Autism

Autism, sometimes referred to as Autism Spectrum Disorder (ASD), is a form of neurodivergence that describes a difference in the way the brain processes the world. Autistic people will differ from non-autistic people in the way they communicate, emote, and think. It is estimated that there are around 700,000 autistic people in the UK, although this number is hard to confirm as many autistic people may not have diagnoses.

Although autism presents in many ways, the core characteristics are differences in the way you communicate, your behaviours and interests, and your sensory processing. Signs of autism could include:

• Atypical communication, e.g. use of gestures, words, and tone of voice different to non-autistic people
• No speech
• Difference in understanding other people’s communication and social cues
• Literal interpretations of language
• Preference for spending more time alone
• Focused, specific interests
• Repeated behaviours and movements (‘stimming’)
• Desire for predictability and routine
• Highly sensitive, or not sensitive at all, to various sensory stimuli, e.g. lights, sounds, textures, smells

This list is not exhaustive, and someone does not necessarily need to exhibit any of these characteristics to be autistic. Diagnosing autism can only be done by a professional autism assessment team.

Autism often co-occurs with ADHD, a form of neurodivergence sometimes referred to as AuDHD. This can lead to heightened experiences of the shared characteristics between the two conditions, such as sensory differences, difficulty regulating emotions, specific interests, and executive dysfunction. People with both autism and ADHD may also find the traits of each competing with each other, which can be exhausting or overwhelming.

Autism is generally understood to exist on a spectrum. This does not mean a sliding scale from ‘more’ to ‘less’ autistic, as is sometimes assumed, but instead refers to a field of varying presentations between people. Every autistic person has their own unique set of characteristics, thought patterns, and skills that come with corresponding strengths and difficulties. These aspects can also change over time and between different situations.

Both adults and children can be autistic. Adults, especially if they are undiagnosed, may have learned ways of adapting behaviour to make the characteristics of their autism less noticeable. This is called ‘masking’, and can lead to increase stress and fatigue.

Autistic women are often more likely mask their signs of autism. This can sometimes make identifying and diagnosing autism more difficult in women and girls.

Greater numbers of diagnoses in recent years have led to some scepticism. Autism expert Uta Frith, for example, is now suggesting that she believes the spectrum has become too inclusive to the point of being misleading.

Your GP may refer you or your child to have an autism assessment. These assessments are made by a team of specialist professionals such as a clinical psychologist, speech and language therapist, psychiatrist, or occupational therapist.

For children, the team will ask about their development, reports from their school, and medical history. They will assess their communication, movement, processing, and reactions, and how they interact with their parent(s). The assessment may sometimes also include a school visit.

For adults, you will be asked to fill in a questionnaire and answer questions about your early life, work or study, behaviours and interactions with family. They will take into account your medical history and may ask to read any relevant information from school or work to help form a full picture.

Following the assessment, you will be given a report detailing whether or not you are autistic, and what your strengths and challenges may be. The report will include advice and information about how you can access support or anything else you might need. Sometimes you might also be given a follow-up appointment.

Being tested for autism can provide important clarity for many people and provide a clearer path for what to do next and how best to manage your day-to-day. Author Ellie Middleton found that a diagnosis in her 20s clarified many unanswered questions she had about herself.

People with autism are statistically more likely to have a mental health problem such as anxiety, depression or an eating disorder. The difficulty of fitting into a world that isn’t built for the way you function can lead to low self-esteem, stress, loneliness, and burnout.

Accessing mental health support through therapy can therefore be an important resource for many autistic people. Often simply having someone to talk to about the challenges you are facing can be the first step.

Many Welldoing therapists and counsellors specialise in working with autistic clients, including training on how they can best understand and support you. You can filter for therapists with autism expertise to find the right therapist for you.