What is Autism?
Terminology in relation to autism is often very confusing for families. The term Autism Spectrum Disorder (ASD) or Autism Spectrum Condition (ASC) is the umbrella term for the many diagnoses that could have been given to a person from previous years. These terms are used when we speak about the autistic population as a whole or in general terms.
Some people could have been given a specific diagnosis of ASD however. The particular diagnosis given has to do with which clinic made the diagnosis and the person’s presentation throughout the assessment process and even the person’s age at the time. Which country you live in at the time also has an impact as different countries use different classification systems.
Autism is thought to be a spectrum of neuro-developmental conditions, characterised by difficulties in the development of social interaction, communication and the presence of strong narrow interests, and repetitive behaviour. These criteria and the complications outlined above meant that health professionals have simplified the diagnostic process now and people will be given a diagnosis of autism or High Functioning Autism. People with autism can have normal or above normal IQ.
Too often when we speak about people with autism, it can be very negative. Here are some strengths that a lot of people can show. These can be attractive qualities to friends and employers alike!
- Great memory, can recall fine detail
- Polite and rule conscious
- Refreshingly frank view of the world
- Encyclopaedic knowledge of subjects of a special interest
- Attention to detail/perfectionist
- Limit choice – free choice can cause anxiety
- Make language explicit – say what you mean and mean what you say. If you’ll be doing something within the next half an hour, don’t say ‘I’ll be two minutes’
- Ensure you have the person’s attention
- Highlight key information
- Check you have been understood
- Warn about changes in routine
- Specific praise – what does ‘well done’ actually mean? Is it well done for brushing your teeth today? Be specific.
- Don’t be subtle
- Don’t take offence
- Avoid confrontation
- Back up changes required in behaviour with visuals
In general terms diagnoses such as Childhood Autism, Classic Autism, Kanner’s Autism (named after Leo Kanner who first used the term) etc would mean the same thing; Autism. This usually means the person meets the full criteria and did so before their third birthday. The people who are given a diagnosis of ASD/ASC, Pervasive Development Disorder – Not Otherwise Specified or atypical autism tend to either not meet the full criteria or maybe did so after age three.
Asperger Syndrome (AS)
Other diagnoses are Asperger Syndrome and High Functioning Autism. There was much debate about what differences there are between the two which has led to the changes mentioned but typically these people present with difficulties in social interaction, have repetitive patterns of behaviour and have no language or learning delay. Although not required for a diagnosis, this group often have motor difficulties. Asperger Syndrome was named after the Austrian physician, Hans Asperger; who studied a number of children in 1944 (only a year later than Leo Kanner’s work) who would, in recent times have been diagnosed as Asperger Syndrome.
Common Co-morbid Conditions
ASC’s unfortunately will often come along with another condition. This is known as co-morbidity. Some common interlinking difficulties are as follows:
Learning Disabilities: These can affect all aspects of someone’s life, from studying in school, to learning how to make a meal. People with autism can have different degrees of learning disability. It is thought 75% of people with autism have associated learning disabilities.
AD(H)D: A child can have both autism and ADHD, but both are separate conditions. The symptoms can be confused and be interlinked, especially in young children, but experts are clear that the apparent similarities will separate out as the child gets older. Symptoms of ADHD include inattention, impulsivity and hyperactivity. Approximately 28% of children with autism also have ADHD.
Tourettes: Is characterised by the presence of multiple motor (physical) tics and at least one vocal tic which vary during the lifetime and tend to wax and wane depending on lifestyle and health. Approximately 28% of children with an ASD are thought to also have Tourettes.
Dyspraxia: Affects the way that the brain processes information, which results in messages not being properly or fully transmitted; it affects people’s motor co-ordination, and the ability to organise or to plan. Numbers are unknown but it is very common in High Functioning Autism/Asperger.
Epilepsy: A common chronic neurological disorder that is characterised by recurrent unprovoked seizures due to abnormal or excessive neuronal activity in the brain. It is usually controlled, but not cured, with medication. There is a heightened risk of development at puberty. It is thought around 25% of children with autism have epilepsy.
Sensory Processing Difficulties
Most people with ASC will have different ways of processing sensory information to the typical population. Consider, for a moment your 5 main senses and also your sense of balance, the sense of where your body is in relation to time and space (ie you have a sense of where you’re sitting in the room and where your body parts are) your body’s ability to control temperature and how your brain processes information.
Now imagine any one of these can be hyper-sensitive (over powering) or hypo-sensitive (low or no registration of sense) and think how that may affect you?
- The sound of a hand dryer can be piercingly painful to your ears…
- The ‘jaggy’ fabric of a new shirt can scratch at and irritate your skin…
- You want your winter jacket on and hood up in the summer, because you are feeling cold…
- The smell of the chip shop is so overpowering you vomit just by walking past it…
- You have to rock back and forth and continually touch the wall behind you to feel secure and grounded about where you are…
- The 15 strip lights on the ceiling are flickering and buzzing at a very high rate and causing you eye and head pains…
These are all things we might consider odd or rude even, but to the person with ASC they are very real and should be considered as a possible explanation for the way they might be behaving.
This can be a complex area and how these differences affect a person can change from moment to moment and are made worse by how the person feels, for example if they are stressed or poorly.
“REACH for me has meant meeting other mums and dads who ‘get’ it without judging and giving my son the opportunity to join in.”