Saturday, October 19, 2002 – Print Edition, Page F1

At the basement computer in a bungalow just outside Ottawa, Sean McRae is designing a town. Eyes glued to the screen, hand to the mouse, he is holding forth on the cost-benefit ratios of various municipal infrastructures: "Light residential versus commercial, hospitals at $500, stadiums at $5,000. All developments must be connected to a power grid or people can't see. Put it here and it's just that simple."

Sean is eight years old. Before his fascination with civic planning, it was clocks, right down to their pinion springs. Before that, it was world calendars, then National Hockey League arenas -- he can name the seating capacity of every one. Sean could read by the age of 3, and recite numbers in five different languages.

But even now he can't brush his teeth, or play with other kids at birthday parties.

Sean was 4 when doctors told Rob and Elizabeth McRae that their son had high-functioning autism. He had the classic social deficits, the screaming tantrums at the beeping of a microwave or the misplacement of a toy, the frustrated hand-flapping, the rocking and running in circles to calm himself, and the fixation on routines and arcane facts (his favourite book is the Nokia cellphone manual).

The McRaes have no idea how their son came by this baffling neuro-developmental disorder. But what they do see is a mysterious genetic connection: Rob McRae is a computer programmer who recognizes his own traits in Sean, the visual memory, technical proficiency and intense concentration. He even rocks in meetings, he says, and so do other colleagues in Ottawa's high-tech field.

In fact, doctors have noted that parents in fields such as engineering and computer science, with their particular talents and quirks, seem to run a greater risk of having children with autism or its high-intellect variant, Asperger's Syndrome. Now, this link is becoming a matter of public debate, pinging through the tech corridors of Ottawa and the on- and off-line networks of Cambridge, Dublin and Boston's Route 128. Some call it "Geek Syndrome."

When the McRaes met parents of other children with Autistic Spectrum Disorders through the Royal Ottawa Hospital, they noticed that most of the families had at least one parent in computers, engineering or math. Elizabeth McRae, who is now president of the Ottawa chapter of the Autism Society, can name 10 off the top of her head.

"If you look at the parents," says Jeanette Holden, a geneticist and professor at Queen's University, "you can think of autism as a 'super them.' "

Anita Acheson calls it the "too-much-of-a-good-thing theory." Mrs. Acheson, who has a 12-year-old son with autism, is an Ottawa computer programmer, married to another computer programmer. As she puts it, 30 years ago, she might have been a math teacher and her husband an engineer. Then they never would have met, as they did at Carleton University's school of computer science.

The Achesons are among the participants in Dr. Holden's project, backed by the Canadian Institutes of Health Research, to collect the DNA of affected families. "Wherever you have a high density of people in computer programming . . . clustering in a certain place," Dr. Holden says, "my sense is you're going to see this trend."

Bill Gates, don of the Microsoft monopoly and the world's richest man, is thought to be the best-known public face of Asperger's, prone to rocking, monotones and temper tantrums. Microsoft has taken the extraordinary step of paying for its employees' autistic children to undergo costly behavioural-analysis therapy.

It may be that human ingenuity has always owed a debt to traits on the autistic spectrum, that from somewhere along this dimension genius springs, giving us the wheel, the steam engine and the rocket as well as the microchip. But in our ever-more-wired world, where toddlers can learn the alphabet on the Internet, it's reasonable to ask whether our technical fluency is slowly enriching the species with a genetic vulnerability to social-deficit disorders.

Hans Asperger himself, who identified the syndrome that bears his name in 1943, likened the affected children to "automatons." One of the leading experts has said computers were invented by and for people with Asperger's. It all leads to an eerie image of the tools remaking their makers.

And nowhere more hauntingly than in the high-tech mecca of Silicon Valley, California. There, nestled in the apron of the Santa Cruz mountains, where Hewlett met Packard and the digital age flickered to life in a Palo Alto garage, residents fear they are in the midst of an autism epidemic.

On a brilliant Saturday morning three weeks ago, 300 anxious parents, teachers and therapists filed into the darkness of the Lewis B. Meyer auditorium at Santa Clara University. They bore notepads, name tags and the most troubling of questions: Why are our children sick?

Santa Clara is one of those blink-and-you-miss-it northern California towns, one of more than a dozen in Santa Clara County, better known by its proud nickname of Silicon Valley. The valley is only 80 kilometres long, but in its brief stretch from San Francisco to San Jose are the low-slung office parks of more than 12,000 electronics and software companies, giants like Intel, Netscape, Sun Microsystems, 3Com and Cisco.

More high-tech professionals live among the valley's 1.8 million people than anywhere else on the planet, and those that have turned up this morning are hearing too much to process: Autism appears to be exploding all over the industrialized world. But here in California, the numbers are staggering.

From 1987 to 1998, the state Department of Developmental Services recorded a 273-per-cent jump in demand to treat autistic disorders, while the state population grew only 19 per cent. And that figure doesn't include cases of high-functioning autism or Asperger's.

Once considered rare, autism is now the No. 1 disability entering California state social services. Greater awareness may partly account for it. But a two-year, state-wide investigation released this week concluded the trend cannot be explained by artificial factors, such as changes to diagnostic practices or immigration.

State officials report an average of eight new cases a day, meaning that a child in California is diagnosed with autism every few hours.

"These kids are coming out of the woodwork," says conference speaker Rick Rollens, a former secretary of the California Senate whose son has autism. "Anyone who doesn't call this an epidemic is in denial. They say these kids were missed before, but that would be like missing a train wreck."

His point is clear on a trip to the nearby Morgan Center, a day school for children and adults with autistic disorders. There's Mattie, 8, who has pulled his Tupperware container of macaroni from his lunchbox and insists on eating it -- right now, though it's only midmorning.

But Mattie can't speak, so he squeals at a deafening pitch, his hands flapping ceaselessly as a teacher tries to distract him with a detailed drawing of an apple tree. Mattie takes a swing at her, but then accepts a magic marker.

And then there comes a glimmer of the mind within: Despite his continued screaming and flapping, he manages to trace that fruit tree with remarkable precision.

Inside, hunched over a piece of foolscap, is Jeff, 35, who has been at the Morgan for 27 years. When he learns there is a visitor from Canada, he looks up: "My mother was born in Canada. In Victoria, British Columbia. My Aunt Helen lives in Victoria, in British Columbia, that's a province in Canada," he says, his pencil hardly pausing as it covers the page in columns of long division and multiplication with nine- and 10-digit numbers.

One in 10 people with autism is a savant. "You can give Jeff almost any number to multiply. He can do it about as quick as a calculator," says Jennifer Sullivan, the school's executive director. Calculators, computers, Gameboys, any gadget with buttons, levers or knobs are the most treasured toys at the Morgan Center. Educators use computer time to reward lessons well done, and exploit them as one of their most powerful teaching tools.

"With computers," Ms. Sullivan says, her students "can't fail, or be judged. They push a button, they make something happen."

Referrals to the Morgan Center have ballooned, as have autism programs at all the local schools, some hiring student aides straight out of Starbucks to cope with the caseload. It was Ms. Sullivan and her staff who organized the Santa Clara conference, officially entitled, "Autism: Is there an epidemic in Silicon Valley?"

In the discussions there, all the usual suspects were trotted out as possible causes: childhood vaccines, despite studies and reassurances from mainstream medicine; environmental toxins; autoimmune triggers; infections; or genes -- their genes.

The morning session was dominated by the similarities between autism and the traits associated with the valley's high-tech heroes, who can devote endless hours to writing code and design silicon chips the size of quarters, but are often more comfortable with computers than with people.

The Massachusetts Institute of Technology, a premier training ground of the techcentric, actually provides a one-day seminar to school its students in basic social skills. It teaches table manners, deciphering body language and how to dress, make small talk, listen attentively, make eye contact -- and ask for a date, in a session called "Nerdy Love."

It was Wired magazine, the high-tech bible, that coined the term Geek Syndrome for the Silicon Valley autism explosion. Not long ago it would have come off as a school-yard slur. But the computer revolution made geek chic -- not to mention wealthy, powerful and proud.

The first Geek Pride Festival took place in Boston two years ago, attracting more than 3,000 attendants, who rallied to the cry of "Be There and Be Square." Silicon Valley has celebrated its idiosyncrasies with similar exuberance, in offices where employees can ride between cubicles on pink bicycles, or descend floors on slides instead elevators.

So it's with little fear of a spam attack that Steve Silberman, who wrote the Geek Syndrome article, took to the stage to discuss Silicon Valley's oddities. He talked about how much children with autism reminded him of the software executives he interviews. One man, with an autistic daughter, so hated the ring of his telephone that he replaced the bell with a light, and disabled the buzz of the clothes dryer in favour of a pop-up icon on his computer to tell him when it's time to unload.

"I think we're all living somewhere on the spectrum," Mr. Silberman told the audience, who laughed as they might at a comedian whose jokes cut close to home.

In the crowd was Sandy McInnis, a slight computer engineer in a blue shirt and dockers. Mr. McInnis and his wife, also a software engineer, have a young daughter with autism. He can see parallels, but he worries the tech-autism link trivializes the disorder's devastating impact: "Autistic disorder is much more severe than Asperger's or being a geek. We are talking here about children who cannot talk, who cannot understand much of anything, scream frequently for no apparent reason."

Certainly many feel insulted by the notion that they carry "geek genes," that the very discussion adds medical stigma to stereotype. Autism, after all, strikes all ethnicities and social classes; one of the highest known rates of the disorder is in Brick, N.J., a town known for fishing and tourism, where residents fear that an unknown toxin is causing autism in four out of every 500 children.

But Ms. Sullivan says the link to tech professionals is tough to ignore. "We all notice that there are more parents who are engineers who have these kinds of kids. Usually there's just something, I don't know, odd about them," she says. "At cocktail parties, they're talking about something you're not remotely interested in, but they don't have a clue, they can't read your body language or see your boredom. Once we had an event at the school and we couldn't get these particular parents to leave. Everyone else had gone, we had our keys in our hand and we were turning out the lights.

"Do I think there's something to it? Yes, I do."

That inheritance plays a strong role in autism is one of the few facts about the disorder no scientist disputes. Families with one autistic child are at high risk for another. When one identical twin has autism, the chances the other will develop the disorder are between 65 and 90 per cent.

Further out on the family tree, doctors talk about "the broad autistic phenotype" -- scientific jargon for milder autism-like traits. Families will tell them about the reclusive uncle, or the eccentric cousin -- or one of the parents themselves, when a spouse sneaks back into the office to talk about her mate's peculiarities.

Researchers have also long remarked that children with autistic disorders often appear to be the offspring of parents in particular careers. In the mid-nineties, clinical psychologist Simon Baron-Cohen, co-director of the Autism Research Centre at Cambridge University, decided to find out for sure.

He compared the professional backgrounds of the parents and grandparents of 919 children with autism with separate groups of parents who had children with Tourette's syndrome, Down syndrome or language delays, as well as a random sample. His 1997 paper reported that the fathers and grandfathers of autistic children were more than twice as likely to be engineers than the others.

He reported that in a 1998 survey of 1,300 Cambridge University students, he found six cases of autism in the families of students of physics, mathematics and engineering (half the sample), and only one among the relatives of the half studying literature.

"They may have a way of thinking that is more autistic-like," Dr. Baron-Cohen says. He is cautious about the implications sounding like "a medical stigmatization of nerdiness," but still suspects that the genetic traits involved lead to a susceptibility to autism.

Most medical experts agree that general traits, rather than genes that specifically cause diseases, have to be involved. If they weren't, the disorder would have disappeared from the population, since people with autism, particularly severe forms, rarely end up having children.

To measure autistic-like traits in adults of normal intelligence, Dr. Baron-Cohen designed the Autism Quotient test, or AQ (see sidebar). He found that scientists scored higher on the AQ than non-scientists, and people in math, physics, engineering and computer science scored higher than those in the life sciences, such as biology.

These findings have led Dr. Baron-Cohen to form the intriguing, if prickly, "Extreme Male Brain" theory. It holds that autism -- which strikes four times as many boys as girls -- is an exaggeration of a set of traits common to engineering types. Since more men than women fit this profile, Dr. Baron-Cohen says, "what we're looking at is whether autism is an extreme of the male brain.

"The male brain is more strongly drawn to systems than to people, on average," he says. "You still have males who are, of course, empathetic, and females who are systematic, but we think what might influence these things are testosterone levels."

Cambridge researchers are now analyzing amniotic-fluid tests from 3,000 pregnancies, to see whether testosterone levels are linked to which children will develop autism. Already they have found that babies exposed to higher testosterone in the womb make less eye contact and begin speaking later than others.

"The other thing to note here," Dr. Baron-Cohen says, "is what directs testosterone levels: It's genes."

Estimates are that anywhere from three to 20 different genes will be proved to be involved in autism -- those tied to metabolism and the immune system, since children with autism suffer food allergies and gastrointestinal troubles, as well as those supervising brain function.

Robert Moyzis, a molecular geneticist at the University of California at Irvine, says that if autism truly is increasing, it might be partly explained by a social increase in mobility and, in a positively frigid clinical euphemism, "assortative mating."

As Dr. Moyzis speculates, "If you have a person with certain personality traits in a small town in middle America, the probability that they would meet someone like themselves in that small town is low. But now we have places like Silicon Valley, and if you like sitting in front of computers writing code, you have a place to go.

"Now, you're thrown into a workplace with people just like you, and suddenly you find you not only have access to meeting these people, but you're compatible. Here's a person who finally understands you."

The talents the two people have in common are what's drawn them to places like Silicon Valley -- but when they date, mate and have children, Dr. Moyzis suspects, "now you're getting an overload of those good genes, and it leaves you susceptible."

The dot-com boom of the 1990s also made the valley fertile ground for what MIT dubbed Nerdy Love. Tech experts flew in from Europe, India, China and South America to stake their fortunes in Santa Clara County. And fortunes they found. During the boom, according to a 1997 Business Week survey, a technology company in the region went public every week, minting 62 new millionaires a day. Soon, Santa Clara County earned another nickname -- "the valley of the boys." Dating services and marketing firms promoted the region as a manhunter's paradise, though of an unconventional kind.

"They're not, you know, the first people you'd think of if you were looking for a husband," says one woman, a San Jose speech therapist (who asked not to be identified, since she works with autistic children and their parents). "I mean they're not at the singles bars striking up conversation."

"Fifty years ago," says Jonathan Shestack, co-founder of the Los Angeles-based parents' group Cure Autism Now (CAN), "you would have been a mechanic in Urbana, Illinois. Now, you're making $175,000 writing code. You're marriable."

Genes, however, are only part of the equation. While risks are high that identical twins will both develop autism, they're not 100 per cent. What's more, since genes cannot spread swiftly through the general population, DNA alone cannot possibly account for the apparent increase of autism cases seen around the world.

Something in the environment has to be a trigger, Dr. Moyzis says. The autism mystery has to involve at least two culprits, he says, perhaps genes and a virus. "We have to stop thinking of genes and viruses separately," he says.

One per cent of Caucasians, for example, have a genetic immunity to human immunodeficiency virus, which causes AIDS. As well, the 125 people who have died in Britain from the mad-cow virus all shared a genetic characteristic that appears to make them develop the disease more quickly than others. Genes can predispose you to an illness, or they can protect you, Dr. Moyzis notes.

So will autism turn out to be something you might be liable to catch? Is there an autism virus? Scientists are now investigating a range of possibilities. But autism has always been one of the big black boxes of medicine, open to a wide range of theories -- some of them dangerous.

People in technology hot spots all over the world debate the so-called Geek Syndrome phenomenon on-line.

One 41-year-old man, recently diagnosed as being on the autistic spectrum, expresses outrage that autism has become fodder to attack the way certain people think. In a parody on the Web, he has created the Institute for the Study of the Neurologically Typical -- "neurotypical" or "NT" being the autism community's label for those who aren't on the spectrum.

"Neurotypical Syndrome," the site says, "is a neurobiological disorder characterized by the preoccupation with social concerns, delusions of superiority and obsessions with conformity." It goes on to note that NTs are afraid of being alone, are prone to lying and partake in absurd rituals to maintain group identity.

And he is far from the first person in the history of autism to feel victimized by experts' explanations.

The disorder was first identified in the early 1940s by Johns Hopkins child psychologist Leo Kanner and by Dr. Asperger at the University of Vienna. In the 1960s, influential Chicago psychologist Bruno Bettleheim developed the infamous "refrigerator-mother theory," positing that autistic children were the products of cold, unfeeling mothers. For years, as Dr. Bettleheim advised, children were snatched from their homes and locked away in institutions, while research on the true science of autism stalled. (Dr. Bettleheim committed suicide in 1990, and it was later revealed that he had falsified credentials and abused his patients.)

Not until 1980 did the American Psychiatric Association include autism in the Diagnostic Statistical Manual of Medical Disorders, known best as the DSM -- the profession's bible for deducing syndromes from symptoms. Doctors realized soon after that autism was not one disorder at all, but rather a constellation of similar symptoms ranging dramatically in severity. So in 1987, autism was classified under a group of related disorders known as Pervasive Developmental Disorders, or PDD. Asperger's Syndrome was included in 1994.

The changes in medical practice have convinced many that the autism increase reported over the past decade merely reflects doctors diagnosing children at younger ages and counting those who were missed or misdiagnosed in the past.

One recent California study, for example, claimed that while autism rates have climbed in the state, diagnoses of mental retardation have dropped. (This week's report from the University of California at Davis, however, noted the same trend, but remarked that at the same time, some children diagnosed with mental retardation are actually autistic.)

Bryna Siegel, a psychologist at the University of California, San Francisco, feels that it is now more socially acceptable to say a child is autistic, rather than mentally retarded.

What's more, she notes, an autism diagnosis gives parents access to costly educational services. "If I say, 'I have good news for you, Mrs. Jones -- your son does not have autism,' she'll say, 'No, no, I'm sure he has autism.' Parents are not always relieved.

"The more prevalent autism becomes, the more people get into the autism business," says Dr. Siegel, a leading expert on autistic disorders.

Diagnosing autism is not as simple as a blood test, but rather, she says, a subjective interpretation of 12 different behaviours listed in the DSM. For example, Dr. Siegel says, a child's affinity for routines and rituals might also be obsessive-compulsive disorder. And how much of a failure to make eye contact should be considered a disability?

"These are the kinds of things that have really mucked up the diagnoses, especially in milder cases. Asperger's is the worst of it," Dr. Siegel says. "I undiagnose more cases than I diagnose."

On a recent morning in her clinic, a couple from Silicon Valley sat in disbelief. For months, they had believed their three-year-old son Benito to be autistic. A San Jose neurologist who spent a few minutes with the child had told them so. But in the three-hour assessment with Dr. Siegel and her assistants, Benito, although hardly verbose, laughed at the puppets, threw himself into the arms of his "playmate" evaluator, followed complicated instructions and showed frustration only at being graded for his performance.

As Dr. Siegel told his parents that Benito may be language-delayed, but definitely not autistic, the boy began to whine. Having played with his trucks for more than 20 minutes as the adults talked, he at last lost patience: "Mommy? Mommy, I want to go home." But mommy was taking notes. "Mommy, mommy, mommy," Benito cried again. "I want to go home."

His mother put down her pen: "You hear that, Dr. Siegel? You hear that kind of behaviour? That's some of the repetitive stuff we're talking about."

She also worries that Benito might be obsessed with the garbage truck: Every week when it pulls up at the curb, he races to the window to watch it.

Later, Dr. Siegel says that beyond genetics, this kind of confusion may be plaguing Silicon Valley. "These parents have come from all over the world here. They don't have extended family around them. They are raising children with no sense of what normal child behaviour is. And now there's this buzz out there about an 'autism epidemic' in the valley."

When talk of the so-called Geek Syndrome began to spread, Patrick Jones, an engineer and marketing director at Network Appliance, a data-storage company, received fearful telephone calls from his friends. "One of them said, 'You know, my wife's an engineer. . . . Should we have a child?' " says Mr. Jones, whose eight-year-old son Connor has autism. "This idea has made healthy people rethink having children. And yet the concept that there's this rash of autism because a bunch of engineers are breeding with each other is insane."

He points out that not all computer people even fulfill the geek stereotype. "Software programmers work in teams -- they have to interact with each other. They don't sit there with the lights dimmed."

Mr. Jones suspects Silicon Valley's autism rates may be attracting attention more because the parents here have the will and resources to do something about it. He, for example, joined CAN and helped to spearhead a remarkable scientific resource, a DNA bank of families with autism created by the families themselves.

Frustrated by the years it takes scientists to collect genetic samples before they can even begin basic research, CAN got computer hardware donated by Network Appliance and Mr. Jones helped design a network system that now contains information on more than 450 DNA samples, available to any autism researcher in the world. Whether the valley's tech expertise is leading to high autism rates, it's surely one of the few places where residents can help decode their own DNA.

The McRaes have yet to donate their DNA to any of the many gene hunts now under way. "Maybe that's selfish," Mrs. McRae says, "but we're not as concerned with causes right now, just coping."

The hard part is all the small things: The morning routine to get Sean washed, dressed and to school, along with his "neurotypical" sister Erin. Wrapping Sean's cutlery in masking tape to hide any engraved lettering that might overload his busy brain. Ensuring his kitchen chair stays in its exact place at the table.

They also try, as much as possible, to indulge Sean's unique interests. When he perfects the design of the Sim City computer-game town he is creating -- which he has named Seanville -- they will allow him to build it, right here in their bungalow. A collection of genuine street signs awaits construction day at the foot of Sean's bed: Indian Road, Maclean Street, Main, Driscoll.

When Sean's voice rises as he discusses his plan, his mother interrupts: "Sean," she says, in the distinct language he best understands, "You're operating at a 10 and I need you dial it back to 5." She reaches out to his chest, and adjusts an imaginary knob.

Carolyn Abraham is The Globe and Mail's medical reporter.

What's your AQ?

Where are you on the autism spectrum? Cambridge psychologist Simon Baron-Cohen and others designed this test, published in the Journal of Autism and Developmental Disorders, 2001. Choose your response to each question: Definitely agree, slightly agree, slightly disagree or definitely disagree.

1. I prefer to do things with others rather than on my own.
2. I prefer to do things the same way over and over again.
3. If I try to imagine something, I find it very easy to create a picture in my mind.
4. I frequently get so strongly absorbed in one thing that I lose sight of other things.
5. I often notice small sounds when others do not.
6. I usually notice car number plates or similar strings of information.
7. Other people frequently tell me that what I've said is impolite, even though I think it is polite
8. When I'm reading a story, I can easily imagine what the characters might look like.
9. I am fascinated by dates.
10. In a social group, I can easily keep track of several different people's conversations.
11. I find social situations easy.
12. I tend to notice details that others do not.
13. I would rather go to a library than a party.
14. I find making up stories easy.
15. I find myself drawn more strongly to people than to things.
16. I tend to have very strong interests, which I get upset about if I can't pursue.
17. I enjoy social chitchat.
18. When I talk, it isn't always easy for others to get a word in edgeways.
19. I am fascinated by numbers.
20. When I'm reading a story, I find it difficult to work out the characters' intentions.
21. I don't particularly enjoy reading fiction.
22. I find it hard to make new friends.
23. I notice patterns in things all the time.
24. I would rather go to the theatre than a museum.
25. It does not upset me if my daily routine is disturbed.
26. I frequently find that I don't know how to keep a conversation going.
27. I find it easy to "read between the lines" when someone is talking to me.
28. I usually concentrate more on the whole picture rather than the small details.
29. I am not very good at remembering phone numbers.
30. I don't usually notice small changes in a situation, or a person's appearance.
31. I know how to tell if someone listening to me is getting bored.
32. I find it easy to do more than one thing at once.
33. When I talk on the phone, I'm not sure when it's my turn to speak.
34. I enjoy doing thing spontaneously.
35. I am often the last to understand the point of a joke.
36. I find it easy to work out what someone is thinking or feeling just by looking at their face.
37. If there is an interruption, I can switch back to what I was doing very quickly.
38. I am good at social chitchat.
39. People often tell me that I keep going on and on about the same thing.
40. When I was young, I used to enjoy playing games involving pretending with other children.
41. I like to collect information about categories of things (types of cars, types of birds, types of trains, types of plants, etc.).
42. I find it difficult to imagine what it would be like to be someone else.
43. I like to plan any activities I participate in carefully.
44. I enjoy social occasions.
45. I find it difficult to work out people's intentions.
46. New situations make me anxious.
47. I enjoy meeting new people.
48. I am a good diplomat.
49. I am not very good at remembering other people's date of birth.
50. I find it very easy to play games with children that involve pretending.

Scoring. Score one point for every "definitely agree" or "slightly agree" response to the following: 2, 4, 5, 6, 7, 9, 12, 13, 16, 18, 19, 20, 21, 22, 23, 26, 33, 35, 39, 41, 42, 43, 45, 46. Score one point for every "definitely disagree" or "slightly disagree" response to the following: 1, 3, 8, 10, 11, 14, 15, 17, 24, 25, 27, 28, 29, 30, 31, 32, 34, 36, 37, 38, 40, 44, 47, 48, 49, 50.

Interpretation. The test assesses five different areas. Autistic-like responses will show poor social skill, attention switching, communication and imagination, and an exaggerated attention to detail. Scores over 32 are generally taken to indicate Asperger's Syndrome or high-functioning autism, with more than 34 an "extreme" score. A "normal" score, based on control groups, is about 16 (or 15 for women and between 17 and 18 for men). A group of mathematics-contest winners scored an average of 24.5. A group of scientists scored an average of 18.5 (19 for men, 17 for women), with computer scientists at about 21, physicists at 19 and those in biology or medicine at about 15.