About Autism

Sections

    Autism Spectrum Difference (ASD*)

    Autism Spectrum Difference (ASD) is characterised as persistent deficits in social communication and social interaction across contexts as well as the presentation of restricted, repetitive patterns of behaviour, interests or activities.

    For a child to be diagnosed as Autistic*, they need a team of experts (Psychologist, Speech Therapist and Paediatrician) that refer to a 'checklist of traits' or 'characteristics' from the DSM-V/DSM-5 - the Diagnostic and Statistical Manual of Mental Disorders, 5th Ed.

    *Autistic people have been advocating for the name of this condition to change from Autism Spectrum Disorder as the term Disorder is offensive. There are some that would like to see the name change to 'Autism Spectrum Condition', but in the meantime with the 'D' still in the title and acronym, the term 'Difference' is being used.

    These characteristics have been used for many years, and are mainly based on a male/boy's presentation of Autism, as experts believed that only boys/males could be Autistic. This makes it much harder for girls/females to be diagnosed (see the section below on the female presentation of Autism.

    Source: Understanding The Spectrum – A Comic Strip Explanation, Rebecca Burgess
    The Mighty
    The Art of Autism

    Autism Diagnosis Criteria

    To meet diagnostic criteria for ASD according to the DSM-5, a child must have persistent deficits in each of three areas of social communication and interaction, plus at least two of four types of restricted, repetitive behaviours.

    • Difficulties in social interaction and failure of normal back and forth conversation due to reduced sharing of interests, emotions and affect as well as response to conversational leads
    • A lack of initiation of social interaction
    • Challenges with nonverbal communicative behaviours used for social interactions, including lack of eye contact and body language
    • Challenges in understanding and use of nonverbal communication, to total lack of facial expression or gestures
    • Challenges in developing and maintaining relationships, appropriate to developmental level (beyond those with caregivers); for example, having difficulties adjusting behaviour to suit different social contexts as well as making friends to an apparent absence of interest in people.
    • Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases).
    • Excessive need to follow routines, ritualised patterns of verbal or nonverbal behaviour, or excessive difficulties with coping with change; (such as motoric rituals, insistence on the same route or food, repetitive questioning or extreme distress at small changes).
    • Highly restricted, fixated interests such as strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests. This can also be highly inflexible thinking patterns.
    • Hyper or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects).

    Autistic people experience the five main senses (and the three new additions of vestibular, proprioception and interception) either at a heightened level (so affected more than usual to these) or at a lesser level (harder to distinguish and feel pain, heat and cold). The unusual interest in sensory aspects refers to the person's excessive smelling or touching of objects, fascination with lights and/or spinning objects.

    Autistic people can be really sensitive to the five senses. For example:

    • Sound: Struggles with noise (even if it doesn’t seem noisy to others).
    • Smell: Certain smells, like certain foods being prepared or butcher/fruit shops, can be really offensive.
    • Seeing: Fluro lights being too bright in a classroom or it’s too sunny outside.
    • Touch: Some Autistic people are very sensitive to touch and don't like to be touched by others (unless asked). This includes clothing and fabrics which if too loose, tight, itchy or scratchy can be really irritating and be refused to be worn. Clothing tags are the worst offenders!
    • Taste: Avoiding touching and/or eating certain foods because of their texture (feeling wet and cold for example, or smelly).
      Learn more about Sensory Processing and Sensory Sensitivities here.

    The Autism Diagnostic Criteria - The Autistic Community's Response 

    There are many Autistics who don't feel comfortable with the wording of the diagnostic criteria, as it focuses on problems and challenges, using words like 'deficits' and 'failure' and is a very negative portrayal and explanation of what Autism is.

    The terminology also defines Autistic socialising as wrong or disordered, but from the Autistic person's perspective, it's just 'different' socialising. This assumption and the use of negative terms are both offensive and hurtful to the Autistic community.

    The criteria also views Autism as a behavioural condition which is also incorrect as we know it's neurological. It also fails to recognise other areas that impact Autistic people such as sensory processing/sensory sensitivities.

    Source: @cariebertseminars, 'Positive Language'

    Social Communication Challenges

    • Autistic people:

      • Tend to struggle to start conversations, so they may not initiate any social interactions.
      • May find it difficult to maintain a 'back and forth' conversation, which means they might not follow up with a question after they've answered something you've asked. This makes it hard to keep the conversation flowing. (Your friend may rely on pre-prepared scripts (see images below) for their social interactions and it's obvious when they've come to an end of the script, not knowing what to say next).
      • May find it difficult talking about a subject that isn't their special interest and may not want to talk about anything that doesn't interest them.
      •  

    Autistic brains interpret language very literally, which is the 'exact' meaning of things.

    For example, you understand what it means when someone tells you to ‘go and grab a chair', but this kind of language can be really difficult to make sense of, thinking all they need to do is literally grab a chair, not realising you meant for them to grab a chair and bring it over.

    Autistic people also have difficulties understanding sarcasm, puns, idioms and metaphors.

    • Sarcasm - saying the opposite of what's true to make someone look or feel foolish. For example, when someone asks if you need help when you're clearly struggling, and you answer, 'no thanks, I'm really enjoying the challenge'.
    • Puns - are a joke using different possible meanings of a word, or words, that sound alike but have different meanings. For example, 'I was struggling to figure out how lightning works, but then it struck me'.
    • Idioms - are words or phrases that aren't meant to be taken literally. For example, when someone says they have 'cold feet', it means that they're nervous and not that their feet are actually cold.
    • Metaphors - describes an object or action in a way that isn’t literally true, but helps explain an idea or make a comparison. For example, they might ask, 'are there actually any sheep, black or otherwise, in your family'?
      •  

    Autistic people tend to struggle using their non-verbal behaviours when socialising. This means that they may struggle to make eye contact when listening or talking to you, as well as not nodding to show you that they're listening and/or interested during your conversation.

    In addition, understanding subtle body language gestures can be challenging. For example, the more obvious actions, like when someone puts their pointer finger on their mouth is understood to mean to 'be quiet, but the more subtle ones, like the thousands of gestures we use when interacting with our friends in conversations, are not easily understood or understood.

    Autistic people also struggle with understanding facial expressions and the tone of voice. This includes understanding others as well as misusing their own.

    • Facial Expressions are difficult for Autistics to make sense of. For example, they know; happy, sad, angry and surprised, but the others we use, like jealous, hurt, offended and frustrated, and the thousands of others, need to be learned.
    • The tone of voice refers to the sound(s) or ways we change our voice when talking that helps us make our point. For example, we use a 'level' or 'mono' tone of voice when being sarcastic as this helps deliver the message. If we sounded excited when being sarcastic, the intention would be lost. There are so many ways that we can use our tone of voice when talking - in our requests, instructions, when joking, or when being sarcastic, which can be really confusing and something your friend needs to remember the next time they hear this tone (put together with the person's facial expression and/or body language.)
    •  

    The difficulties with understanding facial expressions and tone of voice also impact the way the person may communicate and/or respond to you, as they may confuse their gestures (or body language) and their tone of voice. This may result in them something out of context, repeating an expression that doesn't make sense or using a facial expression that may not match what they're saying. Autistic people over time teach themselves or learn 'social sequences' or a kind of 'social performance', so it's likely to be used all the time, without them understanding that they need to adjust their manner for different social situations and settings.

    Social Communication Challenges Explained

    It would be like an actor getting up on stage and performing lines and actions from a Shakespear play (that they used to perform in) when they're meant to be performing in Harry Potter.

    Just because they've acted before, doesn't mean they can always use the same script or performance as it won't be appropriate and will look odd.

    Not only is the actor performing the wrong thing, but they also can't tell from the facial expressions of the audience members that they're making a mistake.

    Source: @autism_sketches, Autism & Scripting

    Wearing face masks

    You may have experienced this social communication difficulty in recent times also interacting with others wearing face masks. You've found it difficult, and even confusing at times, not seeing areas of the person's face that makes the most expressions and they can't see yours which impacts the non-verbal messages you're wanting to express to each other.

    Mask wearing makes socialising SO much harder for your friend as it combines mask-wearing to their known challenges as well as forcing your friend to look into people's eyes which can be really difficult (as mentioned above).

    Source: Teachers Pay Teachers 'Facial Expressions Flash Cards - With Masks - COVID'.

    Source: Humintell, 'Face Masks Reduce Emotion Recognition Accuracy',

    Source: New York Times, 'Silver Lining to the Mask? Not Having to Smile'.
    By Jessica Bennett

    Restricted, repetitive patterns of behaviour, interests or activities

    The following routines/schedules and patterns for both verbal or non-verbal behaviour.

    • Verbal refers to repeating the same words, phrases or even sounds over and over again (called 'echolalia').
    • Non-verbal refers to needing predictability (knowing what's going to happen in the near future) and also insisting on doing the same things over and over and exactly the same way each time. Autistic people have daily routines, schedules and rituals that make them feel comfortable and in control as well as insisting on following the rules (and letting you know when you've broken them).

    Autistic people tend to feel more anxious than Neurotypicals, including feeling overwhelmed, worried, confused, or a combination of these emotions. A way of helping themselves stay calm is liking to know what's happening and having things as predictable as possible. This helps them feel in control and able to deal with the things that are more challenging.

    • 'Unexpected changes' to plans, or when things don't happen the same way as they previously did can be really distressing and difficult to cope with and also might result in a meltdown or shutdown and not be able to participate in events, class, or celebrations etc.
    • Repetitive behaviours also refer to certain movements or noises that your friend may do to keep themselves calm. This is called 'stimming' or self-soothing/self-stimulating behaviours. An example of stimming that your friend may do, and something we all do really, to keep ourselves calm or relaxed is play with fidget toys, twirl our hair, swing our legs under a desk or table or stretch our shoulders when feeling pressured or stressed.
    • We all stim, but sometimes Autistic stims are more obvious, might be practised more often or done in settings that might seem inappropriate like clicking their knuckles during a 'minutes silence'.​​
    •  
    •  

    This refers to hobbies and/or actions that may look and/or sound obsessive or intense to others but is also how an Autistic person keeps themselves calm.

    These are usually subjects or topics that are called  'special interests' or hobbies and have also been called obsessions when the person is completely absorbed in their special interest and might talk incessantly about them. It also wouldn't be unusual for them not to be interested in anything other than their favourite topics, even if everyone else is.

    Restricted and Repetitive Behaviour Explained

    When your friend shares their interests with you over and over again, it might be really annoying.

    Try to remind yourself that it's the way your friend or peer is trying to connect with you.

    Links

    Autistic Strengths and Interests Profile
    Books explaining Neurological Differences
    Download your Autism Assessment Guide

    Person First Langauge...
    because neurology is not an accessory

    When 'person with Autism' is used, it implies that Autism is a mental disorder, as the DSM-5's ASD diagnostic criteria suggest. The distinction when using, 'Autistic person' or 'an Autistic' allows for Autism to not be associated with a mental disorder, condition, disability or some other potentially harmful descriptor.

    This terminology has resulted in those who have accepted or embraced their diagnosis to feel validated and accepted for who they are and also entitles those Autistics who are striving for self-acceptance to feel supported in their efforts.

    Source: @autism_sketches

    Source: @autisticalityau

    The Autism Spectrum

    The way that the Autism Spectrum Disorder is portrayed is as a line (literally, a spectrum) that goes from 'less Autistic', to 'really Autistic'. (There are also those that describe Autistic people as either 'high-functioning', or being a 'high-functioning' Autistic, which assumes that the person is at the 'less Autistic' end of the spectrum. This is both wrong and insulting and there's more on this below.

    Recently, the 'Spectrum' has been modified after the Autistic community expressed their concern over how misleading this linear association is and has been revised to be more like a gradient or colour wheel that now identifies the areas of strengths, challenges and traits associated with Autism, including social communication and executive functioning skills, and language and sensory challenges/differences.

    Source: @autism_sketches

    Source: I CAN Network, Lucy Wallace, Autism, The Spectrum'

    An Autistic person might be able to plot or mark the colour wheel to illustrate their areas of difficulties or challenges, as well as strengths. However, it's important to keep in mind that these dots can move up or down each area of the colour scale every day - or even several times a day - depending on how affected or impacted the person is at any given time. For example, their sensory sensitivities are usually less impacted at home as they tend to have more control in their own environment.

    The Autism Spectrum starts at Autism, not at neurotypical

    Saying 'everyone's a little bit on the Spectrum' is not only incorrect and inaccurate, it's also really offensive to those that are Autistic i.e. those literally 'on the Spectrum'.

    Source: The Little Black Duck, 'Autism Myth'

    High-functioning Autism... It's literally not!

    Functioning labels were originally developed so that Governments could assign a 'level' of funding, or financial assistance, based on an  Autistic person's level of intelligence (IQ) and the degree to which a person's Autism impaired or disabled them. In addition, these 'labels' were used by professionals to describe which end of the 'Spectrum' a particular Autistic person was at to ensure it matched the level of funds and support they would receive from the Government.

    The issue with these functioning labels is that it assumes that there's an easier and harder level of Autism, and it groups Autistic people into certain categories based on whatever people think they need support in.

    With the 'spectrum' understood not being a straight line (or linear), the idea that one 'level' or one 'label' could be applied to describe lots of Autistic people, all of their Autistic traits/characteristics as well as the level, or degree, that they're impacted by their traits is both wrong and outdated.

    The other issue with using functioning labels in relation to Autism is that it implies that a 'high-functioning' Autistic struggles less with communication, social interactions, sensory overload or restrictive or repetitive behaviours. All this does is describe a person's ability to mask their Autistic behaviours and challenges and we know how emotionally damaging this can be.

    Source: @myautisticsoul, 'Functioning labels do not exist in the Autistic identity'

    See more infographics the negativity around Autistic functioning labels, here.

    The term 'high functioning' dismisses the daily struggles and efforts that Autistic people put into the smallest things and calling others 'low-functioning' is shaming those who have decided, or chosen, not to mask their struggles.

    Six Myths about Neurodivergent Children

    By AUsome Training

    Neurodivergent children need to be taught social skills

    This is simply not true and current research supports this. Neurodivergent children have their own very effective ways of communicating but unfortunately are often misunderstood.

    Neurodivergent children need to be taught how to interact with their peers

    Also false! Neurodivergent kids are often othered and excluded by their peers and adults. This in itself shows that the issues do not lie solely with Neurodivergent children. You cannot make friends if nobody wants to be your friend or if other people do not understand you. Interacting, communicating and building relationships are all two-ways tasks and so everyone has a part to play in making these tasks a success.

    Neurodivergent children lack empathy

    There is no evidence whatsoever to support this. In many cases, the opposite is true with Neurodivergent children experiencing hyper-empathy. There may be subtle differences in the ways Neurodivergent children express their empathy and this needs to be understood.

    Neurodivergent kids are not as competent as their peers

    This idea needs to be deleted from society. In order to meet Neurodivergent children with understanding then we must presume competence. This means that we presume Neurodivergent children are just as competent as their peers. This means that we allow for differences in communication styles, adapt our communication but mainly speak to Neurodivergent in the same way we do to their peers. We never make assumptions like “they wouldn’t understand”.

    Neurodivergent children have difficulty learning

    Everyone can learn but they need to be taught in ways that are compatible with their Neurotype. In fact, many Neurodivergent kids are excellent autodidactic learners. This means that they can teach themselves when given the opportunity to follow their interests.

    Neurodivergent children need to be taught how to behave

    Neurodivergent children know how to behave but often they experience such high levels of anxiety, stress and/ or trauma that people who are not informed about such things misinterpret their behaviour.

    Autistic Myths and Misconceptions

    All incorrect stereotypes, assumptions and conclusions - that being Autistic means that you lack empathy, that 'you're not affectionate', that 'you don't look at people when you're talking to them, so clearly you're not interested in engaging socially', that 'you're ok having no friends', that 'you must have an intellectual disability or that 'you don't feel any emotion - can all lead to some very harmful consequences and certainly doesn't respect the lived experience of Autistic people.

    Autistic People Avoid Eye Contact

    Autistic people have explained that their lack of eye contact is due to often lacking the usual social motivation that leads other children to make eye contact, they find it difficult to focus both on spoken language and on another person's eyes at the same time (I'm the same with my ADHD), they may not understand that watching another person's eyes is more revealing than, for example, watching that person's mouth or hands and/or eye contact might be a very intense and overwhelming sensory experience and therefore avoided.

    So, yes, there are Autistic people who don’t give eye contact but many do or it just might be less often or different from non-Autistic children.

    Source: @hikiapp, 'We don't need eye contact'....

    Not all Autistic people avoid eye contact, although sadly many professionals, as well as the general public, believe this one to be true. Autistic girls/women and high masking boys who get dismissed automatically by professionals because 'they looked at me when I spoke to them'.

    So, yes, there are Autistic people who don’t give eye contact but many do or it just might be less often or different from non-Autistic children.

    Source: @Autism_Sketches, 'Autism & Eye Contact'. 'Poll Results'

    Autistic People Lack Empathy

    An important aspect of social relatedness is the ability to empathise with the feelings of others. Empathy involves two major components: a cognitive component (e.g. theory of mind, perspective-taking or mindreading) and an affective component (emotional processing) which allows us to share the feelings of others. The affective component of sympathy involves having an appropriate emotional reaction to another person’s thoughts and feelings and when engaged in affective empathy, we vicariously experience the emotional states of others, understanding that our feelings are not ours but rather those of the other individual.

    Autistic people DO NOT lack empathy. They find interpreting facial expressions, body language and tone of voice in others challenging and therefore can't see another person's distress, anger, sadness, frustration, grief or fear (and might be equally unaware of what they are communicating with theirs.

    This means, that for them to respond appropriately they need to be taught how to recognise what these emotions 'looks' like in the first place as well as knowing when and how to approach, console as well as know what to say/do and how to say/do it that shows the correct amount of empathy that matches the issue/problem, etc.

    The fact is so many Autistic people are in fact empaths and just because they're limited to understanding or expressing appropriate facial expressions to match the situation, does not mean they have limited feelings. Often they can feel too much, (also known as 'hyper-empathetic').

    Processing these powerful feelings can be really difficult and might often result in the person shutting or melting down over something that’s perfectly valid to them, yet a complete mystery to those around them.

    Source: @theinformedSLP, 'How and why to be a neurodiversity-friendly SLP'

    Source: @theautcast, 'Empathy'

    Autistic Symbols

    It's really important to know which symbols to use when supporting your Autistic children and/or friends in your life.

    In conclusion, the puzzle piece is better left in the box it came in than any association with Autism.

    Source: Autistic Truth, 'Symbols'

    Source: @yennpurkis5

    Autism Support

    Source: Kate, Girls Autistic Journey, Illustrated by @introvertdoodles, 'Autism Allyship'

    Source: @autieselfcare, '9 ways to support an Autistic person'

    Source: @autieselfcare, 'Things Autistic People Would Like You To Know'.

    Your Literally Ausome
    Friendship Guide

    A Guide to Understanding and Supporting
    your Autistic Friend.

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