Post No.: 0682
Furrywisepuppy says:
Since Fluffystealthkitten covered ADHD back in Post No.: 0640, I’ve gone ahead to learn more about autism or ASD (autism spectrum disorder) in order to try to understand autistic people better…
Autism isn’t a new phenomenon. Officially, a person on the autism spectrum is somebody who experiences a persistent difficulty with social communication and social interaction across multiple contexts (e.g. difficulties in effectively reciprocating other people’s emotions, problems with non-verbal behaviours during social interactions, problems with understanding, developing or maintaining relationships), and who displays restricted, repetitive patterns of behaviour, interests and activities (e.g. spinning objects or rocking back and forth, exhibiting an extremely narrow and highly-focused area of interest). These features must have been present from early childhood (even if they weren’t recognised until later in life, possibly because the individual had yet encountered situations that exceeded their social capabilities and/or they had learned of strategies to mask those social difficulties), and to the extent that they limit and impair everyday functions.
Autism is considered a developmental disorder i.e. something that’s apparent from childhood and continues throughout a person’s life. It can impact upon a person’s intellectual, emotional, social, physical and/or motor skills. Every person on the autism spectrum will experience difficulties in each of these broad areas but the impact can be different for each individual.
Although autistic people are quite individual and varied, as a general guide, they will share certain patterns of behaviour, including – making literal interpretations of information (instead of contextual ones); having a sense for details (instead of for the big picture); preferring concrete things and facts (instead of abstract things and vague ideas), absolutes (instead of relativism) and calculations (instead of intuitive feelings); and being a stickler for following the rules (instead of occasionally ‘living between the rules’).
It is also common to have particular sensory preferences – many autistic people see, hear, taste, touch and perhaps smell a wholly different world. Textures normally enjoyed by many others may be highly distressing to an autistic person. Loud noises, bright lights, everybody talking at once, and new or unfamiliar situations, can lead to a tormenting sensory overload.
There are debates about how to address autistic people. Most are fine with being called ‘autistic’, ‘autistic person’ or ‘on the autism spectrum’ but are less keen on being called ‘person with autism’ because the latter can sound like it’s something they have that could, or should, be attempted to be ridded of like a disease. Language is loaded with connotations hence it matters. Ultimately, the preference is individual so if you are unsure then it’s best to ask, “What language do you use to describe yourself?” (Don’t ask, “What’s wrong with you?”) Woof!
Note that the diagnosis of Asperger syndrome was removed by the time DSM-5 (the Diagnostic and Statistical Manual of Mental Disorders, 5th edition) was published. It used to be regarded as a ‘mild’ presentation of autism. The presentation now just simply falls under ASD, or sometimes PDD-NOS (autism and pervasive developmental disorder, not otherwise specified). Asperger syndrome however, as of posting, remains within ICD-11 (the International Classification of Disorders, 11th edition) as a subtype of ASD.
Some want to move away from calling autism a ‘disorder’ altogether. They see it as more of a ‘difference’ or neurodivergence. It’s a different way of being, of experiencing the world. Some are okay with ‘condition’ but not ‘disability’ or ‘deficit’ – although many don’t want neurotypical people to presume they don’t experience any difficulties in life because they do. Some in fact find the condition quite disabling.
It is a conundrum because some labels come with a stigma, yet if autistic people are just regarded as ‘different’ and ASD isn’t really a ‘disorder’ then how can they justify receiving special support and maybe dispensations that other ‘simply different’ kids or adults don’t receive in school or life? This conundrum isn’t unique to autism. Basically, if you want help, you’ve got to admit that you experience a problem. Otherwise if there’s nothing wrong with you then it’d be fair to call you rude if you constantly avoided eye contact and fidgeted when talking to someone, for instance – like other people can be called so if they behaved in a similar way. So there are worse labels if we don’t own the medical terms.
Thus a diagnosis may come with negative stigma but it should also come with positive support and understanding. We do need to have medical language to describe autistic people. We should most ideally eliminate the cultural stigma associated with all medical conditions; like how having allergies or being abjectly dismal at mathematics (in ‘the West’ at least) aren’t as culturally stigmatised.
Many people in their 50s or older have started to ask if they’re on the autistic spectrum after going through life feeling misunderstood by others, and by themselves, so far.
Most autistic people have comorbidities (or coexisting conditions) like anxiety, ADHD, Tourette syndrome or intellectual or learning disabilities. ~30-50% of autistic people have an intellectual disability (ID). Dyslexia (affecting literacy), dyspraxia (affecting physical coordination), dyscalculia (affecting numeracy) and dysgraphia (affecting writing) are also common co-occurring conditions with autism. This list isn’t exhaustive.
Autism may come paw-in-paw with anxiety simply because of trying to fit in a predominantly neurotypical world (a world mostly designed by neurotypical people for neurotypical people) and therefore being constantly worried about making all kinds of social mistakes and dealing with the sensory overloads. This can also lead to depression. What’s socially ‘normal’ except as determined by cultural norms, which are often in constant flux? (Having said that, the natural world can occasionally be unpredictable too even though most autistic people prefer a predictable environment.)
Anxiety can be enormously impacting alone. It can itself cause anyone to feel and appear awkward in social situations (non-autistic people can end up fidgeting and pacing about nervously for example too), to focus on how one is feeling instead of being aware of how other people are feeling, and to be tunnel-visioned instead of able to flexibly change plans.
Autism stereotypes abound, like how only males can be autistic (more boys are indeed identified with autism but all genders can be), only kids can be autistic (it’s a lifelong condition), autistic people cannot be happy, they don’t have or want friends and aren’t very sociable, they only like scientific or ‘geeky’ interests and not sporting or creative pursuits, and they are serious and don’t have a sense of humour. The media, like film characters, have historically perpetuated many of these stereotypes. A recurrent stereotype of autistic people is that they have ‘savant’ skills – some do but this isn’t a defining feature of autism. Autistic people generally prefer visual over spoken information – although this isn’t the case for everyone on the autism spectrum.
Autistic people are actually diverse – their strengths and challenges vary in type and intensity. The autism spectrum isn’t really a linear spectrum but a multidimensional spectrum broadly across language, motor skills, sensory filter, perception and executive function traits. (The large variety in presentation does raise the question of whether autism is one condition or a range of conditions that have been clumped into one diagnosis?) This is why many dislike the terms ‘high-functioning’ and ‘low-functioning/severe’ because they undermine the real difficulties or real strengths they might face or possess in other areas of their life. It’d be like calling someone ‘high-functioning’ because they excel at cooking even though they’re dreadful at navigating. What happens is that when someone is labelled as ‘high-functioning’, other people might assume that they don’t experience any problems whatsoever. Demands or expectations that are too high will then be placed on them in areas that they struggle greatly with. And the opposite will happen for those labelled as ‘low-functioning/severe’ – they’ll be assumed to be incapable across the board.
Put simply, the traits of autistic people are quite ‘spiky’ if we were to graph their skills profiles – whereas ‘neurotypical’ people tend to exhibit relatively uniform levels of ability across the board regarding their range of traits, autistic people tend to exhibit major spikes and major troughs across their range of traits i.e. serious strengths in some areas and serious challenges in others. So even those with ‘savant’ skills will have areas they have notable difficulties with. This means that one skill or trait alone won’t make or rule out a diagnosis. It however doesn’t mean that every autistic person will have a ‘special skill’ – it just means that you cannot predict how good someone will be at a task on the basis of their other skills. A general IQ score is therefore not very diagnostic for people on the autism spectrum. (Raven’s Progressive Matrices are suggested as a better test for those with autism.)
These spikes and dips are idiosyncratic hence autistic people have different preferences. It’s crucial not to make assumptions about any autistic person based on what you might know about another autistic person. This is why it’s often said that ‘when you have met one autistic person, you have met one autistic person’! Some, however, dislike this phrase because they think this denies autistic people of their common identity and experiences. Everyone on the autism spectrum experiences some kind of fuzzy difficulty regarding their communication, social interactions and other behaviours. These debates and disagreements amongst autistic people do precisely serve to highlight how diverse in mind and opinion autistic people are though!
So an autistic person can exhibit many differences and similarities with neurotypical people. Differences between autistic people, like between everyone else, can also vary depending on a person’s age and the opportunities offered to them too, not just their inherent capabilities. Some traits will be disadvantages in some contexts but advantages in others as well (e.g. autistic people normally find it easier to concentrate on the details and more difficult to see the broader pictures, which has its pros and cons depending on the task). Many try hard to fit in with expected social norms despite their difficulties, yet they still need support to varying degrees depending on where they sit on the autism spectrum and their individual profiles.
Some attempt to mask or hide their condition by just going with the flow and not causing a fuss, for better or worse. Others will just do their own thing, for a different set of better or worse outcomes. Now if a person is so effective at masking or hiding their symptoms then should they therefore not be considered autistic? The individual aspects of the autistic experience (e.g. the sensory overloads and communication difficulties) happen all at once though, and this masking effort drains an awful lot of energy – and if this mask ever falls, they’d still want understanding for their subsequent behaviours. (Lots of conundrums like this apply to both autism and ADHD, and perhaps other mental and physical health conditions too.)
We are all the same in some ways and different in others. People on the autism spectrum are highly individual. So every new person we meet should perhaps make us feel like a humble novice who’s learning about people from afresh again – as someone without preconceptions about others. And we should see this learning as an ongoing process since everyone can each also personally change as they age too.
Woof! The best thing about modern autism research is that we’re listening more to the voices of autistic people themselves. There’s a great deal more to share from what some of them have said so I’d like to resume this journey of edification another time…
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