I am so confused! What actually IS autism?
2nd September 2020
I get asked this question all the time. And it is a perfectly good question. But actually, Autism is just not something that can be defined easily.
Autism is an ‘Umbrella Term’
Autism is an umbrella term for a whole range of different underlying difficulties, unified by a set of common symptoms. The symptoms mainly include:
A. Difficulties with social interaction
B. Difficulties with non-verbal communication (e.g. understanding facial expressions), and
C. Difficulties making and maintaining friendships with other people.
Along with the above symptoms, to be diagnosed with autism, you have to have some other difficulties that fall under the umbrella of ‘Restricted and Repetitive Interests and Behaviour’. These include:
D. Sensory issues
E. Difficulties with change and rigid thinking
F. Stereotypical behaviours such as hand flapping or rocking, and
G. Very strong interests which exclude other activities.\
If the difficulties of D, E, F, G are sufficiently severe then the main symptoms (A, B and C) will be met.
The difficulties that underpin autism relate to something that has ‘gone wrong’ with the development of the brain. We have to use the term ‘gone wrong’ with caution. Many autism activists claim that there is nothing wrong with them and that they are just different.
In many cases they are right. Some autistic people enjoy how they experience the world and how their brain works and find the lack of acceptance in society a problem. However, other autistic people are frustrated by their autism and to them it is a problem. To others autism is severely disabling. Although, just to make it more complicated, sometimes as well as their difficulties many autistic people recognise they also have ‘differences’ that are useful.
Confused? Well you are not alone.
Everyone who works or knows people with autism recognises that each person’s autism is different. But when it comes to researching autism, there is a strange and totally mistaken assumption that Autism is a SINGLE condition with a SINGLE underlying cause.
This means that there is a belief that the label ‘autism’ fits into the notion that autism simply ranges from mild autism to severe autism.
Coincidentally, there are several competing theories as to the causes of autism. Briefly:
Sensory issues which significantly affect how somebody relates to the world. This includes senses that are too sensitive or not sensitive enough. So for example, one person might not be able to stand background noise, while another person needs it. Or someone might not be able to separate out a conversation from background noise. Some autistic people have quite unusual sensory experiences such as experiencing a sequence of numbers as a colourful landscape or experiencing the world as no more than patterns of colour and shape!
Weak central coherence. This refers to an inability to see the bigger picture, to understand things in different contexts, or to put visual information together effectively.
Executive functioning. An umbrella term for the brain’s ability to effectively master skills such as organisation, problem solving, planning and execution and inhibition. This features in Dyspraxia and ADHD too.
Theory of mind, which is the notion that autistic people simply lack empathy and that the reason they do not fit in is because they lack to ability to metaphorically ‘step into somebody else shoes.’
Monotropism. This is a fancy word for the ability to focus intensely on one thing at a time, and the inability to take in anything outside of this! Think Rain Man.
Processing issues. For example, when a person’s brain only processes information very slowly (meaning you can tell them a joke and it will take until the next day for them to understand the joke and laugh), or when someone is asked to buy milk, eggs and bread, that they get so caught up on associations with milk (milk->cows->fields->pleasant walks in the countryside ->their last holiday) that they don’t register the rest of the list at all!
With the exception of Theory of Mind - which is probably best labelled as a symptom rather than a cause – it is correct that all the above are valid explanations of somebody’s autism, but also all are not!
Correct, because each describes the underlying causes of autism for some autistic people.
Incorrect, because none describe the underlying cause of autism for all autistic people.
Many autistic people have a combination of several of these difficulties, and some have just one or two!
The aim of this post was to outline how far from a homogeneous condition autism is, and to make the point that when we say ‘autism’, we are referring to a vast array of different underlying difficulties which all fall under the label of ‘autism’. The thing that unites them are the symptoms described at the top of this blog, which form the diagnostic criteria!
At Aspiedent we work out which underlying difficulties cause an individual’s autistic symptoms. We cut through the confusion to describe each individual’s autism and make specific recommendations that are specifically tailored to their autism.