Issue 6 Online Extra Autism The Clinical View: What is Autism by Kim Painter, Ph.D.

This article is a companion piece to The New Idealist Issue Six: The Autism Issue which you can download here.

Please note: This article was originally published in The New Idealist section of The Intelligent Review site in August 2014 before being transferred to this new site in July 2015.

Whilst some of the terminology of this article may cause distress to some autistic readers, please be aware this article has been included as the author makes some relevant points about autism in the workplace and the importance of non-autistic people taking the time to understand autistic people. We are also publishing it in order to highlight the ‘autism as a disorder and deficit’ approach of the clinical community. As The Autism Issue challenges this view, it is important this article is read in conjunction with the full issue here.

What is Autism by Kim Painter, Ph.D.

Autism is a neurodevelopmental disorder characterized by deficits in social communication and interaction.  The hallmark symptom of an autism spectrum disorder (ASD) is a lack of reciprocity in interactions with others.  The vast majority of individuals with ASDs want to interact with others but lack the skills to effectively navigate social situations.

Each person on the spectrum has specific strengths and weaknesses.  Some may be very verbal while others may have little understandable speech.  Much of our communication with one another is non-verbal, and those with ASDs often misinterpret social situations and may over-attend to content, missing the social nuances occurring.

The social skills that develop naturally for most children do not come easily to those on the spectrum.  Individuals with ASD must be overtly and directly taught social skills.  For example, most children learn without being taught to make eye contact, to take turns talking in conversations, to use and interpret body language accurately, and to understand sarcasm and figures of speech.  Individuals on the spectrum can learn these skills too, but they generally need to be directly taught these skills.

Individuals on the spectrum may have restricted and repetitive behaviors and/or interests.  These persons may engage in repetitive motor movements such as hand flapping or lining up of items.  A person with ASD may have an intense area of special interest.  While most people have hobbies or interests, those with ASD accrue vast amounts of knowledge about a very focused subject area and often “share” this knowledge regardless of the other person’s level of interest.

Transitions and changes can be difficult for those on the spectrum.  They thrive with routine, sameness, and predictability and may have aversive reactions to even small changes in their routines or environment.  Change can cause significant anxiety and distress in individuals with ASD which can manifest in behavior that may seem surprising or confusing to others.

Challenges in Adapting:

Social skills are foundational to all interactions, both personal and professional.  Establishing and maintaining friendships is an area of difficulty for those on the spectrum.  Dating is also a problematic area because of the extremely complex social nuances involved.  Those on the spectrum may misinterpret statements and may not realize that the other person is politely declining.  There are many unspoken rules of social interaction that are complex to teach.

Even when individuals with ASD are qualified for a particular job or career, they may struggle to secure the job.  A person’s credentials and experience are what qualifies them for the interview but their social skills often land the job.  In most workplaces there are “politics” and power structures to be learned and questioning certain individuals comes with risk that persons on the spectrum may not fully appreciate.  Thus, those on the spectrum may find themselves in sticky situations in the workplace without understanding how they ended up there.

Treatment/Support:

The importance of learning and improving social skills cannot be overstated.  Early intervention is key because research tells us that early and intense intervention creates the best long-term outcomes.  Thus, children with social skills deficits should be identified early and involved in social skills programs to bolster their skills in this area.

Awareness of autism has greatly increased over the past decade and education of the general public should continue.  At times, individuals on the spectrum may come across as rude because they may have interpreted something literally or do not understand the unspoken rules of a particular situation.   If their neurotypical counterparts can understand and appreciate this, the individual with ASD will be less isolated and better accepted.

While treatment generally focuses on the individual with ASD, support groups for parents, siblings, and partners can be very helpful.  Those living with individuals with ASDs may need support and it is often helpful to talk with others in similar situations, as they can be great resources for both practical matters and emotional support.  For those caring for persons with severe symptoms of ASD, it is important to have a strong support system and to take time away to rejuvenate.

About the Author

Kim Painter, Ph.D. is a licensed psychologist in private practice in Summit, New Jersey.  She specializes in working with children, adolescents, and families and is the author of Social Skills Groups for Children and Adolescents with Asperger’s Syndrome: A Step by Step Program.

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