Autism in Korea and Seung-Hui Cho
April 27, 2007 by Kristina Chew, PhD
Filed under Health
Talk to the Chos is the title of an op-ed by Dave Cullen in today’s New York Times. Cullen, who is writing a book about the Columbine High killers, notes a sad—a terrible irony: Fourteen days before Seung-Hui Cho killed 32 people at Virginia Tech, “[a] judge ruled …… that depositions by the parents of the gunmen in the 1999 Columbine school shootings would remain sealed until 2027.” Cullen writes:
It would be tragic to also have to wait 28 years to hear from the family of Seung-Hui Cho, the killer at Virginia Tech. But the tense legal standoff that led to the Columbine ruling is likely to repeat itself in Virginia if we don’t quickly devise an alternative.
In the Columbine case, as in Virginia Tech, the killers’ families went into seclusion and released statements of regret and bewilderment. Parents of mass murderers have their own grieving to do. When the Chos resurface, a ravenous press corps will stalk them, and the public will be hungry for answers. The questions will grow increasingly belligerent and accusatory.
Cullen notes that Cho “demonstrated symptoms consistent with autism and Asperger’s syndrome, but these can also be signs of schizophrenia”; experts are “eager” to speak with his family, to “tease out the differences”: Had he experienced “psychotic episodes” earlier? If so, with what frequency and intensity? What kind of treatment was used, or not? As Cullen writes, “[a] deeper understanding of Mr. Cho’s pathway to murder can help us predict dangerous behavior and respond better to warning signs.”
What happened at Virginia Tech was terrible, inexcusable, unfathomable—-and that is why it is all the more important to try to understand, as futile and limited are efforts may be. The discussion here about Cho possibly being autistic has been going on for some days. It has not been an easy to discussion to follow, as a number of stereotypes about what autism is (an equation of autism with mental retardation, for instance) have surfaced, as well as some curious theories (connecting Cho’s violent behavior to mercury poisoning).
Many parents of autistic children reacted in horror to the suggestion that Cho may have been on the autism spectrum for fear that the public might start not only to connect autism with violence, but even to equate the two. I found this understandable but there is one aspect of Cho’s background that stands out equally to me and that, unlike an autism diagnosis, is simply obvious, and that resonates personally with me as an Asian American and the mother of an Asian American boy: Cho was Asian; more specifically, Cho was born in South Korea and emigrated with his family to the US when he was 8 years old. He was part of at least two cultures—South Korean and American, and also Asian American. In regard to the questions that Cullen raises about what we might learn from speaking to his parents, his sister, and family members—information that might help us to “predict dangerous behavior and respond better to warning signs”—I don’t see how we can overlook Cho’s background and, too, how autism is understood in South Korea.
The Korean word for autism is chapae and literally means “closed in on oneself.” It is formed from the Chinese character za, which means “by oneself,” and pae, meaning “closed.” Two chapters of Unstrange Minds: Remapping the World of Autism by Roy Richard Grinker are specifically about autism in South Korea. “Half Past Winter in South Korea” profiles Seung-Mee and her autistic daughter, Soo-Yong; and “Becoming Visible” notes how autism awareness and understanding are growing in South Korea and discusses a popular movie, Maraton, which was based on the true story of an autistic man, Bae Hyong-Jin, a marathon runner. Says Seung-Mee:
“You can’t escape being a victim…….
“I don’t like looking back to what could have been. This is my life. It’s like I’m always in the middle of winter. I can go forward to spring or I can go backwards to when everything started to go bad. It’s not spring yet, but maybe I’ll get there.” (pp. 230-231)
Michael Goldberg at Autism Bulletin included a note from Professor Grinker in a post on Unconfirmed Diagnosis in Virginia Tech Tragedy and I quote from it in part:
In Korea……. Autism is less stigmatizing than mental retardation but for autistic kids without mental retardation, autism is more stigmatizing for the family than the preferred diagnosis, Reactive Attachment Disorder (which, in cases where there is no demonstrable pathological care-taking environment, can be construed as a version of the refrigerator mother). Here is why autism is more difficult a category for the family as a whole.
In Korea, children American clinicians might diagnose with autism are often diagnosed with reactive attachment disorder (RAD). RAD is sometimes described pejoratively as “lack of love” (aejong kyolpip), a term that, for Koreans, conjures images of orphans craving affection and care. In Korea, RAD is thought to be a condition mimicking autism, caused by a mother’s absence of attachment to her son (this is the Korean version of the “refrigerator mother”). In fact, some clinicians in Korea even prefer to drop the word “reactive,” because, from their perspective, that word identifies the pathology in the child rather than the parent. By calling RAD simply “attachment disorder” (aechak changae), the blame can be more clearly placed on the mother.
RAD is a diagnosis that many parents prefer, even though it directly indicts the mother as a pathological caretaker. First, unlike autism, RAD or lack of love can be ameliorated by giving love; it’s not a permanent condition. An autism diagnosis, however, is seen as a statement that your child has no future. Autism, at least in Korea, is widely considered to be untreatable and many parents who try various therapies, like speech therapy, vitamin regimens, or herbal medicines, give up after a while if their child is not cured. The Seoul-based psychiatrist Dong-Ho Song, who is one of the best trained and busiest child psychiatrists in Seoul, and who is an important member of our Autism Speaks-funded project, had a patient who had been diagnosed with RAD first at the age 18 months and then subsequently by several other doctors throughout his early childhood. He was almost eleven when he came to Dr. Song and received his first diagnosis of autism. [Soo-Yong was originally diagnosed with RAD; doctors felt that her condition was due to neglect.]
……..
Now, as for the shooter at VTECH, Cho Seung-Hui, first, I am not a clinician, as you know. But second, as far as I know from reading the press, there is not much information on him as a child. It is unlikely he would have been diagnosed in Korea. In the U.S. it is also unlikely, if only because Korean-Americans are on the whole very reluctant to seek mental health care (since it is just so stigmatizing). Doctors I’ve interviewed (including Korean-American doctors) tell me that by the time someone gets to a mental health professional that person may be acutely mentally ill. Again, I am not a clinician, but I suppose it’s possible that some clinician somewhere could have at one time used the word autistic as an adjective to refer to — remember again that I am not a clinician — the flat affect and introverted personality of someone who would grow up to have schizophrenia. Remember that in the DSM I and DSM II “autism” was mentioned in the criteria for childhood onset schizophrenia. You can see the criteria on my website at unstrange.com.
To read the full text of Professor Grinker’s note, go to Autism Bulletin.
Seung-Mee, the South Korean mother quoted above, talks about being “always in the middle of winter.” She is able to work and to place Soo-Yong in a special needs daycare during the day, and to provide her with language therapy, music therapy, art therapy, and sports therapy, but does not feel she receives support from her husband or family. Going to a Methodist church has given her support and community, even though she is an agnostic.
I’m not going to speculate about what Cho’s mother, about what any of the mothers of those killed at Virgnia Tech, are feeling now. I’ll repeat the title of Dave Cullen’s New York Times op-ed: Talk to the Chos. There are so many questions here and a lot of work ahead of us to figure out the beginnings of something of an answer.
Thank you for this insight.
I find this topic very interesting.
I am Mexican American and Native American (Yaqui and Apache). In the Mexican culture , I also see the “stigma” placed on the mothers.
I work in an area with high population of Migrant workers.
I hear and see so much guilt with them.
I wonder if the mothers would’ve seeked help or answers, if they weren’t here in the states?
On the other hand, I also wonder about people who do these horrific things. How many over looked the cracks in their lives and being?
I also worry about racism and discrimination of Asperger/Autism population. Being set a fire from this recent incident.
This topic has opened a lot in me right now.
It’s shown me other areas , I haven’t thought of.
I hope more discussion happens. I will be following this one ..
Thank You Kristina
Early childhood schizophrenia no longer exists in the DSMIV, it is now diagnosed as autism. No one else mentions this, but Seung-hui Cho’s father was either 38 or 39 at the time of his birth.38 or 39 is well past the age when autism or schizophrenia is much more common.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17453057&itool=pubmed_DocSum
“The paternal age distribution of the AGRE fathers, whose first child is autistic differs significantly from that of the ‘control’ sample (P=0.005). A 2 goodness-of-fit test with 2 degrees of freedom was conducted using percents in the ‘control’ group age categories to calculate the expected values in the AGRE sample. The shift toward higher paternal ages in those with an affected first-born is seen most dramatically in the group of AGRE fathers who are 30–39 years inclusive, which is 54.7% of the distribution compared with the 41.9 % that is expected. We interpret this shifted age distribution to provide support for the recently reported finding by Reichenberg and co-workers that autism risk is associated with advancing paternal age.”
I think one has to look no further than the father’s advanced paternal age as the cause of his abnormality and his predicament. There have been so many studies published about the rising risk of both autism and schizoprenia, including a brand new one from UCLA, and everyone acts as if the reason for Seung-hui Cho’s abnormal behavior is such a mystery.
Why were the records sealed of the parents of the Columbine tragedy perpetrators sealed until 2027? Why does the robust connection between advancing paternal age and autism, early childhood schizophrenia, later schizophrenia never get discussed? Why does the CDC not mention increasing paternal age as a risk factor for autism? That is the question. When will the true nature of the male biological clock and the reason for the tremendous increase in the children with ASD be publicly acknowledged?
Partly beacue it’s a far too simplistic answer, & partly because, if you’ve been following this blog, the “tremendous increase” in children with ASD can be shown to be due to better & different diagnostic criteria… Please see the essay by Dr.’s Chew & Grinker recently posted on this site about the “invisible” 1 in 150 adults with ASD.
Early childhood schizophrenia no longer exists in the DSMIV
I was not aware of this. I worked with diabled children and adults and some of them had schizophrenia and were diagnosed very young.
Whatever he had he was very troubled and the families his included need to grieve. I feel that better services and school intervention may have gotten him help sooner. The schools should be more concerned with educating our students than the bottom line. They should be focused on every child doing the best that they can rather than what the schools standardized test scores are. This is all very sad.
“I think one has to look no further than the father’s advanced paternal age as the cause of [Cho's] abnormality and his predicament.” Them’s fightin’ words ’round these parts, Leslie. I think you would agree that there is a huge difference between “risk factor” and “cause.” The cause of autism has not been determined yet, and probably involves a number of factors. Let’s not be so eager to “cure” autism that we replace the debunked “refrigerator mother” theory of causation with another equally-bad one, that of the “geriatric father”.
It seems possible that, if Cho’s parents were older, it would have been even more difficult for them to acclimate to living in a foreign country: Note that the news articles say that the pastor of the family’s church mentioned autism; it’s not clear what the parents did as far as finding out about a diagnosis after that. I’m still very hesitant to speculate about Cho’s diagnosis.
This will take the comments off topic but I have to ask – did the studies that they did with “older fathers” include the stats on the mothers and whether or not they took fertility drugs?
Did it include how many older Amish had children with autism? Because the Amish *do have kids as long as wifey is fertile, they will crank ‘em out. (I know, I live in Amish country.)
Professor Grinker’s note affirms a lot of what I thought. My ex’s gf is Asian, and she has no consideration for Bug’s autism and what his needs are. She acts like it isn’t there, and treats him like crap on top of it, calls him dumb, crazy, you name it. That the ex is still with her amazes me.
Has anyone considered selective mutism, a form of severe social anxiety, in relation to Seung Hui Cho? That, in combination with other problems, seems likely to me.
I am astounded; I have just read several of the comments on high functioning autism and its connection to the Virginia Tech tragedy. Some comments were sympathetic (or empathetic). Many comments were about bullying and how this may have contributed to Seung Hui-Cho’s attack and the tragic death of so many. Once again people standing around shaking there heads and not understanding the real tragedy. The real tragedy IS that many in our entire world do not understand that intolerance and bullying is entirely unacceptable. Even though it is entirely unacceptable it is tolerated on many levels. From passive bullying,(such as rudeness) to semi-aggressive bullying ,(such as road rage), to aggressive bullying,(such as direct harm). Don’t turn a blind eye on this. Bullies are alive and well, and pervasive in the family of all mankind. It is not gender based, or age based, or anything else based, but a cancer that ruins the potential of all who are touched by it.
If he was autistic or not, he still was a ruined person who ruined many, many other lives and ended others.
I have as the mother of three disabled children who also are gifted, experienced blatant bullying of me, and worse yet, that of my children. Bullying in the special Education classroom of kids with cancer by the teachers who are trusted to do the right thing, but do not. I have listened to and witnessed outright bullying of my children, by regular teachers, Special Education teachers, and when complained to being bullied the administration. All paid for by your tax dollar. I have seen first hand the survival of the fittest attitude perpetuated by school staff (who are obligated as human beings to not tolerate it) BUT DO. So what is my point, if we want the carnage worldwide and at home to stop, we all, (including myself), must take a long, strong look at intolerance of the glorious differences in everyone. I strongly feel it may at least soften the damage.
I also feel great sorrow for Seung Hui-Cho, who was after all the speculation, was damaged, and remained unaided. What a cost to pay for all the people so greatly harmed in his “wake” of torment.
Thanks for that thoughtful piece, Kristina.
Times op-eds are very short, and one line that had to be cut was about Dr. Dwayne Fuselier, who led the FBI’s Columbine investigation, has been telling me for the past six years who crucial the information from parents is–in any investigation. He desperately still wants to talk to the Harris and Klebold parents.
But it seems all the more pertinent in Cho’s case for several reasons, as you discussed. The very real possibility of mental illness makes an objective analysis all the more necessary. And I definitely understand the fear from the autistic community. I have not heard ANYone who understands the condition suggest that it would lead to violence–quite the contrary: if he were suffering from something on the autistic spectrum, the more autistic he were, the less likely that he would care or even notice any would-be taunting. But that message won’t be effectively communicated to the public unless/until we actually understand what we’re dealing with in Cho. Right now, it’s somewhat-informed speculation. If we can gather a great deal of evidence and make an informed diagnosis, then the press can begin explaining that diagnosis to the public, explain what it means, and if it does involve autism, presumably explain why it was unrelated to his violence.
I’m speculating there a bit–but my point is, that until we can clarify with a high degree of certainty, we’ll never explain much of anything clearly.
The Cho family has a great deal of information. I know it’s going to be tough for them to talk to anyone, but I think it will be in their interest, ultimately, to do so. I hope so.
Mika, thanks so much for your comment—keep telling me what you think!
Moi, I have an “I don’t know but I will try to find out!” to both of your questions (”This will take the comments off topic but I have to ask – did the studies that they did with “older fathers” include the stats on the mothers and whether or not they took fertility drugs?….Did it include how many older Amish had children with autism?) The statistical permutations are making my head sping a bit.
Nancy, thanks so much for relating about what you’ve seen in special ed. In my special ed classroom that my son was in in particular, he struggles in part because there were twins in the class, both bigger and younger than him, and I could just sense that Charlie was not comfortable with them—never warmed up to them (and the three boys were together for some 2 years). This might be a bit off-topic—-I sensed that Charlie felt a bit outnumbered; it was the case, for various other reasons, that the other boys seemed sometimes to get more attention than him.
to Kristina Chew, PhD.
I deeply worry that the media sensation may cause a fear of the disabled that leads to further discrimination. As a PhD. I’m sure you know that throughout history discrimination starts with fear and misunderstanding , and leads to personal justification of horrible actions towards the vulnerable(in this case autistics, and other people with disabilities). This large group of people already are not able in most situations able to defend themselves.They often feel deeply affected but due to age or circumstances may not be able to understand their own need for defense from “bullying”. I define “bullying” as aggressive behavior from anyone who believes in the survival of the fittest, young and old alike. Bullying is a world wide problem, and if you take a hard look it is not restricted to children.
To Dave Cullen:
Thank you very much for commenting here—-I can’t begin to imagine what the Chos are going through now—what life must be like—what can be said? I appreciate your phrase of “somewhat-informed speculation” to characterize the level of discussion of Cho’s diagnosis; I have been troubled by reading too many reports that he had autism, when nothing is confirmed.
I’m wondering what might be done to foster a way—a space—for the Chos to talk.
I sound so harsh about something so close to my heart that it hurts. To all on this site I apologize for anything that appears harsh or rude. I am puzzled and learning too. I know many are dealing with similar issues to my own experiences. Anything to do with the mind or nervous system is very difficult to unravel. Autism has been to my understanding, one of the more difficult.It bears a pain that is in someways unique.There are many disorders that need understanding and empathy. I also believe that in special education the teachers are on the front line of the heartbreak of all disabilities.I strongly believe that those who teach the disabled must be educated at the Phd. level and also prove competence in empathetic behavior towards their students. Additionally these teachers should be highly paid for their hard work. A teacher with hands on experience in their own home is a great asset. Also, any child and their family can be helped with networking with the PROPER mental health community.Perhaps not cured, But the pain lessoned for all.Cho was a high functioner(deserved credit for this, and perhaps his family too), but the tragedy must stop there. My thoughts go to all the damaged lives involved. I do not ever want to see any more news stories like this ,anywhere.I hope for understanding all around.
On the lighter side of things,in a way, saw a wonderful movie that addressed many issues in a Hollywood way. It addresses selective mutism, ect..I would recommend watching it.It has Anthony Hopkins in it, and the title is INSTINCT.Primal, thoughtful,and trying for the truth about all.
Again, my apologies, I never want to appear as a bully, only as some one who wants to help.
Nancy, I really appreciate reading your thoughts here—-how can any of us who are parents of children with special needs, of children who are different in ways that our society does not know how to address—not have strong and impassioned responses to these topics? I’m more than with you about seeing teachers as “on the front lines”; I’m all for doing all that we can to support them. I don’t think you’ve come across as a bully at all—but indeed as someone who cares deeply, very deeply.
Thank you for the movie suggestion—–
To Kristina Chew,PhD.
Thank you for your kindness and understanding. This most likely is one of the solutions to a wide spread problem. It is also a great kindness to open a dialog for those who would love to make a difference. I at one point hired a civil rights lawyer to help with enforcement with The Americans with Disabilities Act, on behalf of my child who is both disabled and gifted. It worked only partially in terms of backing the new school district down. Now even reminding school officials of this law is almost treated as a joke. I am looking forward to the unusual but insightful opinion on the Americans with Disabilities Act by Penn and Teller. This will air next week. This week the topic was illegal immigration, and money spent to build a wall. The title of the show is Penn and Teller Bullsh*t.
To David Cullen;
I believe the Columbine depositions were suppressed for a number of reasons. In the Cho family’s case the circumstances are somewhat different. From a news media standpoint here is a good opportunity to shed some light on something our society wants to look away from. Our disabled community is the largest group of those discriminated against and their families also bear the brunt of this.If this turns into a media feeding frenzy on the Cho family, they will be also forced into a retreat of silence. The surviving Cho family needs to have a safe and compassionate place to speak about their loss,perhaps with an advocate or lawyer present. In the Columbine situation the teenagers involved (both attackers) were minors. Blame speculation was cast. I do not feel that the Cho family is at fault in any way. They also lost a loved one and media must not loose site of this. Legally, this is a law enforcement investigation so the Cho family must be allowed to protect their family members memory.Fear of the disabled will further compound a problem that is already a disgrace. Perhaps that is where media must investigate.
In selective mutism a child will speak fine at home with their parents but not around others. That’s why it’s called “selective” mutism. Cho would not speak even with his parents. Selective mutism does not make a person “cold” and unaffectionate either. Cho never hugged his parents. And when a person with selective mutism does speak they don’t have a flat affect. Cho had every autistic characteristic I can think of and many of them were quite obvious. It shocks me how many professionals still lack an understanding of high functioning autism. It is upsetting to me because when they miss it or misdiagnose it they hurt those who have it.
I am taking a class on autism at the University of Virginia’s campus in Falls Church and need a copy of “Malaton”, the Korean movie referenced in Dr. Grinker’s book, “Unstrange Minds”. Does anyone know where I can find this?
http://www.hanbooks.com is the best site to use (since they have a U.S. distributor).
Most easily searchable under the name Marathon (with the “h”) or even “Running Boy” (which is how they are selling the movie in the U.S.).
The Running Boy edition is suitable for U.S. DVD players (region 3), tho both editions have English subtitles. The Korean version cannot be played in a DVD player purchased in the U.S. but it can certainly be played on computer.
Running Boy: Limited Collector’s Edition + OST CD (Region-3 / … $34.65
Running Boy: Limited Collector’s Edition + OST CD (Region-3 / 3 Disc Box) Korean Title: Mal-A-Ton / Marathon Starring: Jo Seung-Woo, Kim Mi-Suk, Lee Gi-Young Director: Jeong …
Running Boy (Region-3 / 2 Disc Set) $27.00
Korean Title: Mal-A-Ton / Marathon Starring: Jo Seung-Woo, Kim Mi-Suk, Lee Gi-Young Director: Jeong …
I have now viewed the movie and am searching for more information on YOON Cho-Won’s progress. He seemed to make a breakthrough, not only in accomplishment, but in theory of mind, through the experience of training for and running in the marathon. I’d like to know how his world unfolded beyond that experience…
This is a beautiful movie which could bring more understanding to families struggling with the needs of children/adults with ASD if it was more widely viewed in the States.
I still have to see it—now will have to, just in time to get started running with Charlie….. Here’s an article from 2005 mentioning the man whom Yoon Cho-Won’s story was based on, Bae Hyong-Jin—he ran in a historic half-marathon held by the two Koreas.
Thank you Kristina!