The New Face of Autism

I’ve worked with individuals who have autism (ASD) for over 30 years. In that time, there has been a shift in our understanding, diagnosis, and treatment of autism. No two individuals with autism are the same, and every child should be understood keeping their unique strengths and struggles in mind. However, we can see common traits that allow us to view them through a particular lens. That lens helps us understand their strengths and better support their challenges. 

I’m seeing more and more students who are not formally diagnosed with autism but have features consistent with the diagnosis.

Many bright children struggle with social interactions and are exhausted by the demands of school. They come home spent and often take it out on their parents. I’ve met countless parents struggling to best support their children. 

There is a newly identified phenomenon called autistic burnout, when an individual on the autism spectrum becomes physically, mentally, and/or emotionally exhausted. The suspected cause is the result of trying to live in a neurotypical world. For many years, high-functioning individuals with autism were taught to camouflage or mask their autistic traits to fit in better at school or work. For example, individuals on the spectrum were given substitute behaviors other than flapping or pacing, which were considered more socially acceptable. If individuals with autism find themselves experiencing autistic burnout, they are encouraged to go to a space to recharge. Increased self-awareness is an integral part of individuals with ASD learning how to manage the world around them and not become overwhelmed or overstimulated.

There are many misconceptions about autism. I’ve encountered clinicians who have stated that because a child could engage in a conversation, make eye contact, or display empathy, they must not have autism. That is simply not true.

Here are some features of autism: 

• Black and white thinking; cognitive rigidity
• Concrete thinking; literal interpretation of speech 
• Difficulty reading nonverbal behavior 
• Difficulty with transitions and change 
• Intense and limited interests 
• Difficulty with reciprocal conversation; individuals often talk AT you and tend not to ask questions during a conversation 
• Sensory sensitivities: People with sensory sensitivities could be overly sensitive to loud noises, specific tastes or textures, touch, bright lights, or water. They could also be sensory seekers and look to touch others or gain sensory stimulation. 
• Difficulty with perspective taking, considering other points of view 
• Need help understanding slang or figurative language. 
• Engages in repetitive and/or self-stim behaviors such as rocking, flapping, and chewing on nonfood items 
• Social naivety; as with many students who are 2E (twice exceptional), a student with ASD may be intellectually gifted but socially immature 

Some individuals with autism have cognitive impairment and/or language impairment. In contrast, others can be intellectually gifted and have exceptional verbal skills. To meet the diagnosis of autism, an individual must display the following criteria (from the DSM-5)

• Persistent deficits in social communication
• Persistent deficits in social interaction
• Restricted, repetitive patterns of behavior, interests, or activities 

In addition, clinicians can identify if an individual on the autism spectrum is Level 1, Level 2, or Level 3. This evaluates whether the individual has cognitive and/or language impairment and the severity of that impairment; Level 3 is the most severe. I encounter many parents who will declare that their child has mild autism. What is mild? Usually, they mean that their child is not cognitively impaired. 

Many parents ask, is it essential that my child be labeled with autism? It’s crucial to receive an accurate diagnosis to understand the context of a person’s behaviors and for individuals with ASD to understand themselves. Individuals with autism can be misunderstood and labeled defiant due to their overly concrete, literal, and rigid thinking. When staff or coworkers know that an individual has autism, they can provide accommodations that make a stressful school or work environment safe and positive. In addition, when individuals with ASD learn about their unique form of neurodivergence, it helps them with self-awareness and self-advocacy. Many individuals with autism experience relief when they receive the diagnosis. It enables them to understand how their brain works differently and that it’s not their fault. They also learn they have strengths that neurotypical individuals may not have, such as hyperfocus and attention to detail (seeing the individual trees vs. the forest).

Every school has students with autism. Their students might not be formally diagnosed, but the autism is present nonetheless. Some parents are reluctant to have their child formally diagnosed because they fear that the label will limit their access to educational services and that teachers will treat them differently. Many private schools say that they don’t take students who have ASD. The reality is we’re all interacting with students who have autism. So, it would be in our best interest to understand the range of behaviors and characteristics of individuals with autism.  

Many individuals who have autism have co-existing conditions such as anxiety and/or Attention Deficit-Hyperactivity Disorder (ADD/ADHD). As such, many of the strategies we use with individuals with ADHD and anxiety also help support students on the autism spectrum.  

There are a range of strategies we use to help support our students with ASD at TSS. This includes:

• Small classes 
• Executive functioning support
• Scaffolding tasks
• Establishing front-end expectations with clear routines
• Limiting stimulation (being mindful of classroom volume, students wearing headphones, giving instructions one step at a time, less material on a page) 
• Advanced notice of changes in routines and transitions 
• Practicing transitions 
• Avoiding using figurative language, sarcasm, or slang 
• Using visuals or concrete examples to explain abstract concepts  
• Being mindful of verbal overload – give clear and concise instructions; provide instructions in multiple modalities – written down and/or pictures in addition to verbally. 
• Give limited choices, such as two, versus unlimited choices.
• Limit open-ended or vague questions. 

At TSS, EVERY student has access to the accommodations and support needed to succeed. In middle school, we focus on skill building; in high school, we focus on helping students apply their skills to drive their learning. We want students to identify their strengths and struggles, know how they learn best, and advocate for themselves. 

My hope is that we can raise awareness around the presence of autism in our community. We most likely have friends, colleagues, and/or family members who have autism. If we can accurately identify ASD, we can help those individuals by offering appropriate support and celebrating their unique strengths and challenges. It’s time to bury the stigma of autism and recognize that each one of us has our own unique combination of skills and challenges. The better we understand ourselves and those around us, the more we can relate to others,  support each other, and create an inclusive community that celebrates our differences and commonalities.