To answer this we really need to ask several questions.

1) do all children, including autistic children, dissociate?

ANSWER
yes. In fact autistic children tend to dissociate more easily, more continuously and do so far beyond the age of 5 where most non autistic children adapt to no longer commonly dissociate. Autistic children who are used to dissociating (commonly presenting as staring into space, not responding as if deaf or unable to understand/recognise/emotionally or physically respond) are more likely than non-autistic children to progressively compulsively use repetitive self stimulatory behaviors as a form of self hypnosis to regain the comfort of the dissociated state.

2) do all children when subjected to overwhelming circumstances dissociate?

ANSWER
yes.

3) are those with significant information processing, emotional dysregulation and communication disorders more likely to find their circumstances continually overwhelming and, hence, find dissociation comforting.

ANSWER
yes.

4) are those with significant developmental disabilities known to be more commonly subject to family breakdown and abuse than children without developmental disabilities?

ANSWER
yes

5) are those with significant developmental disabilities known to be more commonly subject to additional mental health disorders than children without developmental disabilities?

ANSWER
yes

6) subjected to repeated physical, mental, emotional and sexual abuse, do children, including autistic children dissociate?

ANSWER
yes.

7) can an autistic child be born into a a family or go into care services where from an early age they are at the disposal of psychopath, sociopath, narcissist, substance abuser, pedophile or mentally ill carer/s?

ANSWER
yes.

8) are there any mental health disorders which an autistic person is incapable of additionally developing?

ANSWER
no. People with autism have been diagnosed with all kinds of co-occurring conditions: learning disabilities, epilepsy, gut/immune/metabolic disorders, speech aphasia, oral/verbal dyspraxia, verbal/visual/body agnosias, deafness, selective mutism, attention deficits, emotion dysregulation and rage disorders, conduct disorders, attachment disorders, anxiety disorders, mood disorders, psychosis, compulsive disorders, personality disorders, gender identity disorders, and, yes, dissociative disorders including PTSD.

9) don’t additional diagnoses invalidate earlier ones?

ANSWER
just as one can have diabetes and autism without one invalidating the other, one can have any mental health disorder and autism, including a dissociative disorder, and yes, someone with a developmental disorder can then also develop a dissociative disorder such as DID.

10) doesn’t DID mean a child is highly imaginative? In other words, wouldn’t someone with autism be unable to make up the imaginary friends necessary to develop DID?

ANSWER
research has found that girls with autism did commonly develop imaginary friends where it remained highly uncommon in boys. It is also the case that the alters in DID are not created consciously through processes of conscious imagination. They are created unconsciously, involuntarily, under unbearable circumstances such as rape. In other words the creation on alters occurs in dissociative states where the child may appear to be dead, staring at the ceiling, grimacing with fear, but in their mind has unconsciously become a TV character so as not to personally experience the abuse. To project onto this situation the freedom of a healthy child indulging in high skills of imaginary play is extremely offensive and naive in the context of the traumas which cause DID.

11) do all severely traumatised children develop DID?

ANSWER
no. DID is rare and is considered not part of a tendency toward Post Traumatic Stress Disorder. In other words it is more linked to differences in memory function (the inability to forget) than to imagination. In DID the abuse has been so overwhelming the personality has SPLIT. Fragments of the original personality continue to present, progressively developing separate sense of selves, each with their own history, perspectives, tastes, skills.

12) if someone with autism developed DID would all of their selves exhibit autism?

ANSWER
yes, but likely in different forms, just as if 5-10 children inherited or developed autism, each of their personalities would alter the way their autism presented.

13) as a person diagnosed with autism and DID, how many of your different selves are autistic?

ANSWER
We were diagnosed as psychotic at age 2 in 1965. Later with auditory processing disorder, atypical epilepsy, gut, immune, metabolic disorders and autism. All of these diagnoses were before being diagnosed with DID.

All of my selves are faceblind, all have degrees of verbal and visual agnosias (meaning deafness, meaning blindness). Several were echolalic, others silent, then selectively mute, others with semantic-pragmatic language disorder, one with an encyclopedic memory. One developed functional speech by late childhood. The others progressively followed with the exception of the Core Self who used typed speech because in addition to having always been silent had a stammer that made speech largely dysfunctional. Even this self developed verbal speech. All still have information processing disorders. All of the selves had differing combinations of mood, anxiety, compulsive disorders. Some had greater learning disabilities than others, some had less learning disabilities but significantly more difficulty with social-emotional communication than the ones with greater learning disabilities. Some had significant impulse control problems including self injurious behaviors from age 2, one had Tourette’s, one had OCD, one had GAD, one had mania and laughing fits.

14) if you had not acquired functional communication in late childhood, would you ever have been diagnosed with DID?

ANSWER
No. It required verbal feedback to understand what was going on.

15) could functionally non-verbal people with autism have co-morbid DID which has gone on undiagnosed and deemed part of their autism?

ANSWER
If they were subjected to extreme trauma, yes. Mood, anxiety, compulsive, attention disorders, rage, self injurious behaviors are STANDARD in those with DID. If a child with autism was abused in care (and I’ve worked with several who have been) and then regressed or developed additional behavioral problems or swung between highly contrasting (though still autistic) presentations it would almost always be deemed ‘part of their autism’ as, without functional communication, there would be no counseling, no disclosure. I have directly worked with non-verbal people with autism who have been through abuse and have typed about trauma, dissociation and splitting – and, yes, including two non-verbal people who typed about having developed other ‘selves’. Some are not so ‘lucky’.

Donna Williams, BA Hons, Dip Ed.
Author, artist, singer-songwriter, screenwriter.
Autism consultant and public speaker.

You can find more info at my website http://www.donnawilliams.netincluding my consultation page for DID where I offer online Peer Support.