The Public Perception of Autism in Taiwan

This is the first big research paper I have been working on the past two months. As a high school student, it has been the greatest academic challenge so far in high school, taking so much tears, time, and dedication as someone struggling with debilitating anxiety. Including the works cited, consulted, and a couple interview transcripts, it is 43 pages long. I am excited to share my work with you, especially with those on the spectrum, to gain more perspective of how ASD is portrayed both globally and in Taiwan:

 

“Really? You don’t look autistic. You make eye contact, and you can speak normally.” This was my response when an autistic friend disclosed his diagnosis to me. While I felt ashamed of my hastiness after learning more about autism, my judgment indeed represents common autism stereotypes. Autism is a spectrum disorder that affects a wide range of diverse individuals, so autistic people do not have a certain look. Many of its symptoms, such as communication and sensory issues, are not clearly visible and may be overlooked to the untrained eye. Some older Taiwanese people have no knowledge about Autism Spectrum Disorder, while others have misconceptions like autistic people are violent and incapable of functioning. These misconceptions are  due greatly to incorrect media portrayals. Even though filmmakers have created numerous movies and documentaries about Autism Spectrum Disorder, Taiwanese people often base their perspectives on limited or inaccurate media portrayals of autism, which leads to a lack of support and exclusion from society for people with ASD. To foster increased understanding, more documentaries and commercials should be created based on the real life experiences of people on the spectrum in Taiwan, correcting the views of autism, promoting a more inclusive, autism-friendly environment, and increasing opportunities for early intervention.

Some people know that Autism Spectrum Disorder is an increasingly common condition around the world, but it is also getting more common in Taiwan. According to the statistics from Taiwan’s Ministry of Health and Welfare, the population of people diagnosed with Autism Spectrum Disorder has grown by a factor of 8.6 in the past 17 years, from a population of 1,549 to 13,377 (“The Disabled Population”). Although the reason behind this tremendous growth could be that there are more autistic people than before, there is the possibility that there are now better diagnosis and detection of ASD among the population. Despite the rise in the number of autistic people in Taiwan, autism prevalence in Taiwan is still lower than that in other developed countries (Sun). Since autism is a widespread disability across countries and cultures, this signifies that there may be a lack of autism recognition in Taiwan. Therefore, it is necessary for the public to have more knowledge of ASD in order to seek and support autistic people who have not yet received a diagnosis and to accept those who do have one.

Because Autism Spectrum Disorder is a complex neurological developmental disorder which affects a variety of aspects of autistic people’s lives, many people do not fully grasp its diverse symptoms. Most people know that social and communication problems are one of the identifying conditions for this developmental disorder (“Signs and Symptoms”). Autistic people may be nonverbal and present a lack of interest in interaction with others. They may also exhibit  differences in their use of eye contact and body language. According to the diagnostic criteria in DSM-V, people with ASD also often have special interests, repetitive behaviors, and inflexibility in routines (American Psychiatric Association). For example, an autistic person may prefer routine in their everyday life and feel distressed or disoriented in unfamiliar situations. In addition to communication issues and repetitive behaviors, autistic people often have sensory dysfunction issues, which may be manifested as oversensitivity  or under-sensitivity to the environmental factors (Emmons 33). For example, they may feel anxious in response to bright fluorescent lights or the sound of vacuum cleaners that usually do not affect normal people. Oftentimes, their stress response is exhibited by self-stimulation behavior, such as hand flapping, rocking, or spinning. Sensory Processing Disorder is a condition of ASD that many people cannot identify but affects many autistic people’s lives just as communication difficulties do. In modern society where there is less structure and routine but more sensory input, people in Taiwan should be more understanding of autistic people in terms of the environmental factors that may affect their senses.

Public awareness should be fostered because there are many treatment options and accommodations for people with ASD to help them function better in life, but these options are more accessible to those already diagnosed with ASD. Mark Griffin, a former occupational therapist for special needs children, states that “occupational therapy is all about getting people to do tasks independently”, which includes seemingly trivial tasks such as putting on clothes, brushing the teeth, and feeding oneself (Griffin). Another treatment option, speech therapy, mainly improves autistic people’s communication and language skills. These two therapies treat the main symptoms of autism and are crucial for an autistic person to lead to an independent life. Because autism is a developmental disorder, early intervention for children with ASD is especially critical for their development (National Research Council (U.S.) Committee on Educational Interventions for Children with Autism). If caretakers, teachers, or doctors do not recognize the signs of autism early enough, innumerable people who are on the spectrum will not receive the benefits of early intervention. However, the low autism prevalence in Taiwan, which may be indicative of insufficient knowledge about ASD among the general public, could be causing multitudes of autistic people to remain undiagnosed and unsupported by treatment. In order to allow autistic people to have fulfilling lives made possible by proper treatments, public awareness should be promoted among Taiwanese people.

Without proper and continual assistance for autism, the medical conditions of autism could lead to severe problems such as difficulty finding jobs and high suicide rates in Taiwan. Autistic people need jobs to have independent lives, but as reported by The Economist, “the UN estimates that 80% [of autistic people] do not work” (“Spectrum Shift”). The unemployment rate is possibly even greater based on observations that people rarely see autistic people in Taiwan workplaces. Employers are reluctant to hire people with ASD because they may see them as incapable of work instead of understanding and accepting them. More grievously, autistic people have a shockingly higher suicide rate than neurotypicals. As stated in The Washington Post, “adults with autism and no additional learning disability are over nine times more likely to commit suicide. The rate is shockingly high, but not inconsistent with previous research that estimates that 30 to 50 percent of autistic people have considered committing suicide” (Cha). Applying these statistics to Taiwan could mean that over 6,000 autistic people in Taiwan feel unworthy to live due to their disability. Under the societal pressures of Taiwan and the inabilities to communicate, autistic people could go unnoticed by the public, which would worsen their mental health. Because of the lack of exposure of autistic adults in Taiwan, people may believe that autism can be outgrown as an autistic person develops. Though autistic people can cope better as they receive treatment, autistic children grow up to be autistic adults; autism is a part of their identity. Taiwanese people have to be more aware of these people on the spectrum and recognize their need for continual life-skills training or therapy.

Considering the former reasons, the rise in the ASD population, the importance of treatment, early intervention, societal support, and the improvement of autistic people’s mental health, ASD should be acknowledged among Taiwanese people. Because the media has a great impact on public perception, it is a practical and promising tool to raise public awareness for ASD. The media is accessible to almost everyone in Taiwan through newspapers, television, movies, and anyone’s devices depending on the generation. The advertisements in TV shows, before Youtube videos, or on Facebook timelines are subtly planting perspectives and thoughts into people’s minds even when they are not paying attention. The “mere exposure effect” explains the psychology behind how repetitive exposure to new objects or ideas would attract people more to them (“Exposure”). Oftentimes, these Taiwanese advertisements are promoting products such as toys, food, shampoo, cars, or housing rather than calling for awareness for a cause. However, if the media is used as a tool to educate people about ASD instead of ignoring this important minority of people on the spectrum, the view of ASD in Taiwan can be altered in a positive way. As media expert Mark Griffin commented in a personal interview, “When autism is put away and locked in people’s minds, it is dangerous and scary” (Griffin). Uninformed people could easily distort the image of or form, and imagine the incorrect actuality of ASD, creating presumptions that autistic people are mentally retarded, violent, or incapable of any function in their lives. By using the media to challenge preconceived notions and showing what autistic people are really capable of, Taiwanese people will be more conscious of the support and treatment that are needed.

Dr. Temple Grandin is compelling evidence that the media can portray autism and raise autism awareness around the world. Diagnosed with high-functioning autism in childhood, Temple Grandin applied her strong visual thinking skills in animal industry, showing what autistic people are capable of doing with their strengths when given the right opportunities. In her book Thinking in Pictures, she writes:

Visual thinking has enabled me to build entire systems in my imagination… In fact, one third of the cattle and hogs in the United States are handled in equipment I have designed. Some of the people I’ve worked for don’t even know that their systems were designed by someone with autism. I value my ability to think visually, and I would never want to lose it.  (Grandin 1)

Temple Grandin has tremendous courage to embrace her autism and acknowledge the strengths she possesses to advocate for other autistic people. Her life with ASD was made into the movie Temple Grandin to feature the difficulties and triumphs she had. To this day, she advocates for people with ASD by writing books and providing living evidence which shatters many myths that are present in the public, proving that autism is not only prevalent in males but also in females despite the disparity of the gender ratio, 9:1 (“Gender and Autism”). More importantly, Grandin has shown that autistic people can have fulfilling lives and positively impact others.

Based on solid reasoning and evidence, promoting and creating more films in Taiwan specifically about local autistic people is the most reliable and practical method of raising public awareness for autism. Documentaries, whether historical, scientific, or travel, have great educational value and usually have substantial information for the audience to take away. In a personal interview with Zora Cho, an autism advocate in Taiwan who has created a number of documentaries about autism, she points out that “watching a [film] is the quickest way to learn about autism” (Cho, “Interview with an Autism Advocate in Taiwan”, translated by Jennifer Lin). People can efficiently gain knowledge about ASD in a very short amount of time through movies or documentaries, which are both appealing and accessible to the public in Taiwan. Films about ASD in Taiwan are even more crucial as they initiate people’s discussion about autism and further publicize the topic to others who are not yet informed . These discussions are especially important in Taiwan’s society, because the Taiwanese collectivistic culture tends to value “social interdependence and an individual’s role within the larger family and community”, and disabilities like autism are easily perceived as a “shameful family affair” which are not exposed and accepted in the mainstream society (“Developmental Disability Across Cultures”). There is hope that as films encourage discussions about autism, Taiwanese people will be more understanding and accepting of people with atypical neurological conditions. If more films are based on Taiwanese autistic people, the audience in Taiwan will be able to show more empathy and relate more with circumstances familiar to them. The audience will have a greater social responsibility of supporting people with ASD or engage in other meaningful ways of advocacy. They may sense a deeper connection with a Kaohsiung local child who has autism than they would respond to the story of a foreign autistic child. Films focusing on autism in Taiwan will be educational, purposeful, accessible for the audience, and they will certainly encourage people to learn, consider, or even be more concerned about the autistic people around them.

The idea of promoting and creating films about ASD can be carried out by organizing an ASD film competition every year and giving large cash prizes to the filmmakers who make the three best autism films. With this money, the filmmakers will be able to create more commercials and films on ASD. By requiring that all submissions to the film competition be focused on autism, movies and documentaries all around Taiwan would be gathered together and judged. This film competition will be open to the public, which would help the audience who attend have more understanding of autism. There is a great possibility that Taiwanese people will be very interested in attending if Taipei City mayor Ko Wen Je is at this film competition. His son has Asperger’s syndrome, and he himself has high-functioning autism as well, which gives good reason for him to have an emotional connection with the event (Wang, translated by Jennifer Lin). In terms of the competition, autism advocates and judges who are invited will determine the advocacy awards. The criteria for the films to win the advocacy awards would include accessibility and relevancy for people who do not know about ASD, avoidance of stereotypes, and presentation of the real autism condition in everyday life. The first three winners for the advocacy awards will each receive six million NT, four million NT, and two million NT , respectively. These awards can also bring publicity to the films and filmmakers. For instance, the movie Temple Grandin won 33 awards and was nominated 34 times, which is both commended as a well-made film and brought worldwide attention to autism (“Temple Grandin Awards”). These winners of the competition are required to use the money to further create a commercial or film about ASD, depending on the amount they receive. This will inspire more public advocacy for ASD through the films and commercials after the film competition ends.

Most of the 30 million NT will be used for organizing the film competition of the year, especially on the efforts of inviting Ko Wen Je to attend, which will certainly appeal to the media and many people. Two million NT will go to renting a theater, inviting and paying the autism advocates and judges, publicizing the event around local areas, and organizing the submitted films that will be played in the theater. Twelve million NT will be reserved for the top three cash prizes, and the rest of the grant will be used for the following ASD film competition. If there is not enough money to organize another competition, a submission fee would need to be charged for the next year. This will ensure that the ASD film competition will continue even when the grant money runs out. This method is practical for implementation and reliable to expand people’s awareness of autism, because Ko Wen Je will bring the media and the public’s attention to this event and the audience will have more understanding and acceptance of ASD.

Film experts and fans would probably object that there are already numerous movies, TV shows, and documentaries that portray autistic characters. While it is true that over 50 films have introduced autistic characters, people do not understand that only a few of these films have an accurate depiction of autism, and only one of them is a Taiwanese documentary, focusing on autistic children in Taiwan (Cho, “Full Record of Autism Films”, translated by Jennifer Lin). Released films about ASD often have the problem of portraying autistic people with savant skills or minimizing autism as a serious developmental disorder (Draaisma). Charlie Babbitt in Rain Man, one of the earliest autistic characters that people are familiar with, shows savantism as a trait of autism. He has unique skills in math and memory, but suffers from social, communication, and sensory problems of autism. This movie allows people to easily base their views on the media and form stereotypes that all autistic people are geniuses in a special way, whereas in reality, autism usually does not come with savantism. On the other hand, Sheldon Cooper in The Big Bang Theory normalizes ASD as a unique and quirky personality rather than markedly acknowledging the profound communication and sensory issues that autistic people experience. Sheldon exhibits a very high intelligence, “deficit in understanding relationships,” and arrogance in his interactions with his friends, which amuses the audience, as shown by the laughter soundtrack played after almost every sentence he says (Tobia). While introducing the autistic traits in a comical, humorous way, the TV show avoids the real medical conditions of ASD and normalizes the disability as a mere difference in personality.

There appears to be multiple films with similar portrayals of ASD to Rain Man or The Big Bang Theory, which may further imply that ASD is even a preferable personality by possessing a different set of talents or that “we are all in a sense autistic” (Draaisma). Autism certainly has a wide range of complex symptoms and conditions, but it does not mean in any way that it is not a medical problem at all. There are more than 13,000 autistic people in Taiwan who have clinical diagnoses of autism because they are experiencing distress or have trouble functioning in daily lives. These distorted public views are harming real autistic people and should be replaced by better media representations through truthful autism instances such as Temple Grandin. People in the autism community would know that the spectrum is wide and that no two autistic people are the exactly same. As the Dr. Stephen Shore’s well-known quote in the autism community goes, “if you’ve met one person with autism, you’ve met one person with autism” (Shore). Therefore, it is crucial to have more perspectives from autistic people to avoid stereotyping autism. To reduce the biased public viewpoints of autism, more media portrayals should focus on a variety of people on the spectrum to include as much diversity as possible.

Although holding an ASD film competition may seem to be an uncommon method to raise public awareness, it is in fact the key in terms of catalyzing discussion, promoting the creation of films and commercials, and raising public awareness for ASD. Films about autism are conducive to people connecting with the autism community and providing opportunities for informing people effectively. It is unfair to ostracize someone with a neurological difference because one does not understanding his or her needs and dismissing ASD as a disorder; it is disrespectful to invalidate someone’s diagnosis by saying “you don’t look autistic”; more importantly, it is wrong to stereotype all autistic people by a few labels in DSM-V, because there are millions of personality traits across the spectrum. Therefore, publicizing accurate, truthful, and diverse content about autism through the media can reduce the negative stigma attached to ASD.

 

Works Cited

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Washington, D.C.: American Psychiatric Association, 2013. Print. The fifth version of Diagnostic and statistical manual of mental disorders contains the current criteria of diagnosing Autism Spectrum Disorder.

Cha, Ariana Eunjung. “People on the Autism Spectrum Live an Average of 18 Fewer Years than Everyone Else, Study Finds.” The Washington Post. WP Company, 18 Mar. 2016. Web. 02 Dec. 2016.

Cho, Zora. “Full Record of Autism Films.” Help High-functioning Autism and Asperger’s Understand Relational and Emotional Difficulties. Translated by Jennifer Lin. N.p., 12 Nov. 2016. Web. 03 Dec. 2016.

—. “Interview with an Autism Advocate in Taiwan.” Translated by Jennifer Lin. Online interview. 17 Nov. 2016.

“Developmental Disability Across Cultures.” Caring for Kids New to Canada. Canadian Paediatric Society, Jan. 2016. Web. 14 Nov. 2016.

Draaisma, Douwe. “Stereotypes of Autism.” Philosophical Transactions: Biological Sciences 364.1522, Autism and Talent (2009): 1475-480. Print.

Emmons, Polly Godwin, and Liz McKendry Anderson. Understanding Sensory Dysfunction: Learning, Development and Sensory Dysfunction in Autism Spectrum Disorders, ADHD, Learning Disabilities and Bipolar Disorder. London: Jessica Kingsley, 2005. Print.

“Exposure.” Laws of Attraction. N.p., n.d. Web. 05 Dec. 2016.

“Gender and Autism.” The National Autistic Society. N.p., n.d. Web. 05 Dec. 2016.

Grandin, Temple. “Autism and Visual Thought.” Thinking in Pictures: And Other Reports from My Life with Autism. New York: Doubleday, 1995. N. pag. Print.

Griffin, Mark. “Interview with a Former Occupational Therapist.” Personal interview. 28 Nov. 2016.

National Research Council (U.S.) Committee on Educational Interventions for Children with Autism. Educating Children with Autism. Washington, DC: National Academy, 2001. Print.

Shore, Stephen. “Autism Awareness Month: Interview with Stephen Shore.” Interview. HealthCentral. N.p., 19 Apr. 2009. Web. 3 Dec. 2016.

“Signs and Symptoms.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 26 Feb. 2015. Web. 01 Dec. 2016.

“Spectrum Shift.” The Economist. The Economist Newspaper, 16 Apr. 2016. Web. 02 Dec. 2016.

Sun, Xiang, Carrie Allison, Fiona E. Matthews, Stephen J. Sharp, Bonnie Auyeung, Simon Baron-Cohen, and Carol Brayne. “Prevalence of Autism in Mainland China, Hong Kong and Taiwan: A Systematic Review and Meta-analysis.” Molecular Autism Mol Autism 4.1 (2013): 7. Web.

“Temple Grandin Awards.” IMDb. IMDb.com, n.d. Web. 09 Dec. 2016.

“The Disabled Population.” Ministry of Health and Welfare. Ministry of Health and Welfare, 30 Nov. 2016. Web. 2 Dec. 2016.

Tobia, Anthony, and Annmarie Toma. “Rethinking Asperger S: Understanding the DSM-5 Diagnosis by Introducing Sheldon Cooper.” Journal of Communication Disorders, Deaf Studies & Hearing Aids 03.04 (2015): n. pag. Web. 3 Dec. 2016.

Wang, Qingying. “Nine Famous People with Asperger’s.” Translated by Jennifer Lin. PanSci. N.p., 11 Feb. 2015. Web. 5 Dec. 2016.

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