Fight-or-flight magnified by autism

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I got bitten again today, I am certain it won't be the last time, but it sure makes me think about the first time. This time the child bit me to communicate frustration. The first time, I was bitten because of the amygdala.

When it happened, I didn't even see it coming. I hadn't worked with children on the autism spectrum very long, and, although I was actively researching autism and effective treatments, I wasn't prepared for this situation.

I just saw Susan, sitting at a desk in a cubical, putting together a puzzle, over and over again. The wooden pieces went into place, first the upper left hand corner, then the lower right. The middle piece was deftly placed exactly where it needed to be and the remaining pieces fit in around it. Then, with one swift movement, the puzzle was flipped over; crash, bang, clatter, the pieces spill out onto the desk. Susan shoves them to one side, places the frame back down and begins again, always in the same order, like clockwork.

I watched her for a few minutes, fascinated by her intensity, her precision. The only interruption to her near perfect replay of this event was the occasional quick hand movement needed to shove a stray, curled lock of chestnut brown hair back behind her ear, where it refused to stay for longer than 20 seconds. So enthralled was she in this repetitive, predictable activity I could have sang "God Bless America" at the top of my lungs and I doubt she would have taken her attention away from the ever fascinating coming together and falling apart puzzle.

It is time to go to lunch, so ... insensitive, ignorant me; I reached out to block Susan from flipping the pieces out again. I thought I was doing the right thing. I knew Susan wouldn't leave the puzzle unfinished and I let her do that, and I wanted to keep the pieces in place so she didn't need to repeat the cycle, but I was unaware that her amygdala would be triggered by my suddenly interrupting her world. Faster than you can say, "ow" I had a nice imprint of Susan's dental record on my forearm.

The amygdala is a small, almond-shaped part of the brain. It has some very important functions including social communication, processing the human face as well as scanning the interior environment; the emotional and physiological well being of the individual. The amygdala is also in charge of more basic, survival functions like scanning the exterior environment for potential dangers.

This small, central brain structure is responsible for us jumping out of the way of an oncoming vehicle before we even really think about it or to strike out at a threat to protect ourselves, that whole "fight, flight or freeze" reflex is your amygdala hard at work. This is the center of fear.

Now, let's imagine what would happen if your amydala were enlarged, even more sensitive. Add to that fewer connections to the frontal lobe, the part of your brain that actively "thinks" about information. This fear response becomes a hair trigger. This is the reality of the brain of children affected by autism.

A picture of a snake can cause the same fear and anxiety in a child with autism as a viper on the neck of a neurotypical person (someone who is not affected by autism or another developmental disability). Instead of a mugger in the dark causing you to strike out, a familiar adult, in a safe place, reaching for you at the wrong time, can make you bite.

So looking back, knowing what I know about brain biology now, I completely understand why that sweet little girl sank her teeth into my arm. An action that may have caused a neurotypical child to jump had activated the "fight" impulse, all thanks to an overactive, under-communicative amygdala.

For more information on the research behind this column, and ways to avoid setting off the fear response, visit the EWASDA website at: www.ewasda.org.

Kathleen Gilmore, a resident of Walla Walla, has taught individuals affected by autism spectrum disorders for more than seven years. She has a master's degree in education and is enrolled in a board certified behavior analyst certification program. She is the founder and president of Eastern Washington Autism Spectrum Disorder Association, a local nonprofit organization dedicated to raising awareness and helping families affected by autism. She can be reached through the group's website at www.ewasda.org.

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