More about the diagnosis of autism.

The “Big 3” in the diagnosis of autism are behavioral things. All are included in what can be called “social struggles”. This is the biggest feature of autism which causes us difficulty.

1 “Social deficits/ emotional response” is abnormal. There will usually be difficulty in understanding the way social ‘give and take’ in conversations works. The autistic person might give mini lectures, or answer other’s questions with simple yes or no instead of seeking to promote back and forth social conversation. We may not be interested in what another is saying, thinks, or is doing… and fail to interact, when common social standards would expect that “give and take” conversation to take place.

We may not be aware of other’s attempts to interact with us or we may avoid those attempts, or we may not recognize signs that others wish to avoid us. We may not react with emotional responses where it would be more common or even expected to do so. ( things like congratulating somebody who announced good news, or saying “I’m sorry” to somebody who announces sad or bad news)

2. ” Deficits in non verbal communication” We may not express thoughts, ideas, emotions through words or actions. We may not recognize when others express these things in words or behavior. It is as though we can not “read” the person’s body language or their facial expressions. We miss a lot of social cues… and we fail to give the cues others expect of us. One of the things that is often commented on as a symptom is that eye contact seems to be uncomfortable for many autistic people, and many, especially when young, will tend to avoid making eye contact, or if eye contact is made, it is not “held”. It also seems that many adults may have been extremely uncomfortable with eye contact as children, but have learned to use it to some extent as we age.

It appears to be a common misconception that all autistic folk avoid eye contact, and that this will not change. Offers to shake hands or motions inviting one to take a seat may not be noticed, and likewise may not be used in interactions with others. etc. It is my own belief that most of these social body language cues can be learned and performed. Some with autism may find it impossible to very difficult, as we all are individuals.

3. ” Does not adjust behavior to fit circumstances”. Unless we are taught otherwise, we approach the world and everything in it on one level. We many times may not pick up on the fact that we need to be quieter in the library than at the gym. We may not behave differently at a funeral than we do at a birthday party. Somehow we seem to have difficulty picking up on the subtle differences in situations. I believe this is simply not intuitive on the part of many autistic people, but can certainly be learned.

We may prefer to be alone and be completely uninterested in in what others are doing or thinking. We may have difficulty in many cases playing games or doing things that involve anything “pretend”.

Many older people have learned how to overcome these deficits through past experience and sometimes therapy. We learn how to “mask” the natural traits and to ‘work around’ them to some extent, but I believe it may be very difficult for us to be so intensively alert to see and act on social cues.. what is perceived and assimilated and acted on by those without autism comes to us through focused effort and vigilance. Social interactions can be very difficult and stressful to many of us, though we might be good at performing the expected social basics. What might be a simple trip to the store or doctor office might be completely exhausting and stressful to an autistic person.

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