Its Time To Wake Up To Autism

We aim to provide a description of Autistic Spectrum Disorder (ASD) and the three main problem areas (sometimes referred to as the Triad of Impairments) as well as the associated characteristics encountered by those on the spectrum.

The triad

Communication

Autistic people have a great deal of trouble understanding things in the social environment. This includes both understanding of social cues and conventions, and understanding language. (The primary difference between Autistic Disorder and Aspergers Syndrome is that those with Aspergers are defined to have less severe communication problems and no speech delays.)Autistic people lack normal non-verbal communication and body language, and may thus seem more literal minded or unemotional than they actually are.

Autistic people also have trouble with verbal communication. This usually involves what is called a semantic-pragmatic component. This means that an autistic person may take a statement or question in a very literal or unusual way; like the comic character Amelia Bedelia2 from Peggy Parish's children's book series. This could include things like interpreting “I'd like coffee with my cereal to mean cereal” with coffee in it.

Another example could be innocently answering “what you do when you get a cut” with bleed instead of describing what should be done about the cut.

Many autistic people have other communication difficulties, such as trouble remembering vocabulary, or trouble pronouncing words. Some may have Apraxia of Speech, meaning difficulty coordinating speech movements. Others have characteristics of speech disorders called aphasias. Some autistic people may be mute, or may occasionally lose the ability to speak.

Some may have odd pronunciation, inflection, or vocal qualities. Many autistic people may pause and need extra time to process verbal comments or questions, and to formulate replies. Repeating things that have been heard (echolalia), is not uncommon, nor is repeating ones own words.

Social interaction

One aspect of autism is that it is like being in perpetual culture shock, no matter where the autistic person goes or how long the autistic person stays. They don't understand many of the basic social assumptions that others take for granted (often without even being consciously aware of them). In many situations, it's like being dropped into the middle of an unfamiliar play, and being the only one there who doesn't know the script, you're role, or even what play you're in! What's going on? What should I do? Why is X crying, Y happy, and Z sneaking around grumbling? Life, especially social life, can be very, very confusing! Autistic people generally don't know how to handle innuendoes, either.

Imagination - rigid and inflexible ways of thinking, displayed sometimes through play. Children may use toys with apparent disregard for what their functional use is intended to be e.g. they may prefer to line up cars into exact lines, rather than have races, build a garage for them etc.

Attempts by parents or peers at expanding these set play patterns will not usually be accepted. The child may simply refuse the new ideas, ignore them, and become distressed or angry. The child may engage in behaviours that we normally would not view as 'playing' e.g. spinning objects, clicking light switches on and off, repeating certain bodily actions (e.g. flapping arms). It may also be noticed that the child does not play in ways that demand imagination (most noticeably pretending to be something else - e.g. cowboys and Indians, or imagining make-believe situations - e.g. the table is really a castle). 

The problems referred to resulting from the triad, can sometimes give outsiders the impression that the people with ASD as rude, arrogant, selfish, disrespectful or undisciplined. These judgements are wholly inappropriate when behaviour is actually the result of the impairment, but it should not be forgotten that all individuals are capable of misbehaving, and some problems will be due to disobedience and not the ASD.

Different sub-groups within the spectrum have been described, for example: -

Autism

Aspergers syndrome

High functioning autism

Classical autism

Rett's Disorder

PDD (pervasive developmental disorder)

People may also be described as having autistic traits or features, although it is more useful to consider such children / people as having an autistic spectrum disorder. The term autistic tendencies; is not helpful since it implies uncertainty in the diagnosis.

People in all the sub-groups above, experience difficulties in the three areas described, which are commonly referred to as the triad of impairments. There is evidence that at least in some cases, their perception of sounds, sights, smell, touch; taste may be different, which in turn affects their response to these.

Children of all levels of ability can have an autistic spectrum disorder and it can occur in conjunction with other disorders (e.g. with sensory loss, language impairment and Downs syndrome).

People with an autistic spectrum disorder have a different perspective and experience of the world from ours. It is important to value and develop their particular interests and activities and not to focus on trying to change them (to become like us), which they will find difficult and which they will not necessarily want to do. We need to get into their world and try to see situations from their point of view. This will add to our own insights and understandings. In turn, they will be more relaxed in our company.