There is a common expression or idiom that says that everything that I’m not made me everything that I am, or something to that extent. As such, perhaps the best way to describe Autism is by explaining what it is not. If you have stumbled across this website, then the odds are that your child or loved one has been diagnosed somewhere along the spectrum, and in this process, you are probably doing all the research that you can to understand them, what they have, and of course, as is the most frequently asked question in this scenario, whether or not they will lead a normal life; whatever a normal life means or looks like. After all, what is normal to the spider, is chaos to the fly. So, for all intended purposes, let’s break down this neurological condition by looking at what it is not.
To begin, let’s start by analyzing the common perception, or rather, misperception as to what Autism is. In order to do so, I would like the reader to imagine the following setting; one that isn’t so hard to envision, as it is a background that has been lived, or that is a subjective reality to the individual absorbing the words on this page.
Picture the whole family situated in a small office. By all conventional standards, it is a workspace of elaborate design. The walls are finely decorated with the numerous Ph.D.’s and intellectual achievements of the Psychiatrist or Psychologist whose wisdom and counsel is so desperately sought. Let’s identify him as one Dr. Buddenhagen. The walls are painted a fine color of deep green, the color of life, but an otherwise tactical approach, as it is a comforting and soothing color nonetheless, which is the mood that the doctor in question is trying to achieve. There are motivational pictures, framed and neatly placed around the room, most of which are poking fun at the majority of Psychological conceptualizations such as Maslow’s hierarchy of needs, or Pavlov’s dog. How wonderful, at least the doc has a sense of humor.
Humour aside, the tension in the room is all but palpable, an appropriate response to the serious concern that you have for your loved one in question. You’ve spent hours trying to explain the symptoms that you’ve observed, and you’re waiting, on the edge of your seats as to what the doc’s thoughts are. He sits in front of you in his tweed suit, legs crossed with his pen and notepad situated in his lap observing the individual with an expression of deep contemplation etched across his aged face.
Meanwhile, the dependent sits in the corner of the room, seemingly as if they are in their own little world, and to a degree, they probably are. They are working on a picture, and until this point, they haven’t said a word, or at least that’s the way it seems; in all actuality, the picture of a brain that they are working on speaks volumes to their understanding of what is going on, but nonetheless, this is why you are here, this is why you are concerned. This just isn’t normal. Something needs to be done, something that will normalize them to the way of the world.
It is at this point that Dr. Buddenhagen resorts to the Holy Bible of Psychology; the latest edition of the DSM, and he instructs you to come closer to read the page and the criteria of the diagnosis that he has come to. And it is crucial, that at this point, to stop and realize that this is not what your child or loved one is.
According to the DSM-V, an Autistic diagnosis is determined by the following:
Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive; see text):
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 effect; 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 communication.
Deficits in developing, maintaining, and understand relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.
Severity is based on social communication impairments and restricted, repetitive patterns of behavior.
Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive; see text):
Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypies, lining up toys or flipping objects, echolalia, idiosyncratic phrases).
Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take the same route or eat the same food every day).
Highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).
Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment (e.g. apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).
Severity is based on social communication impairments and restricted, repetitive patterns of behavior.
Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life).
Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level (Centers for Disease Control and Preventions https://www.cdc.gov/ncbddd/autism/hcp-dsm.html).
Now that is all nice and dandy. It helps in the capacity to give your child or loved one a stereotypical cookie-cutter diagnosis. As such, it labels them and nicely places them in a box that poliety says this is who you are, which in all actuality is so far from the truth. On that note, in this regard, there is a common expression in Psychology that it doesn’t matter what you have, as long as it gets treated, and with all due respect, it should otherwise be removed from their practices. Just as it would be wrong for a doctor to treat heart disease as if it were diabetes, so too would it be a serious impediment or detriment to the person to be treated for one mental illness, if in all actuality they had another. So, to this extent, the DSM-V criteria help in its capacity to treat an individual for what they have. However, the problem is, that we often identify or view our loved ones through this lens, as if this is who they are, and it plays a large role in all the stigma that surround mental illness and other conditions of the likes. These people are so much more than a label, categorization, or diagnosis, but it is also at the same time how we often view them. Similarly, the individual with ASD is so much more than an epidemic, which society is also imposing on these beautiful individuals.
To this end, we also tend to view the person with ASD, or what was formerly know as Aspergers Syndrome through the lens of a neurological disorder, further propagating this trend of viewing the individual as a condition, like hello my name is Autism, or my name is Neurological Disorder, viewing it in this sort of dualistic black and white form that says I’m Autistic, as opposed to I have Autism. Again, it is wise, to an extent, to understand what this means. On a rudimentary level, a neurological disorder, like Parkinson’s, Alzheimer’s, dementia, epilepsy, or any other of the likes, is a disease the effects the brain, spine, and the nerves that surround them.
Now that we have firmly established what Autism is not, it is now time to explain what it is. Arguably the best way to do so is found in the word spectrum, or perhaps individualization. In this regard, there is a notoriously infamous quote pertaining to ASD as issued by Stephen Shore, which says “If you’ve met one person with Autism, then you’ve met one person with Autism.”
To further deconstruct this lens of viewing the Autistic individual, let’s look at a further examination of any spectrum. The most obvious is found in a rainbow. Both red and violet reside on the same spectrum, but they are two entirely different colors, just as stars reside on the same spectra, but a class B star is vastly different than that of a class M star, especially in terms of their brightness. To this extent, we see a whole gamut of frequencies in the electromagnetic spectrum, but at the same time, they are all interrelated in one way or another, all of which describe the same thing.
So, in this way, what we see is that on one end of the Autistic spectrum, we have the non-verbal individual with an IQ somewhere around 60 on one end, let’s say the far left, and on the opposite side of this range, we have the highly functional person with what was once known as Aspergers Syndrome or AS, that has an above average IQ of lets say 141; the type that has created for incredible fictional characters like that of Dr. Reed from Criminal Minds with his comorbid condition of Aspergers and Schizophrenia (both of which are of course measured on a spectrum) with his genius IQ, as well as that of the likes of Sheldon Cooper from the Big Bang Theory or Sherlock Holmes. In every instance, the individual has ASD, but they are entirely different in their own capacity. While there are diagnostic criteria that label individuals with Autism, each exhibits it in their own personal way. That is, it appears differently from one person to the next.