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What is autism?


In the past year, the last year of my training as a naturopathic clinical aromatherapist at FytArom, I have fully immersed myself in the world of autism. It was also the subject of my graduation thesis. So here's a little bit about what autism is.


A spectrum

Autism is very broad. It's not called Autism Spectrum Disorder (ASD) for nothing. It's a spectrum and maybe you could even say a 3D model. There are various facets that have something to do with the disorder and you can see all those facets as a spectrum themselves that affects someone to a greater or lesser extent.


A different development

Ultimately it comes down to the fact that the brain works slightly differently than in a neurotypical person. For example, there is often difficulty with communication and stimuli are received differently. Psychologist Remco van der Werff (2021) says that he prefers not to talk about a disorder but about a different development of the brain. He also calls it “brain development the other way around”. By this he means that there is often a stronger development of cognitive thinking first and only later of social-emotional development. Something that happens exactly the other way around in neurotypical children.


Social intuition, sensing and interpreting the unwritten rules of communication, is often developed differently in autistic people. Although many people, especially women, are very good at hiding this, often by compensating for what they lack with their intellect, this can lead to problems in daily life. From discomfort to misunderstandings and even fear in social situations.


Autistic people often process information differently than neurotypical people. Specifically, information we receive through our senses. There can be both over-stimulation and under-stimulation. Some stimuli therefore come in much harder, and others perhaps less so. This can have the consequence that, for example, pain is perceived much earlier or later, but also that the sounds and/or smells of, for example, a busy store come in much more intense.


In short, an autistic person often experiences the world very differently than someone who is not on the spectrum.


Because there is no biomarker (yet) for ASD, a diagnosis is made on the basis of behavioral and experiential characteristics. The specifications are described in detail in the DSM-5.


What is the DSM-5?

DSM-5 is the abbreviation of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. The DSM-5 is the fifth edition of a diagnostic standard work of the American Psychiatric Association. The book describes psychological disorders and their criteria to make it easier to diagnose and group disorders.


Autism according to the DSM-5

There are several criteria that must be met in order to be diagnosed with autism spectrum disorder. These have all been given a letter: A, B, C, D and E. Subsequently, the severity of the diagnosis is divided into 3 groups. 1,2 and 3. The severity of the diagnosis is based on the level of difficulty/suffering from the social communication impairments (criterion A) and limited, repetitive patterns of behavior (criterion B). In short, how much trouble does someone have and how much guidance does the person in question need in order to function in society.


Criterion A focuses on “persistent deficiencies in social communication and social interaction” and consists of several characteristics. All of these features must be present to be diagnosed with ASD. Feature 1 is “deficiencies in social-emotional reciprocity”. Feature 2 is “deficiencies in the non-verbal communicative behavior used for social interaction”. And finally characteristic 3: “deficiencies in developing, maintaining and understanding relationships”.


Criterion B focuses on “limited, repetitive patterns of behavior, interests, or activities”. This criterion consists of 4 characteristics. For the diagnosis of ASD, at least 2 of these characteristics must be present. Feature 1 is “stereotypical or repetitive motor movements, use of objects, or spoken language”. Feature 2 is “insistently holding on to the same thing, being inflexibly attached to routines or ritualized patterns of verbal or non-verbal behavior”. Feature 3 is “very narrow, fixed interests that are abnormally intense or focused”. And feature 4 is “hyper- or hypo-activity to sensory stimuli or unusual interest in sensory aspects of the environment”. This last characteristic is what I mainly focused on in my thesis.


Criterion C states that the symptoms must be present from an early age. Although they sometimes only come to light later when social demands become too high or in some cases are masked by learned strategies or behavior.


Criterion D states that there must actually be “clinically significant distress or limitations in social or occupational functioning or functioning on other important areas”.


Criterion E excludes other disorders as the cause of the problems. This does not mean that several disorders cannot coexist. In fact, this is often the case.


That was it for today. Did you have a good idea of what autism really is? Do you maybe know someone on the spectrum? Or do you have other questions about the subject? Do let me know! For now, goodluck with the next steps on your bridge and I wish you all the happiness and an amazing rest of your day.

❤ Eva


 

Sources

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5®) (5 ed.). (p. d. Hengeveld, Vert.) Amsterdam: Boom uitgevers. Opgeroepen op 2021

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