What Is Autism Spectrum Disorder?
Autism spectrum disorder (ASD) is a neurodevelopmental condition and form of neurodivergence. This condition or identity can cause differences in cognitive, social, and sensory functioning in individuals of all ages and is present from birth. Learning more about ASD and its many connections to identity can be a way to reduce stigmas, learn more about what it might mean to be Autistic, and find resources for support.
What is autism spectrum disorder (ASD)?
Autism spectrum disorder is a neurodevelopmental disorder and form of neurodivergence. Neurodevelopmental disorders are a classification of mental health conditions within the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), published by the American Psychiatric Association.
These disorders have symptoms and characteristics often evident during a child’s early development period, typically between zero and six. Other neurodevelopmental disorders include fragile X syndrome, attention-deficit hyperactivity disorder (ADHD), and forms of intellectual and developmental disability caused potentially by a mixture of environmental and genetic factors.
ASD is marked by two distinct indicators: what the DSM-V refers to as “persistent deficits in social communication and social interaction” and “restricted or repetitive behaviors, interests, or activities.” People with ASD may experience complications with interpersonal interactions and may find it difficult to navigate social relationships. They may also use repetitive movements to self-regulate, called self-stimulation or “stimming.” Some people may have specific focus and interest areas that could seem intense to people without ASD and may focus on a strict routine.
How is autism spectrum disorder diagnosed?
ASD is often diagnosed in early childhood, often during the preschool years, when difficulty with social relationship formation may become more apparent. Diagnosis in childhood usually involves child psychologists and specialists in developmental and behavioral pediatrics assessing a child’s behavior. The Centers for Disease Control and Prevention (CDC) states that a local early intervention system can significantly improve outcomes for children who are diagnosed with ASD, meaning the sooner a diagnosis is made, the more support is given to children with ASD.
However, some people may not receive a diagnosis until adulthood. ASD tends to be underdiagnosed in girls and women, potentially because girls and women tend to internalize ASD symptoms as opposed to displaying them externally, as many boys and men do.
Symptoms of autism spectrum disorder
Per the DSM-V, ASD symptoms can be classified according to the two distinct symptom indicators: difficulties with particular social communication and social interaction and restricted or repetitive behaviors, interests, or activities.
Socially-related symptoms per the DSM-V
Examples of difficulties with specific social communication and social interaction based on the DSM-V diagnostic criteria may include the following:
- Difficulty initiating or responding to social interactions
- Avoidance of or difficulty participating in back-and-forth discussion
- Disintegrated verbal and non-verbal communication (like smiling while expressing disgust)
- Low levels of eye contact
- Lack of interest in sharing emotions
- Difficulty making friends despite a desire to
- Atypical body language
- Difficulty adjusting behavior to different social contexts (may talk to peers the same way they speak to their teachers, etc.)
- Deficits in speech or language comprehension, ranging from being non-verbal to using single words only, to using phrase speech or echoed speech
- Using language exclusively to communicate needs as opposed to making observations or making “small talk”
- Difficulty understanding language nuances like sarcasm, irony, or lies
- Literal language interpretation
- Exhaustion and anxiety related to the strain of navigating social interactions
- Passivity (more common in women) or aggression (more common in men)
- Rejection or intentional disruption of social situations
Researchers have found that some Autistic individuals communicate as effectively with other Autistic individuals as neurotypical people communicate with each other, showing that social “deficits” may only be present for some people with ASD or in certain situations.
Repetitive or restricted behaviors per the DSM-V
Examples of restricted or repetitive behaviors, interests, or activities could include the following:
- Repetitive movements, speech, or use of objects (known as self-stimulatory or ”stimming” behaviors, such as hand flapping, rocking back and forth, or spinning in circles)
- Inflexibility
- Difficulties with life transitions like moving up a grade, moving out of one’s parents' house for college, etc.
- Fascination with lights, spinning objects like fans, or other visual stimuli
- Intense interests and a hyper-fixation on certain activities or topics
- A strong desire to adhere to personal routines
- Rigid thought patterns and resistance to conflict or challenges
- Hypersensitivity or hyposensitivity to certain stimuli
- Ritualized patterns of behavior, like a strong desire to walk around the perimeter of a room a certain number of times
- Distress at unexpected changes
- Indifference to temperature adjustments or pain
- Insistence on following fixed rules and difficulty comprehending why rules shouldn’t always apply (ex., a child playing “make-believe” who can’t understand why, in a fantasy world, a horse could fly)
- Echolalia (repeating words over and over)
Supporting people with ASD
Autism is a form of neurodiversity, meaning Autistic brains can operate in different ways than neurotypical brains. Autism cannot be outgrown and should not be “cured” or “treated.” However, some people with autism do not negatively view the condition, and it is not uncommon for Autistic people to take pride in their identity and to say they would not want a cure even if one were available.
It can be valuable for some people with ASD to receive support to navigate a world that is often built for neurotypical people. These support systems can vary due to individual requirements. Examples of support systems can include:
- An individualized education plan for an Autistic child attending school
- A separate work area for an employee with ASD who has sensory sensitivity and requires minimal noise
- Use of more literal and direct language in media and communications (as Autistic people may have difficulty understanding phrases like “take a seat,” “play it by ear,” etc.)
- Sensory-friendly rooms for Autistic individuals at airports, malls, and other busy and loud locations
- Flexible work schedules that take into consideration the unique minds of neurodivergent workers
Support options
Living with ASD or taking care of a child who has ASD can be complicated. It may be helpful to seek additional support from a therapist. However, traditional in-person therapy settings may not be the most accessible for people with autism. The social expectations and sensory stimuli that one may encounter in a therapist’s office or waiting room may dissuade an Autistic person from engaging with therapy altogether.
A helpful alternative could be online therapy through a platform like BetterHelp. With online therapy, clients don’t have to go in public to talk to their therapist, as they can access communication from home. Some online therapy providers may also provide different options for how to speak to your therapist, such as video, phone, or live chat.
Online therapy may be as effective as traditional in-person therapy at addressing mental health concerns, according to research. One study specifically examined the effect of an online therapy intervention on a group of people living with neurodevelopmental disorders, including ASD. The study found that online therapy helped improve outcomes for Autistic individuals. Online therapy could be a beneficial resource for learning how to navigate the world when you have ASD.
Takeaway
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