Background Information
Arnie Grape, a pivotal character in the 1993 film What’s Eating Gilbert Grape?, is presented as a Caucasian male on the cusp of his 18th birthday. His life is largely centered around his older brother, Gilbert, as Arnie doesn’t attend school and spends most of his days in his company. From the outset, it’s clear Arnie experiences developmental challenges. Doctors initially gave him a grim prognosis, predicting he wouldn’t survive past ten, and later stated his life remained precarious even after reaching that milestone. Arnie exhibits repetitive speech patterns and engages in risky behaviors without grasping the potential danger. A striking example is his water tower climb, where he dangled precariously, laughing, oblivious to the gravity of the situation.
Arnie’s family dynamic is complex. He resides with his morbidly obese and depressed mother, Bonnie, who has become housebound following her husband’s suicide seven years prior. Gilbert is his primary caregiver, while his sisters, Amy and Ellen, manage household chores and cooking. Arnie is generally friendly but seems to lack genuine friendships with town children, likely due to communication barriers. However, his 18th birthday party was well-attended by local children, suggesting a level of acceptance. A poignant moment reveals Arnie’s possible understanding of his father’s death when he refuses to go to the basement, stating “dad is down there” and mimicking a hanging motion. Notably, Arnie is not shown taking any medication or receiving regular medical or psychological care. He is emotionally sensitive and struggles to understand social cues and nuances in communication. His life appears focused on basic survival and immediate experiences rather than long-term goals.
Description of the Problematic Behaviors
Arnie displays a range of behaviors that are concerning and indicative of a deeper issue. He demonstrates a disturbing act of cruelty by decapitating a grasshopper in a mailbox, followed by immediate remorse and sadness over the insect’s death, highlighting a complex emotional landscape. He exhibits repetitive hand movements, particularly bringing his hand to his mouth in stressful situations, and also presents with eye twitches and frequent blinking. Arnie’s tendency to run off and hide, or climb the water tower, causes constant worry for Gilbert. While Gilbert often knows Arnie’s hiding spots, he engages in playful pretense, which Arnie seems to perceive as genuine. Arnie displays inappropriate laughter and amusement when others are hurt or when he himself uses hurtful language, indicating a lack of empathy or understanding of social consequences. His arrest for climbing the water tower showcases his skewed priorities; his main concern is the police car’s lights and sirens, not the legal ramifications of his actions.
Arnie’s inability to care for himself is starkly illustrated by the bathtub incident. Gilbert instructs Arnie to wash himself, leaves him in the bath, and returns the next morning to find him still there, unwashed. This incident also triggers a lasting fear of water bodies in Arnie. His emotional responses are intense and sometimes misdirected, such as his distress and self-harming behavior when he cannot wake his unresponsive mother, suggesting a struggle to process complex emotions and situations. He also has a notable echolalia, repeating words and phrases spoken to him, further emphasizing his communication differences.
Diagnosis: Autistic Disorder (299.00)
Based on the observed behaviors and characteristics, the most fitting diagnosis for Arnie Grape is Autistic Disorder (299.00), as defined by the DSM-IV criteria prevalent at the time of the movie’s release. To meet the criteria for Autistic Disorder, an individual must satisfy criteria A, B, and C.
A. Qualitative Impairment in Social Interaction, Communication, and Restricted Repetitive Behaviors: A total of six or more items from categories (1), (2), and (3), with at least two from (1), and one each from (2) and (3), are required.
(1) Qualitative impairment in social interaction: Arnie exhibits deficits in several areas:
- (a) Marked impairment in nonverbal behaviors: Arnie’s use of eye contact, facial expressions, and gestures in social interactions is not explicitly detailed but his overall social interaction difficulties suggest impairments in this area.
- (b) Failure to develop peer relationships: While children attend his birthday, the text suggests limited meaningful peer relationships due to communication challenges.
- (c) Lack of spontaneous seeking to share enjoyment: The description doesn’t provide examples of Arnie initiating shared enjoyment or interests. However, the text does state he is friendly and tries to interact. The original text incorrectly claims he doesn’t meet this criteria, but this point seems debatable based on the provided information, as friendliness doesn’t necessarily equate to reciprocal sharing of enjoyment.
- (d) Lack of social or emotional reciprocity: Arnie’s inappropriate laughter and difficulty understanding social cues point to a lack of social and emotional reciprocity.
(2) Qualitative impairments in communication: Arnie meets multiple criteria in this section:
- (b) Marked impairment in conversation: Arnie’s echolalia and communication style prevent him from engaging in typical conversations.
- (c) Stereotyped and repetitive use of language: His echolalia is a direct example of this.
- (d) Lack of varied, spontaneous make-believe play or social imitative play: This aspect is not explicitly detailed, but is often associated with autism.
(3) Restricted repetitive and stereotyped patterns of behavior, interests, and activities: Arnie demonstrates:
- (a) Encompassing preoccupation with restricted patterns of interest: His intense focus on the grasshopper and keeping it in a jar, although brief, could be interpreted as a restricted interest.
- (c) Stereotyped and repetitive motor mannerisms: His consistent hand-to-mouth movements clearly fit this criterion. The original text incorrectly states he doesn’t meet criteria (b) – inflexible adherence to routines – stating he doesn’t have specific rituals. However, the presence of other criteria being met is sufficient.
B. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years:
- Social interaction
- Language as used in social communication
- Symbolic or imaginative play
While Arnie’s early developmental history isn’t explicitly detailed in the provided text, it’s reasonable to infer delays in these areas given the severity and nature of his symptoms evident in his teenage years.
C. The disturbance is not better accounted for by Rett’s Disorder or Childhood Disintegrative Disorder.
Arnie’s condition is described as present from birth, ruling out Childhood Disintegrative Disorder and not aligning with the typical presentation of Rett’s Disorder, which primarily affects females and involves distinct physical and neurological symptoms not described for Arnie.
Accuracy of Portrayal of Autism
A general audience watching What’s Eating Gilbert Grape? might perceive Arnie as simply “mentally disabled” due to his need for constant care, communication difficulties, and apparent lack of awareness of social norms and dangers. These general symptoms could be mistaken for intellectual disability or other developmental conditions. However, for viewers familiar with the diagnostic criteria of autism, Arnie’s portrayal aligns accurately with Autistic Disorder. The film effectively challenges the stereotypical media representation of autism, which often focuses on quiet, withdrawn individuals. Arnie is presented as outgoing and vocal, albeit in his unique way, demonstrating the spectrum of autistic presentations. The film does not explicitly label Arnie’s condition, allowing viewers to observe and interpret his behaviors, contributing to a more nuanced and realistic depiction of autism. What’s Eating Gilbert Grape? stands as an accurate and insightful portrayal of an individual living with autism.
Treatment Recommendations
The initial step in Arnie’s treatment would involve a comprehensive medical and psychological evaluation to fully assess his needs and strengths. Creating a stable and supportive living environment is crucial. While his family provides care, his mother’s condition limits her ability to be fully present and effective as a caregiver. Arnie requires consistent, specialized care from individuals trained in supporting individuals with autism. Speech and language therapy is recommended to improve his communication skills, even though he is past typical language development stages. Consistent practice can significantly enhance his ability to communicate functionally. Behavioral therapy is also essential to help Arnie understand appropriate social behaviors and manage potentially dangerous actions. A holistic approach involving family support and active participation in his treatment plan is vital for Arnie’s well-being and development.
This analysis focuses on Arnie Grape’s diagnosis as depicted in What’s Eating Gilbert Grape? and uses the DSM-IV criteria for Autistic Disorder as a framework for understanding his behaviors and needs. The film provides a valuable, though fictional, case study for understanding the complexities of autism.
