In 2013, the Diagnostic and Statistical Manual for Mental Disorders (commonly known as the DSM-V) introduced the diagnosis Autism Spectrum Disorder (ASD: Autism) which was previously four different diagnoses.
- Autistic Disorder
- Asperger’s Disorder
- Childhood Disintegrative Disorder
- Pervasive Developmental Disorder not otherwise specified (PDD-NOS).
It is now recognised that autism is a spectrum, meaning that everyone is unique, and sits at a different point on the spectrum. Autism is a lifelong developmental condition that affects each individual differently both cognitively (thinking and behaviour) and socially (communication and social interaction). People with autism have strengths and difficulties in different areas which affects their lives differently. No two people on or off the spectrum are alike. However, for someone to be diagnosed with autism, they will have a difficulty or delay in two main areas of functioning:
1. Communication and social interaction, and
2. Restricted and repetitive patterns of behaviour.
It’s important to remember that abilities can change over time. We may have the ability to complete a task in one situation but not in novel or new environments. This is especially true for people with autism who usually find change particularly challenging.
Furthermore, people with a delay or difficulty in only one of the above areas are unlikely to meet the criteria for Autism Spectrum Disorder, however it is likely that they will benefit from some of the same supports that a person with a diagnosis of ASD has in place. For this reason, interventions should be based on an assessment of an individual’s strengths and difficulties rather than the diagnosis.
What does ASD / Autism Spectrum Disorder Look Like?
Children’s difficulties or delays may be expressed or observed as follows:
- Children may be delayed in speech and language.
- They may have difficulty understanding others.
- They may find it hard to communicate what s/he wants and find unusual ways of making themselves understood (e.g. may use objects or another person’s hand to indicate what s/he wants).
- They may use an unusual tone, pitch, or accent.
- They may use language in an unusual way (such as being overly formal or academic or repeating phrases or words)
- They may not understand non-verbal communication such as facial expressions, body language and gestures.
- They may have difficulty following instructions and can take information and instructions very literally.
- They may sometimes appear not to hear at all.
- They may seem very independent for their age particularly as they may not seek help from others.
- They may not join in with play with other children.
- They may appear disinterested in other children or people
- They tend to prefer to play or be alone.
- Children don’t often play pretend or make believe as often as same-aged peers.
- Children with autism rarely bring toys and objects to share or show other children or adults (lack of interest in joint attention)
- They may not respond to other people’s greetings, or smiles.
- They may have difficulty with social situations, and understanding social rules (e.g. have difficulty knowing if someone is joking or do not follow the usual social rules for polite behaviour)
- They may have difficulty understanding or processing others’ emotions, thoughts or actions.
- They may have difficulty initiating or sustaining eye contact.
Restricted and repetitive patterns of behaviour
- A strong preference for routine and order is common.
- They may get very upset when their routines are interrupted.
- They may experience difficulty with transitioning between activities and into new environments.
- They may have a special interest which they enjoy talking about a lot, or spend a lot of time doing.
- They may use behaviour (including challenging behaviour) as a way of communicating due to problems with communication and social interaction.
- They may appear to be clumsy and have poor motor skills.
- They may make unusual movements or sounds (commonly known as stimming – for example, they may make unusual movements near their eyes or face).
- They may also have poor problem-solving or organisational skills.
- This means they may be hyper or hyposensitive to various stimuli (see below).
People with autism may also have sensory sensitivities. It is quite common and now recognised in the DSM under restricted and repetitive patterns of behaviour. People with autism may have one or more sensory sensitivities.
They may be hypo – or hypersensitive to certain stimuli. They may be affected by a dog barking but not bothered by loud music. They may find all loud sounds aversive but seek out interesting smells. Sensitivities can be fluid where they change day to day or are dependent on the environment.
There are seven senses that can play a role in how we feel:
People with autism may have difficulty tracking objects, or have a strong dislike to strong bright lights.
Loud noises may be painful for those with autism. They may also have trouble concentrating when there is background noise.
For people with autism, some smells may make them feel sick. They may also seek out smells or sniff objects to gain a better understanding.
People with autism may have a strong like or dislike for particular tastes. They may also appear fussy due to different textures of food.
Certain clothing may be too scratchy to wear. Some people with autism like tight clothing and tight hugs where for others, they find this painful and are oversensitive to the touch of others.
- Balance (vestibular)
People may experience difficulty with balancing and have poor coordination. Some people enjoy the act of spinning in circles while for others this may make them ill.
- Body awareness (proprioception)
People may appear clumsy as they are always bumping into people and objects due to an inability to understand their place in relation to what is around them.
Strengths and Abilities in Autism
People who are on the autism spectrum may display a range of strengths and abilities that can be directly related to their diagnosis, including:
- Learning to read at a very early age (known as hyperlexia).
- Memorising and learning information quickly.
- Thinking and learning in a visual way.
- Logical thinking ability.
- May excel (if able) in academic areas such as science, engineering and mathematics as they are technical and logical subjects that do not heavily rely on social interaction.
- Having an extraordinarily good memory (being able to remember facts for a long period of time).
- Being precise and detail orientated.
- Exceptional honesty and reliability.
- Being dependable in regards to schedules and routines.
- Having an excellent sense of direction.
- Be very punctual.
- Strong adherence to rules.
- Able to concentrate for long periods of time when motivated.
- A drive for perfection and order.
- A capability for alternate problem solving.
- A rare freshness and sense of wonderment.
Where to get more information
If you have questions about autism spectrum disorder (ASD) Altogether Autism is here to help.
Personalised information: We have a free personalised information service, where we can provide information specific to your questions and needs. This is available for anyone in New Zealand. You may have questions about autism for yourself, a family member, friend, colleague, client or student - our service is freely available. Click here for more about our personalised information service.
Altogether Autism Journal: Our journal is published four times each year. You can read previous editions and subscribe for free here: Altogether Autism Journal.