Autism is many different things to many people. It is one thing from the perspective of a medical professional, another thing to an autie’s parents and family, and something else entirely to an autistic person themselves.
The Medical Model or the Deficits Model
The medical model lists out a bunch of ways autistic people differ from the non-autistic population. It talks about the problems and the struggles, paying no mind to the benefits or possibilities, making even the best parts of the autistic experience sound dismal.
Even worse are the doctors making bleak predictions for children that haven’t entered preschool yet (and the parents who believe them) – “They will never…” “They will never…” Often there is no focus on what is possible, only what is out of reach.
I’m not going to list the medical diagnostic criteria here. It can be accessed easily online by searching “autistic diagnostic criteria” on any web search engine.
- If you are in America, you will be referencing the DSM5.
- In the UK and other parts of the world, the ICD 10 & 11 may also be used.
The Whole Person Model or the Differences Model
Both the medical model and my model agree on something. Autism is a lifelong neurodevelopmental difference or neurodivergent brain type. It is present from birth, genetic, and may be masked or hidden by coping strategies.
An autism diagnosis may only be granted if someone is having “significant difficulties in social, occupational, or other life areas.” In adults and teens, autism is often diagnosed when coping strategies fail or during periods of burnout from masking.
Autistic people, generally, have noticeable differences in communication and body language (unless they are well-adapted maskers).
- Differences in communication styles ranging from hyperverbal to non-verbal.
- Verbal autistics are more likely to speak with “sound bites” from TV shows, commercials, movies, and songs.
- May find typed communications easier or need additional processing time to compose thoughts in conversations.
Body Language & Posture
While non-autistic non-verbal communication is often subtle, autistic, non-verbal communication is different. In many ways, it can be more visible. Happy flapping hands can signal that an autistic person is full of joy at a far distance, compared to the more subtle expressions often shown by non-autistics.
Autistic body language and posture will often differ from non-autistic body language and posture, causing confusion. Autistic people may have trouble decoding non-autistics and vice versa.
Autistic people may not naturally give, or may struggle with, eye contact – only giving it to people they know well (if they engage in eye contact at all). Some autistic people “fake eye contact” by looking at people’s mouths, foreheads, or noses.
Autistic socialization is different from non-autistic socialization. Often autistic people will bond and socialize over activities, projects, and shared interests. They may also be completely content with solitude.
- May enjoy solitude, be content engaging in solo activities, not inviting others to join in, happiest on their own.
- May experience intense emotions, find emotional situations overstimulating, or have a difference in emotional expression (appearing more emotional or less emotional compared to non-autistic people).
Autistic people may find familiar people easier to predict and read than strangers and acquaintances. I take the time to study the people in my life and learn their manners, preferences, and habits to ease social interactions and prevent misunderstandings. New people can be tricky.
Autistic adults may have difficulty navigating new relationships and may decide that maintaining relationships with others is “too much work” or “not worth the trouble.”
In autistic children, play is often about learning and discovery. They may be intensely interested in the smaller details and workings of the world. Adult autistics also may continue this love of exploration as their areas of interest expand with age.
Young autistics may find their peers too loud, unpredictable, busy, and irrational. Autistic children may experience bullying that may continue into adulthood.
Interests & Focus
Autistic people often have Intense Interests in specific areas. As adults, they may be specialists or experts in their fields, due to their dedication to a particular, often highly specialized, topic. These interests may be all the autistic person thinks or talks about.
Autistic people may have an extreme focus on details, gaining valuable perspectives on problems (often overlooked by others) from new angles.
This focus can be an autistic person’s biggest strength (it can also be a problem if someone is focused on the wrong thing). If I fixate and get stuck on an issue that is impossible to solve, it can be agonizing because I struggle to “let things go.”
On the flip side, it may be nearly impossible for an autistic person to focus on a topic if they are uninterested. If something doesn’t interest me, it won’t stay in my mind. I can study and study on a boring topic, but nothing sticks if my brain can’t care about the information. This made certain classes in school VERY difficult.
Routine & Surprises
Many autistic people find comfort in routine, predictability, and order. Autistic people may struggle with surprises, interruptions, and chaos. In some autistics, this may partially come from differences in short term memory and executive functioning. In others, like myself, this can be intensified by anxiety.
My life is less chaotic and more efficient with a routine. My memory is tricky. Otherwise, I struggle to know what comes next, and that makes me uneasy. Sometimes I find it difficult not to wonder what’s coming next if I don’t know. I’m always trying to “paint myself” a general mental picture of what’s happening, careful not to make it too specific, to lesson the agony if things change.
Sensory Processing Differences
Autistic people often have either heightened or decreased sensory sensitivity. These sensitivities can change over the autistic person’s lifetime. There may be days and periods of increased sensory sensitivity (when an autistic person is feeling fatigued, tired, stressed, or worn down).
Because of sensory processing differences, autistic people often have an increased interest in the sensory world. These differences may be more evident in autistic children, who sensory seek, and visually stim (analyzing the details of the world) without shame.
Because autistic brains take in massive amounts of detailed information at a high rate of speed, most autistic people experience sensory overloads or sensory shutdowns.
These overloads may be more evident in children. Autistic adults may grow out of overloads or go for long periods without them, only to have them resurface under periods of stress or prolonged environmental exposure to sensory stressors. This is what happened to me, leading to my autism and anxiety diagnosis at the age of twenty-nine.
Autistic people need to take time and regulate and soothe the senses. The activities can vary greatly, depending on the autistic person’s sensory profile. For many years I didn’t know I needed to take care of myself in this way. I was often burning out and making myself ill.
Some autistic people will eat a restricted diet and find comfort in familiar foods. There can be multiple reasons for these restrictions. Often the cause is sensory, and many autistic people will gradually introduce new foods throughout their lives.
Restrictive eating can be dangerous, especially if an autistic person is not getting enough nutrition. Food avoidances and other food issues can be related/lead to serious health issues and can even become life-threatening.
Movement & Stimming
Many autistic people, myself included, express feeling a “need to be in motion.” I often feel like my brain gets tired LONG before my body, and I need to move around to help my energetic body catch up to the tiredness of my mind.
Autistic people may, if relaxed, tend to rock, sway, pace, or jump, to regulate energy. I am known to walk around, singing, humming, and dancing. I also often work out my thoughts by talking to myself. Sometimes I make and mimic little sounds and repeat phrases I have heard, or I may even repeat myself.
Co-occurring Conditions & Additional Support Needs
Because many autistic people will have additional health conditions and support needs, that may fluctuate throughout their lives. It is crucial to take into consideration if an autistic person has co-occurring health conditions.
A shortlist of things to consider below:
- Apraxia or other motor condition
- Language delay
- Intellectual differences
- Additional Mental Health Needs – ADHD, OCD, PTSD, cPTSD, depression, anxiety, eating disorders, other mental health conditions
- Other health conditions to screen for – EDS, POTS, MCAS, gastrointestinal issues, Epilepsy, sleep disorders
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