Autism

Autism is a neurodevelopmental disability characterized by differences in social interaction, verbal and non-verbal communication, sensory processing, and behavior. Signs tend to show up within the first three years of age, though autism is not always diagnosed young. Some autistic children reach their developmental milestones at a typical pace and then regress. The diagnostic criteria require that signs become apparent in early childhood, typically before age three.
Autism is mostly genetic with some environmental influences.This Is How Much of Autism Is Genetic Researchers are still studying causes of autism.
Autism affects information processing in the brain by altering how nerve cells and their synapses connect and organize; how this occurs is not well understood. Autism was previously broken into subcategories like Asperger syndrome and pervasive developmental disorder not otherwise specified (PDD-NOS), though those were merged under the DSM-5.
Therapy for autism can be tailored to an individual's needs. Autistic people may need help with self-care, social skills, communication, emotion regulation, and other skills. Some autistic people learn to live independently in adulthood, but many others need supportive living situations.
An autistic culture has developed, especially online. Some autistic people advocate for acceptance and support instead of a cure.
==Characteristics==
Autism is a lifelong condition.Scott D. Wright , Cheryl A. Wright , Valerie D’Astous & Amy Maida Wadsworth (2019) Autism aging, Gerontology & Geriatrics Education, 40:3, 322-338, DOI: 10.1080/02701960.2016.1247073
# Signs become noticeable during infancy or childhood, though not everyone is diagnosed young. Every autistic person is unique. They may face severe challenges in some areas while being average or above average in others.
Autistic traits usually become noticeable after the age of six months, become established by age two or three years, and tend to continue through adulthood. While there is no cure for autism, the right support can build skills and make life easier.
Autistic people show differences in:
#Social interaction
#Communication
#Restricted interests and repetitive behavior
===Social development===
Autistic people find it more difficult to intuitively understand non-autistic people. This can make social interactions challenging.
In some cases, unusual social development becomes apparent early in childhood. Autistic infants may show less attention to social stimuli, smile and look at others less often, and respond less to their own name. Autistic toddlers may make eye contact, take turns, and point at things less often (if at all). Three- to five-year-old autistic children are less likely to exhibit social understanding, approach others spontaneously, imitate and respond to emotions, communicate nonverbally, and take turns with others. However, they do form attachments to their primary caregivers.
Autistic people tend to find eye contact stressful.For Those With Autism, Eye Contact Isn't Just Weird, It's Distressing Researchers suggest that pressuring them to make eye contact may be harmful.Should We Insist on Eye Contact with People who have Autism Spectrum Disorders
Many autistic people feel lonely, despite the misconception that they prefer to be alone.Autistic people experience loneliness far more acutely than neurotypical people – new research It can be hard to make and keep friendships. Friendship quality matters more than quantity in terms of loneliness. Functional friendships, such as those resulting in invitations to parties, may affect the quality of life more deeply.
Autistic people are at increased risk of bullying victimization.Prevalence of Victimisation in Autistic Individuals: A Systematic Review and Meta-AnalysisWorkplace bullying of autistic people: a Vicious cycle.
Autistic people may begin "masking" to fit in. This means mimicking non-autistic behavior. Examples include suppressing the need to fidget, pretending not to be overwhelmed, and forcing eye contact. Masking is associated with poor mental health outcomes like stress, depression, and suicidality.Conceptualising Autistic Masking, Camouflaging, and Neurotypical Privilege: Towards a Minority Group Model of NeurodiversityCassidy S, Bradley L, Shaw R, Baron-Cohen S. Risk markers for suicidality in autistic adults. Mol Autism. 2018 Jul 31;9:42. doi: 10.1186/s13229-018-0226-4. PMID: 30083306; PMCID: PMC6069847.Cassidy, S.A., Gould, K., Townsend, E. et al. Is Camouflaging Autistic Traits Associated with Suicidal Thoughts and Behaviours? Expanding the Interpersonal Psychological Theory of Suicide in an Undergraduate Student Sample. J Autism Dev Disord 50, 3638–3648 (2020). https://doi.org/10.1007/s10803-019-04323-3 Experiencing autism acceptance can improve mental health.Cage E, Di Monaco J, Newell V. Experiences of Autism Acceptance and Mental Health in Autistic Adults. J Autism Dev Disord. 2018 Feb;48(2):473-484. doi: 10.1007/s10803-017-3342-7. PMID: 29071566; PMCID: PMC5807490.Chapman, Louise; Rose, Kieran; Hull, Laura; Mandy, William (2022-11-01). ""I want to fit in… but I don't want to change myself fundamentally": A qualitative exploration of the relationship between masking and mental health for autistic teenagers". Research in Autism Spectrum Disorders. 99: 102069. doi:10.1016/j.rasd.2022.102069. ISSN 1750-9467. S2CID 253495529. A supportive environment may help autistic people feel more comfortable being themselves.Cook, J. M., Crane, L., & Mandy, W. (2024). Dropping the mask: It takes two. Autism, 28(4), 831-842. https://doi.org/10.1177/13623613231183059
The "double empathy problem" describes how it is harder for non-autistic and autistic people to relate to each other.Damian E.M. Milton DEM979@bham.ac.uk (2012) On the ontological status of autism: the ‘double empathy problem’, Disability & Society, 27:6, 883-887, DOI: 10.1080/09687599.2012.710008Outcomes of real-world social interaction for autistic adults paired with autistic compared to typically developing partnersEdey R, Cook J, Brewer R, Johnson MH, Bird G, Press C. Interaction takes two: Typical adults exhibit mind-blindness towards those with autism spectrum disorder. J Abnorm Psychol. 2016 Oct;125(7):879-885. doi: 10.1037/abn0000199. Epub 2016 Sep 1. PMID: 27583766.Double Empathy: Why Autistic People Are Often Misunderstood Non-autistic people tend to judge autistic people more harshly than they judge non-autistic people.Sasson, N., Faso, D., Nugent, J. et al. Neurotypical Peers are Less Willing to Interact with Those with Autism based on Thin Slice Judgments. Sci Rep 7, 40700 (2017). https://doi.org/10.1038/srep40700Autistic Adults May Be Erroneously Perceived as Deceptive and Lacking Credibility However, they are less judgmental when they know the person is autistic and when they understand autism better,Sasson, N. J., & Morrison, K. E. (2019). First impressions of adults with autism improve with diagnostic disclosure and increased autism knowledge of peers. Autism, 23(1), 50-59. https://doi.org/10.1177/1362361317729526Scheerer NE, Boucher TQ, Sasson NJ, Iarocci G. Effects of an Educational Presentation About Autism on High School Students' Perceptions of Autistic Adults. Autism Adulthood. 2022 Sep 1;4(3):203-213. doi: 10.1089/aut.2021.0046. Epub 2022 Aug 31. PMID: 36606156; PMCID: PMC9645669. suggesting that improving understanding of autism could help.
===Communication===
About a third to a half of autistic people do not develop enough natural speech to meet their daily communication needs.
In childhood, this can include:
*Babies may experience delayed onset of babbling, unusual gestures, diminished responsiveness, and vocal patterns that are not synchronized with the caregiver.
*Toddlers may have less frequent and less diverse babbling, consonants, words, and word combinations; their gestures are less often integrated with words.
*Autistic children are less likely to make requests and share experiences.
*Reduced joint attention. Autistic children may not understand communication attempts (such as looking at a pointing hand instead of looking at what the hand is pointing to).
*Less interest in imaginative play.
Autistic people may have "quirky" speech. This includes echolalia (repeating others' words) and gestalt language processing, which leads to them reversing pronouns. For example, an autistic child might say "Do you want to eat?" when they are hungry. They may stutter or have other issues.Autism and speech
Alternative and Augmentative Communication (AAC) can help nonspeaking autistic people and those who have limited speech skills. Examples include picture boards, tablet apps, and sign language. Experts recommend prioritizing communication over verbal speech alone.Zisk AH, Dalton E. Augmentative and Alternative Communication for Speaking Autistic Adults: Overview and Recommendations. Autism Adulthood. 2019 Jun 1;1(2):93-100. doi: 10.1089/aut.2018.0007. Epub 2019 Apr 13. PMID: 36601528; PMCID: PMC8992808. A speech and language therapist may help with AAC.
Autistic people communicate with each other more effectively than they communicate with non-autistic people.Crompton CJ, Ropar D, Evans-Williams CV, Flynn EG, Fletcher-Watson S. Autistic peer-to-peer information transfer is highly effective. Autism. 2020 Oct;24(7):1704-1712. doi: 10.1177/1362361320919286. Epub 2020 May 20. PMID: 32431157; PMCID: PMC7545656.Neurodivergent intersubjectivity: distinctive features of how autistic people create shared understanding
Difficulty with communication continues into adulthood.Cummins C, Pellicano E, Crane L. Autistic adults' views of their communication skills and needs. Int J Lang Commun Disord. 2020 Sep;55(5):678-689. doi: 10.1111/1460-6984.12552. Epub 2020 Jul 2. PMID: 32618026. However, the right support can make a big difference.
===Repetitive behavior===
Autistic people display many forms of repetitive or restricted behavior. Psychologists split this into 6 groups.
*Stereotypy is repetitive movement, such as hand flapping, head rolling, or body rocking.
*Compulsive behavior is intentional and appears to follow rules, such as arranging objects in stacks or lines.
*Sameness is resistance to change. For example, they may find it stressful if furniture is moved or if daily routines are changed.
*Ritualistic behavior involves an unvarying pattern of daily activities, such as an unchanging menu or a dressing ritual. This is closely associated with sameness.
*Restricted behavior is limited in focus, interest, or activity, such as preoccupation with a single television program, toy or game. Intense interests are generally associated with greater wellbeing.Grove R, Hoekstra RA, Wierda M, Begeer S. Special interests and subjective wellbeing in autistic adults. Autism Res. 2018 May;11(5):766-775. doi: 10.1002/aur.1931. Epub 2018 Feb 10. PMID: 29427546.
*Self-injury includes movements that injure or can injure the person, such as eye-poking, skin-picking, hand-biting and head-banging. No single repetitive or self-injurious behavior is specific to autism, but autistic people may self-injure more often and more intensely than non-autistic people.
Autistic adults report that repetitive fidgeting ("stimming") can help with self-regulation.Kapp SK, Steward R, Crane L, Elliott D, Elphick C, Pellicano E, Russell G. 'People should be allowed to do what they like': Autistic adults' views and experiences of stimming. Autism. 2019 Oct;23(7):1782-1792. doi: 10.1177/1362361319829628. Epub 2019 Feb 28. PMID: 30818970; PMCID: PMC6728747. They have asked that people accept harmless behaviors like finger-flicking or rocking back and forth. While past approaches focused on training autistic people to stop doing anything unusual, researchers have confirmed that this behavior has benefits.Rethinking repetitive behaviors in autismStimming, therapeutic for autistic people, deserves acceptance
===Other traits===
Many autistic people struggle with emotion regulation.Mazefsky CA, Herrington J, Siegel M, Scarpa A, Maddox BB, Scahill L, White SW. The role of emotion regulation in autism spectrum disorder. J Am Acad Child Adolesc Psychiatry. 2013 Jul;52(7):679-88. doi: 10.1016/j.jaac.2013.05.006. Epub 2013 Jun 3. PMID: 23800481; PMCID: PMC3719386.A systematic review of emotion regulation in children with Autism Spectrum Disorder Strong emotions can lead to outbursts (meltdowns) or shutdowns. Learning to cope with strong emotions and recognize when to take a break is important for autistic people.Emotion regulation in autism spectrum disorder: Where we are and where we need to goHelp Your Autistic Child Manage Emotions
Autistic people may have difficulty understanding emotions in themselves and others. This trait is called "alexithymia."Poquérusse J, Pastore L, Dellantonio S, Esposito G. Alexithymia and Autism Spectrum Disorder: A Complex Relationship. Front Psychol. 2018 Jul 17;9:1196. doi: 10.3389/fpsyg.2018.01196. Erratum in: Front Psychol. 2018 Sep 05;9:1638. PMID: 30065681; PMCID: PMC6056680.Alexithymia & autism guide Both autistic and non-autistic people can have alexithymia.
Sensory sensitivities are common in autistic people.Marco EJ, Hinkley LB, Hill SS, Nagarajan SS. Sensory processing in autism: a review of neurophysiologic findings. Pediatr Res. 2011 May;69(5 Pt 2):48R-54R. doi: 10.1203/PDR.0b013e3182130c54. PMID: 21289533; PMCID: PMC3086654.Sensory differences - a guide for all audiences These include under-responsivity (for example, walking into things), over-responsivity (for example, distress from loud noises), and sensation seeking (for example, rhythmic movements).
Motor difficulties are common in autistic people. These can include low muscle tone, trouble with motor planning, and poor coordination. Autistic people may engage in toe-walking, which can cause damage if done too often.Walking on Tiptoes: Is This a Sign of Autism?Toe Walking
Unusual eating behavior is common in autistic people. Sensory sensitivities and fear of the unfamiliar can lead to selective eating. Certain foods may feel inedible to autistic people. Some autistic people also have eating rituals. Autistic people are at higher risk of eating disorders such as ARFID and anorexia.Baraskewich J, von Ranson KM, McCrimmon A, McMorris CA. Feeding and eating problems in children and adolescents with autism: A scoping review. Autism. 2021 Aug;25(6):1505-1519. doi: 10.1177/1362361321995631. Epub 2021 Mar 2. PMID: 33653157; PMCID: PMC8323334.Eating disorders
Strengths of autistic people includeAutism Strengths integrity,Autistic People Care Too Much, Research Says fast problem-solving, logic, pattern recognition, ability to recall environmental details,Implications of capacity in the classroom: Simplifying tasks for autistic children may not be the answer resistance to peer pressure,Social conformity and autism spectrum disorder : a child-friendly take on a classic study and more. Intellectual giftedness is common in autistic people.
==Causes==
Autism has a strong genetic basis. Researchers have associated many genes with autism, but it is not yet fully understood.
Several lines of evidence point to synaptic differences as a cause of autism.
All known teratogens (agents that affect fetal development) related to autism appear to act during the first eight weeks from conception.Arndt, T.L., Stodgell, C.J. and Rodier, P.M. (2005), The teratology of autism. International Journal of Developmental Neuroscience, 23: 189-199. https://doi.org/10.1016/j.ijdevneu.2004.11.001 Evidence suggests that autism begins in the womb.Autism begins in the womb, according to a new study Research suggests that exposure to pollution may increase the chance of autism.
Parents may first notice signs of autism around the time for routine vaccinations. This has sparked numerous mythsDoja A, Roberts W. Immunizations and Autism: A Review of the Literature. Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques. 2006;33(4):341-346. doi:10.1017/S031716710000528X
*Gerber JS, Offit PA. Vaccines and autism: a tale of shifting hypotheses. Clin Infect Dis. 2009 Feb 15;48(4):456-61. doi: 10.1086/596476. PMID: 19128068; PMCID: PMC2908388.Gross L. A broken trust: lessons from the vaccine--autism wars. PLoS Biol. 2009 May 26;7(5):e1000114. doi: 10.1371/journal.pbio.1000114. Epub 2009 May 26. PMID: 19478850; PMCID: PMC2682483. that have led to disease outbreaks, profiteering scams, and preventable deaths in children.Measles outbreak in Dublin, 2000 Researchers have exhaustedly proven that vaccines are not linked to autism, yet misinformation continues.Vaccines are not associated with autism: An evidence-based meta-analysis of case-control and cohort studiesDo Vaccines Cause Autism?Autism and VaccinesKnopf A. Time to remember: Vaccines don't cause autism. The Brown University Child and Adolescent Behavior Letter. 2021 Jul;37(7):9–10. doi: 10.1002/cbl.30559. Epub 2021 Jun 7. PMCID: PMC8207024.Link between autism and vaccination debunkedVaccines Don't Cause Autism (and Here's the Proof) Some people have pointed out that having an autistic child is better than having a medically at-risk child who is permanently damaged or killed by vaccine-preventable diseases.
==How Autism Works==
How autism occurs is not well understood. Its mechanism can be divided into two areas: the physiology of brain structures and processes associated with autism, and the neuropsychological linkages between brain structures and behaviors.
===Physiology===
The diversity of autistic people makes it harder to tease out how autism works in the brain.
Autism appears to result from developmental factors that affect many or all functional brain systems, and it affects the timing of development more than the final product. Research on factors affecting fetal development strongly suggests that signs of autism in the brain appear soon after conception.
Just after birth, the brain tends to grow faster than usual, followed by average or relatively slower growth in childhood. It seems to be most prominent in brain areas underlying the development of higher cognitive specialization.
The immune system is thought to play an important role in autism. Interactions between the immune system and the nervous system begin early in embryo development. If infection or toxin exposure occurs during pregnancy, the pregnant parent's immune response could affect fetal development.Patterson PH. Maternal infection and immune involvement in autism. Trends Mol Med. 2011 Jul;17(7):389-94. doi: 10.1016/j.molmed.2011.03.001. Epub 2011 Apr 7. PMID: 21482187; PMCID: PMC3135697.Chaste P, Leboyer M. Autism risk factors: genes, environment, and gene-environment interactions. Dialogues Clin Neurosci. 2012 Sep;14(3):281-92. doi: 10.31887/DCNS.2012.14.3/pchaste. PMID: 23226953; PMCID: PMC3513682. Illness during pregnancy may be linked to autism.Lee BK, Magnusson C, Gardner RM, Blomström Å, Newschaffer CJ, Burstyn I, Karlsson H, Dalman C. Maternal hospitalization with infection during pregnancy and risk of autism spectrum disorders. Brain Behav Immun. 2015 Feb;44:100-5. doi: 10.1016/j.bbi.2014.09.001. Epub 2014 Sep 16. PMID: 25218900; PMCID: PMC4418173.Atladóttir, H.Ó., Thorsen, P., Østergaard, L. et al. Maternal Infection Requiring Hospitalization During Pregnancy and Autism Spectrum Disorders. J Autism Dev Disord 40, 1423–1430 (2010). https://doi.org/10.1007/s10803-010-1006-y
Researchers are investing neurochemicals in autism. The one with the most evidence is the role of serotonin and of genetic differences in its transport. Some data suggests neuronal overgrowth potentially related to an increase in several growth hormones or to impaired regulation of growth factor receptors. Also, some inborn errors of metabolism are associated with autism, but probably account for less than 5% of cases.
Autism affects many areas of the brain.Brain changes in autism are far more sweeping than previously known, UCLA-led study findsNew Research First to Test 60-Year-Old Theory on Autism Autistic people have more "neural noise," which makes them better-suited for some tasks.‘Noisy’ autistic brains seem better at certain tasks. Here’s why neuroaffirmative research matters Connectivity may be above average in some brain areas (like the cortex) and below average in others (like connections between the frontal lobe and the cortex).
===Neuropsychology===
Many cognitive theories have been proposed to explain autism.
*The "intense world" theory suggests that autistic people experience many things more intensely.Markram K, Markram H. The intense world theory - a unifying theory of the neurobiology of autism. Front Hum Neurosci. 2010 Dec 21;4:224. doi: 10.3389/fnhum.2010.00224. PMID: 21191475; PMCID: PMC3010743.Intense World Theory Of Autism Explained Simply Autistic brains generate much more information than neurotypical brains while at rest.Intense World Theory Of Autism Explained Simply This could make autistic people more easily overwhelmed, creating a need for calm and quiet environments.
*The empathizing-systemizing theory suggests that autistic brains are better at logical and organization tasks, but less effective at empathizing.
**The controversial "extreme male brain" theory is an offshoot of this. This theory has undergone heavy criticism for bias and weak evidence.Extreme Male Brain Theory of Autism Overturned as Huge Study Finds No Link Between Testosterone and Lack of Empathy"The Extreme Male Brain?" Incrementum and the Rhetorical Gendering of AutismSome difficulties behind the concept of the ‘Extreme male brain’ in autism research. A theoretical reviewThe Gendered Brain by Gina Rippon review – exposing a myth
*Weak central coherence theory suggests that autistic people are great at noticing details while struggling to see the big picture.The Weak Coherence Account: Detail-focused Cognitive Style in Autism Spectrum Disorders However, some research has found that while autistic people are above average at noticing details, they have no impairments in recognizing global context.Ozonoff, S., Strayer, D.L., McMahon, W.M. and Filloux, F. (1994), Executive Function Abilities in Autism and Tourette Syndrome: An Information Processing Approach. Journal of Child Psychology and Psychiatry, 35: 1015-1032. https://doi.org/10.1111/j.1469-7610.1994.tb01807.xMottron, L., Burack, J.A., Stauder, J.E.A. and Robaey, P. (1999), Perceptual Processing among High-functioning Persons with Autism. Journal of Child Psychology and Psychiatry, 40: 203-211. https://doi.org/10.1111/1469-7610.00433Mottron, L., Burack, J.A., Iarocci, G., Belleville, S. and Enns, J.T. (2003), Locally oriented perception with intact global processing among adolescents with high-functioning autism: evidence from multiple paradigms. Journal of Child Psychology and Psychiatry, 44: 904-913. https://doi.org/10.1111/1469-7610.00174
Autism is complicated. No single theory perfectly explains everything that autistic people experience.
==Diagnosis==
Diagnosis is based on behavior. Experts check for differences in socializing as well as repetitive behavior, interests, and activities. Differences should not be better explained by by Rett syndrome, intellectual disability, or global developmental delay.
Autism can be diagnosed in early childhood, though diagnosis is often less accurate before age three. Some autistic people are diagnosed in teen or adult years. Cost, wait lists, masking, and stigma are all potential barriers to diagnosis.Lockwood Estrin G, Milner V, Spain D, Happé F, Colvert E. Barriers to Autism Spectrum Disorder Diagnosis for Young Women and Girls: a Systematic Review. Rev J Autism Dev Disord. 2021;8(4):454-470. doi: 10.1007/s40489-020-00225-8. Epub 2020 Oct 29. PMID: 34868805; PMCID: PMC8604819.Addressing current barriers to autism diagnoses through a tiered diagnostic approach involving pediatric primary care providers
Autistic people are diverse in terms of skills and needs. Three rough categories (levels 1, 2, and 3) have been used to describe the level of support a person needs.
Autism is diagnosed more often in recent years. Diagnostic practices have changed to include more people. Historically, autistic womenAutism is still underdiagnosed in girls and women. That can compound the challenges they faceAutism in women 'significantly under-diagnosed'Why Many Autistic Girls Are Overlooked and people of colorAylward BS, Gal-Szabo DE, Taraman S. Racial, Ethnic, and Sociodemographic Disparities in Diagnosis of Children with Autism Spectrum Disorder. J Dev Behav Pediatr. 2021 Oct-Nov 01;42(8):682-689. doi: 10.1097/DBP.0000000000000996. PMID: 34510108; PMCID: PMC8500365.Black And Latino Children Are Often Overlooked When It Comes To Autism have been under-diagnosed, and experts are working to close this gap.
===Screening===
Young children may be tested if they don't meet typical milestones. These include:
*No babbling by 12 months.
*No gesturing (pointing, waving, etc.) by 12 months.
*No single words by 16 months.
*No two-word (spontaneous, not just echolalic) phrases by 24 months.
*Any loss of any language or social skills, at any age.
In the US, children go through an autism screening at 18 and 24 months. In contrast, in the UK, children whose families or doctors recognize possible signs of autism are screened. It is not known which approach is more effective.
However, not all autistic people will show language and communication delays at an early age. Some autistic people with less obvious traits go undiagnosed for years. Screening can happen at any age.
==Support and Prognosis==
Autism has no cure. However, supports can greatly increase quality of life and adaptive skills in autistic people.
Each autistic person has different needs. There is no one-size-fits-all approach. Supports should focus on increasing quality of life and adaptive skills.
===Therapy===
Therapy for autism should be tailored to the individual's needs.
*Applied behavior analysis (ABA) is the most popular therapy for autism. It involves use of rewards and/or punishments to increase desired behaviors and extinguish unwanted behaviors.
**Recently, the efficacyUS Government Reports that ABA Doesn’t Work.Bottema-Beutel K, Crowley S. Pervasive Undisclosed Conflicts of Interest in Applied Behavior Analysis Autism Literature. Front Psychol. 2021 May 5;12:676303. doi: 10.3389/fpsyg.2021.676303. PMID: 34025538; PMCID: PMC8131529. and ethicsWilkenfeld DA, McCarthy AM. Ethical Concerns with Applied Behavior Analysis for Autism Spectrum "Disorder". Kennedy Inst Ethics J. 2020;30(1):31-69. doi: 10.1353/ken.2020.0000. PMID: 32336692.Long-term ABA Therapy Is Abusive: A Response to Gorycki, Ruppel, and Zane of ABA has been questioned, with some experts raising concerns about potential psychological harm, abuse allegations, and PTSD symptoms.“Recalling hidden harms”: autistic experiences of childhood applied behavioural analysis (ABA)Evidence of increased PTSD symptoms in autistics exposed to applied behavior analysisAileen Herlinda Sandoval-Norton, Gary Shkedy & Dalia Shkedy | Jacqueline Ann Rushby (Reviewing editor) (2019) How much compliance is too much compliance: Is long-term ABA therapy abuse?, Cogent Psychology, 6:1, DOI: 10.1080/23311908.2019.1641258Why caregivers discontinue applied behavior analysis (ABA) and choose communication-based autism interventions Quality of ABA therapy can vary.Low standards corrode quality of popular autism therapy
**Early intensive behavioral intervention (EIBI) is an ABA-based model involving 20 to 40 hours per week.
*Speech and language therapy can build communication skills.How Speech Therapy Benefits Autistic Children
*Occupational therapy can build self-care, social, and job skills.
*Talk therapy, such as cognitive behavior therapy and dialectical behavior therapy, may help with stress reduction and co-occurring mental health issues.
*Assertiveness training may help with communication skills and self-advocacy.
===Educational support===
Autistic students can face challenges in classroom settings. Background noise, social nuances, and stigma may be difficult to navigate. They may not know how to understand or befriend their peers.
Some autistic students benefit from special education, while others may attend mainstream classes with support.
Ways to support autistic students include:How Can You Accommodate Autistic Students in the Classroom?
*Visual schedules to help them anticipate the day's activities and make transitions easier
*Social stories to prepare them for new or challenging situations
*A quiet place to take breaks
*Fidget tools for stimming
*Sensory-blocking options like headphones or study carrels
*A peer mentor or "buddy"
*Taking tests in a separate, quiet room
*Integrating special interests into lessons
*Teacher's aides for additional support
Some autistic children may find working in pairs helpful so they can make friends. Others find paired work more stressful than working solo.
Reducing stress at school is important for success.
===Medication===
Some autistic people benefit from medication. However, there is no specific medication for autism.
Here are some common medications.Medications for Autism Spectrum Disorder
*SSRIs may help with anxiety, irritability, and outbursts.
*Antidepressants may help with irritability and hyperactivity.
*Antipsychotics may reduce irritability.
*Stimulants may reduce ADHD-type difficulties.
Many autistic people have co-occurring conditions such as anxiety, ADHD, or epilepsy. Treating these conditions properly can improve quality of life.
Medication often has side effects. Any medication changes should be discussed with a doctor.
===Alternative medicine===
Few alternative treatments are supported by scientific studies. Some, especially "biomedical" treatments,The autism “biomed” movement: Uncontrolled and unethical experimentation on autistic children are harmful or potentially fatal.Autism Pseudoscience: A Guide for PhysiciansThe fake cures for autism that can prove deadlyTreatments that are not recommended for autismWarning: So-called cures and dodgy interventions
*Gluten-free, casein-free diets show no solid evidence of helping autistic people who don't have gluten sensitivities.Marí-Bauset S, Zazpe I, Mari-Sanchis A, Llopis-González A, Morales-Suárez-Varela M. Evidence of the Gluten-Free and Casein-Free Diet in Autism Spectrum Disorders: A Systematic Review. Journal of Child Neurology. 2014;29(12):1718-1727. doi:10.1177/0883073814531330 This diet may reduce bone density.Tye C, Runicles AK, Whitehouse AJO, Alvares GA. Characterizing the Interplay Between Autism Spectrum Disorder and Comorbid Medical Conditions: An Integrative Review. Front Psychiatry. 2019 Jan 23;9:751. doi: 10.3389/fpsyt.2018.00751. Erratum in: Front Psychiatry. 2019 Jun 27;10:438. PMID: 30733689; PMCID: PMC6354568. The harms of further restricting the diets of people with eating difficulties is also a potential problem.
*Chelation is risky and not recommended.James S, Williams K, Silove N, Stevenson SW. Chelation for autism spectrum disorder (ASD). Cochrane Database of Systematic Reviews 2013, Issue 10. Art. No.: CD010766. DOI: 10.1002/14651858.CD010766. Accessed 03 April 2024. In 2005, it killed a five-year-old autistic child.FDA links child deaths to chelation therapy
*Forcing autistic people to ingest bleach ("Mineral Mineral Solution") is an extremely bad idea.Are People Attempting to Cure Their Children's Autism with Bleach Enemas?Parents are poisoning their children with bleach to 'cure' autism. These moms are trying to stop it.
A few less-invasive practices may help autistic people. Research shows some benefits from mindfulness,Benevides TW, Shore SM, Andresen ML, Caplan R, Cook B, Gassner DL, Erves JM, Hazlewood TM, King MC, Morgan L, Murphy LE, Purkis Y, Rankowski B, Rutledge SM, Welch SP, Wittig K. Interventions to address health outcomes among autistic adults: A systematic review. Autism. 2020 Aug;24(6):1345-1359. doi: 10.1177/1362361320913664. Epub 2020 May 11. PMID: 32390461; PMCID: PMC7787674. music therapy,Geretsegger M, Fusar-Poli L, Elefant C, Mössler KA, Vitale G, Gold C. Music therapy for autistic people. Cochrane Database Syst Rev. 2022 May 9;5(5):CD004381. doi: 10.1002/14651858.CD004381.pub4. PMID: 35532041; PMCID: PMC9082683. and pet therapy.Rumayor, C.B., Thrasher, A.M. Reflections on Recent Research Into Animal-Assisted Interventions in the Military and Beyond. Curr Psychiatry Rep 19, 110 (2017). https://doi.org/10.1007/s11920-017-0861-z
==Autism in Society==
Autistic people have developed their own culture and community. Researchers are beginning to seek out and work to align with the priorities of autistic people.Leadbitter K, Buckle KL, Ellis C, Dekker M. Autistic Self-Advocacy and the Neurodiversity Movement: Implications for Autism Early Intervention Research and Practice. Front Psychol. 2021 Apr 12;12:635690. doi: 10.3389/fpsyg.2021.635690. PMID: 33912110; PMCID: PMC8075160.
Autistic people are more likely to have LGBT+ identities.George, R. and Stokes, M.A. (2018), Sexual Orientation in Autism Spectrum Disorder. Autism Research, 11: 133-141. https://doi.org/10.1002/aur.1892Kallitsounaki A, Williams DM. Autism Spectrum Disorder and Gender Dysphoria/Incongruence. A systematic Literature Review and Meta-Analysis. J Autism Dev Disord. 2023 Aug;53(8):3103-3117. doi: 10.1007/s10803-022-05517-y. Epub 2022 May 20. PMID: 35596023; PMCID: PMC10313553. The reason why is currently unclear.
===Autism Rights and Neurodiversity===
The autism rights movement emerged to increase acceptance of autistic people and to defend against abuse.Trivedi, Bijal. Autistic and proud of it. New Scientist. Retrieved on 10 November 2015. Through this movement, people hope to cause others to think of autism as a difference instead of a disease. Proponents of this movement wish to seek "acceptance, not cures."Shapiro, Joseph (26 June 2006). Autism Movement Seeks Acceptance, Not Cures. NPR. Retrieved on 10 November 2015. Key issues include abuse prevention, self-determination, the right to be themselves instead of being forced to assimilate, and seeing autism as a difference to accommodate instead of a disease to eradicate.A History and Overview of the Autism Acceptance Movementden Houting, J. (2019). Neurodiversity: An insider’s perspective. Autism, 23(2), 271-273. https://doi.org/10.1177/1362361318820762
===Debates Around Autism===
Debates on autism often split into two groups. The neurodiversity group argues that autism is a difference instead of a disease, and that support for autistic people should honor their individual needs and quirks. The pathology group argues that autism is a disease that should be cured or ameliorated through behavior training to make autistic people fit in.
The debate about curing autism continues as scientists learn more about causation. Pro-cure advocates, many of which are parents, argue that autism is a disease that causes suffering and should be erased. Anti-cure advocates, many of which are autistic adults, raise concerns about eugenics, loss of human diversity, and the ethics of potential selective abortion.The Problematic Obsession With ‘Curing’ AutismI don't want to be 'cured' of autism, thanks They argue that autistic people are members of a minority group rather that deserves accommodation instead of eradication.Why Don’t Autistics Want a Cure for Autism?
For decades, conversations about autism happened without autistic voices. Autistic people are gaining more of a say in conversations about them.
==References==
Category:Autism