Friday, November 30, 2018

Press Release: Autism Research Program

This year, as last year (technically last January), I went to Washington DC to serve as a consumer reviewer for the autism research program.  I was thankfully less tired this year than I was last year, and the trip was less rife with difficulties.  There was even a smaller workload this time around, which was a kindness since most of the work happened in October (a busy month for me).

I was pleased to be called on to serve again, and was pleasantly surprised to see many of the same faces for other consumer reviewers and scientists.  Shockingly, some of them remembered me too.  They even remembered me positively, which is good because I don't remember being terribly positive at the time.  Mostly I remember being grumpy and overwhelmed and tired.  

Anyway, there was less socialization this year, which was too bad, but I did still get to chat with a few scientists and handed out a few cards.  I have this bad habit of educating people I rub elbows with, but considering the guy running the panel told me he thought I was MVP reviewer, I suppose I must be doing okay.  

Here's the official press release:

The Peer Reviewed Autism Research Program (ARP) consumer advocate Sarah Frisch recently participated in the evaluation of research applications submitted to the ARP sponsored by the Department of Defense. Sarah was nominated for participation in the program by Autism Support of Kent County in Grand Rapids, MI. As a consumer reviewer, she was a full voting member, (along with prominent scientists) at meetings to help determine how the $7.5 million appropriated by Congress for Fiscal Year 2018 will be spent on ARP.

Consumer reviewers are asked to represent the collective view of patients by preparing comments on the impact of the research on issues such as diagnosis, treatment, and quality of life. When commenting on serving as a consumer reviewer, Sarah said, “It’s challenging to represent so many different people, from teachers to parents to autistic children and adults of all kinds, but rewarding to know our viewpoints matter and are taken into account. It's also great to meet so many people that share my passion for bettering all of our lives.”
Consumer advocates and scientists have worked together in this unique partnership to evaluate the scientific merit of research applications since FY07. Colonel Stephen J. Dalal, Director of the Congressionally Directed Medical Research Programs, expressed his appreciation for the consumer advocate’s perspective during the scientific review sessions. “Consumer advocates are an integral part of the CDMRP’s scientific review process. They provide a key ingredient to the review process, the patient’s perspective, which is real and urgent. The collaboration of Consumer advocates alongside the scientists’ subject matter expertise is a truly unique collaboration that is difficult to find in most medical research programs.” 
Scientists applying propose to conduct innovative research focusing on improving the lives of individuals with autism spectrum disorders. The ARP fills important gaps not addressed by other funding agencies by supporting groundbreaking, high-risk, high-gain research while encouraging out-of-the-box thinking. 
More information about the DOD’s ARP is available at the website:
Media Contact:
Erin Bolling, Public Affairs, 301-619-7783

Wednesday, November 28, 2018

Legwork and Life, week of 11/28/18

This is Legwork and Life, where I track the legwork and opportunities in my career as an autistic advocate, and also describe parts of my adult autistic life, including my perspectives on everyday problems and situations.

Hello from my house, where I have safely returned after the 12+ hour drive from my inlaws' house in Connecticut.  Thanksgiving went really well, to the point where I think it's in the running for "best inlaw visit ever."  The other major contender for that title would be my very first visit, where I was fairly cheerful because I was running on the "new relationship" high.  

I dunno if "cheerful" describes my demeanor this time, but my general attitude reminded me of my brother a decade back, save that perhaps I was a mite more talkative.  I'm not sure if that's a genetic thing or what, because I wasn't trying to replicate his particular combination of polite, thoughtful, and caring.  It's not the first time I've noticed the similarities on my better days, so perhaps this is how I would normally act if I wasn't slightly depressed most days.  

Regardless, I'm very pleased that I handled the transitions between home, Washington DC, and Connecticut so well.  My supplements arriving in time definitely contributed to the success, I'm sure.  The visit did burn through most of my blog buffer, which is somewhat to be expected, but I don't feel like the situation is dire or impossible.  I simply need to make sure to spend a lot of time in the next few weeks rebuilding it, before the December holidays strike.  

The trip back from CT was probably one of the nicest such trips I've ever made. There's only so pleasant a 12+ hour trip can be, but having a second driver to switch off with helps.  Music helps.  This year we actually added a third kind of boredom-reducer, a podcast, to the mix.  It wasn't my usual comedy joke advice podcast that I am still working through (it's been at least half a year, probably more, of me just listening to this one podcast to try to catch up).  

Instead, it was a theatrical Dungeons and Dragons (D&D) game podcast.  Basically, a GM runs a D&D campaign, records it, and then adds sound effects and music and such to make the game more immersive and entertaining to listen to.  Since my spouse and I both have a background in D&D, it was just fun to hear all the creative ideas the players and dungeon master came up with.  Since D&D is ultimately a cooperative storytelling experience, it's really cool to see what other people dream up, and it can inspire ideas of your own.  

I'm still pretty done with personally playing D&D, but I don't mind hearing about others' fun experiences, and this is kind of an exaggerated version of that.  It's also something my spouse and I can do together, which he values very much.  

Monday, November 26, 2018

Reading the Research: Identifying GI Disorders

Welcome back to Reading the Research, where I trawl the Internet to find noteworthy research on autism and related subjects, then discuss it in brief with bits from my own life, research, and observations.

Today's article deals with gastro-intestinal (GI) disorders, which are so commonly found alongside autism that some parents and professionals insist they're part of autism.  Regardless of whether you believe that (I don't), GI disorders do affect at least 25% of autistic people, and that number may be a great deal higher than our numbers show.

The reasons are manifold.  First, for autistic people who are nonverbal or have limited communication, it can be really difficult to convey that you're in pain, or what kind of pain you're experiencing, or that the pain is a regular problem.  Second, if you've had pain in a certain area for as long as you can remember, or pain in that area is a very commonplace occurrence, it may not occur to you to bring it up.  I suffered constipation for much of my childhood, and had no idea it wasn't normal.  The most that was said on the subject was teaching me how to use a plunger to unblock the toilet pipes after I was done.

Third, even if you're capable of conveying the information and recognize the situation as abnormal or relevant, talking about your bathrooming isn't really a normal or polite subject, so it's not necessarily addressed.  Fourth, assuming all these previous conditions are met, the autistic person may not be able to pinpoint exactly where it hurts when asked.  The article quite rightly points out that sensory processing disabilities exist, and can really get in the way of diagnosing a potential problem.  When asked to locate the pain, a person might point to their stomach rather than their colon, which muddles the issue quite effectively.

The article also makes the very excellent point that GI problems can lead directly to behavior problems.  This is a surprising revelation to some people, but it shouldn't be.  At least, not when you think about people who live with chronic pain.  In my experience, such people (including me) tend to be get frustrated more quickly, have less patience for things overall, and can be both aggressive and angry in the wrong circumstances.  Parents sometimes mistake these poor behaviors for symptoms of autism... but while autism can't be cured, GI problems can be.

With all this in mind, the researchers developed a short questionnaire to try to simplify the process.  At only 17 questions, it's not at all bad, and could be easily used in a doctor's office when a parent has concerns about their child's behavior.  And with an accuracy rate of 84%, it's significant enough to reasonably send a parent off to a GI specialist.

Hopefully their second study will come back with similar results, and this questionnaire can be adopted widely.  A lot of kids and adults could be spared a lot of suffering as a result.  

Friday, November 23, 2018

Worth Your Read: The Value of IQ

This is a short blurb about a documentary called Intelligent Lives, the subject of which is people with low IQ.  This is sometimes referring to as intellectual disability, or ID.  Autistic people can have IDs as well as other conditions like depression and anxiety, and in fact, one of the subjects of the documentary is autistic.

I wanted to take a minute here to talk about IQ overall.  In the educational setting, IQ measures intelligence.  To the general public, that's the beginning and the end of it.  A high IQ means you're smart and more likely to succeed, and a low IQ means you're not, and are less likely to succeed.

Now, I have a psychology degree, so I learned about IQ in more depth than most people do.  IQ, or Intelligence Quotient, is a measure of how well any given person learns in an educational setting, especially academic subjects.  That's all it does.

Does that seem like the equivalent of overall intelligence?  If it does, let me explain a bit more.  Academic subjects, like math, writing, history, and literature, are only a small portion of what a person draws on to be successful in life.  In addition to these, there is also:
  • Interpersonal intelligence: how well you sense others' emotions and motives, how well you handle disagreements, and how well you can manage and direct people into a working unit.  Autistic people, myself included, often struggle with this form of intelligence.  Because we're so different from others, it's not as intuitive to understand people.  
  • Intrapersonal intelligence: how well you know yourself, your reactions, your motives, your strengths, and your weaknesses.  This skill is important for taking care of yourself.  
  • Musical intelligence: how well you can keep a beat going, identify specific sounds, and even how good your sense of pitch is.  Perfect pitch is fairly rare in Western society, but approximate pitch (which is what I have) is more common.  Musicians usually score highly in this, for obvious reasons.
  • Kinesthetic intelligence: how well you can coordinate your limbs and fine motor movements.  Athletes tend to excel at this, but so do surgeons and gamers.  
  • Existential intelligence: your grasp of what life is about, why we live, and why we die.  This tends to come up in religious settings or philosophical ones.  
  • Spatial intelligence: how well you can visualize things in 3D.  Architects, sculptors, and graphic designers all tend to excel at this.  
Debatably, there are even more kinds than these.  The point being, though, is that IQ simply isn't a catch-all measure of what a person is capable of.  There are all too many high-IQ autistic people that succeed in academia, only to graduate and be unable to keep a job.  Lacking social skills, not understanding how to handle other people, and not having sufficient functional self-care skills (knowing how to do the laundry, keep yourself clean, and take care of a living space, for example), can make it impossible to handle the demands of adult life.  At least one piece of research agrees with me.

I count myself as a lesser example of exactly this phenomenon.  I wasn't supremely ill-prepared, and I'm not brilliantly high-IQ, either.  But college was definitely a difficult experience.  Even though it eased me into taking care of myself, it was still extremely challenging to manage attending all my classes, keeping my area clean, handling personal hygiene, and still remembering to eat and do homework.  I definitely let any non-mandatory social experiences lapse by the wayside for the first couple years, and often forgot to do all of my personal hygiene.  

My grouchy stomach usually ensured I ate, at least.  Even if the food often wasn't very good.  I may have spent most of my 3rd and 4th years in college eating mac'n'cheese for dinner, every night.  And my lunch was often nearly the same thing each day, although I did at least try to make that meal balanced.  

But in the end, I tried various full time jobs using my education and detail-oriented skills, and succeeded in keeping none of them.  The 9-5 schedule simply strangled my energy reserves until it ground me down to misery.  My moderately high IQ didn't help in the slightest for the demands of the real world.  

This documentary will show, in ways mere words can't express, that having a low IQ need not bar you from having a successful life, and doesn't reduce your value as a person.  I'm looking forward to attending the screening of it in my area.  The website for the documentary is here.  Check it out, and see if there will be a showing in your area.  

Wednesday, November 21, 2018

Legwork and Life, week of 11/21/18

This is Legwork and Life, where I track the legwork and opportunities in my career as an autistic advocate, and also describe parts of my adult autistic life, including my perspectives on everyday problems and situations.

Hello from Connecticut, where my inlaws live, and where I'm currently visiting to celebrate Thanksgiving with them.  This year, Chris' family gets us for Thanksgiving, and my family gets us for Christmas.  Next year it'll be the opposite.

I survived the first half of my trip!  The expedition to Washington DC for the Autism Research program was a success.  They might even invite me back next year, it remains to be seen.  I may have slightly made an ass of myself last year (I was less than impressed with all the genetics and mouse models when autistic people are literally dying from lack of support services), but not as much this year.  I suppose that probably bodes well for the future.  I can only be called to serve so many times, but they do seem to appreciate having me around.

Due to nondisclosure forms, I don't get to talk about what I reviewed, but I can say I was a lot happier with this year's crop of applications than I was with last year's.  It was also cool to see some of the same scientists and other consumer reviewers as last year, which was helpful because it's really stressful to get shoved into a room with a bunch of strangers and be expected to interact with them for hours.  They do make things easier by giving everyone nametags, but even so.  I definitely didn't remember pretty much anyone's name, but due to the nametags, that didn't matter so much.

Now I get to work on surviving part 2 of my trip, which includes the added bonus difficulty of not having my supplements every day.  I was an enormous derp and miscounted how many days the trip would be.  So I'm going to be having my pills every other day, and hoping the ones I ordered to be shipped here will come in time.  "Less than ideal" is definitely an understatement.

It should be okay... the pills should arrive by the end of today at some point.  I just really want them sooner because the house I'm staying in is quite old by US standards (nearly 250 years old), and thus quite dusty and possibly molding or mildewing somewhere not easily accessible to humans.  I get fuzzy-headed, grouchy, sad, and anxious when I'm here.  The pills offset that a great deal, though not entirely.

I do still have the generous offerings Chris' family provides to help offset the house as well: an air purifier, a space heater to help with the open window in the room, an electric blanket, and four of those weird Himalayan salt lamps.  I have absolutely no idea if the lattermost do anything, but the light they shed is nice, so I'm not complaining.  I might get one myself and use it as a nightlight, regardless of any claimed positive health effects.  The light they shed is orangeish pink, rather than any kind of blue or white. 

Anyway, wish me luck with surviving Thanksgiving!  

Monday, November 19, 2018

Reading the Research: Disability and Poor Mental Health

Welcome back to Reading the Research, where I trawl the Internet to find noteworthy research on autism and related subjects, then discuss it in brief with bits from my own life, research, and observations.

Today's article helps to clear up a misunderstanding about autism and mental illnesses like depression and anxiety.  Autism, after all, often comes with depressive disorders and anxiety disorders, such as bipolar disorder, major depression, obsessive-compulsive disorder, and panic attacks.  These things can be so well-intertwined with the symptoms of autism, that people equate the conditions.  Having autism, to some people, includes having depression and anxiety.  

While this is generally accurate, statistically speaking (the statistics vary, but 80% is often quoted), it's not accurate in the absolute sense.  Autism, as this study shows, does not innately include depression and anxiety.  Instead, the cause of those conditions is social stress, and the stigma people attach to our lives.  

In much plainer words: we aren't broken (soul-less, rude, inhuman, un-teachable, hopeless, weirdo) people, but other people treat us like we are, and that's painful and hurtful.  Over time, that stress and pain add up, and mental illness can result.  

The researchers describe this stress as "minority stress," equating it with the kind of systematic stress that racial minorities suffer in the US.  The good news about this is that we already know how minority stress can be handled: better education, integration, and better support systems.  When people are exposed to autistic people young (or when they're older, if they're flexible-minded), they can learn to treat us like we're people instead of weirdos.  Our eccentricities can be considered acceptable, even if they're not entirely understood.  

In short, the stigma can be undermined.  With fewer people subscribing to that stigma, and treating us like second-class people, the mental health of all autistic people will improve.  And that will mean fewer suicide victims.  

Friday, November 16, 2018

What's a Social Life, Anyway?

I turned 30 this year.  Societally, 30 is when you're supposed to have your life together.  That includes your social life as well as your professional life.  Since I'm autistic, the social life is the more crippling factor that contributes to the professional life's success or failure.  Autism is, after all, a social disability.  I simply don't think like most people, and didn't learn to socialize and act the same way most people do.

Autism, then, can make for a difficult time making friends, holding conversations, and managing social expectations.  In short, autism can make having a social life very difficult.

When I was a child, a stinging retort some children would throw at each other was, "Oh, get a life!"  Now that I'm 30, I started to wonder if I'd succeeded, and what exactly constitutes a social life.  A social life, I suppose, is the summary of a person's relationships with the people around them and with the general public.  So what's a good one look like?


I expect the definition of a good social life varies based on who you ask.  Some people value achievement, and connections that advance their careers.  Some people value pleasure, and favor people that are entertaining to be around.  Others value social change, and make connections with minority groups, politicians, or nonprofit organizations.  Still others seek truth and understanding, and look for others that can help shed light on difficult questions.  And some value a particular hobby or profession, and seek people within their favored subjects.

I think most people tend to opt for a combination of these and other values, favoring some more strongly than others.

The relationships we seek decide which events we spend our time on. For example, a fancy dinner party for social climbers, a church's Bible study, or a choir or other interest group?

All of my examples so far have been groups you have to leave the house to attend, but you can also attend events virtually.  The online computer game I play with my spouse involves the two of us spending a couple hours per week with people from California, Pennsylvania, Louisiana, and other US states.  We all meet up at a scheduled time and play a very challenging piece of content in the game together.  Personally, I feel this is a legitimate use of my time, but I expect there's at least one person out there that feels that if you're not meeting people outside your house, it doesn't count.  That theoretical person and I will just have to disagree.


Then, too, you need to keep in mind how much social interaction you need, and how much you can take.  I, like most humans, have a certain level of minimum required social interaction in a week.  Less than that level, and I start to get lonely and sad.  My depression gets worse, and my anxiety ramps up.

But especially for introverts like myself, I think there's also a maximum level, after which I run out of energy and become unhappy.  If I go to events all the time, and fill up my schedule, I start to get crabby and short-tempered.  Then that starts leaking out on people that don't deserve it, and that's no good for anyone.  Instead, I have to set aside some time in my day to be alone.  That includes being away from my spouse, by the way, even though I love him very much.  I simply need alone time as part of my self-care. 

So a good social life balances your alone time and your social time.  You don't run out of energy, but also don't starve yourself for socialization.

It's a bit of a tricky balancing act, and I feel like most people don't really have to think about it.  I do, though, and it's not much fun.  The idea of limited energy has been posited before by someone much wiser than me.  If you're not familiar with Spoon Theory, I strongly suggest you click that link and read the short story that explains it.

Putting it Together

So, perhaps a broad definition of "a good social life" would be "a social life that meets your personal needs and values."  Which then begs the question: what are my needs and values? 

Personally, I think my need for social interaction is fairly low.  I'm fairly heavily introverted, and I spent much of my childhood without proper friends, only interacting with people when necessary.  A good book was a much better companion than another person.  Nor do I seem to benefit much from having the sound of human voices nearby (such as from a TV or podcast).  I've heard of people having those on while they're at home "for company," which struck me as kind of odd.  But either way, I'm fairly happy by myself, and rarely suffer the effects of under-socialization.

Over-socialization is a much larger problem for me.  I seem to have something like a daily ration of energy, as well as a weekly ration.  Exceed either one, and the effects linger.  Managing how much socialization is too much is definitely an art, not a science.  I can spend hours in my spouse's company and spend very little energy, for example.  Or for the same amount of energy, spend 10 minutes with a difficult stranger.  So what kind of people I spend time with matters, and what kinds of expectations are put on me also matter.  A fancy party where I have to dress up and make polite conversation costs a lot more energy than a small get-together at a friend's house where we'll be watching a favorite TV show and eating takeout. 

Values-wise, I seem to currently favor people that are interesting to be around or share similar interests to me, with social change and truth being secondary factors.  I should probably be prioritizing my career more highly, but that's exhausting and I tend to run up against my energy limitations. 

My regular week's events include:

  • three "catch up with friends" events, 
  • one "watch a TV show with friends" event,
  • two "exercise with parents" events (one of which inevitably bleeds into lunch and chatting, and why shouldn't it?),
  • one regular church service (where I sometimes run the sound board),
  • one Bible study event,
  • two regular guild meetups in World of Warcraft to play group content together.
Onto this list, there's also the monthly events, which include attending an autism parent support group, attending my condo association board meetings, and going to hang out with a group of autistic adults and play card games or visit local attractions.  (There's also this blog, which is my daily job, and household chores, of course.)

In the End

I spent a lot of my late 20s worrying that I wasn't doing a good enough job managing my life, and that I was becoming a shut-in.  And indeed, I do spend a lot of time indoors and in front of my computer.  But I think, looking at that list, that I'm probably doing okay by way of having a social life.  I suspect I spend more time on self-care than most people do, but when the world is so hostile to people like me, self-care is essential.  Also, my work and my play are mainly at my computer, so it kind of makes sense.  

Hopefully, as I age, I can continue to keep a good balance in my activities and energy levels.  Looking at my list, I feel like I should probably add in a weekly autism-related activity of some kind.  I'm not really sure what to add, though.  The local autism support group doesn't really need clerical help (I already asked), and I don't know what other help I could offer them.  I suppose I can ask the next time I see the chair of their board.  

Beyond that, I'm not really sure what else to look into.  But I expect that's merely because I haven't looked very hard.  Guess I should do that.  

Wednesday, November 14, 2018

Legwork and Life, week of 11/14/18

This is Legwork and Life, where I track the legwork and opportunities in my career as an autistic advocate, and also describe parts of my adult autistic life, including my perspectives on everyday problems and situations.

Hello from somewhere near Chicago, probably still over a thousand feet up.  At the time this posts, I'll likely be on an airplane and just about done with the first leg of my flight to Washington DC.  I'll be taking a flight less than an hour afterwards, which will take me the rest of the way to not-quite-DC-proper for the Autism Research Program conference.

In preparation for all this, I spent the last week or so stressing over research applications and getting intensely annoyed by the scientific writing style.  I've been accused of swallowing a dictionary, or at least reading them for fun (untrue on both counts), but I have nothing on the people that write these research papers and applications.

I complained about this last year, with a lot more heat and frustration than I feel this year...  but that might only be because there were fewer applications to review this year, and one of the applications was actually readable.  Like, someone actually took the time to make sure the application wasn't full of jargon and didn't use run-on sentences.  I was impressed, so I made sure to say so.

I don't get to talk about the contents of the applications I read, but I will say that this year I was assigned to a category that's much less theoretical than last year's.  This category deals more with things like transition programs and concrete research studies on human subjects.  So, far fewer mouse models.  Which was definitely better for my sanity.  I'll probably be much less sharp-tongued this year as a result, which is definitely a plus.

The other preparation I did for the trip is a lot more normal: packing.  When my family would go on trips, my mother would always make and check off important items that needed to be handled before we locked up the house and left.  I'm not quite as organized as my mother, but I did cobble together a packing list years ago.  So yesterday I dug it out and updated it some, as well as putting it on Google Drive for easy accessibility.

There's the usual stuff, like clothes, on there, but there's also things like "power strip," "bottle of NAC," and "feminine products."  I take a power strip with me when I travel, especially if it's by airplane, because you never know when you're going to find yourself at a place with no free spots in a power outlet.  The bottle of NAC (N-Acetyl Cysteine) is in addition to the NAC in my regular pills.  I react rather poorly to mold, mildew, etc, so it's wise to bring extra with me in case of less-than-perfectly-sanitary environments.

Packing my things has reminded me of how many specialized products I use these days.  My deodorant is aluminum-free.  My shampoo is color-safe, which means it uses much weaker cleaning chemicals than most shampoos.  My toothpaste has baking soda in it.  Even my feminine products are odd: a menstrual cup (rather than tampons) and cloth pads.  I use pretty specific lip balms and lotions as well.  That's not even touching my food, which tends to be vegetarian anytime I leave home, and my supplements and vitamins, which have to be very specific brands due to the lack of regulation on that market.

All this specialization makes me kind of sad, because it severely limits my options when shopping.  I made all these choices for reasons, though.  Some of them for health reasons (supplements, deodorant), some for moral reasons (feminine products, vegetarian diet), and some simply for pragmatic reasons (shampoo, toothpaste).

Speaking of specialization, I started on a new book series recently, which I'll probably finish during the travel tomorrow.  It's called Chaos Seeds, and it seems to be self-published.  It's a very specific type of fantasy I hadn't heard of until recently, called litRPG.  It's what you get if you blend MMORPG (massively multiplayer online role playing game) rules, fantastical worlds, and heroes' journeys together.  I found the style extremely difficult to accustom myself to (and the writing improves over time), but I think I've mostly got a handle on it now.  The author of the series is African-American, which is pretty cool.

Wish me luck with the trip!  After I'm done in DC, it's off to the inlaws' for Thanksgiving, where I'll hopefully be able to relax some and eat good food before going home again.  

Monday, November 12, 2018

Reading the Research: DIY Brain Stimulation

Welcome back to Reading the Research, where I trawl the Internet to find noteworthy research on autism and related subjects, then discuss it in brief with bits from my own life, research, and observations.

Today's article addresses an up-and-coming issue in academia, special needs, and other circles: brain stimulation.  John Elder Robison wrote about experiencing a particular type of brain stimulation, called transcranial magnetic stimulation, in his book Switched On, which I reviewed at one point.  He noted improvement in what some people term "autism symptoms" after undergoing the treatment.  

Various types of brain stimulation have also been used to treat Parkinsons, depression, and anxiety.  And naturally, if it can be used for a medical purpose, somebody's going to try it on healthy people and tout the results for improved academic and professional performance.

I, personally, am treated with a particular type of brain stimulation called LENS.  It's non-invasive, like most types of brain stimulation, and has no chemicals to pump into your bloodstream and potentially mess things up in your biology.  I receive it once every two weeks.  It's helped with my anxiety and depression, and possibly with organizational and self-management skills as well.  I was paying less attention to those at the time I started the therapy, so it's hard to say for sure that it's helped.  But a less anxious, depressed brain also probably performs better overall.  

It's a little alarming to me that people would A) decide brain stimulation should be administered to everyone, and B) that they're more likely to demand other people get "fixed" rather than fixing themselves.  Though admittedly, if I was sure the treatment wouldn't damage our politicians, and was also sure it would increase their empathy and decision-making skills, I'd probably opt to have them "fixed" also.  

Either way, it's a major question, and seems like one that's going to be relevant in the next decade or so.  Some academic fields and areas are very competitive, and people with the means to do so may use brain stimulation in hopes of getting an edge on their competitors.  I worry that these unregulated usages will lead to brain damage on a very major scale.

They may also pave the way for brain stimulation to be used in an insurance-covered medical setting, which would be good for autistic people and other sufferers of depression, anxiety, and related things.

Time will tell.  

Friday, November 9, 2018

Mouth Care with Sensory Sensitivities: An Electric Toothbrush Comparison

Today we'll discuss oral hygiene, how sensory sensitivities factor in, and compare two electric toothbrushes side-by-side.  

Oral hygiene is a basic part of personal hygiene, which is important for being presentable to people, especially neurotypical people.  If your breath smells bad, people won't want to be near you or speak to you, because they can smell it and can get grossed out by it.  Brushing your teeth, and also your tongue and mouth, combats bad breath.  It also fights tooth decay by decimating the responsible bacteria.  

The problem with all this is that brushing your teeth can be a really unpleasant sensory experience.  Having bristles scraping against your gums and teeth can be torturous for people with touch sensitivities.  Especially if you go the extra step and invest in an electric toothbrush, which does a much better job than manually brushing.  The electric toothbrush vibrates in addition to your brushing, which polishes your teeth and under your gums much more effectively... but now you're pressing a buzzing object to your gums in addition to the brushing sensations!

Essentially, oral hygiene can be a really unpleasant nightmare for people with sensory sensitivities.  A nightmare that has to be repeated daily, or cavities and fillings and crowns and so many expensive trips to the dentist will result.  

The Toothbrushes

Therefore, making the process as painless as possible is important.  One way to do that is to choose your toothbrush carefully.  Our two toothbrushes are below:

On the left side, my spouse's Phillips Sonicare toothbrush.  His is a basic model, but the company is well established in the electric toothbrush market.  I've borrowed this toothbrush and used separate toothbrush heads for a couple years now.  With it, I've stopped having any cavities whatsoever in my teeth.  

This is particular impressive because it's despite: A) I'm sometimes unable to make myself do any toothcare at all for an entire week (thanks to depression and sensory sensitivities) B) I have bad genes (my dad has had many cavities despite brushing and flossing religiously, and I have had some problems as well), and C) I eat way too much sugar overall, which heftily accelerates how quickly your teeth decay.  

On the right is a Quip toothbrush, a relatively new arrival on the mouth care scene.  The toothbrush is actually only one piece of their oral health recommendations, which include letting you do a subscription plan to have new toothbrush heads and toothpaste sent to you every 3 months.  Other than floss, it's essentially everything you need to care for your whole mouth.  My in-laws generously gifted the Quip toothbrush to me for my birthday, and I've just gotten the chance to try it out, which is what prompted this blog entry.  Thank you!

You'll notice immediately, as I did, that the Quip toothbrush is much smaller.  It's also lighter by a good margin.  What's not obvious from that first picture is that both toothbrushes have detachable heads.  The Quip is simply built more seamlessly.  Below is a picture of the brush heads, along with a manual toothbrush.

Two electric toothbrush heads held in a hand.  One has a scrubbing surface, the other does.  Above them, a manual toothbrush with a scrubbing surface.

As you can see, the Quip toothbrush head comes with a scrubbing surface on the back.  This is actually a feature I'm rather fond of, to the point that I invested in a manual toothbrush like the green one so I could continue to have one available to me.  Having the feature built right into the brush head saves me annoyance, counter space, and money.  

What about the accessories, and the innards?  

Quip electric toothbrush parts and accessories: handle, toothbrush head, motor, a AAA battery, and a plastic cover for the top half of the toothbrush

Sonicare electric toothbrush charging base, handle, and a toothbrush head with plastic cover.
As you can see, the Quip disassembles a lot more than the Sonicare does.

The Sonicare has the handle (not meant for the user to be able to take apart), the toothbrush head (with plastic cover), and the charging base.  The Quip breaks down into the toothbrush head, motor, battery, plastic handle, and sliding cover.  The cover fits either end of the toothbrush.  Due to the sticky tape (not shown) on the cover, it serves as both a travel cover and holder.  You can literally just stick it to the counter or to your mirror and put the handle into it for easy access.

The Quip uses a standard AAA battery, whereas the Sonicare uses a rechargeable battery pack.  I have no information on how long each lasts, but I can safely say the Sonicare battery pack has lasted like 5 years.  I suppose one could always use a rechargeable AAA battery in the Quip as well.

I'll be heading out of town for Thanksgiving soon, so another question arises: How do they handle for traveling?

Quip and Sonicare electric toothbrushes, packed for travel.  The Quip packs into one piece and is much smaller, while the Sonicare's toothbrush head detaches from the handle and needs a clear plastic case.

As you can see, the Quip packs into a single unit.  The white plastic cover slides over the brush head and locks into place.  The Sonicare is better packed in two pieces, with the brush head separate from the base.  The brush head then needs to be covered with a clear plastic case.  One of those comes with every toothbrush head, which means a lot of those little plastic cases build up over time.  

And now, most importantly for people with sensory sensitivities: how do they handle?  I got a couple videos of turning them on.  

The Sonicare makes a medium buzzing sound.  When pressed to your mouth, it also buzzes your teeth, gums, and jaw.  Again, this is the toothbrush I used for years.  The experience of using it is not even slightly enjoyable, and I have to shut my eyes and keep anyone from interacting with me while I use it.  This is in part so I can remember to get all parts of my mouth, and in part because the sensory experience is painful and frustrating, and best managed with my full attention.  

The Quip runs a lot quieter, and vibrates my hand a lot less.  This has the added bonus of not making my hand slightly numb after using it.  It does also vibrate the teeth and gums slightly, but not nearly as much as the Sonicare.  This does make me wonder if its cleaning efficacy is as good as the Sonicare, but time alone will tell that.

Another note on using the toothbrushes.  The brush heads my spouse and I use with the Sonicare are "extra soft."  This is because gum erosion is a possibility with the intensity of electric toothbrushes, and the idea of tooth care is to clean the gums, not destroy them.  I don't know what the Quip's brush softness is, but it's definitely not "extra soft."  I'd guess "soft," not "medium," judging by the manual toothbrushes I own.

It makes sense to me that the Quip perhaps makes up for its gentler vibrations by using "soft" rather than "extra soft" bristles, but I have literally no formal education in dentistry, so I'll double-check that idea when I next visit my dentist.

Both toothbrushes run for 2 minutes.  Every 30 seconds, the toothbrushes stop buzzing for a split second, which tells you to move on to the next quadrant of your mouth.  In this manner, you spend half a minute on each quadrant and get a more thorough cleaning.  This is a good feature, which I'm guessing is standard these days.

The Winner

At least for me, Quip wins this comparison hands down.

It's smaller, lighter, has more functionality, is more portable and travel-safe, and most importantly, its vibrations don't upset me nearly as much as the Sonicare toothbrush's do.  With the Quip, I could see myself brushing my teeth twice a day, as the dentist recommends, rather than once a day as I do now.  Once a day has been enough to keep me cavity-free, but if the Quip doesn't clean as vigorously as the Sonicare, then twice a day would definitely be a wise idea (as well as what the doctor ordered...).

I'm also extremely impressed that they designed a toothbrush where every single one of the parts is easily replaceable.  If the Sonicare's motor ever dies, there won't be any option but to replace the whole handle, which is kind of a waste of perfectly serviceable plastic and the rest of the toothbrush.  If the same thing happens with the Quip, I need only buy a new motor.  Or handle.  Or sliding cover.

This strikes me as more environmentally friendly than the Sonicare, though the question of whether the AAA batteries will add up over time is relevant.  You can somewhat offset that by using rechargeable AAA batteries yourself, I expect.  But each toothbrush head with the Sonicare toothbrush comes with a little plastic cover, and I'm fairly certain Quip's refills won't.  So it's at least a tie, given a conscientious consumer, I expect.

I'll start using the Quip instead of my spouse's toothbrush immediately, and try to add an evening brushing into my oral care routine.

If you're interested in checking out the Quip, I saw it at Target recently on an endcap in the tooth care section.  You can also get your first toothbrush from them for only $25 on their website.

Extra: The Rest of My Mouth Care Routine

Like most children, I was taught how to brush my teeth young.  Unlike most children, I continued to have difficulty adopting that routine and sticking to it into my college years.  I can't remember having a specific reason why I didn't like the experience, but it wouldn't surprise me if the feeling of brush and floss on gums and teeth was just so unpleasant that even 2 minutes was too long to manage.  

After a series of very expensive dental bills, I forced myself to establish a tooth care routine, which I try to do every morning.  I've had multiple oral hygienists tell me it's a pretty good routine, so for completeness' sake, I'll include it here.
  1. Scrub tongue with tongue scrubber.  My tongue tends to build up bacteria, especially in the morning.  Scraping off the buildup makes the clean taste from brushing last longer and reduces the overall amount of bacteria in my mouth.
  2. Floss.  I use two types of floss.  A braided, thicker floss is the staple for between most of my teeth.  It's quite gentle, doesn't cut into my gums, and catches more food and plaque than the regular floss.  A thinner, waxed floss goes between my lower front teeth and their neighbors, which have a metal wire across the back side of them due to orthodontics.  
  3. Brush teeth (and gums).  I use an electric toothbrush with baking soda toothpaste.  There are about 3 bajillion toothpaste types, but my dentist commented to me that my mouth tended to be more acidic than most.  Baking soda toothpaste helps offset that.  I also try to switch brands after each tube.  I read somewhere that the bacteria in your mouth get used to a toothpaste formula after a while, so it's best to do that.  I also try to focus more on the gumline and the back of my mouth rather than the teeth directly.  When the toothbrush's timer ends, I brush the roof of my mouth, then brush my tongue again with the remains of the toothpaste.  
  4. Mouthwash.  This keeps my mouth feeling clean a lot longer, even though it can really sting and tastes quite strong.  Listerine's a good brand.  There's been some back and forth about whether alcoholic mouthwashes are a bad idea, since alcohol can dry out your mouth (which leads to more bacteria).  I brush in the morning, so it's not as much of an issue as it would be if I was using it at night.  If you can't stand the flavor of alcoholic mouthwashes, or you tend to do your tooth care at night, there are several kinds of non-alcoholic mouthwashes that still definitely help.  

Wednesday, November 7, 2018

Legwork and Life, week of 11/7/18

The makeup shopping trip with my friend the cosmetologist happened.  I am now more prepared for my trip to DC, and also have a better idea of what I'm doing with it.
A set of makeup laid out: two brushes, a blush palette, lip gloss, eyeliner pencil, mascara, and an eye shadow palette.
Two makeup brushes (that should last forever with proper care), eyeliner, blue mascara, lip gloss, a blush palette, and an eye shadow palette.
These got added to my tiny collection of no-name makeups that I basically never use, in part because I had no idea how to actually use them properly.  Makeup was just kind of a thing that was annoying, I didn't like, didn't know how to use, and made it so I wasn't allowed to itch my face.

I still mostly hold those views, but thanks to my friend, I now better understand how to use makeup.  She kindly taught me the very basics of how to use it, and then was good enough to summarize those basics and text them to me.  I'll note those basics here for future reference and also so any interested parties who happen to want to learn as well.  Or y'know, anyone who thinks the way I phrase things is funny.

You start with foundation, if your skin needs it.  That goes over most of your face to even out your color.  Then you focus on your eyes.  These are where the brushes come in.  You use a palette of colors for the eye shadow, currently.  It's in fashion to use a lighter color on the inner third (near your nose) of your eyelid, and a darker color on the outer 2/3s.  You then blend the two colors together to have a spectrum.  I favor blue, in case the picture of the hair from last week didn't make that blatantly obvious.

After you've done the eye shadow, you break out the eyeliner pencil.  Apparently a common mistake is to insist on making straight lines on the skin above your eyelashes.  The better course is to use short, smudgy strokes, which is a more striking look.  I didn't entirely understand why this works, but fashion and beauty really aren't my forte.

Then it's mascara time.  The mascara I have in the picture is blue, but most are black or brown.  Putting on mascara is kind of weird, but essentially you put the brush close to your eyeball and blink your eyelashes through the brush.  This can be really challenging because eyeballs aren't supposed to have stuff right next to them.  Fortunately, I've had practice with that, because I sometimes wear contacts.

Once that's done, your eyes are done.  Then you do the blush, which you apply with a cotton ball or a special brush I don't have.  You blend the colors if you have a palette, or use a single color if you have one you really like.  It goes from the point of your cheekbones back toward your ears.  It's basically just to make it look like you have more color in your cheeks.

Finally, you do your lips.  I was told by a different person that you always start with a layer of lip balm before you apply color.  No idea if that's true, but I'm usually wearing lip balm, so it works just fine.  Atop that, you apply the lipstick or lip gloss.  To avoid leaving lipstick marks everywhere, you can take a tissue and blot your work when you're done, then reapply a bit more, and repeat until you're happy.  And apparently, if you really need that stuff to stay, you can put some of the powder from your blush makeup on top of it.  She said that makes it feel weird, but it makes the stuff stay approximately forever.

Beyond the makeup shopping, the last celebration of my birthday happened this weekend.  My parents and grandmother went to a fancy-ish restaurant, where we ate very good food, chatted, and had presents.  It was a pretty good time.

The only other majorly notable event was that my spouse and I voted yesterday.  I expect I won't be terribly pleased with the results of the election, but since I did vote, I have full right to complain when things don't go as I'd like.  The way I see it, if you don't vote, you don't get to complain.  

Monday, November 5, 2018

PSA: Please Vote

Hi there!  This is your reminder to vote.  Our democracy only works if every citizen votes for the candidates and ideas they believe will best serve our country.

If you, like me, find the whole process very daunting, then rejoice!  There's several online websites that will help you sort out the information overload, starting with showing you your ballot ahead of time.

This website:
  • shows you your ballot ahead of time so you know what you're voting on.
  • gives you information about the various candidates and the positions they're running for, with information provided BY those candidates.  (This includes links to their campaign websites if provided, so you can look at those and do your own homework as well.)
  • lets you run through your entire ballot, making your choices, then emails or texts those choices to you.  Then you can simply pull out your phone at the polling place, quickly fill in your choices, and get on with your life quickly.  
All in all, a fantastic service to make voting as simple and easy as possible.  

Please vote.  Our democracy lives or dies with you.  

Reading the Research: The Morals of Autonomous Cars

Welcome back to Reading the Research, where I trawl the Internet to find noteworthy research on autism and related subjects, then discuss it in brief with bits from my own life, research, and observations.

Today's article talks about a technology of the near-future that will serve as assistive technology for autistic people (and other people with special needs) as well as the general populace.  Self-driving cars are currently in existence, but US infrastructure in general isn't designed to support the widespread use of them.  Should that be possible, though, groups of people could buy into having a single self-driving car, or into a service that maintains those cars, and not have to worry about qualifying for a driver's license.  

It's a documented fact at this point that autistic people have a harder time getting our driver's licenses than the general populace.  Whether that's because the training programs simply aren't geared to us, because of brain differences that make the demands of driving challenging, or because of other side effects, the numbers are hard to ignore.  1 in 3 autistic people, versus roughly 90% of US adults.  So there's definitely a need for autonomous transportation.

The main sticking point for this technology has been how to handle crashes.  In cases where the automated system can't avoid probable fatalities (which won't happen often, but absolutely will happen), ethicists and programmers have to grapple with the question of who the system will sacrifice:  the pedestrian bystanders?  The driver and passengers in the other vehicle?  The passengers in the autonomous car?  It's not a pretty question, suffice it to say.

This study aims to quantify what the human answer to that question would be.  Using an online website, they made an online game with various situations and asked participants worldwide to answer them.  (You can participate here if you want to!)  I was kind of surprised to learn that humanity apparently only widely divides into three basic philosophical groups: Western, Eastern, and Southern.  But even then, the differences weren't super major.  Personally, that's encouraging to me.  Also encouraging, people weren't all that much more eager to sacrifice a jaywalker (mildly illegal) than they were a perfectly law-abiding pedestrian.

One would think you could just write the AI to make choices based on the vast majority of humanity's opinion of the situation, or the regional portion of humanity the operator is in.  But unfortunately, it won't be that simple, because at least in the US, people sue at the drop of a hat and no matter whether the decision was the most moral or most agreed-on decision, somebody will disagree.  Lives may be lost due to the decision.  The issue will inevitably end up in court.

I'm hopeful that we can manage to put together the infrastructure, court rulings, and such needed to make this technology a reality for everyone... but I'm not counting on it within the next 10 years.  Maybe 20?  Maybe longer.  Hopefully within my lifetime, anyway.  

Friday, November 2, 2018

Worth Your Read: Why Autistic Employment is so Hard

Employment is a messy, complicated issue when it comes to people with disabilities and special needs, like autistic people.  While it sounds like the author has a physical disability, any disability drastically reduces your chances of being hired.  Like the article's author, I too spent much of my time pretending I wasn't disabled in hopes of getting and keeping a job.  My colleagues rarely, if ever, knew I was autistic, and my bosses only knew it as a matter of legality, rather than actually understanding it. 

This caused me a lot of stress, because it really does take a lot of energy to pretend you're somebody else.  And it sapped my energy and creativity, which should have been spent on my job.  The formalized work environment has never been terribly friendly to me or my disability.  Perhaps due to these things, I didn't keep any of my jobs for very long. 

Would having predecessors in the work place, other autistic people with their own problems, have made it easier?  I'm sure it would have.  But it will never be as easy for us as it is for neurotypical people.  It's a simple question of numbers.  Neurodiverse people are a minority, and what works for one person won't necessarily work for another.  Having people to talk to and share experiences with is certainly helpful, particularly if the person is within your workplace and already understands many of the details...  but that's unlikely overall, sadly. 

That's likely why the author says he grapples with feeling like he's the first disabled person to do his job.  He's accurate that of course he's not the very first, but he is probably the first person with his particular disability to do those things within a certain mile radius.  I had similar issues when I worked in the formal job industry, and like the author, it didn't go terribly well for me.

This difficulty is why autistic people often do better in running our own small businesses or as consultants.  We make most of our own rules and work environments this way, and that allows us to spend much less energy "making up" for our disability and more on the job at hand.  It also lets us leverage any hobbies or special interests we might have.