Autistic people see, hear and feel the world in a different way from other people. If you are autistic, you are autistic for life – autism is not an ‘illness’ and cannot be ‘cured’. Often people feel being autistic as a fundamental aspect of their identity.
You might hear people say that autism is a spectrum condition. This means that, while all autistic people share certain difficulties, being autistic will affect them in different ways. Some autistic people also have learning disabilities and other conditions. As a result, people need different levels of support. Autistic people may also experience over- or under-sensitivity to sounds, touch, tastes, smells, light or colours.
Asperger syndrome is a form of autism. People with Asperger syndrome are of average or above average intelligence. They have fewer problems with speech but may still have difficulties with understanding and processing language.
How do autistic people see the world?
Autistic people say the world often feels overwhelming and this can cause them considerable anxiety.
In particular, understanding and relating to other people, and taking part in everyday family and social life can be harder if you’re autistic. Other people appear to know, intuitively, how to communicate and interact with each other, yet can also struggle to build rapport with autistic people. Often autistic people may wonder why they are ‘different’ and often feel their social differences mean people don’t understand them.
Autistic people often do not ‘look’ disabled. Parents of autistic children often say that other people simply think their child is naughty, while adults find that they are misunderstood.
All autistic people can benefit from a timely diagnosis and access to appropriate services and support.
How autism is diagnosed
The characteristics of autism vary from one person to another but in order for diagnosis to be made, a person will be seen to be experiencing difficulties in three main areas. These are:
- difficulty with social communication
- difficulty with social interaction
- restricted and repetitive behaviours and interests.
There is information about all three areas below.
Difficulty with social communication
For people with autistic spectrum disorders, ‘body language’ can appear just as foreign as if people were speaking ancient Greek.
Autistic people have difficulties with interpreting both verbal and non-verbal language like gestures or tone of voice. Many have a very literal understanding of language, and think people always mean exactly what they say. They may find it difficult to use or understand:
- facial expressions or tone of voice
- jokes and sarcasm
Some autistic people may not speak, or have fairly limited speech. Autistic people will usually understand more of what other people say to them, than they are able to express, yet may struggle with vagueness or abstract concepts. Some autistic people prefer to use alternative means of communication, such as sign language or visual symbols. Some autistic people are able to communicate very effectively without speech.
Others will have good language skills, but they may still find it hard to understand the expectations of others within conversations, perhaps repeating what the other person has just said (this is called echolalia) or talking at length about their own interests.
It helps if other people speak in a clear, consistent way and give people on the autism spectrum time to process what has been said to them.
Difficulty with social interaction
Autistic people often have difficulty recognising or understanding other people’s emotions and feelings, or expressing their own. Such difficulties can make it very hard for autistic people to navigate the social world. They may:
- appear to be insensitive because they have not recognised how someone else is feeling
- may seek out time alone when overloaded by other people
- not seek comfort from other people
- appear to behave ‘strangely’ or in a way thought to be socially ‘inappropriate’, as it is not always easy for them to express feelings, emotions or needs.
Difficulties with social interaction can mean that autistic people may find it hard to form friendships: some may want to interact with other people and make friends, but may be unsure how to go about this.
Restricted and repetitive behaviours and interests
The world can seem a very unpredictable and confusing place to autistic people, who often prefer to have a daily routine so that they know what is going to happen every day. This routine can extend to always wanting to travel the same way to and from school or work, or eat exactly the same food for breakfast.
One young autistic person attended a day service. He would be dropped off by taxi, walk up to the door of the day service, knock on it and be let in. One day, the door opened before he could knock and a person came out. Rather than go in through the open door, he returned to the taxi and began the routine again.
The use of rules can also be important: it may be difficult for an autistic person to take a different approach to something once they have been taught the ‘right’ way to do it. People on the autism spectrum may not be comfortable with the idea of change, but may be able to cope better if they are prepared for it in advance.
Many autistic people have intense and highly-focused interests, often from a fairly young age. These can change over time or be lifelong, and can be anything from art or music, to trains or computers. Some autistic people may eventually be able to work or study in related areas. For others, it will remain a hobby.
An interest may sometimes be unusual. One autistic person loved collecting rubbish, for example; with encouragement, this was channeled into an interest in recycling and the environment.
Autistic people often report that the pursuit of such interests is fundamental to their wellbeing and happiness.
Other characteristics of autism
Autism is different for everyone but as well as the three main areas of difficulty, autistic people may have:
- sensory sensitivity
- learning disabilities.
Rowan loves art but he hates wearing a shirt to protect his clothing – the feeling of the fabric against his skin causes him distress. We have agreed with his school that he can wear a loose-fitting apron instead.
Autistic people may experience some form of sensory sensitivity. This can occur in one or more of the five senses – sight, sound, smell, touch and taste. A person’s senses are either intensified (hypersensitive) or under-sensitive (hypo-sensitive).
For example, an autistic person may find certain background sounds, which other people ignore or block out, unbearably loud or distracting. This can cause anxiety or even physical pain.
People who are hypo-sensitive may not feel pain or extremes of temperature. Some may rock, spin or flap their hands to stimulate sensation, to help with balance and posture or to deal with stress.
People with sensory sensitivity may also find it harder to use their body awareness system. This system tells us where our bodies are, so for those with reduced body awareness, it can be harder to navigate rooms avoiding obstructions, stand at an appropriate distance from other people and carry out ‘fine motor’ tasks such as tying shoelaces.
I have a helper who sits with me and if I’m stuck on a word she helps me. It makes a big difference.
Autistic people may have learning disabilities, which can affect all aspects of someone’s life, from studying in school, to learning how to wash themselves or make a meal. People can have different ‘degrees’ of learning disability, so some will be able to live fairly independently – although they may need a degree of support to achieve this – while others may require lifelong, specialist support. However, all people with autism learn and develop. With the right sort of support, all autistic people can be helped to live a more fulfilling life of their own choosing.
Other conditions are sometimes associated with autism. These may include attention deficit hyperactivity disorder (ADHD), or learning difficulties such as dyslexia and dyspraxia.Who is affected by autism?
Autism is much more common than most people think. There are around 700,000 people in the UK living with autism – that’s more than 1 in 100.
People from all nationalities and cultural, religious and social backgrounds can be autistic, although it appears to affect more men than women. It is a lifelong condition: children with autism grow up to become autistic adults.
Causes and cures
What causes autism?
The exact cause of autism is still being investigated. However, research suggests that a combination of factors – genetic and environmental – may account for differences in development.
Autism is not caused by a person’s upbringing, their social circumstances and is not the fault of the individual with the condition.
Is there a cure?
At present, there is no ‘cure’ for autism. However, there is a range of interventions – methods of enabling learning and development – which people may find to be helpful.
A diagnosis is the formal identification of autism, usually by a health professional such as a paediatrician or a psychiatrist. Having a diagnosis is helpful for two reasons:
- it helps autistic people (and their families) to understand why they may experience certain difficulties and what they can do about them
- it allows people to access services and support.
People’s GPs can refer them to a specialist who is able to make a diagnosis. Many people are diagnosed as children; their parents and carers can ask GPs for a referral.
Different names for autism
Some professionals may refer to autism by a different name, such as autism or autistic spectrum disorder (ASD), classic autism or Kanner autism, pervasive developmental disorder (PDD) or high-functioning autism (HFA).