What is Autism?
A Complex Neurodevelopment Condition Is Autism.
Differences in social abilities, communication, and behavior define it.
The term “limited, repetitive patterns of behavior” is frequently used to describe this. This means that persons with autism suffer differences in the way they communicate and interact socially, and their behavior may be repetitive or intensely focused. Additionally, people with autism frequently encounter sensory impairments that might change how they perceive and react to their environment. Autism is not an illness or disease.
What Are The Signs Of Autism?
Autism can be diagnosed at any age. Usually people who have Autism experience differences in these areas:
Communication differences have always been considered a core feature of Autism and are often broken down into two categories:
Receptive communication involves the ability to make sense of what others mean through their verbal language, facial expression, body language and other non-verbal cues. People with Autism may find some or all of these elements of receptive communication challenging.
Expressive communication refers to how we express our needs, wants, thoughts, ideas, and feelings to others. Some people with Autism experience significant delays in developing language, while others may have an incredibly well-developed vocabulary and be able to talk about specific topics in great detail. Some people with Autism may be non-verbal or have limited speaking skills, while others express themselves mainly through talking.
Social Interaction
Communication involves a sender and a receiver of information – making it inherently social. In social situations there are many nuances that guide our interactions with others, and unspoken rules that change based on the situation and people involved. People with Autism often find it difficult to recognise and understand social cues and may not instinctively know how to adjust their response to suit different social contexts.
Behaviour (Repetitive and Restricted Patterns of Behaviour)
This includes repetitive actions, strong interests, and sensory processing.
Repetitive Actions involve doing or saying something over and over again. Depending on the person, these repetitive behaviours may be very obvious or quite subtle and can include movements, sounds, routines and rituals.
- Movement – physical repetitive behaviour may be an action (like switching the lights on and off or flicking an elastic band) or a body movement (like pacing or hand flapping).
- Vocalisation – vocal repetitive behaviour may include repetitive noises, laughter, and echolalia. Echolalia is when a person repeats (or echoes) phrases, words or parts of words that they have heard, and it often serves a purpose (like responding to a question, as a way to take a turn in a conversation, getting someone’s attention, requesting something or coping in the moment).
- Routines and Rituals – Many routines are a normal part of everyday life (like getting ready for bed or brushing your teeth), and most of us have specific rituals for enjoyment (like having something special for dinner once a week). Routines tend to be even more important to people with Autism. They bring a sense of order and predictability to what might feel like a very chaotic, ever-changing, and sensation-driven world. This strong need for ‘sameness’ though can be misunderstood and interpreted as rigidity or a lack of flexibility by others.
- People with Autism can also have trouble ‘generalising’ their skills. Generalisation means being able to apply something you’ve learned across different people, places and contexts.
Strong Interests
Strong Interests are also often associated with Autism. Sometimes people talk about ‘intense’ or ‘restricted’ interests.
Everyone has interests and things they are passionate about—items we are fond of, activities we enjoy and topics we love to talk and learn more about. This is important for making us feel good and adding to our sense of purpose.
Many people with Autism have interests and passions that are a lot more intense and focused than others experience, often from a young age. Some people with Autism also become attached to objects, or parts of objects, and an interest in collecting is also quite common. Interests can change over time or be lifelong.
Having a strong or highly focused interest can be an incredible strength and if supported can be channelled into meeting new people, studying or building a career.
In combination with other Autism characteristics, it can also pose some challenges however (like limiting the person’s involvement in other activities or impacting them socially).
Sensory Processing
Sensory Processing refers to the way the nervous system gathers, understands, organises, and uses information from our senses (e.g. sight, hearing, touch, taste, smell, balance and body awareness), and turns it into a response.
It is now widely accepted that people with Autism process the information provided by their senses differently to others. These sensory differences may result in unusual or unexpected behavioural responses and can be affected by a person’s sensory sensitivities and preferences, environment, overall health and stress levels at any given time. Some people may quickly respond to just a tiny amount of sensory information (over-responsive), while others may be slower to respond because they need more sensory information (under-responsive).
Theory of Mind is a term used to refer to the awareness that other peoples’ minds are different from our own or the ability to see things from another person’s point of view. It involves being able to recognise and understand the thoughts, beliefs, desires, and intentions of other people and how they relate back to us. When we interact with others, or think about them, we guess what they might be thinking or feeling. We predict their intent, which helps us to work out how to respond. Researchers have found that in Autism the development of theory of mind can be delayed. People with Autism may find it harder to ‘tune in’ to the perspectives of other people and as a result might misread the intentions of others or respond in an unexpected way during social interactions.
Central Coherence is about pulling information together and making sense of it based on the situation or circumstance. It means being able to look for the ‘big picture’ and overall meaning, rather than getting side-tracked by the ‘nitty gritty’ or tiny details. It is also about balancing the ‘big picture’ and the details—being able to work out how much detail to focus and which details are most relevant based on the situation we are in. Having difficulties with central coherence can make it hard to understand the subtle or unspoken rules in social situations (sometimes also called ‘Hidden Curriculum’). Some people with Autism may have central coherence difficulties which make it hard to navigate social situations. On the flip side, having a weaker central coherence means a ‘keen eye’ for detail, and many people with Autism excel in this area.
Executive Function Skills
Executive Function Skills help us to organise, focus, remember and respond appropriately to multiple internal and external messages, and adjust our plans so that we can reach our goals. We use this set of mental skills to manage our thoughts, actions, and emotions so that we can get things done.
Executive Function Skills include things like planning and prioritising, organisation, initiation (or getting started), focus, shifting attention, time management, sequencing, and self-monitoring. Executive functions are basically like a personal management system.
The executive functions’ role is a bit like a conductor of an orchestra—the conductor organises, directs and integrates the members, cuing the musicians so that they know when to play, how fast or slow to go, how loud or soft to play their instrument and when to stop. The conductor monitors and supports the ensemble to adjust if something sounds ‘off’ and pulls everything together—without the conductor, the music does not flow as smoothly.
Many people with Autism have difficulty with Executive Functioning, and may have trouble with certain skills like reasoning, planning, staying organised, getting things done and regulating emotions. Some people may also find it hard to hold more than one train of thought at a time or do multiple things at once (multi-task). Challenges in Executive Function can make seemingly simple activities like cleaning your room, doing homework, or taking out the rubbish, really complicated. Fortunately, there are many strategies that can help.
It is important to note that not all people with Autism have issues with all the aspects of Executive Function. On the surface, challenges in Executive Function, may look like:
- Not listening
- Easily distracted
- Not following instructions
- Trouble paying attention
- Impulsive
- Unmotivated
- Messy or disorganised
- Acting out and getting into trouble
- Forgetful
- Always late
- Not following through
- Starting things but not finishing them
- Leaving things to the last minute
- Spending too much time on tasks that are not important, or too little time on the tasks that are
- Oversimplifying or over complicating
Common Signs of Autism
Below are some of the common Autism signs across the lifespan.
Early Signs in Babies and Toddlers
Signs to watch for in a baby’s first two years relate to their social communication development and include a lack of social behaviours like showing interest in others, smiling, eye contact and using gestures. It is important to remember that children all develop at different rates. Some children will have many early signs while others may only have a few. Some signs also change over time and may become more obvious as children get older. Some early signs of Autism in the first two years may include:
- Not following moving objects with his / her eyes
- Not showing interest in new faces
- Not turning toward a sound, or becoming very unsettled by sounds
- Not attending to or smiling at familiar people
- Inconsistent response to own name
- Not babbling or imitating sounds or words
- Not using eye contact to get someone’s attention (like looking at you, then at a snack and then back at you to show you they want it)
- Not pointing to or holding up objects to show people things or share experiences
- Not using social gestures on their own (like waving bye-bye)
- Not imitating what they see others do
- Not expressing affection openly or avoiding contact with others
- Not initiating social games like peek-a-boo or pat-a-cake
- Not understanding simple instructions
- Not showing interest in other children
- Playing with toys in the same way every time or in an unusual way (like only spinning the wheels of a toy car rather than putting it on the track).
- Not engaging in basic pretend play (like feeding the teddy)
- Becoming easily upset or unsettled when there are changes to routine
- Having very specific or unusual interests
- Repeating body movements or moving in an unusual way (like stretching or stiffening, flapping hands or walking on their toes)
- Avoiding or seeking certain sensations (like covering ears to muffle a sound or sniffing things)
Signs in Kindy Children
Signs of Autism in the preschool years may not become fully obvious until children reach Kindy and developmental differences between them and their same-age peers become more pronounced. There are slightly higher expectations to become ‘school ready’ which can highlight the features of Autism for their caregivers. Early childhood educators are also well placed to identify potential concerns with a child’s development and may encourage families to explore any identified developmental differences further with a developmental paediatrician.
Some signs of Autism in the Kindy years may include:
- Not talking by the time Kindy starts
- Not responding to own his /her own name consistently
- Difficulties with joint attention (i.e. when two people share focus on the same object or activity)
- Preference to play alone rather than with other children
- Is not interested or does not know how to make friends
- Gravitates to the adults in the room over peers
- Does not know how to initiate interactions with other children (might do something unexpected like pushing or taking something from them to get their attention)
- Has trouble taking turns
- Avoids group activities
- Does not like, or avoids physical contact or is very hands on and does not understand social boundaries
- Has trouble regulating their own voice based on the situation (knowing when to use an inside vs outside voice)
- Does not spontaneously participate in pretend play
- Does not tell stories, or the story may be difficult to follow
- Has trouble expressing, identifying, or talking about their feelings
- Has trouble understanding other people’s feelings and how to react (e.g. not realising when someone else is upset)
- Has trouble following verbal instructions
- Repeats words or phrases over and over
- Reverses pronouns (like saying ‘you’ instead of ‘I’)
- Does not understand jokes or teasing
- Gets upset if the routine changes
- Finds it difficult to transition between activities (especially finishing off a preferred activity to move onto something else)
- May overly focus on the details while missing the ‘big picture’ (e.g. might look at a picture book and notice the small details like a snail on a leaf rather than focusing on the characters or main story line)
- Difficulty expanding their interests or having narrow, specific or unusual interests when compared with their peers
- May come across as self-directed (keeping control of a situation by just ‘doing what they want to do’)
- May find it difficult to pull information together to solve a problem
- Difficulty taking a skill learned in one setting and applying it in another (for example being able to do something at home but not at Kindy)
- Difficulty taking a skill they have learned and applying it in a different way (like being able to zip up their own jacket, but not their backpack)
- Needing to follow certain routines or having little rituals (like taking a very specific route to the toilets, or eating parts of their lunch in a specific order)
- May come across as frustrated
- Shows lack of fear or more fear than expected (i.e. being a ‘thrill seeker’ or ‘overly cautious’)
- Sensory differences – irregular reactions to sounds, smells, tastes, sights, or textures
- Avoids certain textures like paint or sand or seeks out tactile sensations and messy play
- Puts objects in their mouth or licks things or refuses to taste anything new
- Avoids places that smell different (like the toilets) or sniffs things and seeks out certain smells
- Is especially sensitive to loud noises or fluorescent lighting
- Is constantly on the move – finds it hard to sit still or is ‘fidgety’
- Likes rough and tumble play or does not like being touched at all
Signs in Adults
Autism is most often diagnosed in early childhood. For some people however, the signs may not be as clear, and it might not be until later in life that the question of Autism even comes up. With an increased awareness and understanding of Autism in recent years, more and more adults are finding out that they too are on the Autism Spectrum. Some people with Autism experience challenges that make daily life difficult, while others simply feel like they have always been ‘different’ without being able to pinpoint exactly why. Others again may not notice that they act differently themselves, but the people around them do.
The decision to seek a diagnosis is completely up to the individual, but if it’s something you or someone you know would like to explore, the best first step is to talk to your GP.
Below are some possible signs of Autism in adults:
- You find that others do not always understand you
- You would rather do things alone than with other people or you would like to do things with other people, but you do not know how to go about it
- You find it hard to keep track of multiple conversations in social situations
- You do not see the point of ‘small talk’ (polite conversation about unimportant things, usually with people you do not know well)
- You tend to avoid group situations and find it easier to do things ‘solo’ – both at work and recreationally
- You find it hard to look at people when they are talking
- New situations make you anxious
- You prefer to do things the same way over and over again
- You like to plan the activities you participate in carefully
- You enjoy consistent routines and schedules
- You tend to get upset if your daily routine is disturbed
- You prefer to do one thing at a time rather than multi-tasking
- You find it hard managing every-day tasks that seem simple for others – staying organised and keeping on top of day-to-day activities can be challenging (like planning meals, keeping up with housework, catching public transport and managing finances)
- You tend to notice details that others do not
- You tend to see patterns in things
- You have a tendency to become so wrapped up in what you are doing that you lose sight of anyone or anything else
- You tend to have very strong interests or hobbies and it upsets you if you cannot pursue them
- Other people frequently tell you that what you have said is impolite although your intention was not to offend anyone
- You have your own unique phrases or descriptive words
- You do not always know how to tell if the person you are talking to is getting bored
- You like to take the lead in conversations so that you do not have to worry about misinterpreting what others say or mean, or you find it really hard to keep a conversation going
- You find it hard to make new friends, or making friends is easy but keeping them is hard
- You find it difficult to ‘read between the lines’ when someone is talking to you (i.e. understanding what they really mean when they aren’t saying it directly)
- When you were young, you did not really enjoy playing games that involved pretending
- You find it difficult to imagine what it would be like to be someone else
- You do not always get jokes – when someone tells a joke, you find yourself wondering why they think it is funny
- When you talk on the phone you are not always sure when it is your turn
- When you are reading a story, you find it difficult to work out the intentions of the characters
- You tend to take things literally (like knowing that when someone says “It’s raining cats and dogs” they actually mean it’s raining hard)
- You tend to have a very strong reaction or no reaction at all to sensory stimuli like textures, sounds, smells, and tastes
- You find some environments uncomfortable, distracting, or overwhelming (because of too many colours and patterns, lighting, noise levels, uncontrollable smells, clutter, or lack of structure)
- You have a strong sense of justice
- When people ask for your opinion you tell people exactly what you think, whether it is what they wanted to hear or not.
- People have told you that sometimes you are ‘too honest’
- You have a special skill that not many other people have
Signs in Girls
New research indicates that Autism presents differently in girls and therefore often goes unrecognised for longer. Girls with Autism also appear to be better at ‘camouflaging’ the features of Autism in order to fit in. Although every person with Autism is different, here are some possible signs of Autism in girls:
- A strong imagination
- A tendency to be a visual thinker
- Special interests in cultures, animals, art, music, and literature. It has been found that while boys with Autism may collect information about topics that hold special meaning to them, girls tend to align their interests with those of their peers, but in a more ‘focused’ way (like collecting and learning the history of Barbie dolls or make-up). Interests may also come across as more ‘mature’ for her age
- An ability to hold her emotions in check at school or work, but is prone to meltdowns at home where she feels free to relax and let go of the emotions that have built up over the course of the day
- She is often better at ‘masking’ her Autism to try and hide the fact that she feels different
- May find it difficult to imitate the behaviours, fashion choices, or hairstyles of other girls in her peer group even though she may want to ‘fit in’
- Likely to research and intellectualise social roles – may invest a lot of effort to learning how to be more like other girls to blend in
- Often described as ‘quiet’ or ‘shy’ in school and other challenging social situations – difficulties with receptive and expressive communication can make it hard to jump into conversations and respond to social situations quickly
- Can also come across as an extrovert, especially in relation to her hobbies and interests
- May be described as a ‘day dreamer’ or ‘quirky’
- May find it hard to understand the ‘levels of friendship’ which makes it difficult to distinguish between an acquaintance and a close friend
- May experience phases of intense friendships, with break-ups or sudden ends
- May have a strong sense of justice – a tendency to stick up for those who cannot stick up for themselves
- May have hyperlexia
- Can appear to be more curious, bright, or gifted than her peers
- May have an advanced vocabulary
- Are often high achievers or perfectionists. May be perceived by others as ‘pedantic’
- Often very sensitive, with intense emotions and difficulties with self-regulating
- Her facial expressions may not match the situation
- She may have distinct sensory differences or sensitivities
- May be perceived as a ‘picky eater’
What Are The Causes Of Autism?
There is no single known cause of Autism. Science suggests that there are likely several causes with strong links to developmental and genetic factors.
Although researchers have identified a number of genes associated with Autism, there is current consensus that no one genetic difference is shared by all people on the Autism Spectrum. Researchers continue to explore causal factors, including other biological and environmental influences, in order to advance our understanding of Autism.
Intensive research over the past 70 years has led to an understanding that Autism is not merely one condition with one cause. Rather it is a collective term for a range of shared characteristics which combine and interact in a way that is unique to each person, highlighting the importance of individualised supports and services.
Autism Myth Busters
Our community is becoming more proactive in understanding Autism and learning to adapt the environment we live in to enhance Autism acceptance.
It is important for our community to recognise the common misconceptions about Autism and deepen understanding. These common misconceptions are explored below.
Myth: All people with Autism have the same skills and difficulties
Myth: All people with Autism have an outstanding ‘savant’ skill
Myth: People with Autism cannot have another diagnosis
Myth: All people with Autism have an intellectual disability
Myth: People with Autism do not speak
Myth: People with Autism do not experience the full range of emotions
Myth: Children with Autism are more aggressive
Myth: People with Autism aren’t capable of forming meaningful relationships and friendships
Myth: Autism is a behavioural or mental health disorder
Myth: There is an Autism epidemic
Myth: Autism is caused by parenting style
Myth: Vaccinations cause Autism
Myth: Autism can be cured
Behaviour Is Communication
Simply put, behaviour is all about how we act or behave in a situation or under particular conditions.
Everything we do is ‘behaviour’, and everybody communicates through their behaviour. A person with Autism may behave in ways that are unexpected or unusual in order to communicate effectively in a situation.
For example, a person needing help might suddenly call out, stand near someone or touch them on the arm. In this situation, all these behaviours would communicate the same intention or purpose, however, some of these behaviours may be considered more appropriate than others, depending on the context. (For example, calling out may be an acceptable behaviour in a park but not in a library).
Behaviour is contextual. It’s more than just what the person does. It involves the interaction between the person, their specific situation, their environment, and the other people around them. So, to understand behaviour we need to look beyond what we merely see on the surface. It’s important to remember that the underlying difficulties related to Autism characteristics can contribute to challenging behaviour, but challenging behaviour in and of itself is not a core feature of Autism and is not synonymous with Autism.
Behaviour Has a Purpose
Behaviour is a form of communication that can convey an important message. There is always a reason for the way we behave.
At times behaviours may be viewed as challenging to manage. However, behaviours don’t happen because the person is intentionally trying to be ‘difficult’, and they generally don’t “come out of the blue” even if the cause isn’t immediately obvious. Challenging behaviour often indicates that the person is unable to cope at that moment and can’t express why in a typical way. It’s frequently the result of a clash between the demands of the situation and the person’s skills to respond, and is influenced by how they feel, what’s happened before and what is happening around them at the time.
The impact of these behaviours is what makes them challenging, both for the person and those around them.
Behaviour is called ‘challenging’ because it challenges those who support the person to understand why it is happening (like parents, carers, teachers and professionals). Challenging behaviours are sometimes called ‘Behaviours of Concern’. Behaviours become concerning if they impact the quality of a person’s life or put them or those around them at risk.
Challenging behaviour usually has 2 main functions: To get or get away from something (like an item, an activity, a sensation, attention or a person).
It is always important to rule out pain or illness as possible contributors to unexpected behaviours.
Imagine you suddenly feel pain while having some dental work done. If you couldn’t use words to express yourself, how would you let the dentist know? More than likely you’d use behaviour to communicate, like grimacing, groaning, waving your hand or jumping out of your seat.
To prevent a behaviour from occurring (or to reduce the likelihood of it happening again), we first need to understand the purpose of the behaviour. To understand why a behaviour happens, we need to consider all the contributing factors — the person’s Autism characteristics; their skills; the environment that they are in; the expectations placed on them; and the other people involved in the situation.