As more attention is paid to autism, neurodivergence, and related conditions, there comes an opportunity to clarify the confusion and misconceptions that still remain. In this two-part article, we’ll discuss terminology and definitions, and we’ll talk about facts and misconceptions.
What is autism?
According to the Centers for Disease Control and Prevention (CDC), autism (more properly known as “autism spectrum disorder” or ASD) is a developmental condition. An estimated 5,437,988 adults in the United States live with ASD. That’s about 21 percent of the population, so it is far from an obscure or rare condition. In 2016, the CDC reported that as many as 1 in 54 children over the age of 8 have ASD, with boys 4 to 5 times more likely than girls to have the condition.
Autism spectrum disorder usually presents itself before the age of 3 and may be detectable at 18 months of age. Symptoms usually continue into adulthood but may lessen over time and with treatment. Diagnosing ASD can be difficult because there are no pathological tests (e.g., there is no blood test). Instead, doctors specializing in the condition evaluate behavior and development to make diagnoses. Because symptoms can be complex and subtle, many patients do not receive a final or definitive diagnosis until later in life. Some people are not diagnosed with ASD until they are adolescents or adults. The delay is not necessarily problematic, but it can be.
Autism as a term and a disorder was first conceived in 1911 by the German psychiatrist Eugen Bleuler, who was looking for a way to describe a particular symptom of schizophrenia (a condition he also first described), which he called “autistic thinking.” Bleuler argued that this symptom was characterized by the patient’s avoidance of reality and replacing it with their own reality. The characterization and conception of autism has obviously evolved a lot since then, and it is still evolving.
What are the symptoms and signs of ASD?
The CDC says that those who live with ASD may behave, communicate, and learn in ways that are different from others, but the condition affects each person differently. For example, when it comes to everyday conversation, some people with ASD may not be affected at all, while others with ASD may be completely non-verbal. The CDC points out that some people with ASD require help in their day-to-day lives, while others require none.
One group of symptoms associated with ASD is delayed or impaired intellectual, cognitive, and language development. This may include the following:
-Delayed language skills
-Delayed movement skills
-Delayed cognitive or learning skills
-Hyperactive, impulsive, and/or inattentive behavior
-Epilepsy or seizure disorder
-Unusual eating and sleeping habits
-Gastrointestinal issues (e.g., constipation)
-Unusual mood or emotional reactions
-Anxiety, stress, or excessive worry
-Lack of fear or more fear than expected
However, it is an unfortunate misconception that all people with ASD have cognitive or intellectual problems. About 50 percent of people who have ASD do not experience such symptoms.
The CDC provides the following examples of the social communication and social interaction characteristics associated with ASD:
-Avoids or does not keep eye contact
-Does not respond to name by 9 months of age
-Does not show facial expressions like happy, sad, angry, and surprised by 9 months of age
-Does not play simple interactive games like pat-a-cake by 12 months of age
-Uses few or no gestures by 12 months of age (e.g., does not wave goodbye)
-Does not share interests by 15 months of age (e.g., an object that they like)
-Does not point to show you something interesting by 18 months of age
-Does not notice when others are hurt or upset by 24 months of age
-Does not notice other children and join them in play by 36 months of age
-Does not pretend to be something else, like a teacher or superhero, by 48 months of age
-Does not sing, dance, or act for you by 60 months of age
Further, the CDC provides the following behaviors and interests that may seem unusual to others. These are known as “restricted or repetitive behaviors or interests”:
-Lines up toys or other objects and gets upset when order is changed
-Repeats words or phrases over and over (called echolalia)
-Plays with toys the same way every time
-Is focused on parts of objects (for example, wheels)
-Gets upset by minor changes
-Has obsessive interests
-Must follow certain routines
-Flaps hands, rocks body, or spins self in circles
-Has unusual reactions to the way things sound, smell, taste, look, or feel
In the second part of this two-part article, we’ll continue to dispel myths about ASD, outline treatment options for those who live with ASD, and discuss more of the related terminology.