Autism in adults
What is autism?
Signs of autism
Certain traits are characteristic of all types of autism. These traits are called the core areas of autism. The traits apply to all individuals with autism – regardless of their intellectual abilities and other capabilities. They are briefly outlined here:
- Challenged social interaction
This may be in the form of problems reading social signals and contexts. Therefore, it can be difficult to know how to behave in social relationships.
- Restricted or repetitive behaviour
You have specific routines or particularly intense interests. People with autism are often preoccupied with the present. They may therefore find it difficult to imagine the future, or something that is not tangible.
- Challenged communication
Many people with autism find it difficult to express themselves linguistically. It is also difficult for a person with autism to understand what others mean and want when they say something. In addition, people with autism may have difficulty reading tone of voice, facial expressions and body language.
- Different sensory experiences
This may be both in the form of great and low sensitivity in relation to sensory impressions. This most often concerns the sense of hearing and sight. But it can also involve the other senses.
When making a diagnosis, the focus is often on the challenges experienced by the individual or the people around him or her. However, it is important to know that one area which can present challenges in one particular context can be a resource in another. For people with autism, for example, it may be a competence to be able to focus on details. Many also have a special capacity for immersion and persistence.
People with autism are also often described as being loyal and honest and capable of creative thinking. Some people with autism have special talents. However, this does not mean that all people with autism have a special talent.
Three to four times as many men and boys are diagnosed with autism. On average, women are also diagnosed with autism later than men. Research has shown that women need to display clearer symptoms of autism than men before they are diagnosed with autism. Therefore, several researchers believe that many women with autism are never diagnosed.
This means that the gender difference may not be as great as it seems. One of the possible explanations for this is that women are better at hiding their social difficulties. They do this by imitating their surroundings so that their behaviour does not create attention. This may have major consequences for the individual, as it will often require a lot of energy to hide autistic traits.
What causes autism?
There is no single reason why people develop autism. However, research shows that genetics constitute the main cause. Here, many genes are involved, meaning that there is not one single gene that causes autism.
Research has also shown that some close relatives of people with autism have what is called ‘the broad phenotype’. This means that they have more traits from autism than the rest of the population without meeting the criteria for autism.
Environment is also of importance
The prevailing theory is that the different development begins in the embryonic stage. This includes changes in connections between central areas of the brain.
Genetics alone cannot explain the changes in the brain. Likewise, genetics cannot explain the wide variations within the autism spectrum.
External circumstances are therefore also important, for example premature birth and certain impacts on the unborn child increase the risk. These impacts may, for example, be infections or toxic substances.
In the vast majority of cases of autism, the exact cause is not known. Regardless of the cause, however, it is a congenital condition. It gives rise to a different development of the brain.
There is no doubt that changes in the brain cause the behaviour that is characteristic of autism. Therefore, autism is considered a life-long disability.
It is believed that autism is caused by changes in the connections between the individual areas of the brain. These changes affect a number of functions, including the executive functions. You can read more about these functions below.
The executive functions are affected
The executive functions are a term for the control tools of the brain. They are sometimes also called the brain’s ‘director’. This concerns, for example, the ability to:
- control impulses
- control your attention
- be flexible in your problem solving.
If you have autism, these functions are impaired.
The diagnosis can be made when a person shows a behaviour that falls within the three autistic traits:
- deviant social interaction
- deviant social communication
- a limited, stereotypical and repetitive repertoire of interests and activities.
The difficulties must affect the person in all situations. The criteria used provide relatively reliable and unambiguous diagnoses.
It should be borne in mind that the symptoms are a description of behaviour. They are not a description of the whole person.
Autism manifests itself in many different ways. The individual symptoms may vary. The degree of severity of the symptoms also varies. The symptoms are also influenced by the person’s cognitive level, personality and social factors such as networks.
This means that autism may change. This can, for example, happen if the surroundings change. When the person with autism gains new experiences, his or her autism can also be expressed in new ways.
There must have been signs of autism in childhood for it to be autism. Therefore, in most cases, the diagnosis is made in children. Occasionally, however, the diagnosis is only made in adolescents and adults. There may be several reasons for this. The most important reason is that the diagnostic system was changed in 1994. Here, the autism diagnosis was extended to include other disorders.
There may also be other reasons why the diagnosis is made late. This may, for example, be due to:
It happens that the symptoms of autism are explained by another diagnosis. This is called diagnostic overshadowing. This may, for example, be ADHD, OCD or anxiety.
Some manage to hide their challenges by imitating the behaviour of others. This is called camouflage. This is often described as being a very energy-intensive process.
Up to 80% of people diagnosed with autism have one or more other mental and/or physical illnesses. It is a task for a specialist to tailor a treatment that takes into account both autism and other illnesses.
Some of the most frequent disorders seen together with autism are:
- Tourette syndrome/tics
- Eating disorders
- Sleep disorders
- Psychosis, including schizophrenia
- Vision and hearing problems
There is also an increased risk of suicidal thoughts, suicide attempts and suicides.
Because people with autism are at greater risk of developing other illnesses, it is important that they attend regular health checkups.
It can be difficult for people with autism to detect and describe symptoms themselves. This can make examination, diagnosis and treatment difficult.
Therefore, it may be beneficial that you, as a person with autism, learn to monitor your own well-being. This applies both physically and mentally. This will enable you to react to changes. For example, you can note how you are sleeping, your mood and your performance of practical tasks when you are feeling good. You can then make a plan for what to do if you ascertain that you are not thriving.
For others, their private and professional networks can help read symptoms and detect changes in behaviour.
When seeking help, it is important to remember:
- People with autism may find it difficult to describe symptoms to a therapist.
- People with autism may find it difficult to remember their own experiences.
Treatment of autism
It is possible to develop
No matter what degree of autism a person has, it is important to know that you can learn new things. Just like others, you always have the opportunity to develop. The difference is that people with autism may need support for this development.
Actions and support for adults with autism
Autism cannot be regarded as a curable disease. Instead, the focus is on creating a good life with autism. The action taken will often be special pedagogical support.
There are advantages in understanding autism as a disability. Adopting this approach often results in a dual focus that is beneficial to the actions taken. The focus consists of:
- The individual’s abilities for learning and development
- How the surroundings can be organised so that it becomes possible for the person with autism to participate.
An important aspect of the special pedagogical support is to help the individual find a meaningful place in society. In addition, there is focus on building up nuanced self-understanding and positive self-esteem. It is crucial that the support is always adapted to the individual’s abilities, motivation and wishes. The support will therefore be different from person to person.
The individual must be in focus
Any action should be organised in cooperation with the individual person. It should therefore be based on three elements:
- An examination of the person’s own perspectives and abilities
- A development plan based on the person’s motivation
- A plan for which strategies can compensate for difficulties
Trusting relationships with the professionals you work with as an adult with autism are crucial in this connection.
When compensating for the difficulties which can accompany autism, predictability and overview are usually significant aspects. Predictability can give the person with autism a sense of being in control of his or her life. It reduces stress levels and creates opportunities for experiencing coherence in everyday life. Not least, it gives an experience of independence.
It is crucial that this predictability is created in collaboration with the individual person with autism. The following can help create greater predictability in an unpredictable world:
- Make visible what is not tangible
This may, for example, be chronological order, sequences, routines etc. It strengthens overview and flexibility.
- Render details visible so that they appear as part of a whole
This can, for example, be done by offering the person specific and visual descriptions of contexts and in this way help him or her to gain understanding and meaning.
- Explain what lies behind ongoing activities
For example, explicitly articulate why the activity is important.
For many adults with autism, it can also be beneficial to help them understand their own and other people’s behaviour, thoughts and feelings. This may, for example, be support for translating ordinary communication into more autism-friendly communication.
There is currently no medication that can reduce difficulties in autism. Medication is only used in cases where the accompanying mental or physical conditions require treatment.
An ethical dilemma may arise in connection with the support. It arises because the person who needs support is also an adult human being with the right to decide over his or her own life.
Therefore, attention should be paid to the right to self-determination. At the same time, it is important that the person gets the support that he or she needs. It is a balance that is most easily maintained if there is close and trusting cooperation between all parties.
Advice for people who have autism
Quality of life is important for everyone. It is therefore crucial that you are aware of where and how you yourself experience meaningfulness and well-being. You must also be aware that it is possible to change the areas in which you do not thrive.
Sometimes, it may be a good idea to consider the following six areas of your life:
- Mental well-being
Are you usually in a good mood and do you generally thrive in your daily life?
- Physical well-being
Do you feel good physically? Do you have symptoms of illness?
- Relationships and friends
Are you happy with your network? It is never too late to seek out new friendships. Many find new friendships in connection with an interest.
Where and how do you get energy? And what are you interested in?
- Housing situation
Does your housing situation match your needs and wishes?
- Education and employment
Do you have a plan for how to realise your education and employment goals? Can any of the things that you like to do be used in connection with an education or a job?
The social services department in your municipality can help you get an overview of what opportunities you have to get support.
In addition, it may be beneficial to:
- Find out about autism and use this knowledge to learn more about yourself
- Be aware of which elements in your life provide you with and drain you of energy. This allows you to prioritise and avoid having either too many or too few plans. You can also acquire knowledge about how to recharge your batteries after an activity that has required a lot of energy
- Have a plan for whom you can contact if you need help
- Pay attention to your sensory needs and how to meet them
- Meet with other adults with autism. This may, for example, be in different
- associations or online
- Strike a good balance between protective strategies and more development-oriented initiatives
- Be aware of how big changes affect you, and seek support when necessary
Know that it is OK to do things differently.
Advice for relatives
Some persons with autism are dependant on close support for most hours of the day. Others may periodically be completely independent of support. However, when faced with difficult events or major changes, they may well again need help. As a relative, it can therefore be helpful to know that autism does not disappear, but is a lifelong disability.
For relatives, it can be useful to:
- Find out about autism
- Listen carefully to the person’s wishes, dreams and values
- Take the person’s outlook on life seriously
- Show genuine interest and curiosity so that misunderstandings can be avoided in so far as possible
- Introduce the autistic individual to knowledge and a wide range of options and possibilities
- Help ‘translate’ the world and, if necessary, show the way forward
- Take the initiative, and accompany the person out into the world
- Respect that the person might do things differently to what you would normally expect
- Know that some people with autism have a so-called skewed cognitive profile.
- This means that they may have good intellectual resources, but also great difficulties with other skills, for example performing everyday tasks. This may seem like laziness at a first glance, but it reflects a real need for support
- Acquire knowledge about communication and culture in the field of autism.
As a relative, it is important to be aware that the support for a person with autism must be adapted throughout life. This must be done based on the current context and the person’s prerequisites, well-being, development potentials, wishes and needs.