How to tell if you re on the autism spectrum
Do I Have Symptoms of ASD or Aspergers?
Do I Have Autism? A Test for Adults
Awareness of autism spectrum disorder (ASD) has grown dramatically in recent years, which reflects an increase in autism tests and diagnoses — and in the public’s understanding that, even late in life, an autism diagnosis can offer major benefits and relief. Still, symptoms of autism — particularly those previously associated with Aspergers — are still frequently misdiagnosed as attention deficit hyperactivity disorder (ADHD), mood disorders, obsessive compulsive disorder (OCD), and other related conditions — leading to poor treatment and lifelong challenges. If you recognize yourself or a loved one in the following descriptions of autism spectrum disorder, make an appointment with a health care professional to discuss an evaluation test for autism.
This free autism test was adapted from the Autism Spectrum Screening Questionnaire (ASSQ) designed to screen the possibility of ASD, and is for personal use only. This is not a diagnostic tool. An accurate diagnosis can only be made through clinical evaluation. This autism test is for personal use only.
Do your family members lovingly refer to you as the “eccentric professor” of the family?
Very Often
Often
Sometimes
Rarely
Never
Do you prefer to play individual games and sports like golf, where everyone works for themselves, instead of team sports and games where everyone works toward a common goal?
Very Often
Often
Sometimes
Rarely
Never
Is your memory like a steel trap, even for facts that you don’t fully understand?
Very Often
Often
Sometimes
Rarely
Never
Are you always bumping into things, or tripping over your own feet?
Very Often
Often
Sometimes
Rarely
Never
Do you enjoy inventing your own words and expressions that might seem quirky to others?
Very Often
Often
Sometimes
Rarely
Never
Even when you’re in a quiet place, like the library, do you find yourself making involuntary noises, like clearing your throat over and over?
Very Often
Often
Sometimes
Rarely
Never
Are you really (really) good at a skill like math or music, but struggle to succeed in other areas?
Very Often
Often
Sometimes
Rarely
Never
When you’re having a conversation with someone, do you prefer to look at the wall, their shoes, or anywhere but directly into their eyes?
Very Often
Often
Sometimes
Rarely
Never
Do people say that you speak like a robot?
Very Often
Often
Sometimes
Rarely
Never
Are expressions like “Curiosity killed the cat” or “Don’t count your chickens before they hatch” odd to you?
Very Often
Often
Sometimes
Rarely
Never
Do you prefer to read non-fiction over fiction books?
Very Often
Often
Sometimes
Rarely
Never
Are you always the first one to notice when a friend has gotten a haircut or made a small change to their appearance?
Very Often
Often
Sometimes
Rarely
Never
Have you always wanted a best friend, but never found one?
Very Often
Often
Sometimes
Rarely
Never
Do you talk to friends at a party the same way you would talk to co-workers in the office?
Very Often
Often
Sometimes
Rarely
Never
Do you have trouble understanding what people mean when they say they feel embarrassed for someone else?
Very Often
Often
Sometimes
Rarely
Never
Did bullies target you in grade school?
Very Often
Often
Sometimes
Rarely
Never
Think about your daily routine.
Would you say you follow the same schedule every day of the week, and don’t like unexpected events?
Very Often
Often
Sometimes
Rarely
Never
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Autism Test Next Steps: Autism Spectrum Disorder In Adults
1. Take the ADHD Test for Adults
2. Read What Does Autism Look Like in Adults?
3. Read: ADHD and Adult Autism: Symptoms, Diagnosis & Interventions for Both
4. Read: How to Get Evaluated for Autism as an Adult
5. Take This Test: OCD in Adults
6. Get the eBook “The Truth About Autism in Adults”
7. Listen to the Webinar: “Could I Be on the Autism Spectrum?”
8.
Take This Test The Autism Test from WebMD
9. Read: Say Goodbye to Aspergers Syndrome
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Autism Spectrum Disorder Treatments for Adults and Kids
Roughly three million American children and adults have Autism Spectrum Disorder (ASD), a complex disorder of brain development caused by rare gene mutations and pre- or post-natal environmental stresses. ASD is a lifelong condition that causes difficulties with social interaction, verbal and non-verbal communication, and repetitive behaviors.
It cannot be cured, but ASD may be managed effectively with three main types of treatment: educational/behavioral interventions, medication, and alternative therapies. Most clinicians prefer to begin with non-medical therapies designed to manage the symptoms that hinder social and academic success and lead to a turbulent home life.
Treating Autism with Educational/Behavioral Interventions
Behavioral therapy is the mainstay treatment for children with autism. Even when a child’s behavior is “good,” this type of therapy can help to teach her new skills, and improve her language and social abilities. Social skills training, for example, can teach individuals with autism how to interpret gestures, eye contact, tone of voice, humor, and sarcasm. Cognitive behavioral therapy can help to manage obsessive behavior and anxiety. Ongoing behavioral therapy is linked with better long-term health outcomes, even when symptoms of ASD are mild.
In early-intervention therapy, the entire family works with professionals to improve social, learning, and communication skills. Parent-training programs teach families how to best cope with autism, and teach parents how to administer therapy at home. Among the most highly trusted parent-training programs are Floortime (derived from the Developmental Individual-difference relationship-based model), TEACCH autism program, the Lovaas Model (based on the Applied Behavior Analysis (ABA)), and the Early Start Denver Model (ESDM).
[Self-Test: Is My Child on the Autism Spectrum?]
Parents of children with autism say that posting lists, rules, and schedules helps to keep the household organized. Checking off checklists can give people with ASD a sense of accomplishment. Physical exercise is also a good intervention for children on the autism spectrum who seem to have boundless energy. Channeling excess energy into an independent physical activity, such as swimming or karate, allows them to burn it off without the pressures of socializing. Schools with friendship groups or lunch bunches can help kids to learn the basics of social interaction.
Treating Autism with Medication
If behavioral and educational interventions aren’t sufficient, medication may help an individual with autism to better manage his symptoms. Three main classes of medication are used with ASD patients: stimulants, antidepressant and anxiety medications, and atypical antipsychotics.
Stimulants are the most common class of medications used to treat ADHD.
ADHD and ASD commonly co-occur, and it’s important to get ADHD symptoms under control when treating a child with both conditions. Children with ASD can be more sensitive to side effects, and should be monitored carefully when prescribed stimulants. A pediatrician may refer a child with ASD to a psychiatrist or a psycho-pharmacologist as the dose is increased.
Antidepressant and anxiety medications can help people with ASD deal with the common challenges of persistent anxiety and obsessive behaviors. Symptoms like running away from new situations, compulsive checking or washing, or anxiety from strict black-and-white thinking can present big obstacles in day-to-day life. Selective serotonin reuptake inhibitors (SSRIs) such as sertraline (Zoloft) or fluoxetine (Prozac) can sometimes help with mood, anxiety, obsessive thoughts, and compulsive behaviors1. They are used off-label.
[Free Download: The Ultimate Guide to ADHD Medication]
A class of medicines called atypical antipsychotics is often effective for addressing motor restlessness, repetitive behaviors, and sleep disturbance in children with autism.
These medications include aripiprazole (Abilify), quetiapine fumarate (Seroquel), and risperidone (Risperdal). The latter medication is the only one of the three that is FDA-approved for treating behaviors associated with autism. A good response to an atypical neuroleptic may eliminate the need for a stimulant.
Every child with autism will benefit from the support of a developmental and behavioral pediatrician or a child psychiatrist with training in the autism spectrum. Seeing a specialist who understands what it’s like to live with an active autistic child is a bonus for parents, as well. Teens with autism can improve using transitional services that will guide them into independence and employment during adulthood with decreased parental support. Many people significantly improve with intensive early intervention and treatment. A small percentage improves so much it is no longer considered “on the spectrum.” Others become able to score in normal test ranges, and can function socially but still have mild symptoms.
Many live independent lives, develop fulfilling relationships, and work with the appropriate supports.
1National Institute of Mental Health. “Medications for Autism.” PsychCentral. (2013). Web. (https://psychcentral.com/lib/medications-for-autism/)
Treating Autism with Alternative Therapies
Many people with chronic conditions like ASD use therapy and medication in tandem with alternative treatments, though their effectiveness and safety are not as well researched. Parents of children with ASD and adults with the condition should consult with a physician before taking any supplements or trying alternative methods.
Amino acids, which can act as neurotransmitters, may help regulate serotonin levels of people with ASD. Taurine may improve visual learning and L-Carnosine may help repetitive verbal habits for people with ASD1.
Auditory integration training (AIT) can help improve auditory processing deficits and concentration.
It involves listening to electronically modified music, voice, or sounds to improve function1. This can be beneficial for people with ASD who have trouble listening, or focusing.
B6/Magnesium supplements have been a popular complementary treatment for ASD for over 20 years. Research studies have reported mild improvement in symptoms with their use1.
b-Calm2 is an MP3 player loaded with audio tracks specifically developed as “audio sedation” to help people with ASD screen out sounds that can cause distraction, induce stress, and adversely affect social and academic performance. The tracks combine two types of sounds: live recordings of nature sounds and white noise. At low levels, people can converse and interact. At higher volume, the tracks can cover up voices and noise to reduce sensory overload.
Casein- and gluten free diets3 and other dietary changes may help to improve behavior, or gastrointestinal symptoms of a comorbid condition.
At least half of families living with ASD try this as an alternative therapy, but much research is pointing away from it being a valid, useful treatment option. It’s important to work with a nutritionist or dietician when making major changes in eating habits to ensure that a child or adult’s nutritional needs are being met. Put a plan in place to determine if symptoms change alongside changes in diet, and recruit teachers to objectively observe if changes are worth the effort. An improvement could be reducing the consumption of processed foods that have high levels of sugar and fat and consuming more whole foods like fruits and vegetables.
Dimethyl glycine (DMG) and trimethyl glycine (TMG) are nutritional supplements that are sometimes suggested to treat ASD. Some small studies found no effect when compared with a placebo1.
Melatonin supplements can help to reduce sleep dysfunction in children with autism. Poor sleep worsens symptoms, such as repetitive behavior and social problems.
Music therapy can help improve social and communication skills for people with ASD, when paired with other educational and therapy interventions, according to some studies1.
Omega-3 fatty acids have been shown to reduce repetitive behavior, hyperactivity, and social skills in some small studies.
Relaxation strategies and mindfulness can help people with ASD to calm down when they feel overstimulated. Weighted clothing or a pressure massage can sometimes alleviate symptoms. Yoga can help some to increase their sense of well-being while decreasing anxiety.
Sensory therapies may reduce sensitivity to touch, light, balance, or hearing for people with ASD. Similar to treatment for sensory processing disorder, sensory therapies for ASD are done by an occupational therapist, who can help retrain the senses. Typically, the OT creates a “sensory diet” a plan in which the child is slowly introduced to activities in a gentle, fun way to help him or her get used to a wider range of stimulation.
[ADDitude eBook: The Complete Guide to Treating ADHD Naturally]
Sulforaphane, a compound found in broccoli sprouts and other cruciferous vegetables, may have a positive effect on the social and behavioral problems associated with autism according to one study4. The compound triggers a “heat-shock” response in some cells, which can decrease hyperactivity and repetitive behaviors. More research is needed to determine if this has a beneficial effect.
1Susan E. Levy, M.D. and Susan L. Hyman, M.D. “Complementary and Alternative Medicine Treatments for Children with Autism Spectrum Disorders.” NCBI. (2009). Web. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2597185/)
2Kay Marner. “b-Calm: An MP3 Player for ADHD and Autism Symptoms?” ADDitude Magazine. (2011). Web. (https://www.additudemag.com/b-calm-audio-technology-adhd-product/)
3“Complementary and Alternative Medicine Treatments for Children with Autism Spectrum Disorders.
” Autism Speaks. (2015). Web. (https://www.autismspeaks.org/what-autism/treatment/complementary-treatments-autism)
4Devon Frye. “Compound Found in Broccoli Shows Promise as Autism Treatment.” ADDitude Magazine. (2014). Web. (https://www.additudemag.com/compound-found-in-broccoli-shows-promise-as-autism-treatment/)
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causes, symptoms, diagnosis and treatment
IMPORTANT!
The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
Definition
Autism, more specifically Autism Spectrum Disorders (ASD), is a group of mental disorders that are characterized by impairments in social interaction and communication – the process of communicating and communicating information to other people.
Autism is characterized by limited, stereotyped, repetitive behavior. In different patients, disorders are expressed to varying degrees, while they may or may not be accompanied by impaired speech and intellectual development.
The first signs of the disease are noted already in infancy or early childhood, anomalies in social functioning and behavior persist throughout life.
Causes of autism
The causes of autism spectrum disorders are not fully understood, but it is believed that genetic factors play a leading role. It is known that the risk of having a child with ASD increases with the age of the parents.
Possible relationship between the onset of ASD in a child and the course of pregnancy: prematurity of the fetus, the use of valproic acid preparations by the mother during pregnancy to treat epilepsy, manic-depressive psychosis, migraine, as well as gestational diabetes in the mother (diabetes mellitus that develops during pregnancy ).
It is unlikely that any of these factors is of decisive importance in the development of ASD, but may be realized in interaction with a genetic predisposition.
Autism is more commonly diagnosed in boys, with a sex ratio of approximately 3:1.
Since the mid-1990s, there have been concerns about the possible association of vaccination with the onset of ASD. Current epidemiological data indicate no such association. Moreover, there is no evidence of an association between the use of vaccines and the risk of developing ASD, even when vaccinating children at risk - brothers and sisters of children with ASD. It has been proven that the preservative thiomersal and aluminum adjuvant contained in inactivated vaccines do not increase the likelihood of ASD in vaccinated children. According to many international studies, changes in the vaccination schedule, the withdrawal of any vaccines and their components did not affect the incidence of ASD.
Disease classification
Depending on the number of symptoms and their severity, there are three main types of ASD: childhood autism, atypical autism, and Asperger's syndrome.
Asperger's syndrome is the mildest form of ASD - intelligence does not suffer, changes can be regarded as personality traits and do not interfere with professional development and social adaptation of a person.
There is a division of the RAS depending on the presence or absence of intellectual disabilities and the ability of a person to use spoken or written language as a means to express needs or desires.
Symptoms of autism
The main manifestations of ASD are disorders in social interaction, communication (anomalies in communication) and limited, stereotyped, repetitive behavior. In addition, patients often have other non-specific problems: various phobias (fears), sleep and nutrition disorders, aggression and auto-aggression (aggression directed at oneself).
Contrary to popular belief, most autism spectrum disorders are not associated with a high level of intelligence, although some patients may have extraordinary abilities in some area of knowledge.
Let us dwell in more detail on the description of the main manifestations of the disease.
Disorders of social interaction and social communication . Parents pay attention to the fact that the child rarely uses eye contact, gestures, facial expressions and posture to regulate social interaction, he has reduced interest in interacting with peers and adults. The child may not speak or start speaking with a strong delay, and if he does, he does not start a conversation, does not ask questions, communicates exclusively on topics of interest to him; can repeat the same words and phrases over and over. The baby has no desire to walk in his arms, he does not always distinguish parents from other people. Such children do not look at the interlocutor, may not respond to the speech addressed to them, to requests, do not respond to the name, they do not enter into or reluctantly enter into a dialogue, do not smile in response.
Often, a child with autism can observe unusual behavior, for example, violation of bodily boundaries, lack of embarrassment or excessive anxiety when interacting with new people, monotonous scenarios in communication.
After the age of 7 years, some children with ASD remain speechless or have a minimal set of words. Other children, starting to communicate, cannot build long-term friendships and take into account social rules. The problem of many older children and adults with autism is the inability to understand and feel the state of other people, their mood.
People with ASD are characterized by naivete, innocence, they do not understand irony and humor well, they experience difficulties in maintaining a dialogue and understanding the rules of behavior.
Many patients with ASD retain excessive or, conversely, absent gesticulation, unstable or excessive eye contact.
Stereotypical, repetitive behavior, limited interests and hobbies .
With the exception of Asperger's syndrome, most patients present with varying degrees of intellectual decline. Children with ASD are characterized by peculiar play activities, for example, a child may use toys in an unusual way: scatter, lick or perform other repetitive manipulations. Already in early childhood, selective interests often appear - for example, it can be the study of moving objects, a passion for narrow topics (interest in the alphabet, numbers, names and individual characteristics of objects). Such children experience pronounced difficulties when it is necessary to switch attention.
With age, the set of symptoms may change in content and severity. Many older children and adults are characterized by inflexibility of thinking, manifested by a lack of response to changing environmental conditions, the difficulty of assimilating and using new information, practical skills, and an excessive tendency to detail.
Autism Diagnostics
When collecting complaints and examining, the doctor draws attention to the characteristics of the patient's behavior, assesses the current psychiatric status and level of development.
To clarify the diagnosis and improve the accuracy of clinical diagnostics, additional standardized methods related to the "gold standard" are used: ADOS-II and ADI-R.
ADOS-II is a test performed by a child or adult psychiatrist or clinical psychologist. It consists in observing the patient performing certain tasks in a playful way. Depending on age, ability to speak and play, the doctor chooses one or another module - a type of testing. The modules differ in the complexity of the proposed games, activities and the presence of speech tasks. The 1st module is used for children speaking in separate words. 2nd - for children using sentences of several words. 3rd - for freely communicating children. 4th - for freely communicating teenagers and adults. With the help of a certain set of toys and items, the specialist creates various game situations. He observes the performance of the work, evaluating facial expressions, words, ways of solving the proposed tasks.
The tasks last about an hour, after which the specialist processes the test results and draws up a conclusion. Usually, the test is recorded on video, which helps to make a more accurate diagnosis and provides an opportunity for other specialists to assess the child's condition.
ADOS-II is not the only criterion for making a diagnosis. As an additional test to collect more data, the ADI-R screening can be used.
ADI-R - an interview with about 100 questions conducted by a psychologist or psychiatrist; but not with the patient, but with his parents or other close people. The questions are aimed at assessing:
- the quality of social contact;
- communication quality and speech characteristics,
- behavior patterns (repetitive, limited or stereotyped actions).
Genetic testing may be recommended in children and adolescents with an established diagnosis to clarify the immediate cause of ASD. It is compiled according to an individual plan with the involvement of geneticists or other specialists.
Instrumental methods of examination are of secondary importance, not leading in the diagnosis of ASD. Electroencephalography (EEG), computed tomography (CT) of the brain, and magnetic resonance imaging (MRI) of the brain are not recommended for all children and adolescents with or suspected ASD. On the one hand, this is due to the fact that the examination may be difficult due to ASD-specific violations of the patient's communication and behavioral skills. On the other hand, these studies cannot confirm or refute the diagnosis of autism spectrum disorder, but may be indicated for diagnosis and treatment in case of suspected presence of other disorders, for example, epilepsy, brain tumor.
Which doctors to contact
Autism can be suspected pediatrician. Confirms the diagnosis, prescribes therapy and observes children, and then an adult psychiatrist, neuropathologist, psychologist.
Autism treatment
There is currently no direct treatment for ASD.
Prescribed medications, for example, from the group of antidepressants, can help in solving various non-specific problems - sleep and nutrition disorders, increased irritability, attacks of aggression directed at oneself or others. The main treatments for ASD are predominantly non-pharmacological in nature. They include educational and psychological assistance aimed at the socialization of a person with ASD - the earlier assistance is started, the better the prognosis for the development of the child.
There are many methods of treatment and care for patients with ASD that have no proven effectiveness: gluten-free and casein-free diets, brain micropolarization, the Tomatis method, bioacoustic correction, art therapy, as well as hippotherapy, dolphin therapy and many others. If parents insist on using these methods, it is important to understand that they should not be used as a substitute for the main treatment program.
Nootropic and peptide drugs are often used in the treatment of patients with ASD.
Currently, there is no convincing evidence of their ability to influence the development of cognitive and speech skills. However, they can increase motor activity, cause disinhibition and sleep disorders.
Complications of the disease
With autism, various damages are possible that the patient inflicts on himself and others.
Due to impaired cognitive functions, speech, difficulties in interacting with others, patients with ASD, with the exception of patients with Asperger's syndrome, in most cases cannot live independently, study and work.
Diagnosis and treatment of other diseases are difficult due to the high pain threshold and behavioral characteristics of those suffering from ASD.
Prevention of autism
There are currently no specific measures to prevent ASD. However, early diagnosis is a necessary condition for organizing early comprehensive care for a child, which can improve the prognosis.
Sources:
- Clinical guidelines.
Autism Spectrum Disorders. Clinical recommendation developer Association of Psychiatrists and Psychologists for evidence-based practice Approved by the Scientific and Practical Council of the Ministry of Health of the Russian Federation, 2020. - p. 52. - Bozhkova E.D., Balandina O.V., Konovalov A.A. Autism Spectrum Disorders: Current State of the Problem (Review). Modern technologies in medicine. T. 12, No. 2, 2020. S. 111-120.
IMPORTANT!
The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
Autism in adults: symptoms, causes, treatment
- What is autism spectrum disorder
- Symptoms of ASD in adults
- Causes of ASD
- ASD Help
- How people with autism spectrum disorder live
- ASD in adults in Russia
The material was commented by Elena Grigorenko, clinical psychologist, molecular geneticist, Ph.
D. Research MSUPU, Head of the Scientific and Expert Council of the Vykhod Foundation
What is Autism Spectrum Disorder (ASD)
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ASD is not a disease, but a developmental disorder. The main difference is that the disease has a beginning, a period of flow and an end. ASD is not contagious, autism cannot be "sick" - a person has it from birth.
Diagnostics of autism spectrum disorders in Russia and other countries of the world is carried out according to the International Classification of Diseases, 10th revision (ICD-10). The United States has its own classification - the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). It differs slightly from the ICD-10, but with the introduction of the ICD-11, the discrepancies will be eliminated. The transition to the new classifier is planned for January 2022. It will no longer have Asperger's and Kanner's syndromes as separate diagnoses, they will be combined into the definition of "autism spectrum disorder".
In the latest edition of the American DSM-5 manual, the category of Asperger's syndrome is also missing [1].
Some doctors believe that there is no need to distinguish between Asperger's syndrome and autism. Tony Atwood, ASD specialist: “Research shows no clear difference between the two diagnoses. There are fewer differences than similarities. Today, both terms may well be interchangeable” [2]. According to Patricia Howlin, clinical psychologist, emeritus professor at the Institute of Psychiatry at King's College London, a member of the British Psychological Society and the Exit Foundation's scientific advisory board, the name "Asperger's syndrome" has long been used very loosely. There was no consistency in mentioning this diagnosis. In addition, in the US, children with Asperger's syndrome did not receive enough care compared to those who were diagnosed with autism. It was believed that they needed it less.
Despite the fact that according to the new classifications of diseases, Asperger's syndrome is not distinguished as an independent diagnosis, some specialists continue to use it in communication.
The main difference from "normal" autism is that speech and cognitive abilities are preserved. The name of the diagnosis was given by the English psychiatrist Lorna Wing in honor of the Austrian physician Hans Asperger, who worked with children with a lack of ability for non-verbal communication. There are ongoing discussions that the term itself is unethical due to Asperger's collaboration with the fascist regime.
© Shutterstock
According to the US Centers for Disease Control 2020, ASD affects one in 54 children [3]. WHO statistics claim that every 160th child [4]. Psychiatrist and epidemiologist Eric Fombon says: “This data is from my old 2012 paper that I worked on with Mayada Elsabag. Now they are outdated. In 2021, autism occurs in one in 100 people” [5].
ASD is a range of mental disorders that cause difficulties with social interaction. Most often, the disorder is spoken of in children, because possible disorders appear at an early age. But it also happens that the symptoms are mild, and as a result of misdiagnosis, people can struggle with other diseases for years without realizing that they have ASD.
Symptoms of ASD in adults
There are currently no hormonal, biochemical or genetic markers to define ASD. Brain scans don't help either — structural changes don't indicate the severity of symptoms or their specific manifestation. Doctors focus on the behavior of patients. Scientists talk about a spectrum of disorders because they vary based on symptom presentation, age, and other health factors. Therefore, each case must be considered separately. Social and communication skills, the severity of mannerisms - unconscious gestures, features of speech and facial expressions, as well as stereotypical behavior are taken into account.
Why is the word spectrum used? The manifestations of the disorder are very diverse. For example, autism can be diagnosed in intellectually and creatively gifted people who demonstrate outstanding achievement in the arts or sciences, or it can be found in patients with brain disorders. The diagnosis occurs in those who avoid society or are basically unable to join it, as well as in those who are constantly looking for interaction, but at the same time cannot communicate according to accepted standards.
Some people with autism are fluent in oral communication, while others are only able to communicate using alternative means of communication, such as cards or special applications for gadgets. And there are many such examples of the diversity of manifestations in the autism spectrum.
It is not possible to self-diagnose to define ASD because it is a complex disorder that requires a high level of specialist skill to define. A person can look at the list of symptoms and find some of them in himself, but this is just a way to suspect deviations. Differential diagnosis is the task of the psychiatrist alone. If you assume that the person you are interacting with for the first time has ASD, remember that every individual is valuable and worthy of respect, regardless of diagnosis. The symptoms can be very different, and no people experience the disorder in the same way. Often it is combined with other diagnoses - in almost 3/4 of cases, concomitant disorders were found; each of them must be considered separately.
There are several indicators, the so-called red flags, that can tell you to seek medical advice.
Emotional and behavioral symptoms
This includes repetitive behavior as well as inability to empathize. Some people with ASD have difficulty trying to interpret social and sensory issues. Autism Spectrum Disorder is often expressed in an increased emotional response to disappointments or changes in familiar situations. In addition, doctors point to an abnormal response to sensory stimuli, such as touch, smell, lack of light: this may be hypersensitivity or, conversely, a lack of response.
Communication symptoms
Patients with ASD may experience difficulties in social interaction, doctors often diagnose speech problems - it can be harsh, like a robot. Some people with autism spectrum disorder find it difficult to moderate their voice, such as lowering it when circumstances warrant it. One of the symptoms is repetitive speech, which is built around the same phrases.
At the same time, an increase in vocabulary often occurs in those areas of knowledge that interest a person. Hyperfocus on one topic is also expressed in the desire to constantly talk about it with other people.
Adults with ASD may not pick up cues from others, such as hand gestures, facial expressions, or body language. Some patients try to avoid eye contact or do not feel the need for it. A person with ASD is not necessarily a closed introvert, he can be quite sociable. From the point of view of the development of communication skills, people with high-functioning autism are distinguished, they have well-developed verbal intelligence, but other diagnostic categories of ASD are found.
Yulia Azarova, editor-in-chief of media resources of the Vykhod Foundation
“There is a hypothesis that people with ASD may have problems with the ability to put themselves in the place of another. But at the same time, some research suggests that people with autism are doing great with empathy, which seems to involve the ability to put oneself in the place of another, and the problem is teaching them to understand when to “turn it on.
”
Difficulty with coordination
Clumsiness itself is not considered a sign of illness, but coordination problems are common in adults with ASD. This makes it difficult to perform simple everyday tasks - from walking to tying shoelaces.
“ASD now has three categories of signs (there will be two of them with the eleventh revision of the ICD): social and communicative deficits and repetitive behavior,” explains Yulia Azarova. “Clumsiness, hypersensitivity, etc., are not medical symptoms of ASD. They may or may not be present. Therefore, these behavioral features belong to the so-called autism red flags, based on which one can notice the atypical development of the child. But in no case should you independently diagnose your child with autism on the basis of, for example, hypersensitivity. The appearance of red flags is a reason to seek professional diagnostics.”
Some of the characteristics of autism spectrum disorder can be seen as positive. So, a person with ASD has a rare concentration of attention, can focus on solving a problem, scrupulously engage in one thing for a long time; he is very attentive to details.
But the presence of some special abilities does not negate the fact that autism is a serious diagnosis that has a great impact on the life of a person and his loved ones. Therefore, it would be a mistake to think of autism as a cute feature or a charming oddity.
If you or your loved ones experience these symptoms, you should consult your doctor. “Only a psychiatrist has the right to diagnose autism in Russia. A psychologist, pediatrician, neurologist or other doctor who observes a child can only suspect that he has this disorder and refer him for further consultation with a psychiatrist,” says Yulia Azarova.
When examining a patient, clinicians consider criteria for social behavior, interpersonal skills, and physical problems that may be indicative of other illnesses. It is not uncommon for people with ASD to be anxious, show signs of depression or, conversely, hyperactivity, so the diagnosis can be mistaken for one of these conditions.
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Causes of ASD
The exact cause of ASD is unknown, but it is believed that 80–90% of cases are due to a genetic predisposition [6].
More than 100 genes have already been found that scientists have linked to the onset of autism. But there are also environmental factors that can also contribute to the formation of this disorder in a child. For example, inflammation in the mother's body during pregnancy has been linked to an increased risk of ASD in the baby. It can occur due to chronic diseases such as arthritis, lupus or diabetes, or be triggered by obesity due to cytokines that cross the blood-brain barrier and attack neural networks.
There is not enough reliable information about medications taken during pregnancy. But there is evidence that some drugs have this side effect. For example, valproic acid, which is used to treat epilepsy and bipolar disorder, increases the risk of having a child with autism by 2–2.5 times [7].
© Hunter Johnson/Unsplash
Another avenue of research is the environment in which the baby was born, such as preterm birth or too low birth weight (less than 2 kg). In any case, if a child has had a difficult start in life, often on follow-up he may have problems with social communication, and in some cases, autism.
Help for adults with ASD
“Too often we try to treat ASD with pills. It's impossible. Medications may be given to people with autism to deal with other problems that they have just like everyone else. For example, depression or anxiety. But there is no drug therapy for ASD,” explains Yulia Azarova.
However, there are ways to help children and adults cope with the symptoms of autism and the difficulties that come with it. According to the clinical guidelines for ASD, approved by the Ministry of Health on July 17, 2020, integrated programs for helping people with autism use applied behavior analysis, rewards and information gathering. These are the symptoms of autism. To help people with ASD, methods that show themselves to be ineffective for correcting autism symptoms, as well as potentially dangerous (for example, holding therapy) are not recommended [8].
“The meditation and mindfulness offered by some doctors is not a therapy for autism. Such methods do not have a high level of evidence.
We can just as well talk about pet therapy: yes, some children like to spend time with animals and then they feel good. But will it be a therapy for ASD symptoms? No. It’s the same here: meditation and mindfulness are good, but they don’t help fight the symptoms of autism,” says Yulia Azarova.
Some people who were diagnosed with ASD as children outgrow it, achieving an "optimum outcome". The term was coined by Deborah Fine, professor of psychology at the University of Connecticut at Storrs. In 2013, she conducted research on 34 people diagnosed with autism. In 2016, scientists reviewed cases of optimal ASD outcomes and concluded that it is possible to talk about the loss of a diagnosis only if it is made early. Timely intensive behavioral intervention plays an equally important role. The majority of people with autism retain symptoms consistent with the diagnosis and require lifelong therapy and support [9].].
How to diagnose and treat amyotrophic lateral sclerosis
How people with autism spectrum disorder live
Patients can lead full, healthy and productive lives.
Due to their high attention to detail and the ability to focus, they can achieve success in their careers. A prime example is environmental activist Greta Thunberg. Fictional characters include Shaun Murphy from The Good Doctor, Saga Noren from The Bridge, or Sheldon Cooper from The Big Bang Theory. At the same time, the creators of the latest series claim that Cooper, who is distinguished by obvious obsessive behavior, social dysfunction, regressive tendencies and an inability to perceive sarcasm, does not have an ASD diagnosis. The writers refuse to pathologize the characters to be accepted without labels.
Lydia Netzer, the mother of a teenager with an autism spectrum disorder, believes that the right decision is not to create the image of a “cute autism” with an official diagnosis [10]. Because otherwise, ASD is perceived as a kind of funny feature: a person with an autism spectrum disorder does not understand hints, is picky in habits, remembers and gives out original facts, instantly solves complex mathematical problems.
This creates the unrealistic stereotype that people with ASD are quirky but always socially successful. In fact, everything is more complicated, and a person can experience serious difficulties, getting into conflict situations with others. "Cute" disorders are deceptive and can lead to the misconception that tolerance is easy.
In addition to therapy and professional help, a person with autism spectrum disorder has to devote a lot of attention to self-advocacy - to defend their views, make decisions, cope with difficulties and express personal opinions in an acceptable way. People with serious diagnoses find it difficult to seek help because they often face a backlash. It is important to find something that brings joy, captivates and works well, rely on a sense of self-worth.
Maverick Crawford, a student and social activist with ASD, suggests praising yourself for small achievements, writing a “support list” indicating things that please and motivate [11]. He recommends self-esteem-building practices and talks about the importance of finding like-minded people and helping others with the same disorder.
Crawford admits that he has speech problems - he often stutters, which can annoy interlocutors. Crawford encourages people with ASD to try to remain calm and take a deep breath before starting a monologue, speak confidently, slowly, concisely and to the point, be persistent and not give up.
“It would be nice if we had enough people with autism who would be so adapted that they could protect their rights,” says Yulia Azarova. - But in Russia such a catastrophic underdiagnosis that basically the diagnoses are received by already very serious patients-children, whose symptoms are conspicuous. And parents have to defend their rights.”
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Large companies organize employment programs for people with autism spectrum disorder. But they require constant investment. For example, in the United States, out of 100 thousand people with ASD at the age of 25, only 58% have a well-paid stable job. For comparison: among graduates without a diagnosis of ASD who graduated from high school, this figure reaches 99%.
ASD in adults in Russia
The Ministry of Health of the Russian Federation confirms that the prevalence of ASD in the Russian Federation is in line with the global average of 1%. There are still no scientific works that would confirm this information, and the number of official diagnoses is only 10% of the predicted number. This significantly complicates the creation of a system of state support for children with autism: the authorities have no real understanding of how many people need to create supporting services. The first research is now being carried out at St. Petersburg State University.
The study is led by Prof. Elena Grigorenko, Head of the Exit Foundation Advisory Board, in collaboration with Maureen Durkin, PhD in Epidemiology and Professor of Public Health and Pediatrics at the University of Wisconsin, USA. It is possible that the factors for the development of ASD will be different depending on the population due to the influence of the environment and genetic characteristics.
Equally important is the availability of diagnostic and therapeutic services. Oksana Talantseva, clinical psychologist, PhD student at the Faculty of Psychology at St. Petersburg State University, member of the working group of the draft clinical guidelines for ASD, says: “This is a new study, and our task is to make it as representative and objective as possible so that the data can be interpreted so that our methods can be applied to others. samples. Our study will tell what and how is the situation with autism in one district of St. Petersburg. But we want it to be scaled up later, so that we can talk about other regions, about the country as a whole” [12].
Elena Grigorenko, Clinical Psychologist, Molecular Geneticist, Doctor of Psychology, Professor at Yale University, University of Houston, Professor at the Department of Molecular and Human Genetics and Pediatrics, Baylor College of Medicine, Researcher at Haskins Laboratories Inc., Leading Researcher at the Center for Applied Psychological and Educational Research, Moscow State University of Psychology and Education , Head of the Scientific and Expert Council of the Vykhod Foundation
“In Russia, ideas about autism generally lag behind the world by about 30 years.
And it will take us a long time to overcome this gap, because we need money for scientific research, which no one has ever done in our country. At least to the extent that they are carried out, for example, in the United States. Prospects depend on how seriously people who make decisions in governing the country will approve this scientific and practical direction. Today there are already grounds for restrained optimism, but time will tell.”
Research in Russia is necessary to assess the scale of the problem, to competently approach the issue of creating a diagnostic system, supporting people with autism and informing the population. Publishing data is an effective tool to improve the situation. Researchers identify several priority state strategies for ASD. First of all, it is worth paying attention to sufficient funding for research and the development of a support system, in which specialists will work according to evidence-based methods.
A separate issue is the employment of people with autism spectrum disorders.
Some companies participate in charitable projects and provide applicants with the opportunity to work in positions that suit them. Thus, the MVS Group, which implements the largest concession in Russia in the field of road safety, has launched a project for the inclusive recruitment of people with ASD.
Anna Shapiro, HR Director, MVS Group
What positions have people with ASD been hired at MVS Group? Why was such a decision made?
We want to make our country safer, more comfortable for everyone. The main objective of the project is to enable adults with autism to successfully build a career and socialize in society, which means they can live a normal life, provide for themselves, have friends, hobbies, and a family.
There are many tasks in the IT sector, including our company, that people with autism can perform very well. The mental and psychological qualities of some of them make it possible to effectively solve problems with a constant high load: for example, processing a large amount of data, when such factors as routine, repetition, and the need to keep the focus of attention for a long time come to the fore.
We currently have eight people with autism in our team. All of them have been trained and are actively involved in the work processes. Employees with ASD work in the information preprocessing department.
What difficulties do people with ASD face during interviews? How did the interviews for your program differ from the standard ones?
The standard interview form (as for neurotypical people) is not suitable for applicants with ASD. Such candidates do not always understand specific questions, metaphors, double entenders, and questions in general about experience. With the help of experts, we have developed a sequence of selection stages and a special interview that helps to assess the characteristics, skills and abilities of a potential employee. Communication is built in several stages:
- telephone interview with the candidate and his guardian, obtaining their prior consent;
- conversation with the parent (guardian) and the candidate himself, passing specialized tests;
- brief meeting with head of department and HR to identify the most relevant candidates;
- meeting with the head of the department and mentor in the office, explaining the algorithm of work, trial tasks for the employee, checking how he assimilates information and his condition during the working day;
- making a decision on employment, work schedule of an employee with autism, on the necessary specific support for him at the workplace;
- registration of relations with an employee.
Did you have to adapt the standard job description for people with ASD?
The people with ASD who work for us are different. Therefore, for each of them it is required to adapt work tasks and convey information in their own way. The most important thing to do when hiring people is to divide big tasks into small and simple ones. The duties of employees with autism should be clearly understood by them, everything should be clearly described, a clear algorithm of actions is needed. Thus, they learn much faster and perform their tasks more efficiently. At MVS Group, mentors work with interns, whom we have attracted to cooperate with the help of our project partner, DistingTec, a company engaged in employment of people with ASD in the IT field. Professional tutors not only physically and psychologically support their wards, but also teach neurotypical employees and the head of the department how to behave and how to correctly formulate their instructions and requests.
