Matt’s conversation was goal directed but his word usage and way of symbolizing things was extremely idiosyncratic. I think that he has word finding problems. He displayed person and pronoun reversal, had poor articulation…Matt’s chief complaint when he came here was his tinnitus. He told everybody he saw about the ringing in his ears. He asked all of them why it occurred. He spontaneously offered his version of why he thought it was occurring and what was making it happen and he asked everybody to do something about it. He was extremely goal directed about that because it was extremely bothersome to him. However, if you just listen to his words you would think that he was being crazy…He, for example, thought that there was a machine in his head and he would talk of things coming out of his ears. Now on the surface of it that sounds quite crazy but what he was thinking of was what he sees in the real world. A child of 5 or 6 has a very imperfect sense of causation. What he sees in the real world is that buzzes are caused by drills, pencil sharpeners, etc., so in his imagination not knowing much about how bodies function, he thinks that there is some machine in his head that is making the buzzing sound and he wants it taken away and that is the way he verbalizes it. He shows self-awareness and distress about the difficulties that he is having in many ways. For example, mother reports that he has talked after a difficult day about feeling hyper and being awful and terrible, about trying to be good, about death, and that at these points he will again ask for help and will directly alloy himself with adult efforts to do things that will fix him.
When this report was written, Matt was verbal after spending many years nonverbal. I am not an autism expert. I just write about what I know from my experiences, or should I say my brother’s experience. It seems unusual to me that someone who was nonverbal for many early childhood years could start talking again. I have seen others with autism as either verbal or nonverbal, not both. Matt stopped talking at age 2 then started talking again several years later.
Matt experienced ringing in his ears for a brief period of time. I am not sure why. It doesn’t seem to fit or make sense. My grandpa right around that time period also suffered from tinnitus due to years of working in a loud factory environment before ear plugs were used. I don’t know if or how this could be related.
Matt had a lot of bizarre thoughts that to me did not seem autistic like. He heard voices telling him to hurt girls. He heard sticky sounds. He thought that people on the radio could hear him and would come after him. He was afraid of tires and men with beards for awhile. He chanted strange songs over and over. “Hands on the table won’t come off, now my hands are stuck on the beard.” By the time he reached the end of the chant, his voice would crescendo in terror. There seemed to be no logical reason for his fears or hallucinations. He did see and hear things, that others didn’t, that seemed very frightening to him. The voices in his head told him to hurt people and urged him to do bad things. Again, some of his thoughts seemed very schizophrenic like and not very autistic like at all.
If you met Matt, you would have difficulty understanding his speech. He doesn’t speak in complete sentences. Sometimes his words don’t make sense. He has a speech impediment, almost a slurring of words, that makes it very difficult for outsiders to understand him. He gets frustrated when people don’t understand him. He tends to say things over and over. He suffered from Tourette’s as well with some of his speech patterns. He also has twitches and tics mainly in his head movements and eyes.
Some of the medications that Matt was on also seemed to aggravate his symptoms of Tourette’s. Yesterday, I spoke a little about his motor issues. When he was younger, I could easily describe him as an elderly man trapped in a child’s body. He was on a medication for awhile that caused body stiffness that progressed into difficulty walking up and down stairs without assistance. After he was removed from the medication those strange symptoms reversed.
Anti-psychotic medications caused unusual side effects or sedated him completely. Some meds made him almost catatonic and lifeless like a limp rag doll. My mom could not tolerate seeing him on those kinds of medications. For the most part, he was unmedicated and we dealt with his psychotic episodes.
I have to remind myself that you really don’t know the basic things about Matt. If nothing else, thinking about this again reminds me of all of the little things that make him the unique person that he is.
Sometimes I am not sure if I understand Matt. Most of all, he has always been a mystery.