Individuals with autism spectrum disorder, or autism, are often labeled as “lonely and self-absorbed”. However, have we ever tried to understand the “loneliness and self-absorption” of the autistic people from their perspectives? Have we ever tried to appreciate the merits, purity and goodness of individuals with autism?

There is a misunderstanding that autism is resulted from inappropriate parenting.

Indeed, autism is a neurodevelopmental disorder. It is an inborn abnormality during the developmental process and its origin is unrelated to parenting. There has been accumulated scientific evidence suggesting that individuals with autism are found to have abnormal brain structure and function, which are highly associated with the manifestation of autistic symptoms.

Some recently published data show that the incidence rate of autism in Hong Kong, mainland China and Tai Wan is about 26 in every 10,000 people (Sun et al., 2013), where proportion of males is four times higher than that of females (Cowley, 2003). There are about 70% of autistic people have mental disabilities. In general, autistic individuals with mental disabilities demonstrate more severe level of symptoms than those with normal intellectual functioning. According to the most recent edition of the Diagnostic Statistical Manual of Mental Disorders (DSM-V; American Psychiatric Association, 2013), the two major characteristics of autism include:

1) Deficits in social communication

2) Repetitive and restricted pattern of behaviors

Causes of Autism:

Up till now, the cause of autism is yet an unsolved mystery. There have been query about the substantial increase in the prevalence rate of autism in the past decades (Goode, 2004), saying that it may be related to measles vaccination or the parents who often ignore their children. These two postulations are not true based on the results of scientific studies. One of the major reasons for the increasing prevalence rate could be related to the increasing awareness and understanding of the public on autism. For instance, in 1998, a movie called “Rain Man”, which truly reflected the everyday difficulties encountered by autistic individuals, was released in the United States and has attracted a lot of attention in the society. Although autistic people are often misinterpreted as “weird” given their socialization deficits, they have many merits (e.g., pure, not taking advantage of others, etc.). Thus, more autistic individuals were uncovered due to our increased awareness towards autism.

What is the most common difficulty experienced by autistic individuals in daily life?
The most common difficulty experienced by autistic people is the difficulty in interpersonal communication and development of social relationship. There two aspects are largely inter-related as development of social relationships should be built upon effective interpersonal communication.

However, individuals with autism are constrained by their language deficiency (e.g., developmental delay in language ability and echolalia) such that they cannot clearly convey their feelings and thoughts. On the other hand, the listeners would likely reduce their communication with autistic people because they cannot understand their conversation, which in turns results in a vicious cycle.

Even when some autistic individuals can verbalize their feelings and thoughts clearly (which could be due to their relatively less severe language deficiency), their development of social relationship can be hindered by their developmental delay in social functioning, e.g., avoid eyes contact and lack of facial expression during conversation with others. Furthermore, some research reported that autistic people can accurately identify if other people are looking at them, they cannot “read” other’s mind and behavior from their gaze (Baron-Cohen, Campbell, Karmiloff-Smith, Grant, & Walker, 1995).

In addition, autistic people often find making new friends effortful. This may be related to their inability to interpret other’s thoughts and behaviors based on their gaze, which usually makes them anxious. Some people may query “is that really anxiety-provoking?”. Try to imagine, will you feel uneasy if you are required to talk with others with your eyes covered the whole day? Therefore, it is postulated that autistic people often exhibit repetitive and restricted behavioral mannerism (e.g., repeatedly turning the light on and off) because such behavior eases their appraisal of the environment (e.g., the light can be turned on by pressing the button) and hence reduces their anxiety. 

Are autistic people generally not able to communication with other people?

This is not true! People with autism can communicate with others, yet through other means of communication. E.g., they can express their inner self through drawing. Some people may ask, “why didn’t autistic people express themselves through speech? Is there any defect in their vocal cord?” In fact, in addition to the abovementioned language delay that constrains expression ability in autism, insufficient activity in certain brain regions, including the frontal lobe and anterior cingulate cortex, could be another possible reason for their communication problems. One of the major functions of frontal lobe and anterior cingulate cortex is to mediate our appropriate, flexible and well-controlled responses to the multitudinous and complex information in the external world. Interpersonal communication is an extremely complex cognitive process. The abnormal brain functions in autism hinder their ability to respond appropriately in social context. As compared with face-to-face interaction, drawing is much simpler from social perspective, and thus it may be easily adopted as a mean of communication by autistic people.

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Baron-Cohen,S., Campbell, R., Karmiloff-Smith, A., Grant, J., & Walker, J. (1995). Are children with autism blind to the mentalistic significance of eyes. British Journal of Developmental Psychology, 13, 379-398. 

Cowley, G. (2003). Girls, boys and autism. Newsweek, 142, 42-50.

Goode, E. (2004). Lifting the Veils of Autism, One by One by One. New York Times. Retrieved May, 21, 2008.

Sun, X., Allison, C., Mattews, F. E., Sharp, S. J., Auyeung, B., Baron-Cohen, S., & Brayne, C. (2013). Prevalence of autism in mainland China, Hong Kong and Taiwan: a systematic review and meta-analysis. Molecular Autism, 4, 7-19.