I-RAP
Improving Recognition and Understanding of Autism and Personality Disorder
Information about autism and personality disorder
1. Highlights
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Autism is characterised by differences in social interaction and communication, by sensory processing differences, and by a strong need for predictability, alongside repetitive behaviour and highly focused interests.
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The neurodiversity movement sees autism as a difference in neurology, not a disorder. However, these differences can be very disabling when an autistic person tries to cope with the demands of education, work and social relationships with non-autistic people.
2. Further Information
ICD-11 defines autism spectrum disorder as “persistent deficits in the ability to initiate and to sustain reciprocal social interaction and social communication, and by a range of restricted, repetitive, and inflexible patterns of behaviour, interests or activities that are clearly atypical or excessive for the individual’s age and sociocultural context.” [1]. This is a deficit-based definition; i.e. it considers the behaviour of autistic people to be deficient or disordered. The neurodiversity movement [2] instead thinks of autistic people as having different ways of processing information, interacting with others and understanding the world from “neurotypical” (non-autistic) people, which contributes to needs and behaviour that are different and do not conform to societal norms, but are not deficient.
Examples of areas in which social differences may be apparent are, according to ICD-11 [1]:
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Understanding of, interest in, and responses to the verbal or non-verbal social communications of others.
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Integration of spoken language with non-verbal communication, such as eye contact, gestures, facial expressions and body language.
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Understanding and use of language in social contexts and ability to initiate and sustain reciprocal social conversations.
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Awareness of neurotypical social norms.
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Imagining and responding to the feelings, emotional states, and attitudes of others.
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Mutual sharing of interests.
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Making and sustaining typical peer relationships.
Examples of areas in which differences in behaviour and interests may be apparent are, according to ICD-11 [1]:
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Adaptability to new experiences and circumstances.
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Strict adherence to particular routines and/or rules.
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A strong need to have things in a particular way (e.g., lining up or sorting objects).
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Moving all or part of the body repeatedly in unusual ways e.g. rocking, walking on tiptoes, unusual hand or finger movements (“stimming”).
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Strong interest or passion for specific topics of interest or specific types of things or objects.
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Lifelong hypersensitivity or hyposensitivity to sensory experiences (smell, sound, touch, vision, taste). This can also include differences in sensitivity to pain and temperature, differences in being able to feel sensations inside your body (“interoception”) and differences in balance and movement.
ICD-11 goes on to say that these differences should have been apparent since early childhood, but may not become fully manifest until later, when the social demands placed on the person become more complex. Further, these differences should have a significant impact on a person’s ability to interact and cope with the world day-to-day.
The neurodiversity movement [2] highlights research which shows that autistic people process information differently from neurotypical people, in ways that can confer both advantages and disadvantages [3]. For example, research shows that autistic people have particular strengths in focusing on details and noticing patterns, in memory, in gaining in-depth expertise on topics and skills that they are passionate about, and in thinking outside of social norms to come up with creative solutions to problems [4].
These characteristics are likely to have been useful to have in the mix when human societies were evolving, and can confer significant advantages in certain modern day professions [5]. In the social realm, autistic people’s strong sense of justice, fairness and honesty, enhanced ability to connect with people that share their interests and/or are also autistic, and enhanced ability to feel other people’s emotions (“emotional empathy”) has also been noted [4, 6, 7, 8].
3. References
[1] World Health Organization (WHO) (2019). International Classification of Diseases, Eleventh Revision (ICD-11), https://icd.who.int/browse11. [2] Kapp, S. K. (2020). Autistic community and the neurodiversity movement: Stories from the frontline. Springer Nature. [3] Silberman, S. (2017). Beyond; Deficit-Based; thinking in autism research. Comment on; Implications of the idea of neurodiversity for understanding the origins of developmental disorders; by Nobuo Masataka. Physics of Life Reviews, 20, 119-121. [4] Autistica (2024a). https://www.autistica.org.uk/what-is-autism/autistic-strengths [5] Masataka, N. (2017). Implications of the idea of neurodiversity for understanding the origins of developmental disorders. Physics of Life Reviews, 20, 85-108 [6] Heasman, B., Gillespie, A. (2019). Neurodivergent intersubjectivity: Distinctive features of how autistic people create shared understanding. Autism, 23(4), 910-921. [7] Milton, D.E.M. (2012) On the ontological status of autism: the ‘double empathy problem’, Disability & Society, 27(6), 883-887. [8] Smith, A. (2009). The Empathy Imbalance Hypothesis of Autism: A Theoretical Approach to Cognitive and Emotional Empathy in Autistic Development. The Psychological Record, 59, 489–510.
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