Kevin Sutton wrote:

>I did not imply that Glenn Gould suffered from Tourette's syndrome.
>Rather, I have read that he suffered from a form of Autism.  It is this
>malady that I would be interested in reading more about, specifically as it
>relates to Gould.  Your post on Tourette's was indeed interesting though
>and I thank you again for taking the time to write so detailed a post.

I refer you back to my post again because I did touch very briefly on
this issue.  I had been trying to keep things as simple as I could.  Sorry,
it seems I had partly, and wrongly, assumed that you had raised the issue
of autism because you understood that there is much overlap between the
features of a recently more widely accepted subtype of autism called
Asperger's syndrome and Tourette's syndrome.  Indeed it is likely that all
conditions, Tourette's, autism and Asperger's syndrome may be genetically
related diseases.

In Asperger's syndrome there is none of the really gross impairment found
in the classical form of autism, in which there is often mutism and 75-80%
are mentally retarded.  Still this is really very much a debilitating
disorder.

My textbook of neurology says:

   Asperger's syndrome is an autistic disorder manifested by poor
   reciprocal interaction, inappropriate interaction, inappropriate
   emotional expression.  impaired non-verbal communication, circumscribed
   interests, and repetitive activities.  These children generally
   function at a higher intellectual level than patients with pervasive
   developmental disorder [i.e.  classical autism].  Like other autistic
   patients, they have stereotyped motor behaviour, clumsiness and tics.
       From Goetz and Pappert, p671;1999


Here is an reasonable description from the psychiatric literature, which
tends to underplay the fact that this is a developmental neuropsychiatric
disorder, and makes it sound as if it were a purely psychological
diagnosis:

   "Descriptions of adolescents and adults with mild autism and Asperger's
   Syndrome indicate that although many of them may have been considered
   odd, eccentric, or schizoid and some may have been diagnosed in
   childhood with psychiatric conditions, such as ADHD, OCD, or depression,
   the diagnosis of mild autism or Asperger's is frequently missed,
   particularly in higher functioning individuals.  It should be noted
   that comorbid disorders, such as depression, can also be missed in
   severely impaired persons with autism and should be considered,
   especially where there is a positive family history.  People with
   these disorders are described as aloof, isolative, socially awkward,
   and gauche.  They are unable to pick up on normal social cues, such
   as facial expression; they are gaze avoidant; and they are lacking
   in empathy.  They are sometimes clumsy; uninterested in group
   activities, such as sport or games; and have narrow circumscribed
   interests that are often unusual and idiosyncratic.

   Speech and language are also unusual and idiosyncratic with lengthy,
   pedantic, aprosodic discourses being common.  Many individuals have
   excellent rote memory and do well in school or college; others,
   however, are unable to sustain consistent education or employment
   because of their rigidity and obsessionalism, which make it hard for
   them to cope with change or the unexpected.  Often aware of their
   difference and extremely sensitive to rejection, these people sometimes
   seek help when relationships fail.  Others can be found in the criminal
   justice system, having committed offenses (e.g., aggressive outbursts
   associated with continuing rigidity) without apparent realization of
   the inappropriateness of their actions or the effect on others."

      Frances L. Burger MD
      Christopher M. Lang MD
      Psychiatric Clinics of North America
      Volume 21 . Number 4 . December 1998

I presume this is what you were interested in, and you will undoubtedly
want to recognise features of Gould's personality here.  Here is another
even better description from the neurology literature from an article on
Tourette's syndrome:

   "Asperger's original paper followed Kanner's description of autism
   by 1 year.  The two conditions are similar, and debate about whether
   they are separate entities continues.  Asperger considered his syndrome
   to be a personality trait, and autism a psychosis; some authors,
   however, ascribe the differences to degrees of severity of a unified
   diagnosis.  The major difference is in language--the autistic child
   is mute or has delayed and abnormal speech, whereas the child with
   Asperger's syndrome (AS) acquires grammar and vocabulary, but with
   socially inappropriate content of speech.  They both develop aprosody,
   which is frequently the presenting feature in AS.  The young autistic
   child is aloof and indifferent to others, but in AS there are
   inappropriate approaches.  In AS there are inappropriate gestures,
   in autism, stereotyped and repetitive routines.  In motor development,
   those with AS are uncoordinated whereas this is not true in autism,
   at least in the preadolescent age group."

      Jeremy S. Stern MA, MB, BChir, MRCP, DHMSA
      Mary M. Robertson MB, ChB, MD, DPM, FRCPsych
      Neurologic Clinics
      Volume 15 . Number 2 . May 1997

Before going and picking out features which might fit with elements
of Gould's personality traits in these quotations, please firstly ask
yourself if you firstly cannot recognise a few of your own personality
features here.  Next note given that this condition is a neurological
disorder there are typically problems relating to motor development - in
very stark contrast to the extraordinary dexterity displayed consistently
by Gould's pianism.  Also note that these patients tend to have a very
narrow and rigid scope of interest whereas Gould's repertoire ranging from
Gibbons to Schoenberg was remarkably wide.  The very fact that Gould's
interpretations could vary so markedly is powerful evidence against any of
the characteristic rigidity of these patients.  Please note that 'aprosody'
of speech is an important diagnostic feature.  This means the speech is
monotonous and mechanical, whereas Gould's radio talks demonstrate a
wonderfully articulate and animated voice.

The point is not to make the diagnosis on personality traits alone, but
to recognise that these are very much NEURO-psychiatric diagnoses.  So
once again I conclude that whereas a case might be made for a diagnosis
of a possible mild form of Tourette's syndrome (so called forme fruste),
a diagnosis of autism/Asperger's syndrome is really way off the mark.

Satoshi Akima
Sydney, Australia
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