Sifting through the US CDC’s official diagnostic criteria for autism ~ Part B (1): Stereotyped or repetitive motor movements

This is the second post in what will probably ultimately become a series of four or five posts, in which I take the official US CDC diagnostic criteria for “Autism Spectrum Disorder” and attempt to make some real-life sense of it, applying it to my own personal situation.

(Disclaimer before moving on: Wednesday’s “histamine attack” morphed into a moderate upper respiratory infection, during which my brain gets a little cloudy, no doubt with help from some of the drowsiness-inducing over-the-counter medications that I occasionally use in order to obtain some relief.  Therefore, my thoughts, word choices, or perhaps syntax/spelling/grammar might require a few edits as I become aware of them.  I might simply forget to close a set of parentheses, but I also might forget to write entire sections of thought (lol).)

With that out of the way, moving on… 🙂

As I mentioned in my previous post, I’m writing this for not only my own “records”, but also for anyone else who might benefit from seeing what the semi-enigmatic criteria look like in real life, even if it’s just one possible example.  I’ve come across a handful of other blog-writers who have written posts of similar themes, and I know how much they helped me recognize that “OK, yeah, that trait does apply after all” in my own journey, so I thought I’d contribute to the supply of that information.

The CDC criteria are spelled out under five separate category headings (denoted with capital letters A-E); the heading for the second criterion (Part B) states: “Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history.”

What might that look like in real life?

Four subcategories contained under Part B illustrate a few examples, although sometimes these aren’t much help, because the lists are short and tend to highlight the more “severe”, “stereotypical” symptoms.  These sub-parts are:

1. Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypes, lining up toys or flipping objects, echolalia, idiosyncratic phrases).
2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day).
3. Highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).
4. Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment (e.g. apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).

Not exactly “real life” language.  I mean, who (besides specialists in this area) uses the word “echolalia” in everyday life?  Who doesn’t “use objects”?  What kid doesn’t “flip objects” at some point in their life?

I’m a little short on time, energy, and brain-stamina today, so I’ll just tackle the first sub-part in this post: “Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypes, lining up toys or flipping objects, echolalia, idiosyncratic phrases).”  🙂

Truthfully, I wasn’t sure whether or not the first sub-part even applied to me, at first.  What would stereotyped or repetitive motor movements look like?  Or speech?  After all, I don’t think I ever flapped my hands or rocked back and forth much, and even though I barely made it under the verbal milestone buzzer, starting to talk suddenly (and for the first time) at age two, I wasn’t aware of any odd or repeated speech.  (I think) I could sit still.  I had a fairly wide vocabulary.  Sometimes, when under stress, I do rock occasionally, but that’s about it…or so I thought.

Apparently, one of the “less-stereotypical stereotypical” movements is spinning.  My jaw dropped when I learned that.  I remember spinning All.  The.  Time.  I remember that one of my favorite activities was to position myself in the middle of the living room, fully outstretch my arms as though flying, and start spinning.  I even had a routine that pertained to this.  It was helpful if music was playing in the room (which was pretty often); that enhanced the pleasurable effect, as did the fact that the carpeting wasn’t one solid color; it had patterns on it.

I would start out slowly at first, looking down almost the entire time.  I would make mental note of how, as my spinning gathered speed, the motion of the patterns in the carpet transformed.  I also noticed the air currents around my arms and their effect on my arms.  Once I got “up to speed” (which I determined from trial-and-error by falling down if I got going too fast), I would then lift my head, shifting my gaze to straight ahead or one of my outstretched hands, focusing on them as the rest of the world spun by in a blur.  Then I would slow down, stop, and then spin in the other direction.  It was a sublime way to spend an afternoon.

Apparently, in the autism spectrum lexicon is the word “stimming” (which is short for self-stimulation, a repeated movement that has a calming effect); that term is losing some favor, however, in favor of less-creepy words like “self-soothing” or “stress/anxiety-relieving” behavior or “focus activity” or something similar.  That’s how the community refers to those stereotyped movements like hand-flapping and the like.

When you’re an undiagnosed adult, it can be tricky to see what some of these movements or self-soothing/focus activities look like.  Most of the widespread information out there pertains to children, and by adulthood, many of us have developed more subtle, more socially-acceptable “stims”.  It just takes a little while to realize that some of those activities are indeed “stims”.

Reading Rudy Simone’s book “Aspergirls” (link to Amazon, which also contains reviews), I realized that I “stim” All.  The.  Time.  I began to see just how immense and central a part of my life these activities have represented.  During childhood, my “stim” activities were borne more out of nervousness and a need for anxiety relief.  They included the spinning mentioned above, biting the inside of my lips, biting my fingernails, picking at my skin, and probably others.  I also enjoyed (immensely!) the living room rocking chair.  My activities as an adult have included playing with split-ends in my hair (which began as a teenager), shaking/wiggling/bobbing my foot or leg, painlessly chomping on one side of my tongue, singing, clenching my teeth/jaw, and painlessly picking at one spot on the palm of my hand (I’ve now developed a small callous).

My communication has always been a little odd, too, in various and persistent ways.  I’ve written before about my “alternative forms” of communication (as I experience and perceive them) and the fact that I do indeed go on and on about a topic (and my theory as to why).  But the echolalia is a more recent realization.  At first I didn’t think that applied to me, but then I thought back to the times where, as a child, I repeated a word over and over again, so much that it actually temporarily lost its meaning and became simple waves of sound that bathed me in a sort of calm.

Apparently, reciting quotes from movies (link to a basic article on FriendshipCircle.org) is another somewhat-lesser-known example of delayed echolalia.  My partner and I have always (and I mean always, throughout our entire 17 years together so far) communicated using movie references.  In fact, we have strung together entire conversations by cherry-picking different lines from different movies!

I’ve also noticed that after a particularly stressful conversation with someone, once I’m by myself, I’ll find myself ruminating about the conversation so intensely that I unconsciously begin to repeat certain words or phrases out loud.  This mildly startles me when it happens.

Sorry for what is probably a really dry and unexciting post.  (At least, it appears that way to me right now.)  I’ll try to add a little more “personality” when I edit it.  I might decide it’s not so bad after all and leave it mostly alone, or I might decide it sucks more than I can perceive right now and make a lot of changes.  Not sure yet, as my head is still a bit (OK, a lot) cloudy.  🙂

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(Image Credit: Cyril Roland0)