The autism spectrum is a set of complex neurodevelopmental disorders that until recently included autistic disorder (AD); high functioning autism (HFA); Asperger’s Syndrome (AS), and pervasive developmental disorder not otherwise specified (PDD-NOS). Controversy and confusion have surrounded the diagnosis of AS and whether it is distinct from, similar to, or identical to a diagnosis of HFA. Following the 2013 release of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the replacement of these subdivisions into a single diagnosis of Autism Spectrum Disorder has created considerable worldwide disagreement, especially in regard to the integration of AS (Posar, Resca, & Visconti, 2015). Autism Spectrum Disorder is now more commonly referred to as Autism Spectrum Condition (ASC).
The term autism is derived from the Greek for “self” and signifies persons living in their own world rather than the world of others (Tantam, 2012) . Current psychoanalytic theorists of autism deem the defining feature to be a lack of social and emotional reciprocity resulting in the “objectification” of other people, who are treated essentially as the means by which the individual’s needs may be met. This disconnection from social interaction; an isolated self, is a characteristic of all ASC, which is quite distinct from other disorders (Tantam, 2012).
While the ASCs were considered rare just two decades ago, autism is now known to be relatively common, affecting the lives of millions of people across the world (Pellicano, 2014) . Understanding of the autism spectrum has undergone numerous adaptations since being first formally identified early in the twentieth century. However, autism existed long before it attracted a label. Autism Spectrum Conditions are found worldwide, with considerable evidence to indicate their existence throughout human history (Deisinger, 2011). Characterised by early-onset difficulties with social interaction, social communication, and imagination, and together with rigid and repetitive patterns of interests and behaviours, ASC exist from very early life and have life-long effects that influence how the brain processes information. The ASCs are conditions in which there are no sharp distinction between normality and pathology with a range of functioning ability that varies in combination and severity, between and within individuals. People with autism have atypical cognitive profiles, such as atypical social cognition and perception, executive dysfunction, together with atypical perceptual and information processing (Lai, Lombardo, & Baron-Cohen, 2014). Although each person on the autism spectrum shares similar difficulties, the degree, extent, and quantity of these difficulties influences how well, or not so well, any person adapts, functions, and interacts with others. Individuals on the spectrum who have high intellect and proficient capabilities in some areas of life, will always have noticeable social impairment together with profound egocentricity, which will affect their abilities to interact with others. The apparent inability to reflect on their own thinking and the thinking of others; known as mind-blindness (Baron-Cohen, 1997), is seen to contribute to impairments in social interaction, communication, and imagination. Mind-blindness is lacking the ability to put oneself into someone else’s shoes, to imagine their thoughts and feelings. Without this ability, it can be difficult to understand how to respond in any given situation.
Since research continues to focus heavily on children, autism is still largely undiagnosed in adults. Few people have a concept of how autism manifests in adults. Mental-health professionals often lack the skills or experience to distinguish autism in adults, from diagnosed disorders with which they are more familiar (Lehnhardt et al., 2013). Consequently, many adults on the autism spectrum have spent much of their lives struggling to fit in without knowing why, with the wrong diagnosis, consigned to psychiatric institutions, or overmedicated for disorders that were non-existent (Wright, 2015). These and other aspects, such as inadequate services and insufficient professional assistance and information (Hagland, 2009), has meant that whether an adult suspects that they may have an ASC, or whether a diagnosis is gained or not, many adults with ASC may not achieve the understanding or specialised help that they require. The result is that they and their families are often obligated to bear the responsibility of this lack of awareness.
Dr. Bronwyn Wilson
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