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Accepting Our Differences: Children with neurologic conditions such as autism teach us important lessons.

Section Editor(s): Brey, Robin L. M.D.; Editor-in-Chief

doi: 10.1097/01.NNN.0000451309.55099.a3
Departments: From the Editor

To listen to a podcast from Editor-in-Chief Dr. Robin Brey about this issue of Neurology Now, go to

Our cover story in this issue of Neurology Now features Alexis Wineman, a remarkable young woman with autism spectrum disorder (ASD). Alexis has persevered in the face of many obstacles and thrived. Crowned “Miss Montana” in 2012, she was the first Miss America contestant with ASD in the 92-year history of the competition. When she learned that each contestant in the pageant had to focus on a platform or an issue, Alexis chose awareness and acceptance of ASD. She came up with the title, “Normal Is Just a Dryer Setting: Living with Autism.” Today, she attends Huntingdon College in Montgomery, AL.



Her story chronicles the many challenges people with ASD face and the determination required to succeed. What I find most compelling is the way she stresses the need to not let “being different” define or limit a person. She even extended her mission to include everyone who feels as though they don't belong.

ASD is a syndrome, as our story points out, not a disease. The main symptom is difficulty with social interaction. Children may appear to develop normally and then withdraw from social interaction. Other symptoms include trouble communicating, inflexible or repetitive behaviors, an inability to monitor clues about how other people are feeling, and a lack of empathy. Some children with ASD—such as Wineman—have relatively mild symptoms, but for others, the symptoms can be disabling. It is important for children with ASD to get therapy early because this leads to the greatest chance for symptom improvement. Treatments always include educational and behavioral therapy and, in some cases, medications. For many children, the symptoms improve with treatment and age.

Many children with ASD, like Wineman, experience delays in getting a diagnosis. Sometimes they are misdiagnosed as having a different problem. These children may be given medications that don't help ASD and cause side effects. Also like Wineman, many children struggle in school and are teased or even bullied.

Unfortunately, this can happen to any child who is “different” in some way—because of a speech impediment, muscle weakness due to muscular dystrophy, trouble walking due to cerebral palsy, a seizure disorder, or cognitive difficulties due to Down syndrome. Children with any of these problems have much to deal with in addition to the normal demands of growing up. Bullying or teasing only adds to the burden.

ASD is very common, occurring in 1 out of every 68 American children. When we add all of the other children with developmental problems that contribute to difficulty in doing well in school or socializing, the numbers are staggering! Chances are you know a child living with this daily challenge. The key is to recognize when a child is struggling, get help in identifying the cause, and find appropriate treatment as early as possible. This is a child's best shot for a successful transition into adulthood.

If you or someone you know has struggled to fit in for any reason, tell us about it by emailing Your story about how you worked through or around this obstacle may be the pivotal factor in helping someone else.

Take good care,

Robin L. Brey, M.D.


© 2014 American Academy of Neurology