10 signs you might have Autism Spectrum Disorder
Autism Spectrum Disorder, commonly shortened to Autism or ASD, has gained significant visibility in our popular culture during the last couple of years. Increasing numbers of shows, blogs, and even treatment approaches have found their way into the Facebook and Twitter feeds of many. One reason for this jump is visibility could be the growing number of children that are being diagnosed with Autism Spectrum Disorder, with some estimates suggesting that 1 in 44 children meet the official diagnostic criteria for the disorder in 2018. With this level of impact, it is highly likely that either your life or the life of someone you know is impacted by Autism at some level.
When making this diagnosis, mental health professionals and medical providers will refer to the Diagnostic and Statistical Manual of Mental Disorders (abbreviated DSM) which is currently in its 5th edition. The approach taken by the DSM is generally to list out all the possible symptoms which previous research and experts in the specific disorder believe define that particular diagnosis and if a person has enough of the symptoms, they are considered to have the disorder and can be given that diagnosis. For Autism Spectrum Disorder in particular, there is significant debate about how the disorder is classified, which symptoms are included, and if the DSM captures the essence of the disorder as experienced by the people who are said to have it.
As of the 5th edition, ASD is generally defined by difficulties related to social communication, social interactions, restricted behaviors, and repetitive behavior. While this may sound somewhat limited in scope, the examples given in the DSM of these symptoms run the entire gamut of human experience. According to the DSM, anything from struggling to maintain conversations, to abnormal body movements, to repeating phrases, to finding certain fabrics unbearable could all point to an ASD diagnosis.
Additionally, the vast majority of research that has been done around the ASD diagnosis has been done with white, middle class, boys under the age of about 8 years old. So when professionals diagnose ASD, they are actually often comparing the person in front of them to how ASD typically presents in a white, middle class, young, boy. This has led to many people who were not white or who were assigned female at birth not getting an ASD diagnosis as a child but coming to realize that their experience aligns with many people with an ASD diagnosis as an adult. An added complication during the diagnostic process is the range of symptoms which may present and the variety of combinations of these symptoms which can occur. This variation is where the “Spectrum” component of the diagnosis comes from. A common phrase in the ASD world is “if you have met one person with Autism, you have met one person with Autism” meaning that trying to draw too many parallels between the experience of two people with Autism is bound to give you as many points of disagreement as points of agreement.
Given the impact of this disorder on social functioning, and how little is talked about adulthood presentations of ASD, it can be worth considering how to tell if you or your partner(s) may be on the Autism Spectrum. Although this list is not exhaustive and everyone’s experience with Autism is unique, many adults with ASD report some level of impact in at least a few of the following areas.
Someone in your family has Autism Spectrum Disorder
Autism is at least partially (somewhere around 50%) impacted by genetics. Although there is disagreement about what this means, it is generally believed that the chance that you would have Autism increases if there is someone else in your family who also has Autism.
Social situations can be challenging
Social situations are often particularly difficult for people with Autism. Many people with Autism, but not everyone, express an interest in making and maintaining long term relationships but can find the mechanics of interacting anything from effortful to completely mystifying. Here’s some ways that may show up:
Not understanding what is happening or not feeling understood
You have anxiety around social interactions
Often preferring to be on your own
Requires enormous effort to be social and mimic social cues (like facial expressions, polite laughter, and making your face seem “engaged”)
Many social rules don’t make sense to you
You often find yourself too close or too far away from someone when talking
Making eye contact is uncomfortable and how much eye contact is the “right” amount of eye contact is unclear
You often talk too much (or don’t realize that the other person is done listening or isn’t interested) or not enough (single word answers when the other person may be expecting a story or more information)
You have templates, scripts, or plans in your head that you use when you interact with people. If something that happens isn’t in one of your plans, it can be very difficult to continue the social interaction and you may stop responding and shut down
It is difficult to say how you feel
One of the core components of social interaction is emotional understanding and expression. Often, people with ASD find emotions to be difficult to describe. People with ASD are just as emotional as people without ASD, but often do not express their emotions as much, as clearly, or in a way that their conversation partner is able to interpret. In terms of emotions, some people with ASD may have some of the following qualities:
Flat affect- your face tends not to express how you are feeling and some people might say you look “bored” or “mad” even though that’s not how you are feeling at all
You are better able to express yourself when you can reference someone else (like your partner) or ask for their input
Your voice can be monotone without much emotion or inflection
If strong emotion does surface, you may experience large displays of emotions (“throwing tantrums”, screaming, crying, becoming “overstimulated”) or you may shut down entirely and not feel anything or think anything for a period of time. Either way, strong emotions can be hard for you to manage.
People tell you that you are rude, blunt, or aren’t interested in others
Unfortunately, many people who don’t have ASD interpret the way that people with ASD move through the world as somehow intentionally being inappropriate or unkind. This is seldom, if ever the case. But many adults with ASD report that their partner or friends may describe them as:
Seeming not caring
Not listening
Not being interested in what your partner or friends are saying or about their lives
Speaking at inappropriate times or about inappropriate things that don’t feel very connected to the current conversation
You like things to be ordered and predictable, and find changes (especially unexpected changes) to be incredibly difficult
People with ASD typically enjoy doing similar things in similar ways. This may manifest as a preference for the same breakfast or lunch every day, taking the same route through a store every time you go to it, or generally trying to avoid too many changes to your day. Some folks with ASD have found that:
Patterns calm anxiety
Using similar phrases when you talk or borrowing phrases that you hear from people around you makes conversation less effortful and helps them follow a predictable pattern
Having a couple things that you know absolutely everything about
Sometimes referred to as “restricted interests” many people with ASD are the ultimate fans. Whether a specific show, a specific person, a hobby, or animal, many people with ASD find one or a few things deeply fascinating and devote a lot of time and energy to understanding everything about them. This knowledge is often very detail-oriented and surpasses a casual interest.
You have an Attention Deficit/ Hyperactivity Disorder (ADHD) diagnosis
Current research suggests that ASD and ADHD may share a common genetic component. For this reason, 15-25% of people with ADHD also share some symptoms with ASD and 40-70% of people with ASD have symptoms of ADHD. Said another way, while ADHD and ASD are distinct disorders, if someone has one they are more likely than the average person to have the other as well.
You identify as queer either in your sexual orientation or gender identity/expression
Studies of sexuality in populations with ASD have found that queer sexual orientation and/or queer gender identity/expression are more common among people with ASD than people who do not have ASD.
You find going to school or maintaining a job to be extraordinarily difficult
Many people with ASD find it difficult to apply for, secure, and maintain a job over an extended period of time. School experiences can be similarly challenging.
Certain sensory experiences can be very confusing, disgusting, or stressful
Many people with ASD report certain sensory experiences as being intense or overwhelming. From simple things like how clothes fit, food left on dirty dishes, or particular smells, to more complex things like sex, interacting with children, or medical procedures, it is common for people with ASD to experience the world through sense that are somehow heightened. These are examples of the unique challenges that some folks with ASD may face:
Sex can feel dirty, gross, or unsanitary which makes the experience more stressful than enjoyable
Certain fabric or kinds of clothes can be impossible to wear or be unbearable against your skin
Feeling pressure (like from a waistband on pants) or not feeling enough pressure can create anxiety or be overwhelmingly unpleasant
Clothes or jewelry may just not “fit right”
Certain smells that other people find pleasant may be nauseating
Only certain foods are able to be eaten because the way that some foods taste or their texture in your mouth is too unpleasant
Living with diagnosed or suspected ASD can often be quite isolating. Living with a partner who has or is suspected of having ASD can leave you unsure of how best to provide support. Thankfully, there are a variety of strategies that can help make life with ASD feel a bit easier to navigate and that can encourage a deeper level of understanding and connection. If you or your partner are interested in discovering more about how ASD may be impacting your life, feel free to schedule a time to chat.
References
Centers for Disease Control and Prevention. (2022, March 2). Data & statistics on autism spectrum disorder. Centers for Disease Control and Prevention. Retrieved June 30, 2022, from https://www.cdc.gov/ncbddd/autism/data.html
Gray, S., Kirby, A. V., & Graham Holmes, L. (2021). Autistic narratives of sensory features, sexuality, and relationships. Autism in Adulthood, 3(3), 238–246. https://doi.org/10.1089/aut.2020.0049
Hall, J. P., Batza, K., Streed, C. G., Jr, Boyd, B. A., & Kurth, N. K. (2020). Health Disparities Among Sexual and Gender Minorities with Autism Spectrum Disorder. Journal of autism and developmental disorders, 50(8), 3071–3077. https://doi.org/10.1007/s10803-020-04399-2
Holt, A. (2020, June 11). Why autistic adults struggle with employment. The Art of Autism. Retrieved June 30, 2022, from https://the-art-of-autism.com/why-autistic-adults-struggle-with-employment/
Kevin M. Antshel Ph.D, Yanli Zhang-James M.D, Kayla Wagner, Ana Ledesma & Stephen V. Faraone Ph.D (2016): An update on the comorbidity of ASD and ADHD: A focus on clinical management, Expert Review of Neurotherapeutics, DOI: 10.1586/14737175.2016.1146591
Rylaarsdam, L., & Guemez-Gamboa, A. (2019). Genetic causes and modifiers of autism spectrum disorder. Frontiers in Cellular Neuroscience, 13. https://doi.org/10.3389/fncel.2019.00385
Sandin S, Lichtenstein P, Kuja-Halkola R, Larsson H, Hultman CM, Reichenberg A. The familial risk of autism. JAMA. 2014 May 7;311(17):1770-7. doi: 10.1001/jama.2014.4144. PMID: 24794370; PMCID: PMC4381277.
Turner, D., Briken, P., & Schöttle, D. (2017). Autism-spectrum disorders in adolescence and adulthood: focus on sexuality. Current opinion in psychiatry, 30(6), 409–416. https://doi.org/10.1097/YCO.0000000000000369