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Intro to Autism
So, what is autism?
Autism, or autism spectrum disorder (ASD), has been getting more attention lately. With popular television shows like The Big Bang Theory and Love on the Spectrum, people are becoming more aware of ASD. The Centers for Disease Control and Prevention (CDC) now estimates that 1 in 44 children has autism. Even the number of adolescents personally identifying as autistic has increased tremendously. Despite ASD capturing the public’s attention, many people, including clinicians, remain confused by the disorder. This blog will help those unfamiliar with autism and the lives of those on the spectrum.
Social awareness
With popular television shows like The Big Bang Theory and Love on the Spectrum, people are becoming more aware of ASD.
So, is autism a mental disorder, syndrome, personality style, trait, or something totally different?
Autism spectrum disorder, or autism for short, is a recognized mental disorder, but the degree one sees autism as a disorder is highly varied and personal. Technically, autism is a mental disorder in the Diagnostic Statistical Manual for Mental Disorders-5th Edition (DSM-5). If you are unfamiliar with the DSM-5, it’s an extensive compendium that lists the features and symptoms of different mental illnesses. It is sometimes referred to as “The Holy Grail” of mental illness in the U.S. The DSM-5 is online, but if you look, don’t get sucked into diagnosing yourself with 1,000 different disorders Chances are you’re not crazy. In the DSM-5, one will find many conditions they’re already familiar with, like generalized anxiety and major depressive disorder, but one also sees lesser-known conditions like pica, which includes eating nonfood substances (e.g., paper, soap, chalk, etc.).
Autism has several symptoms, which fall into three broad categories: social communication/interaction difficulties, restricted behaviors, and highly focused interests or activities.
So, autism is a mental disorder, gotcha. But… what does that actually mean?
Now, it gets a little sticky. A mental disorder is a condition that affects moods, thoughts, and behavior. In the DSM-5, each disorder has different symptoms, or features, that make it unique and separate from other disorders. If we use depression as an example, depression’s symptoms include long periods of sadness, little motivation, difficulty concentrating, and possible suicidal thoughts. Autism has several symptoms, which fall into three broad categories: social communication/interaction difficulties, restricted behaviors, and highly focused interests or activities.
So, I know the symptoms of autism. Can I start to diagnose family members now?
No, you can’t diagnose autism spectrum disorder because you’re not trained, and diagnosing is complex, especially in the case of autism. In some situations, a doctor can feel confident about a specific disorder after encountering it a handful of times. For instance, it didn’t take long for me to understand how depressed people present. The symptoms are pretty consistent, and one quickly learns to ask if the patient is feeling blue, experiencing appetite swings, or cannot get out of bed. Unfortunately, this is not the case with autism.
While autism disorder may only include three broad categories of symptoms, there is a lot of variation in appearance. For instance, higher-functioning individuals are thought of as having a “hidden disability” cause their deficits are not easily seen. Someone high functioning may live an independent life, attend school, and have a full-time job but show subtle difficulties.
Missed social cues
Individuals with autism may miss subtle cues or clues, making for embarrassing or uncomfortable social situations. Consequently, sarcasm can be really difficult for autistic individuals to grasp. If it helps, remember a time when everyone else seemed to get a joke, and you were left wondering what was so funny. We can all agree that feeling wasn’t cool as everyone wants to be part of the “in-group.”
Strong preference for routine
Autistic individuals prefer routines and dislike surprises. Advanced notice is helpful for individuals on the spectrum, as sudden changes can be disorganizing. Just think about how difficult it may be to adjust to unexpected situations in your life and the related anxiety. Now, ratchet that up considerably, and one starts to get a sense of what it’s like for an autistic individual dealing with the unplanned.
Highly particular interests
Some individuals have very strong interests or hobbies that leave others baffled. They may suddenly start talking about Minecraft, model trains, anime, or baseball cards at weird moments. These interests aren’t necessarily bad and may actually help develop social and career interests. Just recall the old career advice about doing what one loves.
Difficulty reading other people
Sometimes it is challenging for autistic individuals to read others’ thoughts and feelings. This difficulty may lead others to mistakenly see autistic individuals as cold, distant, or unemphatic when this could not be more untrue. This deficit is sometimes called being “mind blind.” Imagine the difficulty of constantly trying to figure out whether someone hurt your feelings on purpose or by accident. This is a daily challenge for some autistic individuals.
Sensitive senses
Some people with autism are very sensitive to light, sound, and touch. It is not uncommon for those with autism to be highly sensitive to light or specific sounds. I had one client who was very sensitive to touch and found different clothing fabrics uncomfortable. When working with individuals with autism, I will ask whether my office lighting is okay or disorienting.
Nonverbal
Individuals with more debilitating autism may be nonverbal and unable to communicate with words. Such situations can be incredibly challenging for the individual, friends, and family.
Repetitive behaviors
Some individuals may engage in repetitive behaviors that do not seem to have a specific intent. For instance, a person might flap his hands or snap his fingers for unclear reasons.
So, I have heard people say they have Asperger’s disorder. Is that autism?
Asperger’s disorder was a term previously used to describe high-functioning autism. The name comes from the Austrian physician Johann Asperger, who worked with autistic individuals for much of the 20th century. However, recent changes resulted in the term autism spectrum disorder being adopted in place of Asperger’s. That said, some individuals still prefer Asperger’s disorder over autism. If you are unsure of how someone identifies, it might be best to ask them politely and respectfully.
What causes autism, and why does it seem like so many more cases?
Good question. There are a couple of different hypotheses regarding autism’s development. It is important to say science’s understanding of autism is still developing, and we have much to learn about the condition and its origins. There may be multiple causes, which tends to be the case with most things in life. There is support that the disorder has genetic roots and that autistic individuals experience greater growth in the part of the brain related to more complex thinking compared to others. This growth then tapers off later in toddlerhood.
While there is still much science needs to learn about autism, it can confidently be said that vaccinations do not cause autism. This finding has been found across research and time. Much of the confusion can be traced to a fraudulent study repeatedly disproven over time. It is easy to see why parents mistakenly believe vaccinations cause autism, as symptoms appear around the time routine vaccinations are administered (12-24 months of age). However, just because event A (i.e., vaccination) precedes event B (i.e., symptom onset) doesn’t mean that A caused B or that the two are even linked.
One reason for the increased diagnosis is likely better screening and assessment. Doctors are better equipped to spot possible cases with improved training and tools.
Are autistic people dangerous?
No. Science and research indicate that autistic individuals are no more violent than neurotypical or non-autistic individuals. Actually, autistic people are far more likely to be victimized or exploited than actually commit a crime. Individuals with severe autism may sometimes grow upset, resulting in sudden aggression but such cases are small compared to the larger autistic population.
So, I think I have autism. What should I do?
As I said earlier, whether someone sees autism as a disorder is a very personal choice. So, it’s really up to you as you don’t have to do anything. If you don’t see any particular challenges in your life and friends and family aren’t suggesting otherwise, congratulations; it sounds like you have a great life.
Alternatively, you may want to talk to your doctor if you think that autism is causing you difficulties. Meeting with your doctor is a great starting place, as they can ensure you connect with the right professionals. From there, you will likely meet with a neuropsychologist or other autism specialist that can help with the process if necessary.
In the meantime, enjoy this funny clip of Drax the Destroyer from Guardians of the Galaxy. While writers have never actually said Drax is on the spectrum, he has become a hero in the autistic community for showing many autistic traits while, quite frankly, being a legit badass and saving the universe. Notice how recognizing social cues is a little tricky for him.
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