Autism Spectrum Disorder refers to a range of symptoms which covers individuals who are mildly affected to those with a profound degree of disability. It is a life-long ‘condition’ typically characterised by the so called triad of impairments.
The triad of impairments in autism are three areas of difficulty which all people with autism share. They vary from one person to another but they seem to be common in varying degrees.
Problems with social interaction may show:
- a lack of interest in others
- being aloof, distant and not paying attention
- being alone and withdrawn
- using inappropriate or strange social behaviour because they find it difficult to express feelings, needs or emotions
- a lack of social skills
- difficulties in making and maintaining friendships
- lack of understanding about friendship or strangers.
These problems can make it very difficult for people with autism to fit in socially.
Difficulties in communicating vary widely and they can be verbal and non-verbal. Many have a literal understanding of language and therefore they think people always mean what they say. Something as simple as body language can be totally alien to people with autism.
Problems with social communication may show:
- not fully understanding the meaning of facial expressions, common gestures or tone of voice
- echolalia (repetition of what has been said in a different context)
- difficulties in understanding jokes and sarcasm
- making up words
- unusual patterns of verbal communication
- inappropriate tone of voice
- difficulty differentiating between “I” and “you”
- lack of gestures and facial expressions
- having a literal understanding of language, for example, with sayings or expressions such as “it is raining cats and dogs”, or “kill two birds with one stone”.
Some people with autism have good language skills and are able to hold a normal conversation. However, they will find it hard to comprehend the give-and-take nature of conversations and may talk about their own interests at length.
Others may not speak at all or have limited speech. They will probably understand most of what other people say but use different means of communication such as symbols or sign language.
When speaking to people with autism, it helps to use a clear and consistent tone allowing time for them to process the information given.
Through social imagination we are able to predict and understand other people’s behaviour, thoughts and feelings, imagine situations outside our immediate daily routine or comprehend ideas that might be a bit abstract.
Problems with social imagination may show:
- difficulty in the development of imaginative play where a preference for acting out the same scenes each time is noted
- difficulty in understanding how others think, feel and react
- problems with imagination in general
- problems with predicting actions or events in the future
- putting up with new or unfamiliar situations
- understanding concepts such as danger or threat.
Despite the problems people with autism may have with social imagination, some are extremely creative indicating a vivid imagination rather than a lack of imagination.
People with autism are also often very rigid in their thinking and acting. They may have obsessive compulsive behaviours, special interests or activities, special sensory sensitivity and show a marked resistance to change.
In addition to the triad of impairments there are now other indications of autism traits.
The behaviour of people with autism is often described as repetitive or obsessive. For example, repeating actions or movements like hand flapping, spinning, rocking and/or body movements are very common.
These patterns are usually manifestations people with autism use to deal with anxiety, stress, excitement or sometimes physical pain.
Senses are sometimes intensified or under-sensitive in people with autism. They usually experience some form of sensory sensitivity which can happen in one or more of the five senses causing some sort of distress in normal situations. For example, certain sounds that other people take for granted or ignore may be unbearably loud for a person with autism causing high levels of stress; some types of fabric rubbing against the skin may cause distress; and body awareness and fine motor skills may be difficult to control causing disorientation and inability to avoid obstructions in the physical world.
People with autism love routines because they feel safer knowing what is going to happen every day. Unpredictability causes stress and confusion and taking a different approach or facing something new may be hard for them. They often prefer a fixed daily routine where the same means of travelling from home to school or work is used, where breakfast, lunch and dinner are served at the same time every day or where their favourite programme is available on TV at the same time every week. Sometimes, however, people with autism focus on specific routines or rituals that have no practical function.
Nevertheless, if people with autism are prepared and taught in advance about a forthcoming change, they can cope well with it.
Most people with autism have special interests which start at a very young age. They can range from computers to music or art or even trains. Computers have been described by some people with autism as safe and predictable.
Some people with autism may eventually be able to work or study in related areas and rise to eminent positions and perform with outstanding success. Their determination, narrow and single-mindedness can be immensely valuable and can lead to exceptional achievements in their chosen area.
Differences in brain structures
Someone on the autism spectrum has a subtly different neuron network structure in their brain compared to a ‘normal’ person. There may also be subtle differences in the brain’s biochemistry. It would appear that some areas of the brain of a person on the autism spectrum are very highly developed when compared with a ‘normal’ person’s brain, while other areas are underdeveloped (e.g. physically smaller). The exact ways in which these differences affect the behaviour of an individual is mostly an open research question as this area of science is still very much in its infancy.
There is a proportion, some figures suggest 10%, of people with an Autism Spectrum Disorder that have exceptional skills in some area such as mathematics, music, art, puzzles, spatial construction and memory. For example, I can manipulate certain complex mathematical equations effortlessly in my head, easily solve certain types of complex problems and imagine physical objects from all angles in my mind’s eye.
There is little doubt that people on the autism spectrum are very vulnerable to mental ill-health. High functioning individuals commonly experience co-morbid severe depression, OCD and anxiety. These mental health conditions need to be managed along with all the other symptoms of Autism Spectrum Disorder. The best way to manage them will depend on the individual.
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“When you’ve met one autistic person, you’ve met one autistic person.”