Saturday, July 9, 2016

Autism diaries: repetitive questions and fan brain

J knows that his repetitive questions bother people. He also knows that asking repetitive questions is characteristic of autism. Together, we've Googled sites and blog posts like like "Autism and why all the repetitive questions? I am going crazy!". No amount of repetitive questioning on my part gets him either to explain why he does this, or to let up.

Not that J isn't capable of asking really interesting questions. It's just a matter of getting him off of topics like bomb hoaxes, terrorist attacks, and, of course, ceiling fans. But whenever there's a vacuum, those topics creep back in--especially around his father, who tolerates them better than I do.

One recent evening, after D had just returned from a week-long trip, J followed him into the kitchen and unleashed a bonanza of pent up questions--about bomb hoaxes, terrorist attacks, and ceiling fans. Poor D was completely exhausted and was just trying to have a beer in peace. So I joined them and tried to get J to stop, finally resorting to "asking stupid questions makes you stupid."

At which J gently pushed me out of the kitchen and closed the door.

Sitting down at the table in the adjacent room, I got out my iPhone--my go-to device for communicating with J when we're in different parts of the house.

"Asking repetitive questions give you fan-brain," I typed.

No response. The questions to D about bomb hoaxes, terrorist attacks, and ceiling fans continued.

My next text: "Is your brain on fast? Or on reverse?"

J's questions to D did not relent. But suddenly I noticed that the topic had changed. Apparently of his own initiative, J was asking a question completely outside his typical triad. "When did it become illegal to advertise cigarettes on TV?"

"Good question!" I immediately texted, while D, still behind the closed door with J, racked his memory for an answer.

I hear J's cell phone buzzing with my praise, and he asks another question. "When you were a boy, were there restrictions on cigarette ads?"

"Another good one!" I texted while D gave his reply.

Another buzz behind the door, and another new question: "Did it used to be legal to smoke inside hospitals?"

"That is a really great question!!"

And so on, for about 20 turns of text, buzz, new question, new answer. D finishes his beer, opens the door, and I beckon him over to show him what I've been up to on my phone screen. J follows behind, sees what's going on, and beams in an beautiful broad smile.

Then he heads back up to his bedroom and his assorted fans.


C T said...

I have an Aspberger's nephew who exhibits the same tendency to fixate as his father. His father's fixations have been terrible for family relationships for the past few years, and the son really, really doesn't want to fixate, too. So I've been delving into PubMed for recent findings related to obsessive thoughts.
The research repeatedly shows apparent connections between lower levels of GABA & GABA receptors and OCD. The GABA(A) receptor is decreased when homocysteine is elevated (which fits with MTHFR defects being associated with autism, for MTHFR defects negatively impact conversion of homocysteine to methionine). Myo-inositol has been shown to help protect subunits of GABA(A) receptors in the hippocampus, and some people on Amazon are reporting that it helps them with OCD thoughts.
The research thus supports a two-pronged dietary approach to lessening fixations that consists of
1) supporting homocysteine conversion (making sure to consume enough betaine, zinc, B12 (but not the cyanocobalamin form), and folate (definitely avoid folic acid, though))
2) protecting GABA(A) receptors from internal or external antagonists by consuming enough myo-inositol.
What we eat can't change our genetics, but it definitely affects our phenotypes.

Anonymous said...

The behavior you're describing is fascinating to me from a brain standpoint . Does J ask questions that he knows the answers to (or alternatively, ones that have been asked and answered repeatedly already)? Is that part of the repetitive behavior? Or does he have an endless supply of new questions about the triad topics?

What I find interesting about your description of this interaction is that you seem to have disrupted the repetitive pattern by encouraging (insisting, cajoling, ?) J to willfully reconsider his behavior. Does this seem a plausible interpretation? I've recently been fascinating by the therapies/descriptions that describe using the "functioning" parts of the brain to circumvent the parts that are producing the depression/schizophrenia/anxiety/etc. I think a lot of people are wary of this trend because it can seem close to the demand that people just "snap out" of their distress/behaviors. And I see that danger, because, in practice, the peple who are successful, say, at suppressing their hallucinations or their despair in depression are doing so with a lot of cognitive work (which requires the resources to be able to devote cognitive load to that work, rather than other thinking) and with lots of support (like your iPhone intervention, or lots of time when other demands aren't made of them).


Katharine Beals said...

@C_T--Thanks for this digest of the recent research. Have you seen any particular foods being recommended as particularly good sources for these nutrients?

Katharine Beals said...

@Anonymous: yes, one of the key features of repetitive questioning, at least for J, is the predictability of the response.

It's hard to tell how much cognitive work is involved for him when he moves on to other topics.

C T said...

I would recommend beet juice in large quantities for both betaine and folate. I have a theory that the reason Poland continues to see such low autism rates (1/5 that of western Europe and 1/50 that of the USA) is the regular consumption of barszcz, a clarified beetroot soup, which, in light of how it's prepared, should contain highly absorbable betaine (betaine is water-soluble & heat stable to above 100C).
In light of the May 2016 Johns Hopkins announcement of their recent study finding that excess B12 and folate in mother's blood at birth was correlated with an 17 times greater risk of an autism diagnosis later for the baby, I would absolutely avoid the common forms of the supplements of folate in processed food and multivitamins (that would be folic acid and cyanocobalamin) and instead eat animal protein occasionally for B12 (and take hydroxocobalamin supplements if you want to be certain that there is no extra cyanide hanging out in the body, for hydroxocobalamin is used to treat cyanide poisoning due to the tight bond that cyanide makes with cobalamin) and for folate, drink OJ and eat leafy greens.
Animal products are the best sources of zinc; I'm not an oyster eater myself (I live in Colorado), but they're supposed to be one of the very best sources of zinc. Fruits, nuts, and beans are good sources of myo-inositol; inositol's usefulness in the body appears to be hindered by caffeine, so avoid a lot of caffeine in the diet.

Also, I have a ceiling fan question for J. One of our fans rocks back and forth when operating. Is it OK to just put plastic shims between its base and the ceiling to keep it stable? Thanks!

GoogleMaster said...

@C T, I had not heard about the JHU study re B12 and folate, but I found a summary of the conclusions at WebMD. Whoa... so insisting that pregnant women take folic acid supplements may have had unintended consequences.
(Aspie literalist aside: the reCAPTCHA was "select all images with cars" ... does an SUV count? what about delivery trucks? arghhhh!)