How do I know if I am autistic? And six other frequently asked questions about autism

1. What exactly is autism and how do you know if you are autistic?

Céline Mollink: “Many people with autism have difficulty with social interaction and communication. For example, they find it difficult to read other people’s behavior and body language or have difficulty understanding and maintaining social relationships and friendships. It is also common for these people to take conversations and words literally and have difficulty with small talk. There are also many people with autism for whom this is less the case, or who have learned a lot during interaction.”

“People with autism generally have difficulty understanding the world around them: they often experience it as confusing, overwhelming and unpredictable.”

“This can be a reason to avoid or fear certain places, such as a birthday or a supermarket, where many stimuli come together – sounds, buzz of people, bright lights – and where new and unfamiliar situations arise. It is often the unexpected and therefore unpredictable sounds that are experienced as the most intense.”

“Incentives can also be experienced as pleasant, for example when someone goes to a concert of his or her favorite band. The reaction of people with autism to overstimulation is different: one person turns outward, becomes angry or panics, while the other turns inward and withdraws.”

“Many people with autism have fixed interests. This can be a specific subject, but the interests can also vary. These are topics or hobbies that they can become completely absorbed in and want to know everything about. Structure and overview often give people with autism peace of mind. This can be in the form of fixed, weekly recurring appointments, having certain routines in the day or a clear agenda planning.”

Audrey Mol: “People with autism have a different way of processing information, the brain is, as it were, wired in a different way. In order to make the correct diagnosis, it is necessary to DSM-5 Manual of Psychiatric Disorders the classification ‘autism spectrum disorder’ with specific criteria included. This means that the separate names pdd-nos, Asperger’s disorder and autistic disorder have been replaced by just one classification: autism spectrum disorder.”

2. Is it true that there are more and more people with autism?

Mol: “There are no indications that autism is more common, but the classification is made more often. Because we are learning more and more about how it manifests itself in different phases of life and with different target groups. Society demands much more from us than a few decades ago. The pressure to perform, the social media pressure and the amount of stimuli is great, which means that people with autism get stuck relatively faster.”

“It used to be assumed that autism mainly occurred in children, especially boys. We now know better: girls and women can just as easily be autistic. We assume that on average 1.5 to 2 percent of people have an autism spectrum disorder. The male to female ratio is 4:1, so four times as much autism in men as in women. However, autism is probably much more common in women, it is just less likely to be recognized among them.”

“To diagnose autism, care providers follow an established diagnostic guideline. For adults, this in any case consists of a conversation with the person himself, a conversation with someone who knows the person well and preferably also a developmental history. In all these conversations, the criteria described in the DSM-5 are asked in detail.”

Mollink: “Knowledge about autism in women in particular has increased enormously in recent years. Women are generally more adept at masking their autistic characteristics, partly due to the fact that they focus on their social environment relatively more often and more than men. Partly because of this, many women are only diagnosed at a later age – because they get stuck and are desperate to investigate.”

“We must be alert to overdiagnosis. Someone who likes to hang their clothes by color and loves to sort or hang paintings straight may be a self-proclaimed autistic, but that does not necessarily have anything to do with autism. It could also be something compulsive.”

3. Are people with autism above average intelligence or much less smart?

Mol: “Autism occurs at all levels of intelligence. About 15 to 20 percent of people with autism have an intellectual disability, most have normal giftedness or are sometimes also gifted. What is true is that people with an intellectual disability are relatively more likely to be noticed by their deviant behavior.”

“People with autism who have high intelligence can mask their behavior better. This makes their limitations less noticeable. But that doesn’t mean they no longer suffer from it. When I ask further questions, I always hear how much energy it costs them to participate in daily life and how overextended they are.”

4. Is there a stereotypical autistic person?

Mol: “No, because every person has their own personality and life history with strengths and weaknesses. This also applies to people with autism. If you’ve seen one person with autism, you’ve seen one person with autism. The stereotypical image of the autistic as a computer nerd or as Dustin Hoffman portrayed his ‘Ray’ in the film Rainman does a disservice to people with autism.”

5. Is autism hereditary?

Mollink: “Research shows that if one of your parents has autism, the chance that you will get it is 15 to 20 percent. Environmental factors are also said to play a role: complications during pregnancy or childbirth can influence the development of the fetus’s brain. Consider stress, possible presence of diabetes in the mother, the age of the father, premature birth or taking medication. But not much research has been done into this yet.”

6. Everyone is a little autistic, right?

Mollink: “No, you are or you are not. One person suffers from it more than another, but that also depends on your life course and the context in which you find yourself. If you are in a predictable, calm environment, you may experience much less ‘suffering’ than if this is not the case. But you still have autism.”

Mol: “That is indeed not possible. It is about the sum of all characteristics in combination with a certain level of suffering and getting stuck in one or more areas of life.”

7. Can autism be cured?

Mol: “No, it is not a disease. It’s a different ‘wiring’. You are born with it and you die with it. So you have to learn to take your predisposition into account. Go to that party if you like, but be aware in advance that you may need to recover from all the stimuli for a few days. Fortunately, in addition to disabilities, people with autism also have many talents, just like anyone else. For example, some have a good eye for details and are creative in proposing unusual solutions.”

Mollink: “Autism does not go away, but in my experience you can live well with it. I always felt different and got stuck early in life. Depression, anxiety disorders and physical complaints dominated my life. After a ten-year search within mental health care, I was diagnosed with autism in 2017. Above all, it gave me relief, I could finally start to understand myself better. At the moment I am doing well, I work as a psychologist, I am a mother. Although I still have to take things into account, I have a great need for structure, clarity and overview. But I can live with it.”