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Understanding autism

Autism spectrum disorder, commonly known as ASD, affects how people communicate and interact with others. It affects how they make sense of the world.

Autism is a developmental condition that is typically life-long. People with ASD experience difficulties with communication, social interaction and restricted/repetitive interests and behaviours. These are often accompanied by sensory issues, such an oversensitivity or undersensitivity to sounds, smells or touch. All of these difficulties may lead to behavioural challenges in some individuals.

The term “spectrum” is used to emphasise that autism presents differently in every single person. People with autism have a wide range of challenges as well as abilities.

These difficulties might present as some (or all) of the following characteristics:

1) Social communication and interaction

  • Difficulties with social-emotional reciprocity e.g. being unable to maintain normal back-and-forth conversations, having little or no interest in sharing interests and emotions (pointing or showing), displaying little or no interest in social interactions.
  • Difficulties with non-verbal communication, e.g. abnormal eye contact, difficulties understanding and using gestures (such as nodding), body language and facial expressions.
  • Difficulties in developing and maintaining relationships appropriate to age and development e.g. difficulties with imaginative play and making friends.

2) Restricted and repetitive behaviours:

  • Stereotyped or repetitive speech, movements or use of objects, such as lining up toys, flapping hands, toe walking or echolalia (repeating words or phrases).
  • Inflexible adherence to routines, patterns or behaviour (e.g. eating the same foods, travelling the same way to school etc.) and becoming distressed at changes.
  • Sensory hyper or hypo-reactivity (e.g. to sounds, pain and textures) as described above.
  • Restricted or fixated interests e.g. only playing with certain toys or discussing certain topics.

Language delays are also common with ASD, and many parents first present to a health professional with concerns that their child is not talking. However, language delays can occur with other diagnoses and are not exclusive to autism.

From 1994-2013, when the Diagnostic Statistical Manual (DSM) was revised, autism was divided into three diagnoses: autistic disorder, Asperger’s disorder and pervasive development disorder not otherwise specified (PDD-NOS). Now under the DSM-5, there is a single ‘umbrella’ diagnosis of autism spectrum disorder (ASD), with three severity categories (level 1, level 2 and level 3, in increasing order of severity)

We can typically diagnose a child with ‘classical autism’ at about 2 years of age, when it becomes apparent they are not meeting their developmental milestones.

Symptoms of autism, however, can sometimes be subtle and, especially with level 1 ASD, these may not become obvious until a child starts school or moves into adulthood.

While there are some shared characteristics, it’s important to remember and respect that autism presents differently in different people.

Often, co-diagnoses profoundly affect how a person with autism functions.

For example, a person who is diagnosed with both autism and an intellectual disability will typically have more severe symptoms and learning difficulties than a person with autism who has normal intelligence. Other common co-diagnoses that can affect how a person with autism functions include ADHD, language disorders and anxiety disorders.

Autism is not a physical disability so people on the spectrum look no different to their peers.  This can make it difficult for some people to understand why an autistic person might be behaving or reacting in a particular way.

Many people on the autism spectrum are able to live completely independently, others need support in almost all aspects of their daily life

Let’s all aim to see each person with autism for the person they are, and not for what we think their diagnosis means.