There are over half a million people in the UK with autism, approximately 1 in 100 people. People from all nationalities and cultural, religious and social backgrounds can have autism, although it appears to affect more men than women. It is a lifelong condition.
The exact cause of autism is still under investigation. However, research suggests that a combination of genetic and environmental factors, may account for changes in brain development.
Autism is a complex developmental disability that typically appears during the first two years of life and is the result of a neurological disorder that affects the functioning of the brain, impacting development in the areas of social interaction and communication skills. Both children and adults on the autism spectrum typically show difficulties in verbal and non-verbal communication, social interaction, and leisure or play activities.
Autism 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, whilst 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 independent lives; others require a lifetime of specialist support.
Other conditions are sometimes associated with autism. These may include attention deficit hyperactivity disorder (ADHD), or learning difficulties such as dyslexia and dyspraxia.
The characteristics of autism vary from one person to another but are generally divided into three main groups:
- difficulty with social communication
- difficulty with social interaction
- difficulty with social imagination
People with autism have difficulties with both verbal and non-verbal language. Many have a very literal understanding of language. They can find it difficult to use or understand subtleties of language and conversation, for example, facial expressions or tone of voice, jokes and sarcasm, common phrases and sayings.
Some people with autism may not speak, or have fairly limited speech and have limited comprehension of language. They may need additional ‘clues’, in the form of signs, symbols, words or pictures to enhance their understanding. They prefer or need 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 reciprocal nature of conversations, perhaps repeating what the other person has just said (this is known as echolalia) or inappropriately talking at length about their own interests.
People with autism often have difficulty expressing their feelings and also have problems recognising or understanding others. This can make it difficult for them to fit in socially.
- not understand the unwritten social rules which come naturally to most people. For example, they may stand too close to another person, 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.
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 action
- 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.
There are other related characteristics of autism which may be observed:
Reliance upon/need for routines/rules
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 from one day to the next. 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 processing issues
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 (hyper-sensitive) 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 in relation to the immediate environment. For those with reduced body awareness, it can be harder to navigate rooms avoid obstacles, stand at an appropriate distance from other people and carry out ‘fine motor’ tasks such as tying shoelaces.
Many people with autism have special interests which they pursue with great intensity, often from a fairly young age. These can change over time or be lifelong, 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.
People with autism may have learning disabilities, which can affect all aspects of 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.
People with autism struggle to make sense of their surroundings. Every day life-events can cause them considerable anxiety and frustration. These stresses, paired with sensory imbalances and communication difficulties, can often cause individuals to demonstrate behaviours as a result of fear, anger or as a coping mechanism. Such behaviours usually mask the underlying problems/triggers and present barriers to learning.
Adapted with kind permission from the National Autistic Society 2010