By Lorna Wing (auth.), Kathryn Ellis (eds.)
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The most difficult obsessions to tackle are those which cannot be removed when all else fails. Screaming, self-mutilation, aggression are just such behaviours. With screaming you can pretend not to hear. That is the nearest you can get to taking sound away. But that is easier to write than to do. Your wincing eyes will give you away. It is also more easily done, during the day, by a group of professional people, able to give each other group support. Never, never let a small child get something by screaming.
However, social impairment, far more than other such problems, has a particularly devastating effect because it cuts off those affected from the ordinary sources of learning and emotional support other human beings can provide. Unless the nature of their impairments is understood and skilled teaching and caring are provided, the socially impaired people are psychologically isolated in a world they cannot understand. , Donnellan, A. and Paul, R. (eds) (1987) Handbook of Autism and Pervasive Developmental Disorders, Winston-Wiley, New York.
In those who were unable to talk, only marked mood swings or clear physical evidence of tension and anxiety could be identified as psychiatric. Although all were educated in school, most attended schools for children with severe learning difficulties. Only three went to schools specializing in educating children with autism, and only two are now in units designed for the needs of adults with the same range of conditions. How to increase and spread the amount of expertise available, and how to find practical ways of applying such knowledge to help children and adults with social impairment of all degrees of severity are challenges that face all of us in this field, parents and professionals alike.