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Understanding autism
Understanding autism

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2.2 The autism spectrum

Because of the striking differences among individuals with autism, researchers and practitioners usually talk of the ‘autism spectrum’. This emphasises that autistic individuals may have very different profiles of strengths and weaknesses. Autism Spectrum Disorder (ASD) is the term used within formal autism diagnosis. ASD is also used by some researchers and practitioners; however, many prefer the more neutral term Autism Spectrum Condition (ASC).

A proportion of people on the spectrum (up to about 50%) have profound social and communication difficulties often including little or no speech, markedly restricted and repetitive behaviour and interests, and intellectual disabilities. This variant of autism has sometimes been known as classic or Kanner’s autism, after Kanner, who described autism in 1944 (there will be more on Kanner in Section 6).

Another major group are those who have no obvious language problems and are intellectually capable or even exceptionally bright, while remaining inflexible, bound by routines, struggling to interact socially and communicate effectively. This variant has until recently been diagnosed as Asperger syndrome (after the other main autism pioneer). However, sub-types such as Asperger syndrome are being phased out in contemporary approaches to diagnosis. One contemporary approach treats the spectrum essentially as a continuum on which all autistic individuals have their own specific profile of strengths and challenges. Another approach maintains the notion of a spectrum, but allocates autistic profiles of strengths and difficulties into some newly defined sub-types. You will read more about this in Week 3.

Autism spectrum conditions can occur alongside other psychological and physical conditions (sometimes known as co-morbidity). Epilepsy is fairly common, especially in those with ‘classic’ autism. Depression is also very common, as is dyslexia, although it is not clear if the incidence of these is greater than in the non-autistic population.

Activity 4 Why is autism a spectrum?

Timing: Allow about 15 minutes

Now that you have been introduced to some key facts about autism, write a few notes commenting on why it is considered to be a spectrum. For instance, how much does autism vary between people?

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How do your notes compare with our feedback below? Have you included some of the same ideas?

Although people meeting the diagnostic criteria for autism share characteristic difficulties in social interaction, and the tendency to repetitive or restricted behaviours and interests, these are expressed in different ways and to different extents. One person may speak very little, while another speaks a lot, perhaps not taking the interests of listeners into account; one person may be particularly sensitive to loud sounds, while another has heavy metal music as a special interest. This variety in behaviour, and the genetic and biological variability which underlies it, has meant that the concept of autism has evolved from the original idea of a specific syndrome, to that of a spectrum.

Note that the concept of a spectrum derives from the physics of white light which is made up of an array of colours ordered from low frequencies (red) to higher frequencies (violet) as can be seen in a rainbow. But borrowing this concept has led to the misleading idea that autism is a linear scale with profoundly affected individuals at the 'low' end and less affected individuals at the 'high' end. In practice, a person with good intellectual and language skills, often known as high-functioning, may nevertheless be profoundly disabled by repetitive behaviours and routines which challenge daily living skills. So the autism spectrum needs to be thought of in more complex terms. In this 'infinity spectrum' one individual could be in the 'high' or violet area for intellectual skills, have moderately good language and communication skills (green) but be in the 'low' or red area for daily living skills.

Autism spectrum infinity awareness symbol.
Figure 1 Autism spectrum infinity awareness symbol.