The Potential Danger of Pretend or Imaginary Play In The Autistic Child...
The Slippery Slope... That Could Lead To... Adult Schizophrenia?
UPDATE:
I strongly encourage you to read "Book 3" posted in full on this website... with over 140+ parallels between autism and schizophrenia - including a very common history - I think that the development of schizophrenia in children with autism is certainly an issue all parents should take very, very seriously! At the time I had written the section below (in "Book 2"), I had seen certain things in autism that convinced me schizophrenia also played into this... and now, after a great deal more research, I have absolutely no doubt that this in indeed true... and clearly, I'm not alone in my thinking!
Let me provide for you a quote, that certainly would indicate I am not the only one to see this as a very serious issue: Look at the wording just below the picture of this man... note this appeared in a NARSAD (National Alliance For Research on Schizophrenia and Depression) Newsletter in Fall of 1998! NARSAD is the largest donor-supported organization for research into issues such as schizophrenia... as such, you would think they have a pretty good idea as to where "schizophrenics come from".
This was taken from an article that was supposed to tell us the difference between autism and childhood schizophrenia... clearly, the main "difference" being "age of onset"... well... in my opinion, that is a totally bogus criterion... leukemia is leukemia at age 2 or 80... and likewise, schizophrenia is schizophrenia... at age 2 or 80... you can not say these are "different disorders based primarily on AGE of ONSET criterion"... for that to be true, you needed a constant - the human brain... and we now knew that the human brain was anything but a constant over time... and given metals like mercury were known to have their most devastating effects on "developing cells"... that too would change over time in terms of "what was considered developing" in the human brain at a specific time of life: I quote from this NARSAD Newsletter:
“As the autistic child gets older, a small percentage improve and function well. The majority, however, take on the characteristics of adult schizophrenia with an emphasis on "negative" symptoms (i.e. withdrawal, flattened emotions, poverty of thoughts), rather than "Positive" symptoms (i.e. delusions, hallucinations).” [end of quote, emphasis added, NARSAD Publications: Research Newsletter Archive: Autism and Childhood Schizophrenia, How Related are Autism and Childhood Schizophrenia? By Anne Brown and Rebecca Weaver, NARSAD Staff Writers].
Below was a copy of a "print screen" for the website where I had taken this... look just left of the picture... toward the bottom of it...
http://www.narsad.org/news/newsletter/specialreports/fall98related.html
I discuss a whole lot more on these issues of the dangers of "pretend play" in autism in my third book... and I think all parents will see after reading that book why I have the concerns I do when it comes to pretend play and the autistic child! I fear we have many therapists out there trying to "teach" pretend play to these children without understanding what I see as very real issues when it comes to the loss of self and the loss of one's grasp with reality due to improper communication among the various parts of the brain in these children !
Here's the issue: Concept of self and imagination functions reside together in the frontal lobe... the ability to distinguish between truth and a lie or the "real and non-real" however, reside in the temporal lobe. If these two parts of the brain are not properly communicating... we have a major problem in terms of one's "grasp of reality".... and I very, very much believe this to be the case, that the parts of the brain are not communicating properly in these children. If I assumed little or no communication among the various parts of the brain, I found I could explain almost everything I saw in my son! I discuss this a great deal more in Book 3 - Breaking The Code: Putting Pieces In Place! - a book I urged all parents of children with autism to read - I think it will put in place many pieces of the autism puzzle for many, many a family!!
Note also the huge implications of seizures in all this... teens with schizophrenia lose a tremendous amount of gray matter with puberty onset... and you can not lose that much gray matter without having seizure activity... and if indeed the "majority" of children with autism go on to develop schizophrenia later in life... as I very much suspect to be the case... then this issue is a huge one for all parents of children with autism. Seizures can result in an alteration of one's sensory perceptions (sight, sound, touch, smell, taste), but they can also alter one's sense of self, one's sense of reality, etc. Seizures can occur anywhere in the brain... they need not occur in the motor cortex... you can have seizure activity without the involvement of the motor cortex (i.e., shaking, etc.).
This picture provides a view of what I fear may now await many children with autism at puberty onset... the pink represents gray matter loss - Article entitled: Teens With Schizophrenia Lose Gray Matter in Back-to-Front Wave, posted at: http://www.loni.ucla.edu/~thompson/MEDIA/PNAS/NIMH.html
Note: Puberty should be a time of gray matter THICKENING... but in schizophrenia, these teens are LOSING gray matter... and devastatingly so! Remember: According to the Simpsonwood transcript on mercury in vaccines, it was stated, and I quote:
Dr. Keller, pgs. 116 & 118: "…we know the developing neurologic system is more sensitive than one that is fully developed…"
Note: That states "WE KNOW" - not "we think"... "WE KNOW"!
My research into these issues has now convinced me that metals (mercury, aluminum and iron) target/devastate the most immature cells and destroy them... in autism, that would be the cerebellum (takes 20+ years to mature), in schizophrenia, that would be the entire brain (as shown above) when it should be having gray matter thickening throughout... and in Alzheimer's, that would be the hippocampus (formation of new memories) and the olfactory bulb.... a whole lot more is provided on all these issues in "book 3" posted in full on my website... and yes, Alzheimer's absolutely fits into this puzzle... I have 160+ parallels between autism and Alzheimer's... and note again, the very common history...
Note this "screen print"... from the University of Iowa... a university that specializes in the treatment of schizophrenia - look especially at the second paragraph - I quote:
"Schizophrenia, or dementia praecox, was originally distinguished from dementia in the elderly (later named Alzheimer's disease) because it occurred in relatively young people rather than older people". [end of quote, emphasis added, How Was Schizophrenia Discovered, The University of Iowa Mental Health Clinical Research Center (MHCRC)]. http://iowa-mhcrc.psychiatry.uiowa.edu/new/MHCRC_Web_Page/schizdisc.html
Note again: Primary criterion for pulling apart "schizophrenia" and "Alzheimer's" appeared to be AGE OF ONSET - a totally bogus criterion! For that to be a valid criterion, you needed a constant over time - the brain - and the brain was anything but a constant over time!
http://iowa-mhcrc.psychiatry.uiowa.edu/MH-CRCpages/How%20Was%20Schizophrenia%20Discovered.htm
Indeed, autism used to be called "childhood schizophrenia", schizophrenia used to be called "dementia praecox" and was discovered by Emil Kraepelin, Alzheimer's also used to be called "dementia praecox" and Emil Kraepelin's young protege was none other than Alois Alzheimer! So, these disorders share not only very common parallels (over 140+ parallels across all three), they also very much shared a common history!
And hence, the reasons for which I am now absolutely convinced that autism-schizophrenia-Alzheimer's are the same disorder over the life spectrum... and the result of metal toxicity (mercury, aluminum and/or iron)!
There is much, much more to all this... and how autism and schizophrenia appear to be very much inter-related... in fact, I do believe these are the same disorder over the life spectrum... it took decades to pull these 2 disorders apart... and perhaps that was for a reason... because they are much more alike than different in the first place! Note that "recent research" - again, according to NARSAD - indicates that "autism and schizophrenia may be related"... surprise, surprise! Note this quote in a NARSAD (National Alliance For Research In Schizophrenia and Depression) Special Report entitled The Neurobiology of Infantile Autism, by Roland D. Ciaranello, M.D. - I quote:
"For many years, researchers believed autism and schizophrenia were different variants of the same disorder, but epidemiological research showed that the two disorders did not occur more frequently in the same families than would be predicted by chance, so since about 1971, we have taught that they are distinct. However, more recent research suggests they may be related." [end of quote, emphasis added, The Neurobiology of Infantile Autism, by Roland D. Ciaranello, M.D, NARSAD Special Report, http://www.narsad.org/news/newsletter/specialreports/archautism.html].
Note that "not finding them both in the same family"... in my opinion, just further confirms that these are not "genetic" but rather "environmental assaults" due to things like metal toxicity!
Here's that screen print... note that many other researchers are also finding "common threads"... again, no surprise to me!
The fact also remains that from 1943 to 1971, they were considered "the same"... it was only in 1971 that they were "pulled apart" because of the belief that if indeed "genetic" and "the same", we should see both in the same family... but they were not seeing that... Could it be because the "assumption of this being a genetic disorder" was incorrect to start with!!! That was the reason they were pulled apart... because - "given these disorders were genetic"... if they were "the same" you should "see both" in one family... and they just weren't seeing that! I suspect that "genetic assumption" was the problem... not the fact that they "were the same" in the first place. The fact that so many still have trouble distinguishing the two and that it took decades to pull them apart and that they were pulled apart on a bogus "genetic assumption" and "age of onset criterion" should be enough to raise eyebrows here folks! If indeed parents are screaming "vaccines" for autism... and autism and schizophrenia... and I also believe Alzheimer's... are the same disorder... that certainly poses a HUGE problem for those in the government and in the pharmaceutical industry and as such, we can be certain that they would certainly fight against the "re-merging" of autism and schizophrenia!
This person's "informed hunch" is no better than mine, quite frankly, and based on everything I've researched - thousands of hours now - I absolutely do believe these are the same disorder... there are simply way too many "parallels" and too few "differences" among them... and may I add that the differences may very much be explained by the fact that the brain is not a constant over time and as such... what you see in autism vs schizophrenia may very well be the result of "time of assault" type issues! I also address the "genetics or genes implicated in schizophrenia" issue in the seminar I put together... very eye opening indeed!
The brain is NOT a constant over time... and as such, you can not say that these are not the same disorder based on "age of onset" criteria. Leukemia is leukemia... at 2 or 85... and metal toxicity is metal toxicity... at 2 or 85... and if metals are most devastating to immature or developing cells (as clearly indicated in the Simpsonwood meeting discussing mercury in vaccines), then, you simply can NOT compare the brain of a 2 year old to that of an adolescent or elderly person... the effects of metals WOULD be different based on "what is developing in the brain at the time of the assault"!
Remember this quote from Simpsonwood meeting - a quote by the study's chief author:
Dr. Verstraeten, pg. 166: "When I saw this, and I went back through the literature, I was actually stunned by what I saw because I thought it is plausible. First of all there is the Faeroe study, which I think people have dismissed too easily, and there is a new article in the same Journal that was presented here, the Journal of Pediatrics, where they have looked at PCB. They have looked at other contaminants in seafood and they have adjusted for that, and still mercury comes out. That is one point. Another point is that in many of the studies with animals, it turned out that there is quite a different result depending on the dose of mercury. Depending on the route of exposure and depending on the age at which the animals, it turned out that there is quite a different result depending on the dose of mercury. Depending on the route of exposure and depending on the age at which the animals were exposed. Now, I don't know how much you can extrapolate that from animals to humans, but that tells me mercury at one month of age is not the same as mercury at three months, at 12 months, prenatal mercury, later mercury. There is a whole range of plausible outcomes from mercury. On top of that, I think that we cannot so easily compare the U.S. population to Faeroe or Seychelles populations. We have different mean levels of exposure. We are comparing high to high I the Seychelles, high to high in the Faeroe and low to low in the U.S., so I am not sure how easily you can transpose one finding to another one. So basically to me that leaves all the options open, and that means I can not exclude such a possible effect."
This next (original) section still applies... although now, I see and understand a whole lot more issues fitting into this... based on brain structure and function... see "book 3" for more on that! What I had seen in this child, as described below, I now know has to do with the "need for closure" in persons with autism - as clearly described here (so obviously, I was not the only one to see this as "an issue" in these children... http://www.ont-autism.uoguelph.ca/from.shtml... but again, there is much more to all this in terms of issues with specific parts of the brain not communicating properly and the implications of that for autism, schizophrenia, Alzheimer's and the loss of self and loss of one's grasp with reality.
A whole lot more on all of this in "book 3 - Breaking The Code: Putting Pieces In Place!" posted in full on this website!
Clearly, the views of adults with autism as they relate to the ability to distinguish between "the real" and the "non-real" confirm my views that the teaching of "pretend play" in persons with autism may be very dangerous indeed if those with autism have such difficulty distinguishing the two in the first place!
END OF UPDATE SECTION
This section still applies... although now, I see a whole lot more fitting into this... based on brain structure and function... see "book 3" for more on that!
Like saying a lie, imaginary play is something most autistic children do not do... until they are taught "to pretend".
It has long been speculated that schizophrenia is the adult form of autism. Based on what I have come to understand of the role of partiality in the autistic child's life, I now believe that this may indeed be the case. The best way for me to explain this theory is by providing an example of what I believe can be a behavior that leads down the slippery slope leading to adult schizophrenia. I encourage all parents to read this section carefully, and completely.
For the autistic child, as with any child, fascination starts first with objects and then moves on to people as the child gets older. This is why young children are perfectly happy to just be at home with mom... but, as they grow older, the need to interact with other children becomes more powerful than the need to stay with mom. When the autistic child does that "crossover" - when the need to have friends becomes more important than simply playing with objects - pretend play, in my opinion, can take on a dangerous role... that of actually replacing people!
A mother I know recently commented to me that her son had become obsessed with a fictional character in one of his software programs, so much so, that he identified himself completely with the main character in this software package. Although this autistic child, like so many, kept very much to himself and did not like to be disturbed at all when engaged in a particular task, his mother soon discovered that if she called him by the name of this particular character in the software program, her son would leap to his feet and do just about anything she asked without making a fuss. If the character's name was not used, getting her son to do what she wanted was a lot more difficult.
In this particular program - but again, in my opinion, the "identification" could come from any character in ANY video, book, software, etc. - but, in this particular program, one of the main character's tasks was to take ice cubes and make snow. To accomplish this task, the ice cubes were made, then taken and put on a conveyor belt, passed through a machine and thus made into snow. Each snowflake was then inspected for uniqueness with a magnifying glass.
Note, there are several key things here...
1. A process is involved... this process has a beginning and an end.
2. The process has a particular order.
3. The process involves an individual... a character.
4. The task involves something "with order"... first in the form of placing the ice cubes on a conveyor belt and then in checking with a magnifying glass to ensure the perfect order or uniqueness of each snowflake.
This child came to be so completely identified with this character, that he came to respond primarily when called by the name of this fictional character.
This child also came to spend his time exactly as did the fictional character... the child spent a good part of his day... making ice cubes and putting them into his mother's freezer. So many of these ice cubes were made that the mother had to start bagging them... but the child made so many, that there were always loose ice cubes in the freezer, falling out each time the door to the upright freezer was opened.
If the mother took any of the child's ice, the child became very upset and the usual outburst/tantrum followed.
So, how does this fit in with schizophrenia? Please remember, this is simply a theory I am putting forth... I have no proof that this is what is happening, but, I suspect that it may very well be...
First, I want to emphasize that I believe "pretend play" becomes a very real issue once an autistic child does that all critical "crossover" from objects to persons in terms of what captivates his attention.
In the example above, the child was not allowed to "complete the process". He was only going "as far as" the making of the ice cubes... but, he never completed the process entirely. This, in my opinion, was a definite source of concern.
As the autistic child grows, I believe s/he learns coping mechanisms simply from "being in the world" and as such, he adapts a little more to his environment... picking up the concept of fractions along the way, understanding that things have labels, etc. Thus, coping mechanisms help with "the real world", "the physical world" as the child grows and as such, less focus is given to environmental tasks since the child is now better able to cope... having had years and years of experience to learn to adapt to his/her environment, having had years of labels to help understand so much of his world.
As such, it is my opinion, that environmental issues or issues as they relate to "objects" take less of a priority as the child grows. Socialization, however, becomes more and more important to the child. This is indeed true of all children.
It is, however, a well known fact that the autistic child has difficulty making friends... and herein, in my opinion, lies the DANGER of PRETEND PLAY in the life of the autistic child. As the autistic child searches for "friends" and discovers he has very few... or none... he may begin to identify with fictional characters... to consider "them" "his friends"... and since these "fictional characters" are now "one's friends", in my opinion, it would be natural for the autistic child to want to "play with them" much as a normal child would play with his "real friends".
In our example, the child engaged in the making of ice cubes... just as did the character with which he identified himself. Indeed, this particular child not only engaged in the activities of his "fictional friend", he was "becoming" his fictional friend - responding now, almost exclusively, only when called by the fictional character's name.
Also important to this analysis is the fact that in the above scenario, this child was allowed to make ice cubes - but, the process itself was never completed in its entirety... only a PART of the process was done. There was that key word again: "a part"... a "part" of the "whole" only had been completed!
Based on my understanding of the role of partiality in the autistic brain and the autistic child's inability to deal with the partial, as I observed this autistic child, I could not help but wonder what happens when a process was not completed, a conversation or activity with a fictional friend or character identified with was interrupted?
It is my belief that the fact that the process, conversation or activity was never completed makes it so that this "partiality" becomes the main focus of the child's attention...and just as the autistic child strived for completeness in the physical environment by spinning, etc., so may the autistic adult strive for completeness by "finishing" the process, conversation, task or activity that was left incomplete or "partial".
It is my belief that as the autistic child grows, by definition, he is simply "exposed" to more labels and concepts... and picks more up along his journey through life in terms of dealing with his actual physical world.
Given the fact that the life of the autistic child was one that demanded "exactness" and "order" in everything, I began to question what would happen if that "completeness in order" was missing... if, for example, a process was left only "partially done" as in the above example.
If a child was allowed to so completely identify with a fictional character, would that child not accept that character as part of his "reality" and consider that "part of his world" or "that new person or process" in his world something that needed to be made "sense of" and categorized or completed?
I could certainly see that as the environment became better coped with, the focus of the child's attention could certainly shifts to processes and other "issues" of conversation/process, etc. that had remained yet unresolved . As the autistic child can not cope with partiality and reverts to spinning, so too, do I suspect, the adult autistic person seeks a method to complete the partial...only now, it is to complete the partial within... and this, I believe could be what leads to schizophrenia.
This may very well explain why the schizophrenic is seen "talking to people who aren't there".
Therefore, to allow children who are autistic to identify with fictional characters may, in my opinion, actually lead to bigger problems down the road as the brain may focus on incomplete processes (as the ice cube to perfect snowflake example), incomplete conversations (as in with fictional friends), or any other incomplete or partial task, etc., that may have been interrupted and left "undone".
As such, I personally, will not encourage ANY imaginary play in my autistic child and will be very careful if he initiates it himself... careful to complete the task... to make sure tasks are completed with the verbalization of an "all done", etc.
In terms of "imaginary friends"... something I've not had to deal with... I will do my best to "snuff them out somehow" as soon as possible by perhaps suggesting the "imaginary friend" - "is gone", perhaps using the words: "bye bye" or something like that! This is one I still have to observe very closely in Zachary... to make sure he does not start to fall down that possible slippery slope that perhaps leads to adult schizophrenia. :o( This one is such a huge issue that I am simply, personally, not willing to take a risk by allowing my child to engage in anything that has to do with "imaginary friends".
I suspect that with so much in the life of the autistic child, LABELING pretend play will be critical in helping the autistic child to cope... to make him understand the difference between reality and the "pretend world". This may be as simple as explaining to the child for example that "dogs don't talk", "your imaginary friend is not real... he is not someone you can call on the phone... not someone who can really come and fill up your bucket in your sandbox", etc.
Indeed, for the autistic child, I truly believe that it is CRITICAL that pretend play be labeled for what it is.
Also critical in my opinion is the fact that any actual identification with a character/person be limited by constantly reminding the child that "his name is...." and actually using the child's real name only. Teaching the concept of "what's your name?"- of one's "self"- early on, I also believe is key... and using the child's real name and that name only when calling the child.
It is too easy for parents, siblings and others around the autistic child to fall into the trap of letting the child identify with a fictional character and allowing him to "respond to that name" when called by that name since that is "the name" that gets the child's attention. But, in this case, allowing that identification with a fictional character by the autistic child gives him, in my opinion, exactly what you do not want to provide... control over a potentially dangerous situation!
If you think about it, pretend play allows the autistic child TO CONTROL the situation, or his world... to make it "just the way he wants it"... much in the way "spinning" is used by younger autistic children to "do away with partiality". Indeed, many coping mechanisms seen in autistic children provide this sense of control over the situation. I find this to be true with spinning, self injurious behaviors, screaming, biting, associations whereby children create "new objects" out of parts to make a new entity (see information on creation of a truck in section on fractions), etc.
The key for parents is to allow only those coping mechanism, like Labeling, Echolia, Ordering Language, Counting, etc., that actually help the child cope with life in a productive way and to work at eliminating all negative and potentially harmful coping mechanism that allow the child to not only control his world in a negative manner, but also allow the autistic child a means of eliminating the need to understand his world. Labels, in my opinion, are truly the parent's most powerful ally in this fight against autism. If something has a label, it is a whole in and of itself... even a partial can be perceived as its own entity. Labels are, I believe, also key to keeping the child in "this world"... because they remove the frustration of "not understanding this world" and as such they can help ensure pretend play is labeled as pretend and this too, helps keep the child, in my opinion, "grounded in reality" as opposed to a fictional world he can completely control on his own. I encourage all parents to review all coping mechanisms and to encourage only the use of "positive ones" in working with their children. Parents will also find very valuable information under my section entitled Exercises I Do At Home. These are exercises I have done with my son in an attempt to help him deal with issues of "partiality"... in an attempt to help him better cope with his world!
My theory is simply that... a theory... as is everything else I have provided in these materials. However, in my opinion, based on what I have come to understand of the role of "partiality" in the life of the autistic child, I believe it is a theory that may warrant investigation.
Issues with "partiality" may also help explain other disorders that involve completing a task, such as obsessive compulsive behavior.
As I suspect that adult schizophrenia may be tied to the need to "complete the partial", so do I suspect that this may also be true for obsessive compulsive behavior. Many autistic children are reported to have obsessive compulsive disorders... and although many other children are labeled simply as "obsessive compulsive disorder" (and do not have the label of autism), I suspect obsessive compulsive behavior may simply be another, perhaps milder form of autism.
I once heard a young man speak of his life with obsessive compulsive disorder. The young man was approximately 17 and had no other "label"... he had not been labeled as autistic. As he talked he explained how he felt he could "catch germs everywhere" and that as such, he constantly had to wash his hands. If you think about it, much in the way that a bandage is quickly removed by the autistic child who has not had a bandage labeledm - a child who has not learned to cope with something (the bandage) which is not part of the whole (the skin) - so too, do I suspect a person suffering from obsessive compulsive behavior may be attempting to "remove" something (germs) that are not part of the whole (the skin or person). Again, this is simply a theory... but given we see so much "obsessive compulsive" type behavior in the autistic, it is certainly an interesting one - at least in my opinion. :o)
In closing this section, I want to mention one final thing. There is apparently research showing that schizophrenics often have parasites (i.e., hookworms) in their brain tissue.
Of course, as in so many other things, the medical community is quick to refute this possible link. You'll see this one listed and refuted under a very popular link called "Quackwatch" by simply doing a search for "Hulda", a somewhat controversial person in the medical community. Not surprisingly, "Quackwatch" also does not believe vaccinations can cause autism - as shown in this link. Given that most "advisors" for "Quackwatch" are from the medical community, this is not surprising to me. The medical community, a community so closely linked to the pharmaceutical industry, has long denied the vaccine/autism link - just as have the pharmaceuticals and the many government organizations (i.e., CDC, NIH, etc.) directly linked to this issue of vaccinations. I provide this information on parasites in the schizophrenic as "information only" for those who may wish to look further into this topic since I did find it to be a rather interesting one.
As a child, my mother always use to treat all her children for parasites on a regular basis. When hyperactivity seemed to be a little overwhelming, she always suspected worms. If indeed autistic children are prone to parasitic infestation due for example to the fact that they are often "licking things" and, in Zachary's case, actually eating sand (that may be laced with the eggs of parasites), that would certainly contribute to hyperactivity. As such, treating for parasites (i.e., worms) may be a good idea.