Autism

Autism is a lifelong developmental disability. It is part of the autism spectrum and is sometimes referred to as an autism spectrum disorder, or an ASD. The word 'spectrum' is used because, while all people with autism share three main areas of difficulty, their condition will affect them in very different ways. Some are able to live relatively 'everyday' lives; others will require a lifetime of specialist support.

The three main areas of difficulty which all people with autism share are sometimes known as the 'triad of impairments'. They are:

-difficulty with social communication
-difficulty with social interaction
-difficulty with social imagination.


It can be hard to create awareness of autism as people with the condition do not 'look' disabled: parents of children with autism often say that other people simply think their child is naughty; while adults find that they are misunderstood.

All people with autism can benefit from a timely diagnosis and access to appropriate services and support.

What are the characteristics of autism?

The characteristics of autism vary from one person to another but are generally divided into three main groups.

Difficulty with social communication

"For people with autistic spectrum disorders, 'body language' can appear just as foreign as if people were speaking ancient Greek."

People with autism have difficulties with both verbal and non-verbal language. 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.
-Some people with autism may not speak, or have fairly limited speech. They will usually understand what other people say to them, but prefer to use alternative means of communication themselves, such as sign language or visual symbols.

Others will have good language skills, but they may still find it hard to understand the give-and-take nature of conversations, perhaps repeating what the other person has just said (this is known as echolalia) or talking at length about their own interests.

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.

Difficulty with social interaction

"Socialising doesn't come naturally - we have to learn it."

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
appear to be insensitive because they have not recognised how someone else is feeling
prefer to spend time alone rather than seeking out the company of other people
not seek comfort from other people
appear to behave 'strangely' or inappropriately, as it is not always easy for them to express feelings, emotions or needs.
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.

Difficulty with social imagination

"We have trouble working out what other people know. We have more difficulty guessing what other people are thinking."

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. 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
understand the concept of danger, for example that running on to a busy road poses a threat to them
engage in imaginative play and activities: children with autism may enjoy some imaginative play 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

Love of routines

"One young person with autism attended a day service. He would be dropped off by taxi, walk up to the door of the day service, knock on it and be let in. One day, the door opened before he could knock and a person came out. Rather than go in through the open door, he returned to the taxi and began the routine again."

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: 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.

Sensory sensitivity

"Rowan loves art but he hates wearing a shirt to protect his clothing - the feeling of the fabric against his skin causes him distress. We have agreed with his school that he can wear a loose-fitting apron instead."

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) or under-sensitive (hypo-sensitive).

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.