«Open questions are stressful for autistic children»

Mr Huber, when you enter your practice, the first thing you see are lots of little plastic animals on the wall shelf. Do autistic people like animals?

It happens that autistic people like animals. The behaviour of animals is often easier to classify than that of humans. If a dog is happy, for example, it wags its tail. Humans sometimes express their joy with laughter, sometimes in a different way. They use more subtle forms of expression. This is difficult for people on the autism spectrum. They are often limited in their ability to understand the facial expressions and gestures of the other person.

I can use language in such a way that the child is very likely to react and talk to me.

Matthias Huber, psychologist

Now you yourself have Asperger's syndrome and classifying the behaviour and feelings of others is part of your job. Do you experience any limitations in this respect?

On the contrary. It's easier for me to assess autistic people because I have a similar way of looking at the world, analysing it and using and decoding language. I can use language in such a way that the child is very likely to react and talk to me.

For example?

Open questions create stress. That's why I formulate my questions very precisely and in detail. For example: «When you practise the guitar, do you look at the strings or straight ahead or somewhere I haven't mentioned?» Autistic people are detail-oriented - both in their thinking and in their perception. A dialogue with precise questions is interesting for them and they can respond better. Children without autism experience it as strange. «Is he crazy?» a youngster once asked. My questions were too detailed for him.

With whom and how do you carry out autism assessments?

Children come to us with a suspected diagnosis of ASD, Asperger's syndrome, early childhood autism or atypical autism. The diagnosis is always made by a team of medical and psychological specialists. Together with the parents, we take a family and developmental history, obtain information from teachers and special needs teachers and carry out perceptual, IQ and autism-specific tests.

An important part of this is the clinical interview. The content and form of the answer as well as the non-verbal behaviour provide information. For example, if I ask an autistic child whether they have a favourite colour, they will often answer «yes». A child without autism names the colour and perhaps mentions their bicycle, which is the same colour.

What is the average age of the children you examine?

They can be between 1.5 and 18 years old. On average, they are around 11 years old. They are often adolescents who have previously received other diagnoses that do not explain all of their abnormalities or peculiarities.

How did Asperger's syndrome manifest itself in you when you were a child?

I hardly ever talked. I only answered questions if I knew the answer 100 per cent. I also didn't manage to develop my thoughts and turn them into sentences. So I often only answered when the topic was already over. I also usually looked away when someone was talking. Otherwise I was too distracted by visual stimuli and only heard wuwuh, wuwuh. I also often didn't recognise irony in the past. That's typical for autistic people. It can lead to interpersonal problems.

Other children don't realise that someone with autism also wants a best friend.

Matthias Huber, psychologist

Can and do autistic children want to make friends?

I know a lot of people who don't have any friends. They actually wish they did, but they can't socialise so easily. Other children are often irritated: He just stares or doesn't look at you. They don't realise that someone with autism also wants a best friend and would like to be invited to a birthday party. Many autistic children are also afraid of bullying.

Are you speaking from experience?

I was spat at and beaten as a child because I didn't communicate according to the norm. Children often bully out of helplessness. They don't know enough about autism. This means that anyone who bullies autistic people needs more information.

The helplessness is palpable in the whole environment. Where, for example, can parents get information and support?

They receive support from specialised counselling centres. With more information and understanding, there is sometimes no need for therapy. I often find that the diagnosis alone brings relief. Those affected recognise that they are not weird. That their way of perceiving and thinking opens up new perspectives for them.

What perspectives has your way of thinking opened up for you?

I had many special interests: in addition to palaeontology and smoke detectors, I was also interested in human thinking, which led me to psychology. As I didn't have a perfect social profile, I initially struggled to find a job after graduating.

Twelve years ago, Professor Felder, then Director of KJP Bern, offered me the opportunity to conduct clinical interviews with children with suspected autism in order to find out how they think, feel and perceive. Over the years, this developed into a 70 per cent position. I limit my work to autism. I feel very confident in this area, even though I am always learning new things.

This leads to the last question: autistic people are dependent on familiar situations and processes. What was it like for you to answer questions that you didn't know before the interview?

In general, unexpected questions on unfamiliar topics are more difficult. In this case, it wasn't a problem because the questions were all about autism. I opened a memory of all the questions I had been asked in the last 12 years and looked for similarities. This allowed me to draw on existing answers.