Have you ever been concerned that your friend, relative, client or student struggles to understand people; seems to be stuck doing the same things over and over; and finds certain sounds, smells, sights or sensations intolerable? Or do you think that these aspects describe you? If yes, you may have identified someone with “autism spectrum disorder” (ASD). Current estimates suggest around 1 in 59 of us are on the autism spectrum. Although new findings indicate this figure may be an underestimation. A large scale survey (sparked by a Channel 4 documentary this year) found that many on the autistic spectrum are undiagnosed. The survey found that the largest undiagnosed group are women who may be unconsciously practicing “social masking”. But why is this important? Put simply, studies reveal failure to diagnose ASD leads to a poorer quality of life. Undiagnosed ASD in adolescence and adulthood has been linked to an increased risk of depression, anxiety and suicide and, for children, without an appropriate diagnosis, access to necessary services such (e.g., learning support) is likely to be neglected. The aim of this article is to raise awareness on ASD.  

So what is autism spectrum disorder? ASD is a psychiatric disorder that begins in childhood (in the early development stage). It can be reliably diagnosed as early as 2. Individuals with ASD typically experience social difficulties. Many with ASD fail to appropriately initiate conversations and may not respond to others’ social advances. For those on the autism spectrum, many struggle to understand non-verbal aspects of communication (e.g., encoding facial expressions and eye contact) and find it hard to develop and maintain relationships.

Many people with ASD harbour obsessions centred on specific routines that lead to repetitive behaviours (e.g., drinking tea only at certain times, lining up yoghurt pots or echoing back the phrases or movements of others). Often, people with ASD find it hard to tolerate changes in their usual environment (e.g., they might experience extreme stress if they are unable to sit on their usual bus seat) and are consequently often insistent on sameness. Many with ASD have restricted and/or intense interests (e.g., a person with ASD may be abnormally preoccupied with white socks or transport systems) and may have unusual attachments to certain objects (e.g., a whistle or miniature flag).

Frequently, people with ASD harbour abnormal insensitivities to particular stimuli (e.g., he/she might walk around the streets mid-winter in a T-Shirt and not notice the cold) or harbour abnormally intense sensitivities (e.g., he/she might find the humming of a cooler intolerable or the rubbing of clothing on the skin unbearable). Others with ASD have abnormal fascinations with particular stimuli (e.g., a fascination with moving lights or the feel of a cushion).

The severity of autistic features vary widely. The most recent diagnostic manual, the Diagnostic and Statistical Manual of Mental Disorders (5th edition; DSM-5), recognises 3 levels of severity (based on social impairments, and restricted patterns of behaviour). Level 3 is the most severe form; individuals at this level may have no power of speech. At level 2 (moderate), individuals may have full power of speech production, but may only speak in situations which they feel comfortable in. At level 1 (i.e., high functioning autism, previously referred to as Asperger’s syndrome) individuals have no or only mild disability and invariably have full power of speech.

It is estimated that around 10% of people with ASD have “savant” abilities (skills that most people do not posses). These special abilities include prowess mathematically, artistically, musically or mechanically. Notable individuals with ASD who have successfully exploited their abilities include Stephen Wiltshire (known for his artistic ability), Bill Gates (rumored to be affected with ASD), Isaac Newton, Albert Einstein and Charles Darwin.

However, despite the gifts bestowed to some with ASD, most people on the autism spectrum struggle to function independently. For example, only around 15% of individuals with ASD are employed and many struggle to live independently as adults. Notwithstanding, despite these struggles, many with ASD still have a good quality of life. With early diagnosis, the right support and interventions, people with ASD can feel fulfilled and participate in society usefully. Society as well has a big role in including those with ASD. With greater awareness, comes greater acceptance and more inclusion.

By Thomas O. H. Brown BA (Hons.) PGCert. MBPsS and Daniel MacInerney BSc. (Hons.) MSc.

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