What is Autism?​

Autism Spectrum Disorder is a developmental disorder where individuals may experience differences in social communication, sensory sensitivities and repetitive patterns of behaviour. Individuals with Autism may have a unique way of interacting with others and the world around them.

 

This may mean that an individual has trouble communicating and understanding what others may think and feel, heightened sensitivity to sensory stimuli and preference for routines and ritualised behaviour.

 

DSM-5 criteria for Autism Spectrum Disorder;

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A. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by all of the following, currently or by history:

1. Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.

2. Deficits in nonverbal communicative behaviours used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.

3. Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behaviour to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.

 

B. Restricted, repetitive patterns of behaviour, interests, or activities, as manifested by at least two of the following, currently or by history;

1. Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypies, lining up toys or flipping objects, echolalia, idiosyncratic phrases).

2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behaviour (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day).

3. Highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).

4. Hyper- or hypo reactivity to sensory input or unusual interest in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).

 

C. Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life).

 

D. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.

 

E. These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level.

 

Based on the symptoms varying levels of severity can occur.

• Level 1 “Requiring support” - Without supports in place, deficits cause noticeable impairments in social communication and functioning.

• Level 2 “Requiring substantial support” - Marked deficits in verbal and nonverbal social communication and inflexible behaviour.

• Level 3 "Requiring very substantial support”- Severe impairments in social communication and functioning.

 

Why is it difficult to diagnose Autism in girls/women? 

(why is there a gap between diagnosis of girls in ASD? Does ASD present differently in girls? What have we learned about girls with Autism(what do they experience?), How can we support them?

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Autism may be more difficult to diagnose in girls or women as they may not present with repetitive behaviour or may control their behaviour more in public than boys or men. Due to some stereotypes traits of what Autism can look like it may be difficult for girls to receive a diagnosis.

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Autism characteristics in girls can look different compared to boys and they may be more likely to mask autistic traits and present with less social difficulties. Girls may have learned to smile or make eye contact from a younger age which can present as a more subtle form of Autism that may not be recognised immediately.

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How does Autism present in girls?

The characteristics of repetitive behaviour or focused interests may present differently in girls as they may engage in interests similar to non-autistic girls and they increased intensity of the behaviour may go unnoticed.

Some common characteristics of girls with Autism include; a special interest in art, music and animals, difficulty in cooperative play with peers, mimicking others in social situations, not expressing emotions at school but expressing difficulty in emotion regulation or meltdowns at home and sensory sensitivities.

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Common Myth Busters on Autism

Myth – Autism is a childhood condition.

Fact – Autism is a neurodevelopmental condition that is lifelong. If individuals are able to access appropriate supports it can greatly benefit managing emotional or social difficulties.

 

Myth – Autism is a disease.

Fact – Autism is not a disease that needs to be cured with medication. Individual’s with Autism experience impairment in communication and social skills that may impact that overall wellbeing.

 

Myth – Individuals with Autism don’t feel emotion.

Fact – Individuals with Autism may struggle with interpreting their own or others emotions or expressions but are capable of feeling emotions.

 

Myth – Individuals with Autism have an intellectual disability.

Fact – It is possible that some individuals with Autism may also have an intellectual disability but this is not the case for everyone. Individuals with Autism vary widely on skills in cognitive ability and social communication.  

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Why is Assessment and Diagnosis Important? 

(Differentials, mental health, Support from school/coaches, family/friends)

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Comprehensive Autism Spectrum Disorder assessment and diagnosis is important to understand difficulties in communication or repetitive behaviour. Assessment and diagnosis can help children, and their families build understanding and learn effective support strategies. Assessment and diagnosis can also provide access to funding, accommodations and provisions in educational and occupational settings. 

 

A comprehensive assessment gathering information from multiple raters such as parents and teachers across different settings is important in understanding where individuals may be experiencing difficulties and the appropriate supports that can be provided in these areas. Even if a diagnosis is not provided, undergoing a comprehensive assessment process can be beneficial in understanding and strengths and difficulties individuals may be experiencing in different areas of their life.