At the age of 17 my son George has learnt to enjoy Christmas presents. He used to dislike and fear them. At the sight of a wrapped gift he would clap his hands over his ears and turn away. Later, if he was offered a present he would pass it on to one of his brothers – “That’s not for me, that’s for Sam” – or drop it unopened into the bin.

George is autistic. Presents, like so many other aspects of Christmas, affronted his hypersensitivities. He didn’t like surprises, he didn’t understand secrecy: he knew that receiving presents called for some kind of social response but he couldn’t work out how to react. He might have liked the contents of the parcel – most of his favourite things started life as Christmas or birthday presents – but he comes to things gradually, when they’ve been hanging around for a while, becoming part of the landscape. Novelty is a nono. And as for Father Christmas himself, he embodied several of George’s strongest dislikes, which included beards, deep voices and furtive behaviour. “No, Father Christmas is NOT coming to George’s house,” he announced when he was 3.

My second son, Sam, 16, is more profoundly autistic than George. George has some social awareness, which is why presents scared him, because they were part of a pattern of social behaviour to which he didn’t know the rules. Sam, however, is aloof, oblivious of social exchanges. His response to presents is like that of an 18-month-old; he enjoys ripping the paper off, but pays little attention to what’s inside. As for connecting the gift to the donor, that’s completely beyond Sam’s range. Unlike George, he’s never been scared of Father Christmas, but nor has he ever been interested in him. The red suit, woolly beard, silly laugh. . . to Sam it’s not magic, it’s just more incomprehensible adult behaviour. In fact, autism and magic don’t mix. To appreciate magic, you need a strong grasp of what’s normal, what’s expected, and that’s just what most autistic people lack.

I have a third son, Jake, who is not autistic. At Christmas, more sharply than at any other time, the difference between his world view and that of his brothers is brought home to me. Jake shows all the responses you’d expect of a nine-year-old boy. He’s seen through Father Christmas but he enjoys reminiscing about the days when he was taken in by the benign deception, and he still loves the bumpy surprises of his stocking. He’s excited about the presents he’ll receive, but capable of making thoughtful choices for other people. He enjoys the camaraderie of the school play rehearsals, likes it that routines are turned upside down and homework has fallen by the wayside. He grumbles a little about singing carols in the old folks’ home, but accepts the importance of doing so. The Church of England primary school he attends is big on the “true meaning of Christmas”, and Jake is just about able to acknowledge that Christmas is about more than acquisition and gluttony.

For his brothers, such responses are simply unavailable. Autism is a social disability: parties, family gatherings, expressions of neighbourly goodwill, may be meaningless or overwhelming. Autists don’t see things from another’s standpoint (the term autism comes from the Greek word for self), so giving pleasure to others through present-giving or a shared meal means little. The upheavals of the season – the house transformed by decorations, the influx of new possessions, the special food – will probably be unwelcome. Leo Kanner, who first defined autism in 1943, wrote of a strong desire for “the preservation of sameness” as a key characteristic of the condition. To most autists, Christmas must seem like an outrageous assault on this sameness. The more able may understand the religious aspect, but George and Sam can’t deal with abstract ideas. George, I think, would be able to identify baby Jesus, angels, shepherds etc, but they would have no more significance than Thomas the Tank Engine and friends: rather less, in fact.

My job as parent and Christmas-fairy-in-chief is to adjust the traditions of the season to appease everyone’s conflicting needs. Take the dinner: I’ll cook the whole lot, because there are grandparents and friends to consider as well as the boys, but while Jake will sit with the adults, eat sprouts and be polite, I’ll let George devour his ketchup-covered turkey in another room because he’s more comfortable eating alone, while Sam will be happier ignoring the festive fare and eating exactly what he eats on the other 364 days of the year – Birds Eye potato waffles. He won’t want to share our feast, nor will he mind that we don’t share his. He simply doesn’t compare himself to other people. I’ll stick on a CD of carols: Christmas music is something they respond to with enthusiasm.

They like the decorated tree, too, because they like things that glitter and shine. No chocolate decorations, though: they’d pull the whole thing over to grab them. I’ll try to prevent a repeat of the episode when George threw the Christmas pudding into the fire (perhaps there was a logic – you do set light to puddings, after all). I’d have minded less if I’d bought it at Tesco, but I’d made the wretched thing myself. But there’s no point taking it personally. George was incapable of connecting the destruction of the pudding with my feelings about it.

I’ll go to hear Jake say his one line in his play, because he’ll be pleased if I do. George would be agitated if I showed up at his carol service – he doesn’t like mixing school and home – so I shan’t. As for Sam, if he saw me he’d bellow: “Car – HOME!” and disrupt everybody else. Besides, Sam hates noise and crowds, so the staff of his autistic unit may well decide not to inflict his school production on him, nor he on it.

There’s another set of needs to be taken into account: those of the adult family members, who find it hard to relinquish their notions of what families ought to feel and do at Christmas time. The adults in our family have long since learnt to accept that their proffered gifts will not be met with cries of gratitude and delight. They valiantly keep proffering, and I’m glad they do because, at least in George’s case, there’s been progress towards the “right” response. But in our society, which packages Christmas as very much a children’s festival, it takes time to swallow one’s disappointment and accept that, in an autistic family, expectations will be overturned. The Treehouse educational charity, which runs, among other things, a parent support group, recognises this. At the Treehouse School, a specialist autistic provision, they do put on a Nativity play but they adapt it carefully to the capabilities of the children. They take everything slowly, make sure everyone understands what they’re doing, and withdraw anyone who can’t cope. The show is warmly appreciated by the parents, who say it gives them the chance to feel like a typical family.

After nearly 18 years of living with autism, I no longer mind whether my family feel typical or not (the emphasis is on the “not”). But I do appreciate my sons’ immunity to the less agreeable manifestations of the Christmas spirit. On the day there’ll be no squabbling, no cries of “it’s not fair”. There’s none of the feverish anticipation that can lead to a feeling of anticlimax; my sons don’t suffer from the “tears before bedtime” syndrome. George and Sam have no greed, no awareness of money or peer pressure; advertising doesn’t reach them. Jake’s longing for a Nintendo Wii has been a monotonous leitmotiv for much of 2007, but George is no more consumerist now than he was at age 13 when he wrote: “Dear Father Christmas, I would like a stick of rock and some firewood. Love from George.” If only everyone’s wishes were so easily met.

— The Pears Foundation will match all donations made to Treehouse through the Times Appeal

Autism: the disorders and their treatment

AUTISTIC SPECTRUM DISORDERS (ASD)

Autism is a complex and lifelong condition for which there is no cure. A comprehensive evaluation requires a psychologist, neurologist, psychiatrist, speech therapist and other professionals. Because hearing problems can cause behaviour that could be mistaken for autism, children with delayed speech development should also have their hearing tested.

Diagnosis ASD can usually be diagnosed when a child is 2. Some people may never obtain a proper diagnosis and still manage to live full and capable lives, but most will benefit from one because it brings relief, allows access to services and therapies, and aids family support.

Treatment There is no cure, but the earlier a diagnosis is made the better the chances of appropriate management via therapy, educational programmes and support groups.

ATYPICAL AUTISM

Autism affects the way individuals relate to people around them. Traits include difficulty with social interaction (eg, appearing aloof); difficulty with verbal and nonverbal communication (eg, words, gestures, expressions or tone of voice); difficulty with social imagination (eg, a limited range of imaginative activities, possibly copied and pursued rigidly and repetitively); and sometimes an accompanying learning disability.

ASPERGER’S SYNDROME

Children with autistic behaviour but well-developed language skills often have Asperger’s syndrome diagnosed. As with atypical autism, someone with Asperger’s syndrome has difficulty in communicating, social relationships, and social imagination. The condition differs from atypical autism in the following ways: Social relationships – many people with Asperger’s syndrome enjoy human contact, although they find it hard to understand facial expressions; difficulty with communication – those with Asperger’s syndrome may speak fluently, but they may not understand reactions of those around them. They may also sound overprecise; lack of imagination – while they often excel at learning facts and figures, they can find it hard to think in abstract ways; special interests – they may also have an obsessive interest in a hobby and they often find change upsetting.

PERVASIVE DEVELOPMENTAL DISORDER NOT OTHERWISE SPECIFIED (PDD-NOS)

Children with some symptoms of autism but not enough for a diagnosis of atypical autism or Asperger’s syndrome are often said to have PDD-NOS. This term is used only when all other possible diagnoses have been eliminated and varies in meaning depending on the individual. Research is continuing into the possibility of positive criteria for PDD-NOS.

Source: www.nas.org.uk