RECOMMENDED BOOK: Autism: A Practical Guide for Parents
One of the essential criteria for autistic disorder is that the affected individual has a qualitative impairment in social interaction. This can be manifested by at least two of the following: a) marked impairment in nonverbal behaviors to regulate social interaction, b) failure to develop peer relationships appropriate to developmental level, c) lack of spontaneous seeking to share enjoyment, interests, or achievements with people (e.g., by pointing out objects of interest), or d) lack of social or emotional reciprocity.
Cookie Monster clearly demonstrates adequate social interaction. For example, in the interaction below with Kermit The Frog, he uses very good eye contact and hand gestures to facilitate communication. He clearly demonstrates social reciprocity in playing the guessing game with Kermit and it is clearly established in Sesame Street that he has developed good relationships with other Muppets such as Kermit, The Count, and Prairie Dawn.
The next criteria that would need to be met is a qualitative impairment in communication. This would be evidenced by at least two of the following: a) delay or total lack of the development of spoken language, b) marked impairment in the ability to initiate or sustain a conversation with others, c) stereotyped and repetitive use of language or idiosyncratic language, or d) lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level.
While Cookie Monster does have some problems speaking with proper grammar (e.g., “Me Want Cookie!”) he does not truly meet any of the criteria mentioned above. Someone may want to make an argument that his language is idiosyncratic and that he can sometimes be repetitive (e.g., “Om, om, om, om, om”) when he eats a cookie, but I just chalk that up to him being extremely happy that he is eating cookies. Clearly, Cookie Monster is very capable of carrying on lengthy conversations, initiating them (as he does in the video clip with Kermit), and sustaining them.
Lastly, to meet criteria for autistic disorder, Cookie Monster would need to have a repetitive or stereotypes pattern of behavior, interests, and activities, as manifested by at least one of the following: a) an encompassing preoccupation with one of more stereotypes and restricted pattern of interest that is abnormal in intensity and focus, b) an apparently inflexible adherence to specific, nonfunctional routines or rituals, c) stereotyped and repetitive motor mannerisms, and d) persistent preoccupation with parts of objects.
Cookie Monster can be said to meet some of the latter criteria (a and b) because he is clearly pre-occupied with cookies to an abnormal degree and it seems that he has to eat his cookies each day and is not too flexible on the matter. However, anyone can meet one or two criteria of various mental health disorders without having the condition of interest due to not meeting full diagnostic criteria. That is the case with Cookie Monster. I have not seen any convincing evidence that he meets criteria c or d.
So what does our furry little blue friend have wrong with him? Obsessive compulsive disorder (OCD) is technically possible in which his compulsive cookie eating may be a way to relieve anxiety caused by recurrent and persistent thoughts to devour cookies. However, to answer this would really require a good clinical interview with him to see if he meets all the criteria of true obsessions and compulsions. Furthermore, he would need to engage in compulsive cookie eating for more than an hour a day and we do not know if he does that. Another possibility is bulimia nervosa, in which someone binge eats a large amount of food and then uses inappropriate mechanisms to prevent weight gain, such as vomiting or laxative use. We have no idea if Cookie Monster is running to the bathroom afterwards but if he is trying to prevent weight gain, it does not seem that it is working as he does seem overweight.
My impression is that Cookie Monster has impulse control disorder not otherwise specified. This is a failure to resist an impulse, drive, or temptation to perform an act that is harmful (e.g., causing obesity, diabetes mellitus) to the individual or others. Most people with this condition feel an increasing sense of tension or arousal before committing the act and then experience pleasure, gratification, or relief at the time of committing the act.
Related Blog Entry: Why Kermit the Frog Rules.