Autism Spectrum Disorder: Insights and Perspectives

BY: Neighbors’ Consejo|

Autism Spectrum Disorder (ASD) is a diverse and complex condition that influences how individuals perceive and interact with the world around them. With increasing awareness and ongoing research , new insights and perspectives that shape how we approach diagnosis, treatment, and support.

According to the National Institute of Mental Health, “autism spectrum disorder (ASD) is a neurological and developmental disorder that affects how people interact with others, communicate, learn and behave. Although autism can be diagnosed at any age, it is described as a “developmental disorder” because symptoms generally appear in the first 2 years of life.” Autism spectrum disorder DSM-5 diagnostic criteria:

Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.
Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communications.
Deficit in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social context; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.

The article “How autism became autism” considers, “the concept of autism was coined in 1911 by the German psychiatrist Eugen Bleuler to describe a symptom of the most severe cases of schizophrenia, a concept he had also created. According to Bleuler, fantasied thinking was characterized by infantile wishes to avoid unsatisfying realities and replace them with fantasies and hallucinations. ‘Autism’ defined the subject’s symbolic ‘inner life’ and was not readily accessible to observers. Psychologists, psychoanalysts and psychiatrists in Britain used the word autism with this meaning throughout the 1920s and up until the 1950s. However, in the 1960s, many British child psychologist challenged the contentions about infantile thought assumed by Bleuler and created new methods to validate child psychology as a science, in particular epidemiological studies. ‘Autism’ was then completely reformulated as a new descriptive category to serve the needs of this new model of child development.”

What about the theories? There are three psychological theories of ASD: Theory of Mind, Weak Central Cohesion, and Executive Functioning.

Theory of Mind Deficit (ToM): One of the most common and most researched theories of autism is the Theory of Mind (ToM), hypothesis developed by Simon Baron-Cohen. ToM was originally developed when researchers were examining characteristics that may or may not be unique to the human species. The idea was that an individual with a theory of mind should be able to identify mental states within themselves and others, and use this information to make predictions regarding others’ behavior.
Weak Central Cohesion (WCC): Individuals on the spectrum have Weak Central Cohesion (WCC). The WCC theory suggests that individuals on the spectrum struggle to incorporate information at different levels, and as a result, fail to integrate detail into global entities. This theory has been used to describe both assets and deficits in individuals with ASD.
Executive Functioning Disorder: Pennington and Ozonoff (1996) proposed the executive dysfunction theory of autism when they observed that individuals with ASD struggled in a complex task involving abstract concepts such as reasoning and planning. Additionally, Minshew and Goldstein (1998) found that as the complexity of tasks were increased, individuals with autism were more impaired than those without autism.

“The DSM-5 was released in 2013. The DSM-5 redefined autism. Autism spectrum disorders is the only classification for autism in the current edition of the DSM. There are no subcategories. However, if someone had an established diagnosis of Asperger’s, Autistic Disorder, or PDD-NOS from the DSM-4 they would likely be considered as having autism spectrum disorder (ASD).”

Levels of autism:

Level 1: Most people (children and adults) with level 1 ASD are likely able to communicate verbally using words and more complex language as compared to those with level 3 autism who might not be able to speak using words at all. People with this level, often struggle with some aspects of communication and social interactions.
Level 2: Is in the middle of the spectrum as it relates to the level of support a person could benefit from to function more independently and successfully in daily life. When considering the diagnostic criteria for level 2 autism, a person is said to require “substantial support”.
Level 3: According to the DSM-5, someone with this level “require very substantial support”. What this means is that the person would benefit from more assistance and more accommodation in their daily life, in order to function independently and successfully. People with level 3 autism may not speak verbal language (although some do). They might have very challenging behaviors, such as frequent meltdowns, aggression, or self-harm.

How does ASD affect daily life? According to the Institute of Behavioral Health:

Sensory Processing: Individuals with autism often experience atypical sensory processing, which affects their perception of the environment.
Communication: Communications difficulties are a hallmark of autism. Communication is a complex and multifaceted process that requires the use of verbal and nonverbal cues. People with autism often experience difficulties in their ability to communicate with others, whether through verbal and non-verbal means.
Executive Functioning: Is a set of cognitive skills that are necessary for planning, organizing, and completing tasks. Individuals with autism often experienced difficulties with executive functioning, which can impact their ability to manage daily tasks and activities.
Social Interaction: Is an essential part of daily life, but it can be challenging for individuals with autism. They may experience difficulties initiating and maintaining conversations or understanding nonverbal cues, such as facial expressions and tone of voice.
Routine and predictability: they may struggle with changes in their routine or unexpected events, leading to increased anxiety and distress. For example, an individual with autism may have a set morning routine that includes specific activities or a particular order of events.
Emotional Regulation: People with autism may experience difficulties recognizing, interpreting, and regulating their own emotions, as well as understanding the emotions of others.
Repetitive Behaviors and Interests: These behaviors can include things like hand flapping, rocking back and forth, or an intense interest in a particular topic or activity.
Sleep: Sleep difficulties can be challenging, and people with autism may struggle to fall asleep, stay, or wake up feeling rested and refreshed.
Employment: For example, someone with autism may struggle with multi-step tasks or social cues from their colleagues.
Mental Health: anxiety, depression, and other mental health conditions are more common in individuals with autism than in the general population. This can be due to the challenges and stressors associated with living with autism, as well as the stigma and discrimination that individuals with autism may face.
Strengths and Abilities: People with autism often have exceptional memory, attention to detail, and problem-solving skills. These strengths can be utilized to excel in a variety of fields, from science and technology to the arts.

“There is still so much stigma around autism and it has to stop. Some autistics still feel forced into hiding their true selves. For example, if an autistic does something out of the ordinary or makes a mistake, people might tell them that they don’t want to be friends. But some autistics get curious about certain things, and they sometimes don’t realize when they are going in too deep.”

What is the treatment? According to the Mayo Clinic, “no cure exists for autism spectrum disorder, and there is no one-size-fits-all treatment. The goal of treatment is to maximize your child’s ability to function by reducing autism spectrum disorder symptoms and supporting development and learning. Early intervention during the preschool years can help your child learn critical social, communications, functional and behavioral.”

To sum up, autism spectrum disorder (ASD), presents a wide array of challenges and unique strengths, requiring a nuanced approach to diagnosis and intervention. The increasing awareness and ongoing research shed light on the critical aspects of sensory processing, communication, and social interaction that impact daily life for individuals with ASD. Addressing these areas with tailored support and early intervention can significantly enhance their ability to navigate the world.

References:

Autism Diagnostic Criteria: DSM-5 | Autism Speaks. https://www.autismspeaks.org/autism-diagnostic-criteria-dsm-5.

Autism Spectrum Disorder – National Institute of Mental Health (NIMH). https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd.

Evans, Bonnie. «How autism became autism». History of the Human Sciences, vol. 26, n.^o 3. PubMed Central, https://doi.org/10.1177/0952695113484320.

Exploring Theory of Mind, Weak Central Cohesion, and Executive Functioning in ASD | Reading Rockets. https://www.readingrockets.org/topics/autism-spectrum-disorder/articles/exploring-theory-mind-weak-central-cohesion-and-executive.

How Autism Affects Daily Life. https://www.ibhcare.com/tips-for-writing-great-posts-that-increase-your-site-traffic.

Innovations, Behavioral. «Types and Levels of Autism Spectrum Disorder». Behavioral Innovations, https://behavioral-innovations.com/blog/types-and-levels-autism-spectrum-disorder/.

It’s Time to Stop the Stigma | Autism Speaks. https://www.autismspeaks.org/life-spectrum/its-time-stop-stigma.

What Is Autism. https://www.autism.org.uk/advice-and-guidance/what-is-autism.