What Is Autism?

Autism is commonly seen as a spectrum disorder (Autistic spectrum disorder ASD), with varying deficits as a result. Someone with autism may have differing degrees of deficits, but they would still be on the same spectrum. It is also highly heritable. It is a condition that not only concerns medical disabilities, but also disabilities that society enables too, as it is a condition that is stigmatised and affects mental health. This essay will discuss what deficits autism is associated with, the strengths it offers, and whether it is associated with other disorders.

Kanner (1943) was one of the first people to identify autism, by studying 11 children who were introduced to them as idiots and imbeciles. This highlights the lack of social sensitivity and knowledge around the subject. It was discovered that they all had certain characteristics that they shared, such as inability to form affective relationships with people and relate to situations. A certain aloneness seemed to be deeply engrained, meaning they preferred to act alone and rarely asked for help. These deficits were not limited to social situations, as they also hated loud noises and fast-moving objects, showing that physical aspects of the environment also affected them. Much later, a triad of deficits was coined by Wing and Gould (1979). It involved deficits in communication, social interaction and imagination (meaning they tended to repeat a lot of behaviours due to a lack of creativity). They identified that all three deficits usually occurred together. This triad is still largely used in today s definition of autism.

Another key theory that has been explored is theory of mind . This theory involves testing whether autistic individuals can identify the mental states of other people and adapt their behaviour accordingly. The term mental states comprise their emotions, and their intentions in scenarios. Initially evidence was strong that theory of mind is compromised in autism. Baron-Cohen (1992) studied this theory using a penny hiding game, where autistic children participated in two conditions. The first involved the experimenter hiding a penny either in both hands, in one hand and neither, whereas the second involved the subject hiding the penny. In each condition the person who did not hide the penny guessed which hand they held it in. Generally, the children did not seem to understand that they had to not only hide the penny, but they must not disclose any information about the location of it. This may mean that they do not understand the intention of the guesser. Similarly, Pedreno et al (2017) found similar deficits of theory of mind in autistic adults. 35 adults with autism high functioning autism were given three tasks. A strange stories task involved the participant making inferences about a character s thoughts, a classic faux pas test where they had to detect an error in someone s speech, and a reading the minds test where they were shown pairs of eyes and asked to tell what emotion they conveyed. All 3 tasks produced lower scores than the control group. To put things in perspective, theory of mind can be a useful diagnostic feature in individuals with ASD. However, that does not mean it can be the main distinguishing factor (Brewer et al, 2017). The presence of said deficit can be additive to a diagnosis, but not central to it as ASD can still be present without deficits in theory of mind .

Another measure of cognition that has been theorised to be reduced in ASD is intelligence. Since several other cognitive deficits are seen, it does not seem unfathomable that intelligence could be affected too. Yet, intelligence may be underestimated in ASD. Dawson et al (2017) assessed 38 children on two scales of intelligence Raven s progressive matrices and the Weschler scale of intelligence. Especially in the block design subtest, individuals with autism performed better than those without. These individuals are not necessarily impaired excessively in fluid intelligence. However, the scales used in this study may not be generalised to all individuals. It cannot be known for sure whether it is a good test of intelligence, as it is difficult to quantify intelligence. These tests may be applicable for certain cultures, but not so for other cultures that may develop other skills for society. This will always be a limitation for intelligence studies, so caution has to be used in interpreting these results.

On the other hand, deficits of function are not the only effect seen in individuals with ASD. They also display strengths in certain aspects, such as perceptual functioning. Mottron et al (2006) reviewed this enhanced function using 8 principles of perception. In one task, where they were given figures that were either possible or impossible to copy, they were more adept at identifying when it was impossible to copy than typically developing individuals. This may because autistic individuals have less of an emphasis on hierarchical brain activity& certain process are more localised or have increased functioning. For example, posterior parts of the occipital lobe, which are specialised in extracting smaller parts of the visual field and in extracting unique features, may be enhanced in autism. This would explain the performance in the impossible figures task . There are also other areas in perceptual tasks that may be enhanced. These strengths point to the fact that even though autism has been viewed as a disorder that brings deficits in function, there are certain benefits as well.

Having covered how ASD affects general functioning and intelligence, it is important to discuss whether it affects everyone equally. Although for any disease or disorder it is clearly going to affect individuals differently due to within-subject factors, one factor is worth discussing in ASD: gender. It has been established that autism affects men and women differently. Throughout time autism has been viewed as mainly a male disorder, so much so that a diagnostic gender bias is present (Loomes et al, 2017). Even after meeting the diagnostic criteria, females may be less likely to be diagnosed. This may be due to social reasons, where clinicians discount the possibility of a diagnosis in females due to stereotypes& however, there may be another factor called camouflaging . Hull et al (2017) gave a questionnaire to 92 adults who were given a diagnosis and delved into their experiences of camouflaging to uncover why they do it and what its characteristic features may be. Results showed that this process mainly occurred in social situations, as a way to fit in with society. However, they discovered this may not be so straightforward, as trying to mask personality may be draining in the long term. Camouflaging shows a capability for females to be self-aware of their condition and to be flexible, even if it is not their natural personality. However, this study did not cover certain aspects for example, since the questionnaire fundamentally concerns camouflaging in autism, the participants may be trying to be good subjects by providing answers that satisfy the experiment s objectives. A red herring approach may be more applicable, where they mask the true objective by asking other irrelevant questions occasionally. However, this is difficult to do in without affecting the main experiment too much. Furthermore, the experiment did not cover camouflaging in autistic individuals who cannot write in English (since the questionnaire was written), meaning it did not cover all possible demographic features. Apart from these coping mechanisms, a specific female autism phenotype has been found. Frazier et al (2014) conducted a large-scale study to investigate cognitive ability in both genders. They tried to minimise clinical gender bias as much as possible, so that only cognitive factors were present. Verbal IQ and non-verbal IQ was tested, as well as other language test for vocabulary and phonological processing. Females tended to show greater social impairment, and lower cognitive ability than males. These findings consolidated ideas of a specific female autism phenotype. One area where the study falls short is the lack of controls. Only males and females with autism were included, so the lack of people without an autism diagnosis neglects comparison of cognitive scores with typically developing populations. This could have been useful in seeing how much the scores deviate in autism

One aspect of autism is how closely it is linked with some other co-occurring conditions. That is because autism does not only affect people biologically, but socially too. Kenny et al (2016) studied how the UK population refer to these individuals. It was found that there is no single way to describe them, and it often differs with different people. Those that think of autism as being part separate entities may refer to them as living with autism , whereas others who think it is part of the individuals refer to them as autistic . The point is that something as simple as the choice of words to describe can be sensitive in some instances. Their deficits in social interaction also may leave them unable to fit in with societal expectations, which may be hard on their mental health. Lai et al (2019) completed a meta-analysis for the prevalence of these conditions, with the highest being ADHD with 28% and Anxiety coming second with 20%. Especially since the percentages were higher than the typically developing population, it is of particular concern and needs careful monitoring in autism populations. However, these co-occurring conditions can also be used to the advantage of clinicians. Mandy and Tchanturia (2015) investigated whether women with eating disorders may have undiagnosed Autism. This was because individuals with autism often tend to be rigid with their behaviours and do not change, following repetitive patterns. This is also observable in these women. Using the Autism Diagnostic Observation Schedule (ADOS) to test 10 women with eating disorders, they found that seven of them either scored within the threshold for autism or showed symptoms. This provides ample evidence that other conditions can be used to diagnose autism, especially if the typical behaviours are shown. This may cover for the fact that some females use camouflaging techniques or are not diagnosed due to gender bias.

In summary, Autism has made giant strides since it was first described, from a condition that was perceived to only have deficits in social function to one that also has other benefits. It does not affect intelligence as much as initially thought, and it is closely tied to mental health. These other conditions may aid diagnosis, but also highlights how we should help these individuals in a clinical setting and in society.