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  • Lemuel Tan

What is Autism Spectrum Disorder (ASD): A Brief Summary

Autism Spectrum Disorder (ASD) is a developmental disability. As the name implies, it is a spectrum ranging from “Level 1 - requiring support” to “Level 3 - requiring very substantial support”. There is no one type of ASD and each individual with ASD shares varying strengths and weaknesses. ASD now encompasses previous diagnoses of: Autistic Disorder, Pervasive Development Disorder – Not Otherwise Specified (PDD-NOS), Asperger’s Syndrome.

According to Autism Spectrum Australia, it is estimated that 1 in 70 Australian are on the autism spectrum. The Centre for Disease Control & Prevention (CDC), which is an arm of the American Health Department, reports that about 1 in 44 children have been identified with ASD. ASD is suggested to be more common in boys than girls, 1 to 4 ratio. However, there is current early evidence that suggests that girls are often under-reported due to cultural and role expectations. The current cause of ASD is unknown, however, genetic factors have been identified. Siblings have a 35% higher chance of developing ASD symptoms.

At its core, individuals who struggle with ASD may experience challenges in the 4 broad domains: interpersonal communication, social interaction, sensory needs and repetitive and restrictive behaviours. The range of severity for each domain varies from individual to individual. Some symptoms may include:

· Struggles to understand & apply social reciprocity – give and take, eye contact, back and forth conversation, another person's point of view, etc.

· Struggles with sensory issues – sound, light, texture, taste, touch, etc.

· Presents with repetitive behaviours – flapping hands, rocking body, spinning, echoing speech, etc.

· Strong interest in certain ideas, hobbies, activities, etc.

· Learning delays such as: language, movement, cognition, etc.

· Appearing to be easily emotionally dysregulated (flipping the lid).

· Mental health issues such as anxiety, stress and depression.

It is very normal for older children and adults to learn how to cope with the ASD symptoms, this is called “masking” in the ASD community. Masking is often an unintentional or subconscious coping mechanism. This is so they can appear to be normal to others and be accepted - we all want to fit in, belong and be accepted. However, if those who have ASD are honest, they will tell you that it is difficult, challenging, tiring and that “it [people or social communication] just does not make sense” or “I just don’t get it”. Masking may look like: making eye contact, mimicking behavioural gestures, making smiles and facial expressions, hiding or minimising personal interest/passions, utilising well-rehearsed responses to difficult questions, having increased social interest in others – hyper-awareness of the feelings of others, hiding ‘stimming’* behaviours, pushing through intense sensory discomfort, etc. As you may have noticed, these appear to be normal social interactions. However, for those struggling with ASD, it is a huge struggle deep inside. It can be tiring, confusing and anxiety provoking. People who struggle with ASD can appear physically normal and have no ‘physically observable’ signs of disability.

*Stimming is short for self-stimulating. It is an emotional regulation mechanism, often unconscious. When someone with ASD feels a sudden rush of feelings, that energy needs to go somewhere. Stimming provides an outlet for that energy.

Depending on where you are in the spectrum and how ASD affects the individuals, presentations may vary widely. Cultural and gender often further “hide” the ASD symptoms. For example, a 10-year-old Caucasian girl who has a very strong interest in unicorns and can name the different types of fictional unicorns can be seen as “normal and passionate”. This may not necessary be the case as it could be a form of masking to hide her strong interest for ‘sameness in activity’ in a socially and gender accepting way. She may not even be aware that she is hiding it. She may struggle in other domains such as being poor in math (developmental delays), does not like mashed potatoes (sensory to texture), “flips her lid” on weekends (non-routine from school), goes into a meltdown state when she is late for school (non-routine) and rocks herself when she is angry (stimming behaviour). She may have many friends and could tell you how Group A dislikes Group B and that she is actually friends with both groups. Again, this may be a form of masking by “flitting” between groups to hide the struggle to socially engage and connect in a meaningful way – she may be alone inside or not be aware that she is alone.

The above scenario could be seen as ‘growing up issues’ or “childhood issues” and an ASD diagnosis may be missed as the problems described are not at the severe end of ASD. Individuals like these are sometimes called “high functioning autism” as they can still function quite well in society despite struggling with ASD. They sometimes do not even meet the clinical diagnostic threshold of ASD – Level 1, however, the struggles and internal challenges are real. Their strengths and passion can elevate them to be very good at what they do due to their “strong interest” and “hyper-focusing”. However, they may struggle with an inner sense of restlessness as they may not understand how ASD works - “I don’t get it why others are…..”, “Why do I keep doing these behaviours and routines…..”, “I feel no one gets me….”, etc. This coupled by the fatigue of masking often results in a higher prevalence of depression and anxiety challenges.

If you believe you or someone close to you are struggling with ASD symptoms, it is important to talk about it. Hiding it often makes things worse. There is a growing movement called “Neurodiversity” which reflects and encourages the acceptance of those struggling with neurological difference deserving the same rights, respect and acknowledgment. If you are concerned about yourself, please do reach out and speak to a professional who is well versed in ASD.

AURE: Psychology, Counselling & Therapy currently provides ASD testing for children and adults.

Disclaimer: The material on this blog is not to be used by any commercial or personal entity without expressed written consent of the blog's author. The article above is an opinion of an individual clinician and should not be taken as full clinical advice. The statements on this blog are not intended to diagnose, treat, cure or prevent any mental health or mental illnesses. Always consult your doctor for medical advice or seek professional therapy.

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