Disclaimer: This is not meant to be medical or legal advice; the following is provided only as an informational guide. Please consult your primary care physician and/or a healthcare or mental health professional for the most up-to-date guidance on autism.
What is autism?
Autism spectrum disorder is an umbrella term for a series of conditions, deficiencies and disadvantages relating to the development of the brain. It mainly affects behavioral patterns, social cues, communication, intelligence and social interactions. Formerly known by names now considered to be harmful or pejorative, such as “Asperger’s syndrome” (which is now outdated), today the condition is far more understood, and new treatment options are available.
When does it begin?
Typically, autism manifests itself as early as childhood, usually at 1 year old. However, there are cases where development proceeds normally, then children “regress” mentally at 18 or 24 months old, as this is when the symptoms of autism first show up. There are also cases of undiagnosed autism, resulting in people being diagnosed as late as 16 years old.
What can I expect?
This is a very difficult question to answer, even for me, an autistic. My behaviors are second nature to me, so it’s very difficult to narrow down what is considered abnormal. However, that’s what research is for! After verifying with the Mayo Clinic (a reputed, American hospital known for its wealth of information on many diseases), I can confirm the following, that, for example, I’m known for doing. Keep in mind, this is not an exhaustive list:
We tend to get lost in our own little world, and are loners by nature. In fact, we get so distracted, we can barely hear you!
We’re not particularly fans of physical touch or certain physical sensations, such as hugs, patting our back and even kissing. This doesn’t mean we don’t crave your affection, of course! We just process it very differently from others.
We have great trouble maintaining eye contact. We don’t particularly look into others’ eyes- we turn away, or focus elsewhere. This doesn’t indicate a lack of trust in the other person, or a lack of desire to speak with you. It’s just a strange little quirk that characterizes us.
We can have speaking difficulties, which, if not properly corrected by a speech therapist in time, can lead to problems down the line. I, for example, didn’t learn to speak until I was five years old. I now have a stutter and tend to “twist my tongue” a lot.
We don’t emote a lot; we, in fact, have speech affectations that makes us sound like robots.
We have a tendency to say or do inappropriate things at the worst of times. It’s not intentional; we lost track of ourselves most of the time.
We suck at the art of conversation. We tend to only speak what is necessary, and usually about our interests and likes. We also have a lot of trouble noticing social cues, like facial expressions, poses and tone of voice. Ironically, we are also quite empathetic, as we can “tell” when something is bothering someone, or when they’re upset. I know, we’re weird. I know what you’re thinking: How can you say that you don’t feel emotions normally when you can tell when someone’s upset? That’s a totally fair question, I promise. It’s just one of our quirks; we can’t express our emotions correctly, but we know when you might have difficulties. We might not see things in the heat of the moment (during actual conversation, for instance), but we tend to notice when you least expect it. I call it an emotional sixth sense.
We, at some point in our lives, will repeat phrases from, for example, TV shows and videogames a lot, without understanding what they mean or why they may not be appropriate. I did this a lot in high school, often repeating Stewie Griffin’s (Family Guy) famous catchphrases, for example. “Damn you all!” was my favorite. I would not understand what that meant until I was in college, no joke.
We tend to have a terrible time with sarcasm. We’re very literal-minded. Most jokes fly over our head, or we don’t get them. When we do get them, we don't typically laugh- not because the joke wasn’t funny, but because we just can’t.
We may look emotionless or apathetic, but this couldn’t be further from the truth. We do have feelings and emotions! We just don’t express them very well. For example, we might look indifferent or normal when we’re told that a relative has died. But this does not mean that we’re not taking it hard. This is where knowing a person well enough comes into play, or understanding how autism works benefits you. We express grief differently. We might resort to doing other things to keep ourselves preoccupied, like cleaning aggressively while dealing with tachycardia and cold sweats. We could just sit perfectly still and stare at an empty space, not addressing the outside world. We have wildly different ways of expressing our emotions- just because we don’t conform to neurotypical reactions to certain situations (like cheering and jumping up and down after being told we won an award) doesn’t mean we’re not feeling! If our emotional responses look exaggerated or otherwise “fake”, they aren’t. We’re usually trying to demonstrate that we do understand emotional output.
We’re very routine-minded. We share this trait with OCD patients. We need things in a certain order, or arranged in a certain way. For example, I pose my Amiibo® figures in certain, cinematic poses, but they need to be aligned according to height. It drives me crazy when I’m not able to work it out, LOL. If our routines are somehow disrupted or altered, we’re not happy campers! We get wildly upset and our bodies go into a severe state of anxiety. Yes, this will happen even during the most inane circumstances, like skipping a face cream for a day.
We’re a lot more receptive to light and sound than most. That’s why most autistics dislike yelling or screaming or raising tone of voice, like during a church service, or in a concert. I’m a believer, but I have never been able to attend church normally because most ministers will yell or shout to emphasize the point of their sermon, and it greatly upsets or irritates me. I’m Catholic in that regard; I like things nice and quiet, and will not tolerate speakers at loud volumes (ironically, I can blast music on my headphones all day if I want. I wonder why). Light shows are also a no-no for us autistics. This is why certain movie theaters will hold special screenings for autistic people where audio is more moderated and lights are dimmed considerably. We also have difficulty with touch, as I’ve said. Temple Grandin, for instance, has admitted that she had issues with clothing and now usually wears turtlenecks because they offer just the right amount of pressure. She is also famous for developing a “hugging machine” for cattle, to relax and calm them down with a gentle touch. She’s even used it on herself!
We’re really picky eaters. We just can’t deal with certain textures and flavors. For example, I can’t stand veggies- not because they’re, well, veggies, but because I really hate the rough, cold texture of salads. We’re also creatures of habit; we easily fall into unhealthy eating habits, like only eating chips and pretzels because we agree with their textures. This is obviously a bad idea for nutritional reasons. One way to avoid this is to vary our diet every day, and never stick to a certain snack or food for more than a day or two. I should know; I hate eating rice twice in a day, which is why leftovers and I don’t get along. I need variety in my foods.
We are really, really smart; much smarter than most. What we lack in social skills, we more than make up for in academics. We tend to display remarkable aptitudes at very early ages; for me, it was the English language. I had a natural talent for it, even when I was nonverbal. I could understand cartoons very well. But in most cases of autism, math and social studies are the norm for aptitude. We’re clumsy, so we’re not very good at woodshop or home economics classes, but put us into science and languages and we excel. Me? I wish I had that mathematical brilliance! But my understanding of math ended at basic algebra; I’m terrible at trigonometry, physics and chemistry.
We struggle with normal methods of discipline when growing up. Please don’t treat your autistic child as a neurotypical one. Yelling and punishments don’t work very well; gentle and patient, but firm, guidance works best. As parents, we are absolutely allowed to get frustrated with our children when things don’t work the way they should, or when they misbehave. But don’t take it out on them; they’ll react badly.
We get obsessed very easily. We in the neurodivergent world sometimes call this “hyperfixations”. This one is difficult to explain. We have a tendency to focus heavily on one thing, and only one thing. Everything else becomes a blur and our attention shifts focus only on that. Growing up, for example, I was a huge Disney’s Gargoyles nut. It was unreal. One time, I spoke to my classmates for about 15 minutes about one episode. I was more or less asked to shut up! Embarrassing!
We really can’t understand physical attraction sometimes. We might not even get into relationships until much, much later in our lives- usually not by choice. Because our brains process emotions and things like endorphins and hormones differently, we might not feel attracted to someone, nor do we know when someone is into us. This isn’t due to a lack of knowledge on, for example, the dating game! We just struggle in this regard.
We autistics have sexual needs and desires, just as much as anyone, when the time comes. Yes, I’m approaching this taboo subject... because it shouldn't be a taboo in the first place. We might not focus on relationships as much as others, but we absolutely have erections and periods, where appropriate (don’t start with me; both are inconvenient). We also can have sex if we want to. We simply explore the subject differently. As the experience varies with the patient, I really can’t tell you what is right or wrong. That’s a question that only an autistic can answer and discover on their own. If you’re a parent, you shouldn’t force them into a certain path. Let them explore and learn on their own and offer teaching of how sex works when needed. We’re also perfectly capable of expressing our gender/sexual identity, and we shouldn’t be penalized or otherwise coerced to conform to your standards. It goes without saying, of course, but it never hurts to get the point across again.
I think my child is autistic. What treatment options are available? Which do you recommend?
I am not a doctor, so I can’t answer this for you. I can, however, offer my own experience as a brief example. Always consult a doctor first if you suspect a child or someone you know is autistic. Growing up, my mother noticed the symptoms as early as age two. Back in the late 80s/early 90s, autism was practically nonexistent in Puerto Rico, and there was very little guidance on it. As such, I was never formally diagnosed at the time because doctors simply didn’t want to, or they just found me to be smart. When it was my time for kindergarten, the teachers wanted to send me to special education. My mother fiercely refused, as she believed I could thrive with my peers in a normal setting, in spite of my disability, and she did not want me isolated from everyone else. For decades, she suffered alone, guiding and coaching me along the way, fighting for a diagnosis, until, by a series of coincidences and paths crossing, she finally found a doctor who diagnosed me formally at age 16. It was only when this happened that my life finally made sense. Everything I did, every quirk, every habit, had an explanation. It took a long time, and a lot of emotional suffering, but I was able to attend college, as well as graduate school. Basically, I was thrown into the den of wolves! I made a lot of mistakes, and behaved inappropriately many times, and I regret the vast majority of those instances. But today, I can happily say that I am a successful, thriving adult because of those mistakes.
To combat the emotional imbalances caused by autism, I was initially prescribed sertraline at age 16. I was on this medication for over 20 (!) years, and I have nothing but good things to say about it. As I aged and began to achieve true independence and ability, other mental conditions came to light, and so my medicine regimen was changed. For a time, I was put on zolpidem for insomnia. But after 10 years, I made a conscious decision and effort to wean myself off of the medication due to concerns over long-term side effects. Today, I am doing very well with a combination of counseling and support. I have since moved on from sertraline due to an ever-changing medical situation, and now take aripiprazole, duloxetine, atomoxetine, buspirone, trazodone and magnesium supplements. I have all of my bases covered: I can sleep well, function peacefully (with only the occasional difficulty) and, well, live. I’m doing so well that I was finally able to learn to drive!
Warnings and a few things to consider!
Don’t do the stupid thing. Vaccines do not cause autism. Genetics are responsible for autism, not you, nor vaccines. Vaccinate your child and protect them from many dangerous maladies!
It is currently not fully known or understood whether environmental factors are responsible for autism. This research is ongoing.
Be mindful. Not everyone appreciates the puzzle piece as the symbol of autism due to the evil influence of the Autism Speaks foundation (please avoid Autism Speaks). It’s best to use the infinity loop of autism, or the gold infinity loop. But personally, I don’t mind either symbol. To me, when you solve a puzzle, you get a pretty picture: you!
Don’t be ableist. Not every autistic can work due to a variety of reasons: maybe they struggle with severe anxiety, for example. Don’t judge- understand instead.
Autism can’t be prevented, but it can be treated and managed in time. If you suspect there are signs, visit a doctor.
