My brother’s always been a shy child, but he had a good relationship with family and friends. In his teenage years, he started to withdraw. I was the only one to whom he kept talking. He began to spend most of the day in his bedroom. He also began to use monosyllable words to reply to my parents, aunts, cousins… Never started a conversation unless you addressed him. Now, at 19 (almost 20), it has evolved to the point he doesn’t talk to anybody, not even to me, and not even with monosyllables. He doesn’t look anybody in the face either (he didn’t do that a few years ago). If I try to talk to him, he ignores me or makes a sound of annoyance and kicks me out of his bedroom. He is very childish too, in the sense that it is part of his routine to watch cartoons with his favorite stuffed toys (he refuses to throw toys away). He prefers their company to that of people. I don’t even know if he has friends. He certainly avoids his college peers. He has dinner alone and goes to sleep early (I bet it is only to avoid us too). He only goes out if he needs to get a book in the library or if he has to go to college. Otherwise, you’ll find him home.
Is he afraid to become an adult? Could that be the reason he behaves like a child despite being almost 20? Could he have social anxiety? Autism, even? Maybe Aspergers. Some symptoms coincide:
• Difficulty to socialize and make friends; isolation
• Rigid routines (he gets distressed if he can’t follow them)
• Fear of change (he doesn’t want to throw old/broken things away)
• Hygiene issues (he rarely showers and shaves and he never uses deodorant)
• Sensitivity to noises and light
• Repetitive motor mannerisms (which he didn’t have as a child)
If he had autism, though, he would have some speech difficulties, wouldn’t he? He actually uses sarcasm and understands it perfectly. Never shown any speech delay either. Besides, I think I read someone is born autistic, so he can’t become autistic at the age of 18. It’s been an evolution, that’s why I’m not sure what is going on. Is he just a very immature teenager or does he have a condition? (From Spain)
Your deep concern for your brother is admirable and your research about his condition is impressive. I can understand why you might think he has autism.
Since 2013 the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has classified Autistic disorder, Asperger’s, childhood disintegrative disorder, and Rett’s disorder all under the title of “autism spectrum disorder.” While it would not be possible to offer an official diagnosis, here is a brief online quiz that might help in identifying if your suspicions about your brother’s behavior are correct.
Typically, there are two major criteria in the classification of autism: Communication deficits and abnormal behaviors — so your concern is justified. His monosyllabic speech and repetitive mannerisms and lack of eye contact fit these categories. You can find greater details about autism diagnosis here. More information about Asperger’s is here, and Retts Syndrome here. There is also a wonderful memoir, Look Me In The Eye: My Life With Aspergers by John Elder Robison that is excellent.
But there may be a number of other possibilities causing his reaction and only qualified mental health or medical providers can make an accurate diagnosis. The fact that he is in college and cares about his grades is important. He may have all these reactions, but he must still be motivated academically. Having goals and needing to put the effort in toward them is always a powerful way to help someone — regardless of the diagnosis.
Also, the university will typically have a counseling center, which you could suggest for him to go to as a way of preparing for whatever will follow graduation.
If he is unwilling to go to the counseling center offer to go with him to get a physical check-up. A number of the other possibilities for his symptoms may be medical and a physician would be able to note this or make arrangements for follow-up evaluations.
I wish you well in looking for some solutions for your brother. He is lucky to have you as a sister.
Wishing you patience and peace,
Dr. Dan
