Autism

What is Autism?
Autism is a lifelong developmental disability, sometimes referred to as an autism spectrum condition (ASC), which affects the way a person communicates and relates to people around them.The word ‘spectrum’ is used because all people with autism share three main areas of difficulty but their condition will affect them in very different ways.For instance some people are able to live relatively everyday lives whilst others will require a lifetime of specialist support.

Identifying that a person has autism can sometimes be difficult as people with the condition do not ‘look’ disabled.Therefore parents of children with autism often say that other people simply think their child is naughty; while adults believe they are misunderstood.

All people with autism can benefit from a timely diagnosis and access to appropriate services and support.

Characteristics of autism
The characteristics of autism vary from one person to another but are generally divided into three main difficulties, which are sometimes known as the 'triad of impairments' –

• Social communication
• Social interaction
• Social imagination

 

Social communication
People with autism can have difficulties with the use and interpretation of both verbal and non-verbal language. This can cause difficulties to express themselves and understand the intended language of others, for instance when using or interpreting facial expressions, tone of voice, jokes and sarcasm, and common phrases and sayings.

Some people with autism may not speak or have fairly limited speech. They will usually understand what other people say to them but prefer to use alternative means of communication themselves, for instance sign language or visual symbols.

However, other people will have good language skills but may still find it hard to understand the give-and-take nature of conversations.In this instance they may repeat what the other person has just said, which is known as echolalia, or talk at length about their own interests.

Social interaction
Socialising is something that most people take for granted but for someone with autism understanding how to interact is a major barrier. The difficulty lies in the person not being able to recognise or understand other people’s emotions and feelings, and their ability to express their own.

Some examples of these difficulties are:

• Do not understand the unwritten social rules, which most people pick up naturally, such as standing too close to another person.
• Appear to be insensitive because they have not recognised how someone else is feeling.
• Prefer to spend time alone rather than seeking out the company of other people. Do not seek comfort from other people.
• Appear to behave 'strangely' or inappropriately, as it is not always easy for them to express feelings, emotions or needs.
• In some cases they may wish to interact with other people and make friends but are unsure how to act.

 

Social imagination
Social imagination allows us to understand and predict other people's behaviour, make sense of abstract ideas and to imagine situations outside of our immediate daily routine. Difficulties with social imagination means that people with autism find it hard to:

• Understand and interpret other people's thoughts, feelings and actions. Predict what will happen or could occur next.
• Understand the concept of danger, for instance that running on to a busy road poses a threat to them.
• Engage in imaginative play and activities. Children with autism may enjoy some imaginative play but prefer to act out the same scenes each time.
• Prepare for change and plan for the future.
• Cope in new or unfamiliar situations.

However, difficulties with social imagination should not be confused with a lack of imagination; many people with autism are very creative and can excel in such areas.

In addition to the triad of impairments, other related characteristics include -

Love of routines
The world can seem a very unpredictable and confusing place to people with autism, who often prefer to have a fixed daily routine so that they know what is going to happen every day.

Rules can also be important; it may be difficult for a person with autism to take a different approach to something once they have been taught the 'right' way to do it. People with autism may not be comfortable with the idea of change but can cope well if they are prepared for it in advance.

Sensory sensitivity
People with autism may experience some form of sensory sensitivity. This can occur in one or more of the five senses - sight, sound, smell, touch and taste. A person's senses are either intensified (hypersensitive) or under-sensitive (hypo-sensitive).

For instance, a person with autism may find certain background sounds, which other people ignore or block out, unbearably loud or distracting. This can cause anxiety or even physical pain.

People who are hypo-sensitive may not feel pain or extremes of temperature. Some may rock, spin or flap their hands to stimulate sensation, to help with balance and posture or to deal with stress.

People with sensory sensitivity may also find it harder to use their body awareness system. This system tells us where our bodies are, so for those with reduced body awareness, it can be harder to navigate rooms avoiding obstructions, stand at an appropriate distance from other people and carry out 'fine motor' tasks, such as tying shoelaces.

Special interests
Many people with autism have intense special interests, often from a fairly young age. These can change over time or be lifelong, and can be anything from art or music, to trains or computers. Some people with autism may eventually be able to work or study in related areas whilst for others, it will remain a hobby.

A special interest may sometimes be unusual. For instance a person who enjoys collecting rubbish could be encouraged to channel this interest into recycling or protecting the environment.

Learning disabilities
People with autism may have learning disabilities, which can affect all aspects of someone's life, from studying in school, to learning how to wash themselves or make a meal. As with autism, people can have different 'degrees' of learning disability, so some will be able to live fairly independently - although they may need a degree of support to achieve this - while others may require lifelong, specialist support. However, all people with autism can, and do, learn and develop with the right sort of support.

Other conditions are sometimes associated with autism, these may include attention deficit hyperactivity disorder (ADHD) or learning difficulties, such as dyslexia and dyspraxia.

What causes autism?
The exact cause of autism is still being investigated; however, research suggests that a combination of factors - genetic and environmental - may account for changes in brain development.

People from all nationalities and cultural, religious and social backgrounds can have autism, although it appears to affect more men than women. It is not caused by a person's upbringing, their social circumstances and is not the fault of the individual with the condition.

Is there a cure?
At present, there is no 'cure' for autism; however, there are a range of interventions, which enable learning and development that can be helpful for the individual. Further information about developmental methods can be found on the National Autistic Society’s website - www.autism.org.uk/approaches

What is a diagnosis?
A diagnosis is the formal identification of autism, usually by a health professional such as a pediatrician or a psychiatrist. Having a diagnosis not only helps people with autism and their families to understand why they may experience certain difficulties but also enables them to access services and support. GPs can refer individuals to a specialist, who is able to make a diagnosis.

Some professionals may refer to autism by a different name, such as autistic spectrum disorder (ASD), classic autism or Kanner autism, pervasive developmental disorder (PDD) or high-functioning autism (HFA).