Autism Spectrum Condition
Autism is a spectrum, and as such it includes a wide range of individuals. For some individuals autism is also accompanied by a learning disability, but others have average or above average intellectual ability. People with autism include those who need a great deal of support: those who can live independently by managing their lives within the parameters of their own needs. Indeed some people in this latter group may remain unknown to supporters or service providers unless a breakdown occurs in their own managing strategies.The characteristics of autism vary from one person to another but are generally divided into three main groups:
Some people with autism may not speak, or have fairly limited speech. Many individuals with autism limited by their speech are able to use alternative means of communication, such as sign language, visual symbols or technological aids. Others will have good language skills, but they may still find elements of communication hard to understand; such as the give-and-take nature of conversations, they may be repeating what another person has just said (this is known as Echolalia) or talking at length about their own interests. People with autism have difficulties with both verbal and non-verbal language.
“For people with autistic spectrum conditions, ‘body language’ can appear just as foreign as if people were speaking ancient Greek.”
Many have a very literal understanding of language, and think people always mean exactly what they say. They can find it difficult to use or understand: facial expressions or tone of voice, jokes and sarcasm, common phrases and sayings; an example might be the phrase ‘It’s cool’, which people often say when they think that something is good, but strictly speaking, means that it’s a bit cold. It helps if other people speak in a clear, consistent way and give people with autism time to process what has been said to them.
People with autism often have difficulty recognising or understanding other people’s emotions and feelings, and expressing their own, which can make it more difficult for them to fit in socially. They may not understand the unwritten social rules which most of us pick up without thinking. They may stand too close to another person for example, or start an inappropriate subject of conversation. Individuals may appear to be insensitive because they have not recognised how someone else is feeling. Sometimes they appear to behave ‘strangely’ or inappropriately, as it is not always easy for them to express feelings, emotions or needs.
They often prefer to spend time alone rather than seeking out the company of other people, they may not seek comfort from other people. Others may be over familiar, insist on friendship and become obsessed with other individuals. Difficulties with social interaction can mean that people with autism find it hard to form friendships: some may want to interact with other people and make friends, but may be unsure how to go about this “Socialising doesn’t come naturally – we have to learn it.”
Social imagination allows us to understand and predict other people’s behaviour, make sense of abstract ideas, and to imagine situations outside our immediate daily routine.
“We have trouble working out what other people know. We have more difficulty guessing what other people are thinking”.
Difficulties with social imagination mean that people with autism find it hard to understand and interpret other people’s thoughts, feelings and actions, predict what will happen next, or what could happen next. They may have little understanding of the concept of danger, for example that running on to a busy road poses a threat to them.
Children with autism may have limited imaginative play, some engagement in play activities but prefer to act out the same scenes each time prepare for change and plan for the future cope in new or unfamiliar situations. Difficulties with social imagination should not be confused with a lack of imagination. Many people with autism are very creative and may be, for example, accomplished artists, musicians or writers.
Other Related Characteristics Of Autism
Love Of Routines
The world can seem a very unpredictable and confusing place to people with autism, who often prefer to have a fixed daily routine so that they know what is going to happen every day. This routine can extend to always wanting to travel the same way to and from school or work, or eat exactly the same food for breakfast. Rules can also be important to an individual with autism; it may be difficult for a person with autism to take a different approach to something once they have been taught the ‘right’ way to do it. People with autism may not be comfortable with the idea of change, but can cope well if they are prepared for it in advance.
People with autism may experience some form of sensory sensitivity. This can occur in one or more of the five senses – sight, sound, smell, touch and taste. A person’s senses are either intensified (hypersensitive), under-sensitive (hypo-sensitive) or both. For example, a person with autism may find certain background sounds, which other people ignore or block out, unbearably loud or distracting. This can cause anxiety or even physical pain. People who are hypo-sensitive may not feel pain or extremes of temperature. Some may rock, spin or flap their hands to stimulate sensation, to help with balance and posture or to deal with stress. People with sensory sensitivity may also find it harder to use their body awareness system. This system tells us where our bodies are, so for those with reduced body awareness, it can be harder to navigate rooms avoiding obstructions, stand at an appropriate distance from other people and carry out ‘fine motor’ tasks such as tying shoelaces.
Many people with autism have intense special interests, often from a fairly young age. These can change over time or be life-long, and can be anything from art or music, to trains or computers. Some people with autism may eventually be able to work or study in related areas. For others, it will remain a hobby. A special interest may sometimes be unusual. One person with autism loved collecting rubbish, for example; with encouragement, this was channelled into an interest in recycling and the environment.
People with autism may have learning disabilities, which can affect all aspects of someone’s life, from studying in school, to learning how to wash themselves or make a meal. As with autism, people can have different ‘degrees’ of learning disability, so some will be able to live fairly independently – although they may need a degree of support to achieve this – while others may require lifelong, specialist support. However, all people with autism can, and do, learn and develop with the right sort of support.
Other Conditions Sometimes Associated With Autism
What Is Asperger's Syndrome?
Asperger’s Syndrome is sometimes referred to as high functioning autism or mild autism. While this is understandable it can be misleading as it does not present a true picture of the diagnosis, nor the particular support needs that an individual may have. It is however now agreed that people with this syndrome are part of the autism spectrum.
Individuals with Asperger’s Syndrome are usually better able to communicate than those with classic autism, by virtue of their language abilities, but still experience some difficulties with social communication and social interactions. People with Asperger’s Syndrome frequently show a deep interest in a particular subject or hobby, and many have extensive knowledge about it. These interests will often form their preferred topic of conversation, but unless prompted they may be unaware of a need to consider the listener’s level of interest, or to give the listeners a turn to speak.
Where a person with Asperger’s Syndrome has an average or above-average intellectual ability, this clear focus of attention can lead to high levels of achievement. Memory, logic and mathematical skills are common, but success can be impeded by an apparent contradictory need for continuing support in social interactions or situation requiring people working together. It can be difficult to recognise and understand a need for social support in individuals who are otherwise high achievers. With the right support and encouragement, people with Asperger’s syndrome can lead full and independent lives.
What Are The Characteristics of Asperger's Syndrome?
The characteristics of Asperger’s syndrome vary from one person to another but are generally divided into three main groups:
Difficulty With Social Communication
“If you have Asperger’s syndrome, understanding conversation is like trying to understand a foreign language.”
People with Asperger’s syndrome sometimes find it difficult to express themselves emotionally and socially. For example, they may:
- have difficulty understanding gestures, facial expressions or tone of voice
- have difficulty knowing when to start or end a conversation and choosing topics to talk about
- use complex words and phrases but may not fully understand what they mean
- be very literal in what they say and can have difficulty understanding jokes, metaphor and sarcasm. For example, a person with Asperger’s syndrome may be confused by the phrase ‘That’s cool’ when people use it to say something is good.
In order to help a person with Asperger’s syndrome understand you, keep your sentences short – be clear and concise.
Difficulty With Social Interaction
“I have difficulty picking up social cues, and difficulty in knowing what to do when I get things wrong.”
Many people with Asperger’s syndrome want to be sociable but have difficulty with initiating and sustaining social relationships, which can make them very anxious. People with the condition may:
- struggle to make and maintain friendships
- not understand the unwritten ‘social rules’ that most of us pick up without thinking. For example, they may stand too close to another person, or start an inappropriate topic of conversation
- find other people unpredictable and confusing
- become withdrawn and seem uninterested in other people, appearing almost aloof
- behave in what may seem an inappropriate manner.
Difficulty With Social Imagination
“We have trouble working out what other people know. We have more difficulty guessing what other people are thinking.”
People with Asperger’s syndrome can be imaginative in the conventional use of the word. For example, many are accomplished writers, artists and musicians. But people with Asperger’s syndrome can have difficulty with social imagination. This can include:
- imagining alternative outcomes to situations and finding it hard to predict what will happen next
- understanding or interpreting other peoples thoughts, feelings or actions. The subtle messages that are put across by facial expression and body language are often missed
- having a limited range of imaginative activities, which can be pursued rigidly and repetitively eg lining up toys or collecting and organising things related to his or her interest.
Some children with Asperger’s syndrome may find it difficult to play ‘let’s pretend’ games or prefer subjects rooted in logic and systems, such as mathematics.
Other Related Characteristics of Asperger's Syndrome
Love of Routines
“If I get anxious I get in a tizz. I have a timetable; it helps me to see what I have to do next, otherwise I get confused.”
To try and make the world less confusing, people with Asperger’s syndrome may have rules and rituals (ways of doing things) which they insist upon. Young children, for example, may insist on always walking the same way to school. In class, they may get upset if there is a sudden change to the timetable. People with Asperger’s syndrome often prefer to order their day to a set pattern. For example, if they work set hours, an unexpected delay to their journey to or from work can make them anxious or upset.
“I remember Samuel reciting the distances of all the planets from the sun to a baffled classmate in the playground when he was five. Since then he has had many obsessions, which he loves to talk about at length!”
People with Asperger’s syndrome may develop an intense, sometimes obsessive, interest in a hobby or collecting. Sometimes these interests are lifelong; in other cases, one interest is replaced by an unconnected interest. For example, a person with Asperger’s syndrome may focus on learning all there is to know about trains or computers. Some are exceptionally knowledgeable in their chosen field of interest. With encouragement, interests and skills can be developed so that people with Asperger’s syndrome can study or work in their favourite subjects.
“Robert only has problems with touch when he doesn’t know what’s coming – like jostling in queues and people accidentally brushing into him. Light touch seems to be worse for him than a firm touch.”
People with Asperger’s syndrome may have sensory difficulties. These can occur in one or all of the senses (sight, sound, smell, touch, or taste). The degree of difficulty varies from one individual to another. Most commonly, an individual’s senses are either intensified (over-sensitive) or underdeveloped (under-sensitive).
For example, bright lights, loud noises, overpowering smells, particular food textures and the feeling of certain materials can be a cause of anxiety and pain for people with Asperger’s syndrome.
People with sensory sensitivity may also find it harder to use their body awareness system. This system tells us where our bodies are, so for those with reduced body awareness, it can be harder to navigate rooms avoiding obstructions, stand at an appropriate distance from other people and carry out ‘fine motor’ tasks such as tying shoelaces. Some people with Asperger’s syndrome may rock or spin to help with balance and posture or to help them deal with stress.
Who Is Affected By Asperger's Syndrome?
There are over half a million people in the UK with an autism spectrum disorder – that’s around 1 in 100. People with Asperger’s syndrome come from all nationalities, cultures, social backgrounds and religions. However, the condition appears to be more common in males than females; the reason for this is unknown.
What Causes Asperger's Syndrome?
The exact cause of Asperger’s syndrome is still being investigated. However, research suggests that a combination of factors – genetic and environmental – may account for changes in brain development.
Asperger’s syndrome is not caused by a person’s upbringing, their social circumstances and is not the fault of the individual with the condition.
Is There a Cure For Asperger's Syndrome?
There is currently no cure and no specific treatment for Asperger’s syndrome. Children with Asperger’s syndrome become adults with Asperger’s syndrome. However, as our understanding of the condition improves and services continue to develop, people with Asperger’s syndrome have more opportunity than ever of reaching their full potential.
There are many approaches, therapies and interventions, which can improve an individual’s quality of life. These may include communication-based interventions, behavioural therapy and dietary changes. Information about many of these can be found on The National Autistic Society’s website at: www.autism.org.uk/approaches
Diagnosis of Asperger's Syndrome
Because Asperger’s syndrome varies widely from person to person, making a diagnosis can be difficult. It is often diagnosed later in children than autism and sometimes difficulties may not be recognised and diagnosed until adulthood. The typical route for getting a diagnosis is to visit a GP.
He or she can refer an individual to other health professionals who can make a formal diagnosis. Most frequently they will be psychiatrists or clinical psychologists and, in the case of children, paediatricians.
Some people see a formal diagnosis as an unhelpful label; however, for many a diagnosis:
- helps the individual, families, friends, partners, carers, professionals and colleagues to better understand and manage their needs and behaviour
- is the key needed to open the door to specialised support, e.g. supported living or finding suitable employment.
There are diagnostic differences between conditions on the autism spectrum. Sometimes people may receive a diagnosis of autism or autistic spectrum disorder (ASD), high-functioning autism (HFA) or atypical autism instead of Asperger’s syndrome.
Alternatively, they may be given a diagnosis of pervasive developmental disorder – not otherwise specified (PDD-NOS) or semantic pragmatic disorder. However, people who have been given these diagnoses will have similar difficulties and similar support needs to those who have Asperger’s syndrome.