I’m starting right at the very beginning as it seems a very good place to start.
What is Autism?
Autism is defined in the dictionary as
‘a disorder of neural development’
‘a bio-neurological disorder’
‘individuals presenting symptoms of abnormal self-absorption’
‘a spectrum of psychological conditions characterised by widespread abnormalities of social interactions and communication’
But I think that a deeper explanation is required. Certainly a more in depth one is needed to make any sense of how autism shows itself in individuals.
Although autism as a name has been around since 1912, and almost certainly there have been individuals throughout history displaying autism that was labelled as something else, it wasn’t until 1979 when detailed research was carried out to piece together an actual definition and subsequent diagnosis. The researchers were Lorna Wing and Judith Gould and they came up with a three sided description and diagnosis tool that they titled the ‘Triad of Impairment’.
Impairment of social communication:
- Difficulties or impairments with spoken language. Many people with autism learn to speak much later than other children and can have difficulty with pronunciation, semantic meaning and grammar. Some people with autism engage in echolalia which is where an individual repeats something they have heard either previously or immediately though they may not have an understanding of what they are saying. Echolalia from TV programmes is often prevalent.
- Difficulties interpreting and understanding facial expressions and body language- for example if a smile is known to mean someone is happy, then smiling in any other situation (nervousness, grimace etc) will not be understood. Some people with autism attempt to deal with their lack of understanding of facial expressions by trying to copy the expressions of people around them.
- Difficulty understanding implied meaning in words and tone of voice. For example saying ‘that’s excellent work’ in a sarcastic tone of voice may be taken as a genuine compliment. This also extends to a potential difficulty with understanding social jokes where there is an implied meaning, or where there is a word with a double meaning. Many people with autism have more of a ‘slapstick’ sense of humour where people falling off things, or animals doing funny things are found highly amusing.
Impairment of social relationships (also called social interaction):
- Difficulties with interpreting social norms and expectations. I will definitely talk more about this later as this impairment is one that can be difficult to actually pin down when a person is described as simply ‘odd’. It includes things such as simply ending a conversation without leaving a short pause before saying goodbye. Or bringing up a personal topic of conversation with someone not personally known, e.g. a checkout assistant.
- Difficulty maintaining appropriate eye contact e.g. staring, or difficulty with using eye contact at all.
- Difficulty in understanding and applying the ‘rules’ of friendship. Many people with autism are very keen to have friends but struggle to understand nuances and expectations within a friendship and can inadvertently upset or be upset by others.
- Some people with autism struggle to empathise on more than a basic level with other people. They could come across as cold or unfeeling when they actually simply do not understand or relate to another person’s situation or feelings. This can also extend to a lack of recognition of other people as people and some individuals with autism will approach others as a means to satisfy their own needs. For example moving someone’s hand towards something they want or need.
Impairment of social understanding (also called rigidity of behaviour or inflexibility of mind):
- Difficulties in understanding, accepting and coping with change. This does not mean that people with autism cannot change or do things differently, but that they are likely to find it more upsetting and confusing when things change unexpectedly or too often. With the right support for an individual, change can be implemented effectively and can be very beneficial. I will probably talk more about this later too.
- Inflexibility of mind can lead to rigid behaviour for example wanting a room to look exactly the same way all the time, perhaps by not allowing the window to ever be opened as it would change the look of the frame. Or by sticking to the usual way of things i.e. if coffee break is usually at 10am and on one occasion it would be beneficial to move it to 10.15am to allow time to finish a task, this could cause anxiety.
- Difficulties with imagination does not necessarily mean that people with autism cannot imagine things or play imaginatively. This may be so with some individuals however others will have creative and elaborate imaginations. Some people with autism will engage in very repetitive play and activities, for example doing the same thing repeatedly- standing up and sitting down, walking back and forth, picking something up and putting it down, tapping something on the hand, drawing the same shapes or words repeatedly etc. This can also be manifested as a result of difficult sensory processing and stimulation (particularly with regards to ‘stimming’ or ‘flapping’) and this is definitely something I will talk about later.
- Difficulty with predicting a situation or event.
- Difficulty imagining the future. For some people with autism, saying that something will happen in 2 weeks will not mean anything other than a lot of anxiety as they cannot visualise or process what the concept of ‘2 weeks’ actually means and looks like.
- Difficulty transferring learnt skills. For example, something could be taught and learnt in one environment with certain people but then in another environment or with different people the skills acquired seem to be lost. An extreme example would be where a child learns to swim but can literally only do so in the pool in which they learnt. Every other pool, sea or lake they entered would be as if for the very first time.
- Becoming fixated, obsessed or showing a particular interest in a single or a small number of things. For example vintage cars, trains, foods, TV programmes etc. The individual will watch, draw, think about and talk about their interests repeatedly and not necessarily with regard to whether their audience is also engaging with the topic.
This is just the beginning of the description of autism and there is so much more that can go alongside or hand in hand such as OCD (obsessive compulsive disorder), ADHD (attention deficit hyperactive disorder), learning difficulties, dyslexia, anxiety disorders, depression, epilepsy and many others. I have really only just scratched the surface and of course every single individual has a different map of autism and their own full and unique personality on top of that. Each of the points I have mentioned above can be manifested differently and in different combinations.
The National Autistic Society provides further information on all of the points I have raised as well as lots of real life examples and places to go for further information. It’s a great website.
I am not a trained diagnostician in autism, I have just written what I know, what I see, what I have learnt and what I have read and I thought it would be important to write an overview (even though it’s quite long) so that I have a starting block from which to explore more specific aspects of autism in greater detail.