What is Autism?

The term Autism Spectrum is used for a range of conditions that impact on an individual.  The word ‘spectrum’ is used because of the range of ways in which people can experience autism.

As the Scottish Strategy for Autism states:It is important to explain the choice of language and terminology used (…) because the complex nature of autism spectrum gives rise to a range of personal and professional perspectives. Although this means that it is not easy to find a common language that reflects the views of the various groups, what we have tried to do is reflect the diversity of the community in a positive way (Scottish Strategy for Autism, page 9).

Autism is a lifelong developmental condition. People with autism tend to have a wide range of skill sets including different strengths and difficulties, however autism is characterised by a triad of impairments and people typically find challenges with:

social interaction

social imagination

communication

People with autism also tend to share common traits such as sensory sensitivity, repetitive and stereotyped behaviours and special interests. Autism can also be associated with physical difficulties and it is recognised that there can be a vulnerability to mental health and wellbeing. Some people with autism may also have learning difficulties like dyslexia and other conditions like dyspraxia  or epilepsy. Others will have autism without any of these associated difficulties, but if one does have any of them, it might be helpful to describe them to support their case when trying to obtain a formal diagnosis.

Although people share common difficulties due to their autism, the way that this affects their life can vary greatly from person to person. Peter Vermeulen, in his book ‘Autistic thinking: this is the title’ (Jessica Kingsley Publishers, 2001) writes about the strengths of people with autism. Autism can create a wide range of barriers in everyday life and these can impact upon an individual to varying degrees. Whilst some people are able to live relatively independent lives, others will require more intensive support throughout their lifetime. The daily level of support an individual requires may be further impacted by additional learning needs in addition to their autism.

As autism is a lifelong condition impact will be likely to change throughout the person’s lifetime, and in relation to the support they are accessing. It is important to remember that the autism spectrum is not a linear condition with ‘high functioning’ and ‘low functioning’ ends, but rather a condition in which there are also impacts from the environment and sometimes from the stresses of daily life.

 

What is Asperger’s Syndrome?

The first accounts of clinicians and researchers writing about Asperger’s syndrome (AS) date back to the early forties of the 20th century when Austrian Pediatrician Hans Asperger, described a group of children whose observed traits eventually came to be named after him. Typically people with AS have average or above average IQ. There are, however, associated difficulties with social communication, interaction and imagination, which can create barriers in everyday life.

These difficulties can have a significant impact on quality of life. As such difficulties can make it difficult for the individual to understand social norms and shared understanding. The invisible nature of autism can also significantly increase misunderstandings and difficulties to functioning in everyday life.

 

How common is autism?

Autism is a lifelong condition, which is currently understood to be three to four times more common in men than women. Although anecdotally, autism is less-recognised in women by professionals, recent studies may lead to increased realisation and recognition of occurrence in females.

It is currently suggested that an incidence rate of around 1 in 88 is the best estimate across the population at large.  Scottish reports state that almost every school in Scotland will have at least one child with autism; this would mean that there are around 6,900 pupils with autism in Scotland. No prevalence studies have ever been carried out on adults thus far. Therefore, the figure for the whole population is a very rough guide. It is estimated that over 50,000 people in Scotland have autism – 35,000 of these individuals being adults.

For example, people with autism may:

  • have difficulty understanding and interpreting verbal and non-verbal communication;
  • have difficulties in a two-way conversation and may appear to have no interest in others’ opinions or different subjects;
  • take things literally, which can lead to confusion and misunderstandings;
  • have an unusual pattern of speech;
  • have difficulties interpreting meaning (particularly implicit meaning) from the tone and manner in which things are said;
  • find it challenging to keep up with the pace of social communication/’banter’;
  • have difficulty in understanding that other people see things from a different point of view;
  • have difficulty understanding pronouns e.g. he/she and may refer to self in third person;
  • have difficulty following the rules of conversation including non-verbal communication, topic relevance and topic maintenance;
  • have difficulties in generalising or understanding abstract concepts;
  • behave in ways that are difficult to understand. Such behaviour may be a form of communication. It can be more productive to view behaviour in this way and to develop supportive communication strategies rather than to assume there is a behaviour problem.

For example, people with autism may:

  • have difficulty comprehending time and predicting the future or the course and results of actions;
  • find it difficult to imagine what other people are thinking or see how their actions might affect another person;
  • excel at learning facts and figures,but find it hard to understand abstract or less concrete concepts, such as those relating to time, involving the taking on of another’s perspective or imagining a particular scenario;
  • have difficulties generalising a skill from one setting to another- transferring skills;
  • find change difficult to manage or upsetting; difficulties with flexibility and adjustment;
  • prefer to order their day according to a set pattern, breaks in routine can cause anxiety;
  • have difficulty engaging in pretend play as a result of thinking in a more concrete manner and having difficulties with the abstract.

For example, people with autism may:

  • may lack awareness of the social skills to interact in a conventional way;
  • have difficulties forming and maintaining relationships and friendships;
  • appear aloof and indifferent to other people;
  • find it hard to understand non-verbal signals, including eye contact, facial expressions, gestures; which enable a ‘picture’ of another’s perspective (thoughts and feelings) to be formed;
  • have difficulty understanding the rules of society and identifying what is expected behaviour in different situations.

For example, people with autism may:

  • be hypo (under-sensitive) or hypersensitive (over-sensitive) to noises, light, smells, certain tastes or fabrics etc.;
  • have poor depth perception, e.g. problems with throwing and catching, clumsiness;
  • problems with three-dimensional vision;
  • have a dislike of being touched or need to be held/restrained;
  • have a high pain threshold;
  • feel less able to process multiple sensory inputs – with some people claiming only to be able to process one sense at a time and lacking a sense of integration in their perception. This can result in a strong feeling of overwhelm.

For example, people with autism may:

  • have difficulties with motor skills, e.g. manipulating small objects, clumsiness;
  • have difficulties with maintaining balance or posture.

Anxiety is known to be common in people with autism: this may lead to mental health and well being issues, for example, people with autism may:

  • experience mood disturbances, e.g. depression, aggression or anxiety;
  • demonstrate self-soothing or self-injurious behaviour such as rocking, head-banging or hand-biting. This may be in response to the need for sensory input, or as a result of confusion, frustration, fear and/or anxiety caused by the environment or those around them. (see also a note on behaviour in the social communication section).

For example, people with autism may demonstrate:

  • stereotyped and repetitive motor mannerisms, e.g. hand or finger flapping or twisting, complex whole-body movements;
  • a persistent preoccupation with parts of objects rather than using an object functionally, e.g. spinning wheels of a car than play with a car and garage;
  • narrow, deep interest in chosen topics, e.g. timetables, collecting objects, sciences etc.