In this blog, we define autism spectrum disorder (ASD) from a diagnostic point of view. However, it is important to note that all individuals are unique and different in their own ways. When describing ASD through a diagnostic lens, the focus is on symptomology that may cause difficulties in these individuals’ lives. However, we must also remember that people are multifaceted, and can be seen through a variety of lenses. While it is often times helpful to understand ourselves and others through a diagnostic lens, it is important to note the neuro-affirming perspective which challenges diagnoses, and aims at accepting diversity without pathologising differences. Whether they experience ASD or not, every person is an individual, with their own unique personalities, experiences, strengths, and challenges, aside from any autism diagnosis they may have.
What is Autism Spectrum Disorder?
We will explore autism spectrum disorder (ASD), including an overview, symptomology and well as currently understood causes of ASD.
Before we begin, it is important to acknowledge different schools of thought relating to autism spectrum disorder. The traditional medical model, and the neuro-affirming model differ in the ways ASD or neurodivergence is discussed. The neuro-affirmative movement recognises autism spectrum disorder as a natural neurological variation rather than a disorder. A focus of this movement is accepting and supporting the diverse perspectives, communication styles, and sensory experiences displayed in ASD. This approach challenges traditional medical models that pathologize autism and promote neurotypical behaviours. Instead, it promotes neurodiversity, valuing the unique strengths and contributions of neurodiversity. Neuro-affirmative practices focus on accommodation, accessibility, and respecting autonomy, fostering environments where individuals can thrive authentically.
In this blog, we describe ASD from a medical model perspective, to allow understanding of what ASD is at a symptom level. However, this does not disregard the fact that outside of these symptoms, individuals with ASD also have a range of strengths, passions, and their own personality which makes them who they are.
ASD is classified as a neurodevelopmental disorder. ASD has a range of manifestations, which ultimately reflects the spectrum of symptoms, severity of symptoms, and different combinations of these (1). The Diagnostic and Statistical Manual of Mental Disorders (DSM-V-TR) is the primary diagnostic reference used in Australia, offering a comprehensive framework for understanding ASD(2).
What Causes Autism Spectrum Disorder?
The aetiology of ASD is complex, and is still being researched today. Current research suggests an interplay of genetic predispositions, environmental factors, and epigenetic mechanisms shapes the neurodevelopmental pathways leading to ASD (3,4). Genetic factors have been found to be a significant predisposing factor, with ongoing studies exploring specific genes and their variations associated with ASD (4). Prenatal complications and certain environmental influences are also implicated in the etiological framework (1).
Current research is exploring the role of epigenetic mechanisms—modifications that affect gene expression without altering the underlying DNA sequence—in influencing the development of ASD (3). This evolving understanding emphasizes the importance of considering not only genetic factors but also the intricate ways in which environmental and epigenetic elements contribute to the neurodivergent origins of ASD.
Therefore, there is no one ‘cause’ of ASD. It is also important to note that research, and thus our understanding of ASD is ongoing, and researchers continue to deepen their understanding of the complex interconnections that contribute to the neurodiversity within the autism spectrum.
What are The Symptoms of ASD?
Clinical manifestations or symptoms of ASD can be summarised in the following categories:
- Social Challenges: Individuals with ASD commonly experience difficulties interpreting and responding to social cues, resulting in impaired social interactions (5).
- Communication Differences: Language abilities vary widely among individuals with autism spectrum disorder, ranging from excellent proficiency to notable delays or challenges in verbal communication. (6).
- Repetitive Behaviours: Repetitive movements, adherence to routines, and intense interests characterize common behavioural patterns seen in ASD (7).
- Sensory Sensitivities: Heightened sensitivities to sensory stimuli, such as lights, sounds and textures contribute to the sensory challenges faced by individuals with ASD (8).
References
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- Lord, C., Elsabbagh, M., Baird, G., & Veenstra-Vanderweele, J. (2018). Autism spectrum disorder. The Lancet, 392(10146), 508–520. doi:10.1016/S0140-6736(18)31129-2
- Sandin, S., Lichtenstein, P., Kuja-Halkola, R., Larsson, H., Hultman, C. M., & Reichenberg, A. (2017). The heritability of autism spectrum disorder. JAMA, 318(12), 1182–1184. doi:10.1001/jama.2017.12141
- Hallmayer, J., Cleveland, S., Torres, A., Phillips, J., Cohen, B., Torigoe, T., . . . Risch, N. (2011). Genetic heritability and shared environmental factors among twin pairs with autism. Archives of General Psychiatry, 68(11), 1095–1102. doi:10.1001/archgenpsychiatry.2011.76
- Tager-Flusberg, H., Paul, R., & Lord, C. (2005). Language and communication in autism. Handbook of Autism and Pervasive Developmental Disorders, 1, 335–364.
- Richler, J., Bishop, S. L., Kleinke, J. R., & Lord, C. (2007). Restricted and repetitive behaviors in young children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 37(1), 73–85. doi:10.1007/s10803-006-0332-9
- Ben-Sasson, A., Hen, L., Fluss, R., Cermak, S. A., Engel-Yeger, B., & Gal, E. (2009). A meta-analysis of sensory modulation symptoms in individuals with autism spectrum disorders. Journal of Autism and Developmental Disorders, 39(1), 1–11. doi:10.1007/s10803-008-0593-3
- Reichow, B., & Volkmar, F. R. (2010). Social skills interventions for individuals with autism: Evaluation for evidence-based practices within a best evidence synthesis framework. Journal of Autism and Developmental Disorders, 40(2), 149–166. doi:10.1007/s10803-009-0842-0
- Dawson, G., & Burner, K. (2011). Behavioral Interventions in Children and Adolescents With Autism Spectrum Disorder: A Review of Recent Findings. Current Opinion in Pediatrics, 23(6), 616–620. doi:10.1097/MOP.0b013e32834cd58b