01. Difficulty in social communication
Although autistic adults tend to be comfortable with functional communication (exchanging information), informal conversation (especially small talk, which may be considered inauthentic), can be difficult.
An autistic person may experience challenges with social communication and interaction, have intense interests and a strong need for routines and predictability, and be hyper- or hypo-reactive to sensory input.
Within these areas of challenge, autism will be expressed in different ways for each person, e.g. difficulty making small talk or having a balanced conversation, sensitivity to certain sounds or textures, and the need to stick to a daily routine. The traits experienced may change during the lifetime of a person as coping mechanisms or compensation strategies are learned and appropriate support is provided. However, this does not mean that the person has grown out of their autism. It would be more accurate to say that they have ‘grown into’ their autism, a process that is never finished and requires a phenomenal amount of energy to maintain.
Many of the challenges autistic people face are not self-perceived as ‘symptoms’ of their autism but as difficulties created by their environment: a society that largely refuses to make accommodations for people with cognitive/invisible disabilities.
Although autistic adults tend to be comfortable with functional communication (exchanging information), informal conversation (especially small talk, which may be considered inauthentic), can be difficult.
Social interactions may not be initiated due to uncertainty about what to say, and emotional states may not be readily shared with others.
Speaking in groups can be a particular challenge as a result of difficulty reading the non-verbal cues associated with turn-taking. Many autistic people fall into one of two extremes, either being unable to participate in a group conversation at all, always waiting for the right moment to interject but not finding it, or ‘hogging’ everyone’s attention by interrupting and talking over the top of others – again, being unable to spot the right moment to take a turn.
‘I sit there like a fish on dry land, my mouth opening and closing, but never actually getting a chance to talk. It’s really frustrating. Someone else will always jump in before I can. It’s like they just spend the time thinking about what they can say next instead of listening. And even if a short pause does come up that I could use, by then the conversation has usually moved on and what I wanted to say doesn’t matter anymore’. (Kylie, 23)
Aspects of body language or gestures that are natural and intuitive for neurotypicals may require conscious effort to learn and reproduce appropriately for autistic people.
Eye contact, for example, may be avoided because it feels unnatural, too intense, or even painful. Conversely, eye contact may be held for too long, giving the impression of staring, if the person has been taught the importance of eye contact but is unsure of the ‘correct’ amount for each different social situation.
Facial expressions may also be either under or over expressive, as many autistic people have difficulty with proprioception. For example, some may inadvertently frown without actually being upset.
‘When I first saw myself recorded on video at age 13, I was horrified. At first, I didn’t recognise myself. I asked my aunt who that skinny, gormless-looking girl was, and she said: but it’s you! My mouth was hanging open and I was just staring at the other children, slouching so badly it looked like I had a deformity. Then I kinda got why nobody wanted to play with me. But it still took years of practice in front of the mirror to get all the muscles in my face to work together properly and maintain a normal expression, and to learn a good posture’. (Anna, 34)
Autistic people may be unsure of how to adjust their behaviour to suit various social contexts and may need explicit guidance on, for example, who is ok to hug and who should just get a hello from a small distance.
Some may show no apparent interest in their peers. However, this doesn’t usually mean that there is no desire for a friend, but just that an actual ‘peer’ (i.e. someone who has a similar outlook on life, shared interests and ways of communicating), hasn’t been identified.
‘I don’t care about other people’s interests. Most of what guys my age want to talk about is boring – drinking beer, cars, going out, picking up girls. My parents say to listen politely anyway, but I don’t see the point in pretending. It’s really hard to meet anyone who is like me and wants to talk about my stuff’.
Autistic people may show a range of repetitive movements such as handwringing/flapping, rocking, spinning, pacing, or bouncing (colloquially also called ‘stimming’), in response to certain stimuli or in an attempt to process thoughts and emotions.
These movements represent coping mechanisms intended to soothe overwrought nervous systems and should, therefore, not be suppressed.
‘My hands are almost constantly moving, fingers squeezing fingertips, rubbing the fabric of my jumper, or flying around when I talk. I never notice this until I see somebody else looking at my hands. Then I try to keep them still, but this takes so much effort that I can’t focus properly on whatever else I was doing. It’s like a pressure builds up inside of me, and I lose the sense of where I am in space. It’s quite disconcerting, so I’ve pretty much given up trying to control it’. (Jane, 39)
Stereotyped motor movements can also include the use of objects, for example flipping or chewing objects. For some, it may include speech (repetition of another person’s words) or vocalisations.
Autistic people tend to follow ritualised patterns of behaviours; for example, they may have specific greeting rituals, always dress the same way, or eat only certain foods.
These patterns serve to alleviate anxiety and uncertainty, making life a tiny bit more predictable. While it may not be the healthiest way of coping with anxiety, it may be the only way the person has at their disposal. Another contributing factor may be impaired executive function, decreasing the autistic person’s ability to be mentally flexible and adjust to new situations quickly. Some may show extreme distress at what appear to be small or even imperceptible changes.
Many also have difficulties with transitions between activities and need advance warning if a ‘change of gears’ is coming up. Again, this is due to executive function issues, which are hardwired into the brain and therefore impossible to change just by mere effort of will.
‘When I’m working on the computer, I get so annoyed by anyone coming into the room and interrupting me to ask a question. It’s a sensation of physical discomfort to be abruptly pulled out of whatever I’m doing, and then it takes me ages to find my way back to my train of thought. I also often miss lunch when I’m working because I find it hard to stop a task before it’s finished’.
Autistic people may have intense interests that appear narrow or even obsessive to family and friends.
These interests serve a purpose: in memorising timetables and bus routes, a sense of predictability can be imposed on a chaotic world; knowing how various things fit within their respective categories creates a comforting overall structure where everything has its place; learning about history furnishes an understanding of how humans behave on a large scale. Gathering of information can help reduce the confusion by an anxiety-inducing environment.
For many, these interests also help in creating a more solid sense of self. Autistic author Rudy Simone* writes, ‘Information gives our thoughts an anchor, it gives us an identity and is something we can control.’
‘I never really knew who I was. Other children seemed so sure of themselves, slotting easily into their expected roles. I didn’t fit in with the boys but also didn’t like the girls’ squealing. Learning everything there was to know about horses gave me a sense of identity. I was the horsey person’. (Stephan, 28)
The intensity and all-consuming focus that differentiate an autistic ‘special interest’ from a regular hobby may have its cause in neurological differences that affect executive function, making self-regulation more difficult.
Autistic people may also collect items and sort them into categories, again creating a comforting sense of structure. They may become very attached to specific items and provide them with great meaning. They may want to talk about their current interest more than others are willing to listen.
*Simone, R. (2010). Aspergirls: Empowering Females with Asperger Syndrome. London, UK: Jessica Kingsley Publishers, p.19.
Autistic people process sensory input differently on a neurological level. Most commonly, the sense of hearing is affected, effectively turning up the volume of the world.
Quiet droning or buzzing sounds such as those created by computers, which are almost inaudible to most people, may create discomfort to the point of the person being unable to focus on anything else. High-pitched or sudden noise may be experienced as physically painful. Moderate noise made by a group of people talking may feel deafening.
All senses can be involved, with some getting a headache from fluorescent or bright lights, some not being able to wear certain fabrics because they feel like a wire brush against their skin, some avoiding certain foods because the texture or taste cannot be tolerated, and some feeling nauseated by the smell of perfumes. Everyone is different, with thousands of possibilities of sensory issues.
‘My eyes are really sensitive to light. Any kind of bright light makes them water and get red, even normal indoor lighting. That’s why I basically have to wear sunglasses all the time. I always get looks by strangers when I’m in the supermarket, and at work, half of my colleagues have told me at one point or another that they found it annoying having to talk to me without seeing my eyes. I haven’t disclosed my ASD, so it’s my fault in a way, but I just wish I didn’t have to explain myself’. (Harold, 52)
The lesser-known senses of proprioception (knowing where one’s body is in space without having to look), thermoception (sensing temperature), and nociception (sensing pain) can be affected, explaining why some autistic people appear to be indifferent to pain, hunger, or the cold, or why they may have an odd-looking gait and stumble over their own feet.
Different sensory processing doesn’t only lead to adverse reactions. Many everyday aspects of the environment, such as running water, sunlight sparkling in dew drops, subtle smells of mown grass, the tactile experience of burying one’s hand in a bag of rice grains, clicking pebbles, etc., can be experienced as highly pleasurable, contributing immensely to the person’s happiness and sense of calm.
Enhanced or ‘savant’ abilities are estimated to be present in 10% of autistic people while being extremely rare (less than 1%) in the non-autistic population*.
Commonly enhanced abilities, if present, include factual memory, detailed visual recall and visual imagination, musical or artistic aptitude, maths or language skills, and instant pattern recognition. The person usually doesn’t learn the skill in the traditional way, but may appear to be proficient without any effort, or they may be self-taught.
‘Typos stand out to me as if they were in a different colour from the rest of the text – there is a pattern to language, and if something breaks that pattern, it’s rather obvious. But it’s not just that; I notice deviations from patterns everywhere. My parents always called me lucky because I find so many four-leaf clovers … but I don’t even have to look for them. Walking past a clover patch with a four-leaf in it feels like a hiccup, a glitch in the system, and I spot it immediately’. (Rosie, 40)
Many theories attempt to explain savantism, but none have been confirmed to date.
*Treffert, D. A. (2009). The savant syndrome: an extraordinary condition. A synopsis: past, present, future. Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences. 364 (1522): 1351–7. doi:10.1098/rstb.2008.0326