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Autism is a disorder that has a wide spectrum of behaviors and issues. Some people with autism kick and bite, while others are delicate and gentle. Some have never spoken a word, others talk up a storm.
Because of this, even though autism is almost always diagnosed at 18-24 months, children on the upper end of the spectrum are often not recognized as autistic until they are 8 or 9 years old.
Because autism can look so different, it sometimes confuses parents and professionals alike. It is not always clear which challenges should be focused on for a particular child: Do you prioritize working on toilet training or eye contact? Speech or attention span? Fine motor skills or academics?
No matter how sophisticated an autistic person may be, there is one fundamental aspect that caries through in all situations: a difficulty deeply interacting with other people on a consistent basis.
I worked with a 15 year-old patient at an autism treatment center many years ago. He shook my hand and looked me in the eyes. He spent the first fifteen minutes talking about his favorite television shows, smiling appropriately, always with great eye contact. He interacted with tremendous skill. I couldn't spot any developmental delays. I thought to myself, "Why are you here?"
But as the time passed and he kept speaking, I realized that he hadn't shared anything personal about himself. He just kept talking about TV shows. Also, he hadn't asked a single question about me.
Then it was clear: he spoke about television to avoid anything deeper. It was a buffer to keep the human interaction at bay. He was the highest functioning autistic person I had met to that point and still, fundamentally, his biggest challenge was an inability to have a deep and meaningful interaction.
In the end, that's what it's always about.
(image source: Cherrymountains @ Flickr)
