Autism Spectrum Disorder (commonly referred to as just "Autism"), is a lifelong neurological brain condition. It's a pervasive developmental disorder. Autistic people tend to struggle in social situations, prefer routine and familiarity, and experience sensory sensitivities.
More men than women are diagnosed with autism. Autistic women may go undiagnosed or misdiagnosed (e.g. with bipolar disorder or even borderline personality disorder).
Autism is more common in men than in women. This is because men are likely to be diagnosed during childhood before or around the age of 4, unlike women, who are diagnosed less than men and they are diagnosed later in their teenage years or early adult years. The majority of women mask their autistic traits to fit in with the neurotypical crowd by being "normal and sociable" to others, making it difficult to detect autistic women than autistic men, but eventually, they will suffer from burnout, once their masks are ripped off or they are at home away from society. Apart from that, autistic women are usually misdiagnosed as having other disorders such as bipolar disorder or even borderline personality disorder, due to frequent mood changes and eating disorders, compared to autistic men being misdiagnosed as having schizophrenia or even schizoid personality disorder when it comes to being aloof, quiet, very emotionless, asocial, lonely, and strange around others.
Appearance[]
In the episode Lines in the Sand, a 10-year-old autistic boy Adam Kelvey presents to Princeton-Plainsboro Teaching Hospital for an examination.
Signs[]
Autism is a multifaceted spectrum. Each autistic person has different needs and skills. An autistic person may have significant impairments in some areas while having near-average or above-average skills in others. Autism includes strengths as well as challenges.[1][2]
Autism is not based on a single trait, but rather on a pattern. The main characteristics are differences in social interaction and communication, restricted interests, and repetitive behavior.
Children should be screened for autism if they are not babbling by twelve months, not gesturing by twelve months, not using single words by sixteen months, not using two-word spontaneous phrases by twenty-four months or if they have any loss of language or social skills. However, autism is not always obvious from a young age.
Social interaction[]
Autistic people struggle to intuitively understand non-autistic people. It can be harder to interpret facial expressions, body language, and subtext. They may not pick up on social rules.
Many autistic people find eye contact uncomfortable.[3]
When young, they may be less responsive to social stimuli.
The "double empathy problem" describes how it is harder for non-autistic and autistic people to relate to each other.[4][5][6][7] Non-autistic people tend to judge autistic people more harshly than they judge non-autistic people.[8][9] However, they are less judgmental when they know the person is autistic and when they understand autism better,[10] suggesting that improving understanding of autism could help.
Some autistic people learn to "mask" their differences in an attempt to fit in and avoid mistreatment. However, this can lead to loneliness and negative mental health effects, sometimes severe ones.[11][12][13] Autistic people are generally happier when they can be accepted for who they are.[14]
Communication[]
A third to a half of autistic people do not develop enough natural speech to meet communication needs. They are less likely to make requests or share experiences. They may benefit from augmentative and alternative communication methods like sign language or communication apps.
Some autistic people repeat words and phrases, which is called echolalia. This may be a communication attempt, a way to process what is being said, or a way to self-regulate.
Autistic people may find written communication easier than speaking. The internet has been a lifeline for many autistic people who seek friendship and understanding.
Repetitive Behavior[]
Autistic people display many forms of repetitive or restricted behavior. Psychologists split this into 6 groups.
- Stereotypy is repetitive movement, such as hand flapping, head rolling, or body rocking.
- Compulsive behavior is intentional and appears to follow rules, such as arranging objects in stacks or lines.
- Sameness is resistance to change. For example, they may find it stressful if furniture is moved or if daily routines are changed.
- Ritualistic behavior involves an unvarying pattern of daily activities, such as an unchanging menu or a dressing ritual. This is closely associated with sameness.
- Restricted behavior is limited in focus, interest, or activity, such as preoccupation with a single television program, toy or game. Intense interests are generally associated with greater wellbeing.[15]
- Self-injury includes movements that injure or can injure the person, such as eye-poking, skin-picking, hand-biting and head-banging. No single repetitive or self-injurious behavior is specific to autism, but autistic people may self-injure more often and more intensely than non-autistic people.
Autistic adults report that repetitive fidgeting can help with self-regulation.[16] They have asked that people accept harmless behaviors like finger-flicking or rocking back and forth. While past approaches focused on training autistic people to stop doing anything unusual, researchers have confirmed that this behavior has benefits.[17][18]
Other[]
Atypical sensory needs are common in autistic people. They may be easily overwhelmed or find certain types of sensory input (e.g. loud noises) acutely painful. Some autistic people are under-responsive and may seek out intense sensory input.
Many autistic people struggle with emotion regulation.[19][20] Strong emotions can lead to outbursts (meltdowns) or shutdowns. Learning to cope with strong emotions and recognize when to take a break is important for autistic people.[21][22]
Autistic people may have difficulty understanding emotions in themselves and others. This trait is called "alexithymia."[23][24] Both autistic and non-autistic people can have alexithymia.
Sensory sensitivities are common in autistic people.[25][26] These include under-responsivity (for example, walking into things), over-responsivity (for example, distress from loud noises), and sensation seeking (for example, rhythmic movements).
Motor difficulties are common in autistic people. These can include low muscle tone, trouble with motor planning, and poor coordination. Autistic people may engage in toe-walking, which can cause damage if done too often.[27][28]
Unusual eating behavior is common in autistic people. Sensory sensitivities and fear of the unfamiliar can lead to selective eating. Certain foods may feel inedible to autistic people. Some autistic people also have eating rituals. Autistic people are at higher risk of eating disorders such as ARFID and anorexia.[29][30]
Strengths of autistic people include[31] integrity,[32] fast problem-solving, logic, pattern recognition, ability to recall environmental details,[33] resistance to peer pressure,[34] and more. Intellectual giftedness is common in autistic people.
Co-occurring conditions[]
The following conditions commonly co-exist with autism:
- ADHD
- Schizophrenia
- Obsessive-compulsive disorder (OCD), agoraphobia, social anxiety disorder, PTSD, and other anxiety disorders
- Depressive disorders
- Speech processing disorders
- Sensory processing disorders
- Learning disorders (dyslexia, dysgraphia, or dyscalculia)
- Eating disorders (ex. ARFID and anorexia)
- Maladaptive Daydreaming
- Selective Mutism
- Seizure disorder
- Savant Syndrome
Cause[]
Autism is mostly genetic[35] and it begins in the womb.[36][37] Some prenatal factors (e.g. maternal infections) may increase the odds of autism.[38][39] All known teratogens (agents that affect fetal development) related to autism appear to act during the first eight weeks from conception.[40]
Parents may first notice signs of autism around the time for routine vaccinations. This has sparked numerous myths[41][42][43] that have led to disease outbreaks,[44][45] profiteering scams, and preventable deaths in children.[46] Researchers have exhaustedly proven that vaccines are not linked to autism,[47][48][49][50] yet misinformation continues. Some people have pointed out that having an autistic child is better than having a medically at-risk child who could be permanently damaged or killed by vaccine-preventable diseases.[51]
Support[]
Autism is lifelong.[52] The right support can make a huge difference in quality of life.
Therapies for autism include occupational therapy, speech and language therapy, counseling, and support groups.
Applied behavior analysis (ABA) is the most popular therapy, but it is controversial due to ethical issues,[53][54] questionable efficacy,[55][56] and the risk of inflicting harm.[57][58] While there has historically been very little research about potential harms,[59][60] emerging research shows a potential link to post-traumatic stress disorder.[61][62]
While support needs vary, many autistic people cannot live fully independently. Lifelong services can help them manage things like employment, health and safety, and other areas where they might need support.
Autistic people often do better when they are allowed to be themselves. Enjoying their special interests is good for their wellbeing.[63] Behavior like stimming[64][65] and avoiding eye contact[66] can help them stay calm and adapt to situations.
Autism in society[]
Autistic people have developed their own culture and community.
Autism rights and neurodiversity[]
The autism rights movement emerged to increase acceptance of autistic people and to defend against abuse.[67] Through this movement, people hope to cause others to think of autism as a difference instead of a disease. Proponents of this movement wish to seek "acceptance, not cures."[68] Key issues include abuse prevention, self-determination, the right to be themselves instead of being forced to assimilate, and seeing autism as a difference to accommodate instead of a disease to eradicate.[69][70]
Debates around autism[]
Debates on autism often split into two groups. The neurodiversity group argues that autism is a difference instead of a disease, and that support for autistic people should honor their individual needs and quirks. The anti-neurodiversity group argues that autism is a disease that should be cured or ameliorated through behavior training to make autistic people fit in.
For decades, conversations about autism happened without autistic voices. Autistic people are gaining more of a say in conversations about them.
External resources[]
- The Autism Wellbeing Wiki, another Fandom wiki
- Embrace Autism
- Thinking Person's Guide to Autism
- Autism articles on wikiHow
- Autistic Self-Advocacy Network
References[]
- ↑ Autism Strengths
- ↑ Strengths of Autism: Why Autistic People Excel at Specific Tasks
- ↑ For Those With Autism, Eye Contact Isn't Just Weird, It's Distressing
- ↑ Damian E.M. Milton DEM979@bham.ac.uk (2012) On the ontological status of autism: the 'double empathy problem', Disability & Society, 27:6, 883-887, DOI: 10.1080/09687599.2012.710008
- ↑ Outcomes of real-world social interaction for autistic adults paired with autistic compared to typically developing partners
- ↑ Edey R, Cook J, Brewer R, Johnson MH, Bird G, Press C. Interaction takes two: Typical adults exhibit mind-blindness towards those with autism spectrum disorder. J Abnorm Psychol. 2016 Oct;125(7):879-885. doi: 10.1037/abn0000199. Epub 2016 Sep 1. PMID: 27583766.
- ↑ Double Empathy: Why Autistic People Are Often Misunderstood
- ↑ Sasson, N., Faso, D., Nugent, J. et al. Neurotypical Peers are Less Willing to Interact with Those with Autism based on Thin Slice Judgments. Sci Rep 7, 40700 (2017). https://doi.org/10.1038/srep40700
- ↑ Autistic Adults May Be Erroneously Perceived as Deceptive and Lacking Credibility
- ↑ Sasson, N. J., & Morrison, K. E. (2019). First impressions of adults with autism improve with diagnostic disclosure and increased autism knowledge of peers. Autism, 23(1), 50-59. https://doi.org/10.1177/1362361317729526
- ↑ Conceptualising Autistic Masking, Camouflaging, and Neurotypical Privilege: Towards a Minority Group Model of Neurodiversity
- ↑ Cassidy S, Bradley L, Shaw R, Baron-Cohen S. Risk markers for suicidality in autistic adults. Mol Autism. 2018 Jul 31;9:42. doi: 10.1186/s13229-018-0226-4. PMID: 30083306; PMCID: PMC6069847.
- ↑ Cassidy, S.A., Gould, K., Townsend, E. et al. Is Camouflaging Autistic Traits Associated with Suicidal Thoughts and Behaviours? Expanding the Interpersonal Psychological Theory of Suicide in an Undergraduate Student Sample. J Autism Dev Disord 50, 3638–3648 (2020). https://doi.org/10.1007/s10803-019-04323-3
- ↑ Cage E, Di Monaco J, Newell V. Experiences of Autism Acceptance and Mental Health in Autistic Adults. J Autism Dev Disord. 2018 Feb;48(2):473-484. doi: 10.1007/s10803-017-3342-7. PMID: 29071566; PMCID: PMC5807490.
- ↑ Grove R, Hoekstra RA, Wierda M, Begeer S. Special interests and subjective wellbeing in autistic adults. Autism Res. 2018 May;11(5):766-775. doi: 10.1002/aur.1931. Epub 2018 Feb 10. PMID: 29427546.
- ↑ Kapp SK, Steward R, Crane L, Elliott D, Elphick C, Pellicano E, Russell G. 'People should be allowed to do what they like': Autistic adults' views and experiences of stimming. Autism. 2019 Oct;23(7):1782-1792. doi: 10.1177/1362361319829628. Epub 2019 Feb 28. PMID: 30818970; PMCID: PMC6728747.
- ↑ Rethinking repetitive behaviors in autism
- ↑ Stimming, therapeutic for autistic people, deserves acceptance
- ↑ Mazefsky CA, Herrington J, Siegel M, Scarpa A, Maddox BB, Scahill L, White SW. The role of emotion regulation in autism spectrum disorder. J Am Acad Child Adolesc Psychiatry. 2013 Jul;52(7):679-88. doi: 10.1016/j.jaac.2013.05.006. Epub 2013 Jun 3. PMID: 23800481; PMCID: PMC3719386.
- ↑ A systematic review of emotion regulation in children with Autism Spectrum Disorder
- ↑ Emotion regulation in autism spectrum disorder: Where we are and where we need to go
- ↑ Help Your Autistic Child Manage Emotions
- ↑ Poquérusse J, Pastore L, Dellantonio S, Esposito G. Alexithymia and Autism Spectrum Disorder: A Complex Relationship. Front Psychol. 2018 Jul 17;9:1196. doi: 10.3389/fpsyg.2018.01196. Erratum in: Front Psychol. 2018 Sep 05;9:1638. PMID: 30065681; PMCID: PMC6056680.
- ↑ Alexithymia & autism guide
- ↑ Marco EJ, Hinkley LB, Hill SS, Nagarajan SS. Sensory processing in autism: a review of neurophysiologic findings. Pediatr Res. 2011 May;69(5 Pt 2):48R-54R. doi: 10.1203/PDR.0b013e3182130c54. PMID: 21289533; PMCID: PMC3086654.
- ↑ Sensory differences - a guide for all audiences
- ↑ Walking on Tiptoes: Is This a Sign of Autism?
- ↑ Toe Walking
- ↑ Baraskewich J, von Ranson KM, McCrimmon A, McMorris CA. Feeding and eating problems in children and adolescents with autism: A scoping review. Autism. 2021 Aug;25(6):1505-1519. doi: 10.1177/1362361321995631. Epub 2021 Mar 2. PMID: 33653157; PMCID: PMC8323334.
- ↑ Eating disorders
- ↑ Autism Strengths
- ↑ Autistic People Care Too Much, Research Says
- ↑ Implications of capacity in the classroom: Simplifying tasks for autistic children may not be the answer
- ↑ Social conformity and autism spectrum disorder : a child-friendly take on a classic study
- ↑ Park, Alice. This Is How Much of Autism Is Genetic, Time Magazine
- ↑ Hamilton, Jon. Brain Changes Suggest Autism Starts In The Womb, NPR
- ↑ A routine prenatal ultrasound can identify early signs of autism, study finds, Science Daily
- ↑ Lee BK, Magnusson C, Gardner RM, Blomström Å, Newschaffer CJ, Burstyn I, Karlsson H, Dalman C. Maternal hospitalization with infection during pregnancy and risk of autism spectrum disorders. Brain Behav Immun. 2015 Feb;44:100-5. doi: 10.1016/j.bbi.2014.09.001. Epub 2014 Sep 16. PMID: 25218900; PMCID: PMC4418173.
- ↑ Atladóttir, H.Ó., Thorsen, P., Østergaard, L. et al. Maternal Infection Requiring Hospitalization During Pregnancy and Autism Spectrum Disorders. J Autism Dev Disord 40, 1423–1430 (2010). https://doi.org/10.1007/s10803-010-1006-y
- ↑ Arndt, T.L., Stodgell, C.J. and Rodier, P.M. (2005), The teratology of autism. International Journal of Developmental Neuroscience, 23: 189-199. https://doi.org/10.1016/j.ijdevneu.2004.11.001
- ↑ Doja A, Roberts W. Immunizations and Autism: A Review of the Literature. Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques. 2006;33(4):341-346. doi:10.1017/S031716710000528X
- ↑ Gerber JS, Offit PA. Vaccines and autism: a tale of shifting hypotheses. Clin Infect Dis. 2009 Feb 15;48(4):456-61. doi: 10.1086/596476. PMID: 19128068; PMCID: PMC2908388.
- ↑ Gross L. A broken trust: lessons from the vaccine--autism wars. PLoS Biol. 2009 May 26;7(5):e1000114. doi: 10.1371/journal.pbio.1000114. Epub 2009 May 26. PMID: 19478850; PMCID: PMC2682483.
- ↑ Benecke O, DeYoung SE. Anti-Vaccine Decision-Making and Measles Resurgence in the United States. Glob Pediatr Health. 2019 Jul 24;6:2333794X19862949. doi: 10.1177/2333794X19862949. PMID: 31384629; PMCID: PMC6657116.
- ↑ Rao, T. S. Sathyanarayana; Andrade, Chittaranjan. The MMR vaccine and autism: Sensation, refutation, retraction, and fraud. Indian Journal of Psychiatry 53(2):p 95-96, Apr–Jun 2011. | DOI: 10.4103/0019-5545.82529
- ↑ McBrien, Jacqueline et al. Measles outbreak in Dublin, 2000, Pediatric Infectious Disease Journal
- ↑ Anders Hviid, Jørgen Vinsløv Hansen, Morten Frisch, et al. Measles, Mumps, Rubella Vaccination and Autism: A Nationwide Cohort Study. Ann Intern Med.2019;170:513-520. [Epub 5 March 2019]. doi:10.7326/M18-2101
- ↑ Taylor, Luke, Amy Swerdfeger, and Guy Eslick. Vaccines are not associated with autism: An evidence-based meta-analysis of case-control and cohort studies, Vaccine
- ↑ Knopf A. Time to remember: Vaccines don't cause autism. The Brown University Child and Adolescent Behavior Letter. 2021 Jul;37(7):9–10. doi: 10.1002/cbl.30559. Epub 2021 Jun 7. PMCID: PMC8207024.
- ↑ LeGare, Jennifer. Link between autism and vaccination debunked, Mayo Clinic Health System
- ↑ Kurchak, Sarah. I’m Autistic, And Believe Me, It’s A Lot Better Than Measles, Medium
- ↑ Scott D. Wright , Cheryl A. Wright , Valerie D’Astous & Amy Maida Wadsworth (2019) Autism aging, Gerontology & Geriatrics Education, 40:3, 322-338, DOI: 10.1080/02701960.2016.1247073
- ↑ Wilkenfeld DA, McCarthy AM. Ethical Concerns with Applied Behavior Analysis for Autism Spectrum "Disorder". Kennedy Inst Ethics J. 2020;30(1):31-69. doi: 10.1353/ken.2020.0000. PMID: 32336692.
- ↑ Shkedy, G., Shkedy, D. & Sandoval-Norton, A.H. Long-term ABA Therapy Is Abusive: A Response to Gorycki, Ruppel, and Zane. Adv Neurodev Disord 5, 126–134 (2021). https://doi.org/10.1007/s41252-021-00201-1
- ↑ Reichow B, Hume K, Barton EE, Boyd BA. Early intensive behavioral intervention (EIBI) for young children with autism spectrum disorders (ASD). Cochrane Database Syst Rev. 2018 May 9;5(5):CD009260. doi: 10.1002/14651858.CD009260.pub3. PMID: 29742275; PMCID: PMC6494600.
- ↑ Bottema-Beutel K, Crowley S, Sandbank M, Woynaroski TG. Research Review: Conflicts of Interest (COIs) in autism early intervention research - a meta-analysis of COI influences on intervention effects. J Child Psychol Psychiatry. 2021 Jan;62(1):5-15. doi: 10.1111/jcpp.13249. Epub 2020 Apr 30. PMID: 32353179; PMCID: PMC7606324.
- ↑ Aileen Herlinda Sandoval-Norton, Gary Shkedy & Dalia Shkedy | Jacqueline Ann Rushby (Reviewing editor) (2019) How much compliance is too much compliance: Is long-term ABA therapy abuse?, Cogent Psychology, 6:1, DOI: 10.1080/23311908.2019.1641258
- ↑ Kupferstein, Henny. Why caregivers discontinue applied behavior analysis (ABA) and choose communication-based autism interventions, Advances in Autism
- ↑ Rodgers M, Marshall D, Simmonds M, Le Couteur A, Biswas M, Wright K, Rai D, Palmer S, Stewart L, Hodgson R. Interventions based on early intensive applied behaviour analysis for autistic children: a systematic review and cost-effectiveness analysis. Health Technol Assess. 2020 Jul;24(35):1-306. doi: 10.3310/hta24350. PMID: 32686642; PMCID: PMC7397479.
- ↑ Bottema-Beutel K, Crowley S, Sandbank M, Woynaroski TG. Adverse event reporting in intervention research for young autistic children. Autism. 2021 Feb;25(2):322-335. doi: 10.1177/1362361320965331. Epub 2020 Oct 19. PMID: 33076682; PMCID: PMC7870528.
- ↑ McGill, Owen and Robinson, Anna. “Recalling hidden harms”: autistic experiences of childhood applied behavioural analysis (ABA), Advances in Autism
- ↑ Kupferstein, Henny. Evidence of increased PTSD symptoms in autistics exposed to applied behavior analysis, Advances in Autism
- ↑ Grove R, Hoekstra RA, Wierda M, Begeer S. Special interests and subjective wellbeing in autistic adults. Autism Res. 2018 May;11(5):766-775. doi: 10.1002/aur.1931. Epub 2018 Feb 10. PMID: 29427546.
- ↑ Kapp SK, Steward R, Crane L, Elliott D, Elphick C, Pellicano E, Russell G. 'People should be allowed to do what they like': Autistic adults' views and experiences of stimming. Autism. 2019 Oct;23(7):1782-1792. doi: 10.1177/1362361319829628. Epub 2019 Feb 28. PMID: 30818970; PMCID: PMC6728747.
- ↑ Kapp, Steven. Stimming, therapeutic for autistic people, deserves acceptance, The Transmitter
- ↑ Steweart, Rozella. Should We Insist on Eye Contact with People who have Autism Spectrum Disorders, Indiana Resource Center for Autism
- ↑ Trivedi, Bijal. Autistic and proud of it. New Scientist. Retrieved on 10 November 2015.
- ↑ Shapiro, Joseph (26 June 2006). Autism Movement Seeks Acceptance, Not Cures. NPR. Retrieved on 10 November 2015.
- ↑ Hookway, John. A History and Overview of the Autism Acceptance Movement, Brainwave.watch
- ↑ den Houting, J. (2019). Neurodiversity: An insider’s perspective. Autism, 23(2), 271-273. https://doi.org/10.1177/1362361318820762