Autism is a condition many people would like to understand a little better, especially if they are close to someone diagnosed with it. But even that can be tricky because of how autism works, says Alise Lane, behavioral health expert and Board Certified Behavior Analyst (BCBA) for BlueCross BlueShield of Tennessee.
“About 1 in 44 people in the U.S. is affected by autism spectrum disorder (ASD), and no one knows what causes it,” says Lane. “The fact that autism looks different for every person makes it difficult to understand from the outside. But getting the facts is a great place to start.”
What is autism spectrum disorder?
Lane: Autism is a condition marked by development delays in areas like social skills, repetitive behaviors and daily living. It doesn’t look the same across the board — which is why it’s referred to as a spectrum. It can range from someone who’s nonverbal to someone who’s very high-functioning and just interacts a little differently.
The CDC defines ASD a developmental disability that can cause significant social, communication and behavioral challenges. People with ASD don’t look different, but they may communicate, interact, behave and learn differently. People on the spectrum range from gifted to severely challenged in terms of learning, thinking and problem-solving.
What are the signs someone may be autistic?
Lane: Lack of eye contact is a common one. You may find it difficult to carry on a conversation with someone on the spectrum unless it’s a topic they are very interested in. Small talk can be tough, and they’re often brutally honest.
The signs differ over time:
- Early on, babies may not like to be held or may miss developmental milestones, such as talking or walking on time.
- Children are often rigid in their play. For example, if you move a toy, a child with autism may have a tantrum so aggressive that they injure themselves.
- As an adolescent, they may prefer to play in their own world, being inwardly focused and not engaging with their peers.
- As an adult, similar patterns may emerge in social settings. They may also focus on activities such as video games where they can make connections with minimal social interaction.
The CDC notes that people on the spectrum may:
- Avoid eye contact
- Prefer being alone
- Prefer not to be held or cuddled
- Not point at or look at objects
- Have trouble understanding other people’s feelings
- Have trouble relating to others or taking an interest in things that don’t relate to them
- Appear to be unaware when people talk to them but respond to sounds
- Be unable to talk, play or relate to people despite wanting to
- Repeat words, phrases or actions
- Have trouble expressing their needs using typical words or motions
- Avoid playing “pretend” games (ex. “feeding” a doll)
- Have trouble adapting when a routine changes
- Have unusual reactions to how things smell, taste, look, feel or sound
What causes autism?
Lane: No one knows. Most scientists agree that genetics plays a role, but there are only a few things we know for certain:
- Children who have a sibling with ASD are at a higher risk of having it, as are children born to older parents.
- There is no scientific evidence that childhood vaccines cause autism.
- People with certain genetic conditions (fragile X syndrome, tuberous sclerosis) are at increased risk.
- When taken during pregnancy, valproic acid and thalidomide are linked with higher risk.
- The critical period for developing ASD appears to occur before, during and immediately after birth.
Any myths or misconceptions about autism you’d like to address?
Lane: Autism itself doesn’t mean a person is more or less intelligent; they just understand and process the world in a way that looks different to some people. Not everyone who has autism is excels in one area. Yes, there some who have hyperfocus and can do miraculous things in their minds, but not everyone with autism has that ability.
What does intervention for autism look like?
Lane: Early intervention is the best intervention.
- If you’re delayed in communication, there’s speech therapy.
- If you’re delayed in motor skills, there’s occupational therapy.
- There’s also applied behavior analysis (ABA), which is used to increase social skills, decrease maladaptive behaviors (meltdowns, tantrums) and teach replacement behaviors. Not everyone has the same needs for intervention so it’s important to be thoughtful and specific to children’s specific needs when considering this therapy.
How should you interact with people on the autism spectrum?
Lane: Most professionals recommend using person-first language like “Jamie has autism” or “Jamie, who is on the spectrum.” But it’s important to ask each individual what they prefer and use that. People are more than a diagnosis, and person-first language helps put you in the right mindset. But it’s important to accommodate what the individual prefers first.
After that, try to understand where they’re coming from. Conversations don’t always go as expected when you’re talking with someone who’s on the spectrum. Come from a place of kindness, and be ready to work with them. Most of the time, people on the spectrum will be upfront about their diagnosis. Appreciate that honesty! It can be very refreshing. Try to find shared interests and common ground, and listen in the same way you’d like for someone to listen to you.
Learn more about autism
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