"Am I autistic?" It appears that many adults are asking themselves this question. With the CDC's estimated prevalence of autism spectrum disorders jumping from 1 in 150 to 1 in 110, many questions begin to surface. Have pervasive developmental disorders gone throughout the course of history without being recognized? Is autism being over-diagnosed or under-diagnosed? Are autistic disorders more common than imagined?
The "Am I Autistic?" Question
The autism spectrum is vast and levels of severity range from severe to very mild. PDD-NOS appears to be a "catch-all" for cases that don't quite fit the criteria for classic autism. As awareness about autistic disorders grows, many people find that they can relate to people on the spectrum through their own experiences. This may lead some to question whether they have autism or not. The focus here is autism and not Asperger's, and the following scenario concerns a fictional person who questions whether she is autistic or not.
Is Jane Autistic?
Jane reads about autistic disorders and as she learns more and more about the topic, she begins to make connections to her own experiences. She asks herself "Am I autistic?" after delving into the symptoms of pervasive developmental disorders.
• Early Development
As an adult, Jane remembers little about being a small child but she recollects that her parents often talked about how quiet she was. When visitors came over, she would hide behind the couch and she barely said a word before her third birthday. She didn't walk until she was 18 months old, according to her parents and she refused to go up and down steps, making it necessary for an adult to carry her up and down stairs.
• School Years
Jane was quiet at school and she made very few friends. She was held back in first grade because she had difficulty keeping up with the rest of the students academically and she had speech therapy a few days each week in school. Later, Jane began to excel in class finally graduating in the top 20 in her class. She was painfully shy in school throughout and preferred the company of her teachers to her peers.
• Adulthood
Now that Jane is an adult, she continues to struggle with social situations but she has managed to make friends and marry. The very idea of a job interview, a party or meetings with the PTA is unnerving. She likes to stick to a routine and becomes a little agitated when there are changes in her schedule. As she learns about autism, she begins to wonder if she meets the criteria for diagnosis.
The main obstacle in answering Jane's question is that it is impossible to evaluate her as a child. Many of the connections she makes to autism occurred in the past; they may no longer be present. For example, avoiding stairs may be a sign of a sensory problem, but as an adult, she may no longer have this challenge. She may have met the criteria when she was a child but not as an adult.
What should a person facing this dilemma do?
Problems with Self-Assessment
The glaring problem with self-assessment is subjectivity. It is extremely difficult (if not impossible) to see yourself objectively, which can make assessing the situation problematic. When a person looks at a condition like high functioning autism, he may look back on his personal experiences, picking ones that fit and downplaying ones that don't. In Jane's example, she may not focus on her love for poetry and fiction as well as her interest in visiting the theater or her ability to "read" another person's body language. The focus is on negative aspects of dealing with social situations rather than the positive ones she may have experienced.
Assessment can begin with evaluating the situation. Are the symptoms of autism interfering with the ability to function? Autism is a universal condition. People struggle with social situations and they often find comfort in familiar surroundings. Everyone needs sensory input and nearly everyone can relate to sensory overload. A person may focus so intensely on one subject or activity that he loses sight of everything else. It is when these aspects, among others, interfere with the ability to function that a diagnosis and intervention may be necessary.
Relating to Autism
Autism is a universal condition. Typical people face the same challenges as people with autism do from early development through awkward teenage years and into adulthood. In cases of autism, the challenges are magnified to the point that they are unmanageable without guidance. Recovery may be possible and perhaps many adults who would have been diagnosed today were not when they were children. Learning how to navigate the world with an autistic disorder isn't easy but it is possible. This is the goal of behavioral interventions and therapy.
A person asking, "Am I autistic?" may benefit from discussing his concerns with a psychiatrist, physician or neurologist. After evaluation, he may find that while some autistic tendencies that interfere with daily life are present, a plan of action may be in order. Like many other aspects of the autism spectrum, there may be no definitive answer to the question.
