DAN JONES

The causes of autism aren’t fully known. There is variety in autistic individuals, with everyone having their mix of challenges and often additional co-occuring conditions. As it is something people are born with it is clearly genetic, but how and why it expresses differently in different individuals is currently unknown. It could be that genes associated with autism are expressed differently in the presence of other genes, or it could be they are expressed differently in the presence of certain levels of certain hormones during birth, and some of the differences in how it is expressed could be environmental, like how the child is raised. It is likely to be a mixture of all of these elements. One question is why does autism continue to persist? This may be because it has benefits for society like perhaps autistic indivuduals are more likely to be very good at focusing on one task and obsessing about that one task and that one subject, so they manage to achieve things others don’t have the time, focus or patience to achieve (or others would rather focus on socialising and feel they are missing out, if they were to spend hours alone working on a project or problem), like maybe becoming obsessed with how arrows travel through the air, and wanting to know why an arrow travels as it does, and what would make it travel further and more accurately. An autistic person may focus on this thought for years until they develop an arrow which is more efficient and better than other tribes arrows, which helps the tribe survive and gives the autistic person an advantage to the tribe. It could be that the downside is some people are born with very high levels of needs, which means they require more care, but may not contribute to the tribe. This is a similar argument to one I remember learning about schizophrenia when I worked in mental health homes. That schizophrenia is genetic, and at it’s worst (and without medication etc) it can be quite debilitating, but for some people and in some settings they have incredible creativity and connections of thought which others generally don’t have.

There are questions about why more people are autistic nowadays. The currently thought reason for this is that there aren’t more autistic people, just less stigma, so more people are comfortable seeking diagnosis, and better ability to diagnose autism, as well as all of the adult from all the decades where they weren’t diagnosed as children, now seeking diagnosis. There are also more females being diagnosed autistic than their used to be. It used to be thought that autism was more of a male issue, and it may have a slightly more male bias – although with time it may turn out this is incorrect, but now it is recognised that females and males can be autistic, it is just expressed differently in females to males. For example I think females may find emotional sensory overload more of an issue than males, but this isn’t so easily picked up because people seem to think autistic people don’t have feelings and don’t get emotional, so in the past if a female was getting emotionally overwhelmed psychologists and psychiatrists are likely to assume the problem is something else, not autism. Females are also known to mask better than males, which can hide autism for years.

So, we have a situation where there is more awareness and acceptance around autism, often support requires a diagnosis, so that can encourage people to seek diagnosis to see if they are autistic or what might be causing their challenges, so that they can access help for themselves or their child. So, more parents and teachers are recommending children for diagnosis, meaning more autistic people are being diagnosed (they would be autistic with or without diagnosis, so in the past, there would be the same number of autistic people, but fewer of them would end up in a position of seeking a diagnosis). Then you have adults seeking diagnosis, who were undiagnosed autistic children, and you have all the females now seeking and being diagnosed autistic. All of this together creates an enormous sudden uptick in diagnosed autistic people. To add to this, you have a high number of people self-diagnosing, where they haven’t formally been to a doctor for an autism assessment referral, but they feel that they are autistic and feel comfortable nowadays to state that.

Not seeking an autism assessment could be because in some countries like the USA, maybe it costs money to do and isn’t easily affordable, in other countries, like the UK, perhaps it is because often there is a long waiting list for the assessment. For me, it took about a year from going to the GP the first time to ask them to make a referral for an autism assessment, through to actually attending that assessment and being told I am definitely autistic. Then there was a wait after this to get that in writing.