Patients with autism depend on realistic approach

Experts rule out link between disorder and high intelligence

Ten years have passed since the curtain rose on Ocean Heaven, the first Chinese film to tell the story of autistic patients and their families.

Directed by Xue Xiaolu and starring Jet Li, Zhang Wen and Gwei Lun Mei, the movie continues to score extremely high ratings on numerous websites.

On the review platform Douban, some 50 percent of moviegoers gave the film a four-star rating, while 25 percent said it merited five stars. On mtime, a popular movie discussion website, nearly 300 of 5,769 respondents gave the film 10 points out of 10.

However, the movie has only earned 14.02 million yuan ($2.13 million) at the box office, a near-record low for Li, the lead actor. In comparison, Tangshan Earthquake, which was screened one month after Ocean Heaven, has recorded ticket sales of 649 million yuan.

According to one popular comment on Sina Weibo, "Everyone who watches Ocean Heaven likes it, but the problem is that not enough people have decided to go and see it."

Sun Zhongkai, head of the Beijing Stars and Rain Education Institute for Autism, which helps autistic patients and their families, said there is a major problem in sharing knowledge about the developmental disorder with the public. Although there are a growing number of reports about autism and its patients, accounts that lack "standout points" rarely attract much attention.

Online reports about autism nearly always include links that guide the reader to stories or videos tying the disorder to examples of genius.

A commonly seen headline is "Ten autistic geniuses that changed the world", with scientists Albert Einstein and Isaac Newton, along with composer Ludwig van Beethoven always on the list.

According to a 2003 study by Simon Baron-Cohen, an expert on autism based at Cambridge University, Einstein and Newton may both have had symptoms of Asperger's syndrome, the central condition in the group of difficulties known as Autism Spectrum Disorders, or ASD.

Wu Liangsheng, a senior teacher at the Beijing Stars and Rain Education Institute for Autism, said that during his days as a teacher he met autistic patients who were especially talented, but in general, high intelligence among those with the disorder is extremely rare.

"The exact ratio of autistic children who have extremely high intelligence is not known－but it is surely less than one in 10,000. The majority of autistic patients are not extraordinarily talented, but they do face all kinds of difficulties in life", he said.

Standing out

Zhou Jian, a senior neurology doctor at the Brain Hospital of Hunan Province in Changsha, the provincial capital, said there is no medical evidence suggesting a strong possibility that autistic children have a high degree of intelligence.

"Some autistic patients are so engrossed in their own environment and care little about the outside world, so if they do something that looks miraculous to others, then they stand out," she said.

"For example, they could draw a duck in fine detail, including every visible feather, but this should not be mistaken as genius. Even Asperger's syndrome does not necessarily mean extremely high intelligence."

Lack of knowledge

The mother of a 26-year-old autistic patient said her son, Li Jiayang, was diagnosed with the disorder in 2005 when he was 10.

The woman, who only wanted to give her surname of Yang, said her son showed signs of autism, such as having little concern about his surroundings, when he was 1, but at the time, local doctors had scant knowledge about the disorder, so they did not know how to help him.

Yang said some autistic patients are so "wrapped up in their own world" that they are capable of outstanding achievements.

"My son could memorize a dictionary when he was a child, but could not do so after he was diagnosed and we started taking measures to help him. I think that might be the case in other reports about 'geniuses'," she said.

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Wu said that nearly every journalist who visits the institute asks about signs of genius among those being treated, and at the start of their stories many reporters cite examples of high intelligence among autistic patients.

There is a market for such stories, one example being Zhou Wei, a 13-year-old diagnosed with slow intelligence development, who showed his talent for mathematics on a television show in 2014. His accomplishment earned him the nickname "the Chinese rain man" after the 1988 movie Rain Man, which portrayed tensions between two brothers, one of whom has autism.

Footage of Zhou appearing on the show, where he performed a highly difficult calculation involving a 16-digit number in less than a minute, went viral nationwide. When tested later, he was found to have an extremely high aptitude for math.

Zhou does not have autism, but since he appeared on the show, more people have linked the disorder with abnormally high intelligence.

In September 2017, a public interest program was launched on WeChat, enabling participants to buy electronic drawings by children who have autism or Down syndrome. The drawings, to be used as screen savers, cost just 1 yuan.

Within seven hours, the program had raised the target amount of 15 million yuan. However, it strengthened perceptions of a link between disorders such as autism and high intelligence. On WeChat Moments, many people marveled at the drawings, saying they must have been produced by geniuses.

A vicious circle has emerged, where activities involving autistic patients with high intelligence attract attention but also serve to foster wrong impressions among the public.

A search online for "autism" results in "genius" being one of the first words to come up.

Sun, from the Beijing Stars and Rain Education Institute for Autism, stresses that the 99.99 percent of autistic patients who lack any special talent need the most attention.

"Partly due to 'high-intelligence miracles', the public often underestimates the negative effects of autism, which is commonly called 'the lonely disease', as it tends to make those who have it introverted," Sun said.

"It can be very serious. A patient has little interest in the outside world and simply stays in his or her own space. People with autism don't speak with anybody else or interact with others. In some extreme cases, they hardly speak at all."

Cai Chunzhu, who wrote the book Daddy Loves Xihe in 2011, described his son Cai Xihe, who has autism, in a light, humorous way, but the boy can only utter a few words.

Once, he said "happy", which made his parents so excited that they asked him to say it every day so that they could reward him with a biscuit. He was unable to do so, and in the end they gave up.

Life becomes more difficult as autistic patients grow up and their parents age.

Switching jobs

Li, the 26-year-old patient with the disorder, graduated in 2016 from a college in Dalian, Liaoning province.

A doctor found he had a normal level of intelligence and learning ability. However, after graduation, Li changed jobs four times, staying less than three months in each one.

Yang, his mother, said her son is only able to follow a strict routine that involves little interaction, and he can barely communicate with others on complicated issues.

He now works as a part-time poster designer two days a week, earning just over 2,000 yuan a month. Yang and her husband both have full-time jobs to support the family.

Wu, from the Beijing Stars and Rain Education Institute for Autism, said,"At least Li finished higher education and can work part-time. Only one in 10 autistic patients finish primary school."

Ke Xiaoyan, a senior doctor and head of the child psychology institute at Nanjing Brain Hospital, said the proportion of ASD patients worldwide is about 1 percent, higher than previously predicted, because all related syndromes are now included in such estimates.

Du Zhigang, a senior neurology doctor at Beijing Ditan Hospital, predicted there could be as many as 10 million people with ASD in China.

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