as if one were merely a trained seal, or a performing dog, or a fish, dipped out of an aquarium and held up by the tail?"
    3. Even though he looked into the doctor's eyes, then at his mother's and father's slippers, what presence could he feel? Describe that presence.
    4. What does the snow say to Paul?
    5. Paul thinks, "These gross intelligences, these humdrum minds so bound to the usual, the ordinary? Impossible to tell them about it! Why, even now, even now, with the proof so abundant, so formidable, so imminent, so appallingly present here in this very room, could they believe it?" What does this tell us about the "gratifying and creative side of autism" the editors talk about in the introduction to this story?
    6. What caused Paul to tell his mother he was thinking "about the snow?"
    7. How did Paul's mother and father deal with his confession differently?
    8. What caused Paul to turn and run up the stairs to his room?
    9. The author writes, "'Listen!' it [the snow] said, 'We'll tell you the last, the most beautiful and secret story--shut your eyes--it is a very small story--a story that gets smaller and smaller--it comes inward instead of opening like a flower--it is a flower becoming a seed--a little cold seed--do you hear? we are leaning closer to you--'." What is going on with Paul in this passage?
    10. To what extent does Paul suffer from childhood schizophrenia? To what extent does he suffer from autism? What would be YOUR diagnosis between the two disorders; support your answer.

    When you've finished paste your work into an e-mail titled "Week 12 Homework." Then e-mail your work to me at aeaptl@gmail.com.

Week 12 homework is to be completed by 3:00 pm
Monday, May 18
for full credit. It will accepted after that date for half credit.

Reminder:
When e-mailing your work, be sure to paste your work INTO your e-mail.
Do NOT include your work as an attachment.

Copyright ©2009 Clay Sisman