About Autism

Autism is a relatively common neurodevelopmental condition that represents a form of natural human variation, bringing both strengths and challenges. Autistic people present with a range of intellectual and communication abilities. It's important to get to know each individual, their passions, perspectives and ways of interacting with other people and the world. Autistic people often experience difficulties when their environment is not suited to their social communication style, need for predictability or sensory sensitivities. Neurotypical people (individuals without Autism) need to listen to and respect the lived experience of Autistic people, especially when they are advocating for the supports that work for them. Autistic individuals are not unwell or broken, and there is no need for a 'cure' for autism. We need to work together to reduce the stigma around Autism, and reject ideas of attempting to 'fix' or 'train' Autistic people to fit in with neurotypical society. Autistic people should not have to blend in or 'camouflage' in order to be accepted. Our society is all the richer for having Autistic individuals who are able to share their passions and innovative ideas with the world in their own way.

It's important to remember that Autistic people are likely to see things differently to neurotypical people because their brain is 'wired differently'. Autism is associated with a range of neurodevelopmental differences, and tends to run in families. There are different genetic variations that run in families, but they often seem to be related to similar processes of brain development. There is evidence that the differences in the neural 'pruning' process (the brain's usual process of getting rid of some brain cells to make way for faster communication between the remaining brain cells) in the areas of the brain associated with executive functioning (i.e. organising, decision-making, planning, understanding social context) and emotion processing (i.e. identifying emotions in self and others, noticing and interpreting tone of voice, facial expressions, gestures) begin during pregnancy. Visual processing is often a strength for Autistic people, and they may have an excellent chronological autobiographical memory (i.e. detailed recall of events or places they attended when they were quite young).

Autistic people may focus on different aspects of their environment and notice patterns or small changes that others do not. They may be very upset if their routine is interrupted or things don't go the way they were expecting. It's a good idea for neurotypical people to assume that Autistic people have a good reason for doing things the way they do. It's our job to take time to understand the Autistic person and look for ways to change our own behaviour or adjust the environment to better meet the Autistic person's needs, rather than focusing on encouraging the Autistic person to change their behaviour to fit in with us.  

Early signs of Autism include enjoying doing the same things over and over, less frequent eye contact, and making fewer attempts to share their interest or enjoyment with their parents. Autistic children may be very interested in exploring aspects of their environment, but tend to do this as a 'solo mission' and in their own way. Sometimes parents may worry that their child is deaf (i.e. the child may not respond when their name is called) but the child may also put their hands over their ears in response to some sounds (i.e. vacuum cleaner, hand dryer). Some parents may describe their child as "in a world of their own", less aware of the activities of people around them. Some children are very aware of small changes in their routine or environment, and find it hard to predict what will happen next. They may insist on particular routines to make their day more predictable, and need extra reassurance when something goes wrong. They may give affection on their own terms (i.e. preferring a tight squeeze rather than a kiss or a tickle). 

Older children may present as experts in their chosen area of interest, able to talk at length on their favourite topics, to re-enact particular scenes of interest from movies or YouTube, and to focus on specific details and statistics. They may be less interested or confident in following someone else's topic. They may prefer to interact with one person at a time, rather than joining a group conversation or team activity. Autistic children may feel more comfortable being around people older or younger, rather than their same-aged peers. They may seek out friendships with people who share their passions, as they have a shared knowledge base and specific language and examples to draw on in conversation. 

As social demands increase in high school, Autistic adolescents, especially girls, may study popular students to see what actions, fashion choices and jokes are deemed socially acceptable. They may copy others' behaviours without understanding why other people might do things a particular way. Autistic individuals often find it exhausting to attempt to camouflage with their peers. Adolescents may find it hard to get ready for school and need time alone to relax and recharge when they come home. It can be empowering for Autistic adolescents to understand the own strengths, to learn to manage their own supports and gain the confidence to self-advocate, and to connect with others in ways that are less emotionally draining.  

Autistic adults are often specialists in their area of interest, and have a wealth of knowledge to share. They have often developed routines to manage their day and avoid emotional or sensory overload. They may need some assistance to find further study options, employment and perhaps to connect with others through their interests if they choose to. Some common challenges involve navigating the 'tearoom' conversations at work and making small-talk at social events. They may struggle with balancing their need for sameness and routine with the needs of others in the family who prefer spontaneity and unplanned adventures. In romantic relationships, Autistic adults often have difficulty anticipating their partner's unspoken needs, and expressing their own needs. Neurotypical people often expect their Autistic partners to be aware of and conform to neurotypical cultural norms of expected behaviour in relationships (i.e. behaviours we may be familiar with from our family of origin, or from movies or social media). Couples often need to work together to find communication tools and ways to express intimacy and love that meet both their needs. 

It can be helpful to identify if Autism fits for a child, adolescent or adult in explaining their social communication style, need for sameness and routine, and tendency towards repetitive movement, intense interests, and sensory sensitivities. This opens the door to tailoring strategies to each Autistic individual's needs and preferences, and to continue to develop strategies as they come across new challenges over time. Autistic individuals tend to cope better when those around them can glimpse the world from an autistic perspective, and can plan ahead to avoid potential pitfalls.

In our everyday language, we talk about Autism, Autistic people, Autistic individuals, Autistic students, Autistic women etc. This is identity-first language, which recognises that Autism is an important part of the person's identity, something to celebrate and be proud of. Identity-first language replaces person-first language (i.e. person with Autism, student with Autism), which was intended to remind everyone that autism is just a part of the individual, and doesn't describe all that they are. Person-first language was a reaction to the outdated and offensive medical terminology in which people were referred to as a diagnosis (i.e. "there's a broken leg in bed 3", "autistic", "epileptic", "asthmatic"). In using Identity-first language, Autistic people are reclaiming the word Autistic with a capital A, to destigmatise Autism and recognise the lived experiences of Autistic people. Using Identity-first language centres Autism as integral to each Autistic individual's perspective and ways of interacting with the world. 

In diagnostic reports, it's necessary to use the technical language required by funding bodies such as the National Disability Insurance Scheme (NDIS), and to address the eligibility criteria for school support classes, employment support programs etc. Therefore in psychological reports, we will explain why an individual meets the DSM-5 diagnostic criteria for Autism Spectrum Disorder (ASD). In diagnostic reports, it is often necessary to include a Level, ranging from Level 1 "requires support", through Level 2 "requires substantial support", to Level 3 "requires very substantial support". Funding bodies often use these terms to ensure that the most funding is provided to those with the highest level of support requirements. While the diagnosis of Autism Spectrum Disorder remains stable over their lifetime, their level of support required can change over time, depending on their social network and supports already available in their home, school, work and community. Some individuals may be able to access additional supports if they also meet diagnostic criteria for an intellectual disability. 

Remember that unless you are applying for funding, it's most useful to refer to Autism rather than Autism Spectrum Disorder (ASD). When referring to the DSM-5 diagnostic criteria, the diagnostic term Autism Spectrum Disorder replaces older terms including Autistic Disorder (also known as Classic Autism, Childhood Autism, Kanner's Autism), Asperger's Disorder (also known as high-functioning Autism), and Pervasive Disorder Not Otherwise Specified (PDD-NOS, also known as Atypical Autism). Terms including "high-functioning" or "low functioning" are no longer used, as they can over-simplify the range of strengths and challenges for each individual. For example, someone who is highly articulate can have difficulty gauging how much to talk in an interaction, when the other person is bored or tired, and when it's time to switch topics. We don't need to burn the older books about Asperger's, but as we move forward, resources will refer to Autism and the Autistic community when describing the full range of strengths and abilities Autistic people possess, and the supports that Autistic people find most useful.