Autism

There are many theories about what autism is, how it works, and why it might be expressed the way it is. They differ greatly in their perception of autistic people, not least due to the time in which each theory was developed.

Today, we believe that autism is a neurotype that results in a different way of perceiving, processing, and experiencing the world.

Sentences like that are very vague, however, and tell you very little about what autism feels like, or what it can look like from the outside.

​Autism is classified in the diagnostic systems as a developmental disorder, marked by a number of symptoms or diagnostic criteria. The current understanding of Autism Spectrum Disorder (ASD) is that it may be expressed in vastly different ways in spite of the underlying difficulties being quite similar. As such, it may seem counterintuitive that two very different people may have the same diagnosis.

Diagnostically speaking, ASD is a description of a number of symptoms and behaviors.

What follows is a combination of these, along with observations made by colleagues, as well as personal experience. There is an emphasis on describing the characteristics of those with more subtle support needs, as those with more obvious support needs tend to be diagnosed earlier in childhood. However, we have attempted to make the descriptions inclusive.

Note that this information is a short summation and that a nuanced description would fill a book – or several.

Autistic people may have these characteristics:

  • Differences in social communication and interaction, which may show themselves in a number of ways, such as;
  • Difficulty making friends, and may often be teased or bullied by others.
  • Delayed language development, or unusual language abilities that include advanced vocabulary and syntax but delayed conversation skills, unusual prosody and a tendency to be pedantic.
  • A tendency to use and interpret language in a concrete way.
  • May have reduced mimicry and use of body language.
  • May have difficulties with eye contact, perhaps experiencing physical discomfort when attempting it.
  • Difficulties interpreting other people’s emotions and motivations.
  • Delayed social maturity and social reasoning.
  • Difficulty with the recognition, communication and regulation of emotions.
  • Differences in interests, either in focus or intensity – often called a special interest.
  • Insistence on, or desire for, sameness and routine, sometimes seen as;
  • Intense emotional outbursts due to stress when routines or plans are changed, when surprised, or when changes are made to the surroundings.
  • A marked disinterest in making plans that alter the daily routine, a preference for weekdays due to predictability, or avoidance when changes are suggested.
  • Sometimes, this need for sameness affects social conduct to an obvious extent, such that social interactions are scripted and must be consistently the same.
  • A love of or desire for repetition, which may be expressed through, for example, repetitive movements, sounds, or seeking the same music or video content repeatedly.​
  • An unusual profile of learning abilities.
  • Challenges in executive functioning, resulting in, for example;
  • A need for assistance with daily living and organizational skills.
  • Difficulty controlling focus, often unable to focus on tasks the person finds uninteresting, but hyperfocus on interests.
  • Difficulty with planning and prioritizing, for example; finding it equally important to tidy inside the cupboards when the task was to clean before guests arrive.
  • Motor skill differences, such as;
  • Clumsiness in terms of gait and coordination.
  • Fine motor skills either challenging or the person may have a remarkable talent in something requiring fine motor skills, such as drawing or calligraphy.
  • Sensitivity to specific sensory experiences/inputs, such as sounds, aromas, textures, or touch.
  • Please note that symptoms or their presentation may differ, and be influenced by the presence of other conditions. For example, many people are both autistic and ADHD’ers, and so experience elements of both. A common issue in such a case is to crave routines and sameness, but to get frustrated and ‘bored’ if those routines are upheld.

The advantages of a diagnosis can be:

  • Increased understanding of one’s challenges and strengths.
  • Being recognized as having genuine difficulties coping with experiences that others find easy and enjoyable.
  • A positive change in other people’s expectations, acceptance and support.
  • Acknowledgement of confusion and exhaustion in social situations.
  • Access to support and resources through state, municipality and school systems.
  • Better decision making with regard to careers, friendships and relationships based on greater self-understanding.
  • A sense of identification with online and/or offline autistic communities.

What is it like to be autistic?

Being autistic is experienced in many different ways, as autistic people can have vastly different profiles of symptoms, as well as personalities, interests, and aspirations. However, common experiences for autistic people include:

  • Anxiety is very common, but can take many different forms. The most common is a general sense of anxiety, being constantly worried about social misunderstandings and sources of sensory overload, or over-analyzing everything. It can feel like your brain never shuts off, there is never peace and quiet, because even when there is nothing to worry about, your mind will still find something.
  • Low self-esteem and low self-worth are also very common, often stemming from being bullied or socially excluded, having your behavior corrected often, and feeling that others have an easier time getting through life and internalizing that thought: “What is wrong with me?”, “I’ll never become somebody worthwhile”, etc.
  • Social challenges are one of the core aspects of the autistic experience, but they range greatly. Some autistic people do not perceive themselves as all that different, but may wonder why friendships don’t seem to last long, or why it’s hard to make new friends. In some cases, the social challenges are more obvious to the surroundings than to the person themselves. Other autistic people perceive their own social challenges with perfect clarity; They see it when others perceive them as weird or strange, or when others whisper about them. They notice the misunderstandings almost as they are happening, but can’t seem to find a way around it. They may spend hours every day going through social situations and analyzing what went wrong, trying to figure out the motivations of others. (These examples may feel caricatured, but we see them regularly in our clinical work and indeed, in our social lives, too.)
  • A feeling that the world is chaotic and unstructured. For many autistic people, this perception or feeling, is a part of why they might like to hold on to certain routines in their daily lives. In some autistic people, it can be related to a difficulty with time perception, or with sensory or cognitive overload. Time can feel like it passes with irregularity, and because of that, events – even if planned – can feel like surprises, coming out of nowhere. When cognitive overload is at the forefront, it can feel like a world of bits and pieces of information, constantly being flung at the person, and they are overwhelmed and “can’t see the forest for the trees”. Sensory overload is one of those aspects that tend to be difficult to control. Sudden, loud noises, changes in natural lighting, a bug landing on your skin, a whiff of a stranger’s strong perfume, are all examples of sensory experiences which we have no control over. This then makes the little parts of the world that we can control, all the more important. As such, when someone mentions insistence on sameness or strict routine adherence, we must always consider anxiety, time perception, and sensory or cognitive overload.
  • Emotional Dysregulation. The autistic person doesn’t recognize their emotions as they are climbing, and they may suddenly ‘go off’ and even surprise themselves. There will often be feelings of embarrassment or shame tied to these outbursts. In autism, this is often related to challenges in interoception, the ability to notice and interpret signals from the body about what is going on. Interoceptive differences can also cause difficulties with noticing states of being and emotions, including temperature changes, hunger, thirst, and much more.
  • Rejection Sensitive Dysphoria, in which the person reflexively interprets any criticism as a personal one, for example internalizing “You left the cupboard open” as “You’re a bad person”, or “You’re a failure”. This can cause panic attacks or meltdowns, because the perceived message is so unbearable.
  • Mental exhaustion. The autistic person spends their days coping with social challenges (and not least, the fallout that can occur because of the reactions from others), sensory and cognitive overload, not to mention any co-occurring disabilities, conditions, or challenges. It is no wonder that many autistic people express that mental exhaustion affects them on a daily basis.

What should I do if I think I am autistic, or someone I know may be autistic?

Most people considering whether they are autistic begin with self-diagnosis.What you can do on your own, is to research beneficial strategies for autistic people and try to find those which will work for you. We suggest using neurodiversity-affirming sources, such as autistic advocates – of which there are many. 

You may also consider whether an official diagnosis is worth it or not. Unfortunately, there isn’t one simple answer. An official diagnosis can be a route to government assistance, but in some countries, it may also hinder access to certain educations or career paths. Some of the cons include that official testing can be expensive and hard to access. Furthermore, many professionals who do official tests aren’t necessarily experts in autism, which is not ideal. Lastly, the tests designed for autism were designed based on a very specific sample, which means there are many groups – and symptoms – that a strict testing does not account for, which would mean the test may not be valid if conducted by someone who is not specialized in autism. 

On the positive side, professionals with expertise in various neurodivergences have the training to disentangle traits and characteristics  in order to do differential diagnosis. That is, a professional must always consider whether a number of other diagnoses better explain the symptoms described, and indeed, if several diagnoses are perhaps appropriate. (For example, if there is co-occurring anxiety, depression, signs of PTSD, or something else entirely.)  This is something that the average person may overlook in their personal exploration, which may make it more difficult to identify or access appropriate supports. This, of course, comes down to finding the right professional.

Our best advice will be to consider your own situation, what you might want the diagnosis for, and whether you have access to a professional whose judgment you trust. Naturally, we also suggest using Energy Accounting as a way to explore your own support needs as well as your strengths and finding ways to improve your quality of life.