9:22pm November 25, 2011

“
The possible connection between symptoms of movement disturbance and “mental” disorders was first discussed in 1874 by Ludwig Kahlbaum a German physician. A summary of Kahlbaum and others’ descriptions of patients can be seen in the list below. In the nineteenth century the term catatonia was used. Later, catatonia came to be defined more narrowly as a kind of schizophrenia characterized by absence of movement. Regardless of the terms used, there has been a continuing awareness of these behaviors in persons diagnosed with a variety of psychiatric and neurological disorders, including autism/mental retardation.

Characteristics of Catatonia

Simple Disorders of Movement

Repetitive movements – self stimulation, repeated actions

Abnormal facial movement – expressionless, flaccid or fixed expression, abnormal eye movements, grimaces, teeth grinding, facial tics, lip movements

Abnormal gait – too fast, slow, halting, peculiar, stiff walking

Mannerisms – posing, unusual manner of eating, tic-like movements

Blocking and freezing – lack of movement, difficulty starting movement, stopping during on-going movement, difficulty completing actions

Unusual postures – odd hand and body postures, flexion of neck, trunk or limbs

Abnormalities in muscle tone – too little or too much muscle tone, rigid, floppy

More Complex Disorders of Volition
Automatic obedience – excessive compliance, follows commands instantly

Echopraxia – forced imitation of another person

Lack of imitation – unable to imitate others

Negativism – does the opposite of what is expected or routine

Stripping

Extreme suggestibility

Difficulty initiating actions, postures, thoughts

Difficulty stopping or switching actions, postures, thoughts

Very Complex Disorders of Overall Behavior
General overactivity – continuous movement, difficulty stopping

Impulsiveness – action without consciousness of motives, easily aroused without inhibiting components

Frenzy – explosive or violent movement episodes

Destructiveness, aggression

Self mutilation

Extreme response to minor changes

Decreased activity – motionless, stays in one place for long periods, difficulty initiating

Decreased responsiveness – little or no response to others, aversion to contact with others, stupor or arrest, deepening and intensification of attention

Maintenance of postures – including thought and perceptual postures

Disorders of Speech
Vocal or verbal tics

Stereotyped verbalizations

Mutism – lack of speech or decreased use of speech

Slowness or delay in answering

Labored speech

Unusual vocal melody – lack of intonation, stereotyped intonation, monotone voice

Unusual loudness of volume – shouting, screaming, whispering

Disturbance of rhythm of speech – talks too fast, too slowly, with unusual stress patterns

Outbursts of speech

Swearing

Falsetto voice

Repeats names of places, cities, towns

Unmotivated laughter

Echolalia

Repetition of words, phrases, topics

Unintelliglble speech

(Sources include Kahlbaum (1874/1973), Bleuler (1911/1950), Abrams and Taylor (1976), Wing and Attwood (1987), Sacks (1990), Realmuto and August (1991), Lund, Mortimer, Rogers, and McKenna (1991), Johnson (1993).)

[…]

In contrast to the view that catatonia is a type of schizophrenia, the literature contains documentation of a wide range of causes of catatonia including infections (e.g., encephalitis lethargica, herpes simplex); vascular events; brain lesions; metabolic differences (e.g., porphyria, carbon monoxide poisoning); drugs (e.g., alcohol, neuroleptics, lithium); and epilepsy (i.e., non-convulsive epileptic status).

In Characteristics of Catatonia, above, we list some of the symptoms that have been associated with catatonia. Our interest is in understanding the symptoms, rather than the label, syndrome, or diagnostic category. Many of these symptoms have also been identified as problematic for people with labels of autism/mental retardation.
”

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Movement Differences and Diversity in Autism/Mental Retardation: Appreciating and Accommodating People with Communication and Behavior Challenges by Martha Leary and Anne Donnellan

Despite many problems I have with this book (not least of which is the extremely medicalized tone), parts of it including this one remain the easiest way of explaining to people the wide range of autistic traits affected by my movement disorder. (Which is basically a progressive intensification of certain movement-related aspects of autism for some people. It’s variously called “autistic catatonia”, “parkinson-like movement disorder related to autism”, and a zillion other labels.) And also for just explaining certain things that have been there all along before progressively getting more intense.

I’ve had every one of these traits, to varying degrees, at varying times, but never all at once. The ones I generally have now don’t all happen at once either, they’re all part of living with abilities that shift around all the time.

Also note that “movement” in this book applies to not only regular body movements. The book lists aspects described this way as “postures, actions, speech, thoughts, perceptions, emotions, memories”. Which I do find to be a very good way of summing things up despite the odd terminology – because most things in autism that affect regular movement also affect all of these things as well.