What is Autism
Autism Spectrum Disorder (ASD or Autism), is a lot of things. It is a different way of sensing, thinking, learning, and relating to the world. It is not a disease to be cured, but a neurodevelopmental difference that shapes how a person experiences everyday life, often in ways that are invisible to others until stress, change, or co-occurring conditions make them impossible to ignore. The core features of autism are (1) impairments of social cognition, and (2) restricted or repetitive behaviors.
Social Communication and Interaction: Autistic individuals may communicate differently due to alterations in social cognition (see our whitepaper: Understanding Social Cognition). This can include finding it exhausting to maintain eye contact, struggling to interpret neurotypical body language or tone of voice, or taking language very literally. Some autistic people are non-speaking, while others are highly articulate.
Restricted and Repetitive Behaviors or Interests: This can manifest as a strong preference for routine and predictability, deep and intense passions for specific subjects (often called "special interests"), or engaging in repetitive movements (like hand-flapping or rocking) known as "stimming" to self-regulate emotions and sensory input.
Today, autism is increasingly viewed through the lens of neurodiversity. This perspective recognizes that neurological differences like autism are natural variations of the human brain. Supporting this concept, it has become recognized that autism is also associated with a variety of unique strengths including: exceptional attention to detail and pattern recognition; deep focus and concentration on areas of interest; honesty, loyalty, and a strong sense of justice; and a unique problem-solving skills and "out-of-the-box" thinking. A distinct neurodevelopmental profile, not a behavioral problem
While ASD is a diagnostic entity unto itself, it is actually more common for an autistic person to have at least one co-occurring condition than to have autism alone. Among persons with high-functioning autism the most common co-occurring conditions include:
Neurodevelopmental and Mental Health Conditions
Attention-Deficit/Hyperactivity Disorder (ADHD): This is one of the most common co-occurring conditions. Studies suggest that 50% to 70% of autistic individuals also meet the criteria for ADHD. They may struggle with executive functioning, impulse control, and focus.
Anxiety Disorders: Up to 50% of autistic people experience severe anxiety. This can stem from sensory overload, the stress of navigating a neurotypical world, or struggles with social interactions (Social Anxiety).
Depression: Autistic individuals, particularly teenagers and adults, have higher rates of depression. This is often linked to social isolation, burnout from "masking" (hiding autistic traits to fit in), or lack of support.
Obsessive-Compulsive Disorder (OCD): It can sometimes be difficult to distinguish between autistic repetitive behaviors/routines and OCD compulsions, but many autistic individuals genuinely experience intrusive thoughts and compulsions that cause distress.
Psychosis: Upwards of 15% of autistic youth will go on to develop a primary psychotic disorder like schizoaffective disorder or schizophrenia. More information about the overlap between autism and psychosis can be found in either our patient-oriented primer: Distinguishing the features of autism from psychosis or the clinician-oriented white paper: Distinguishing autism spectrum disorder from schizophrenia..
Neurological, Gastrointestinal and Other Physical Health Conditions
Autism isn't just about behavior and communication; the systemic differences in the body often lead to physical health comorbidities.
Gastrointestinal (GI) Issues: Chronic GI problems are incredibly common. This includes chronic constipation, diarrhea, acid reflux, and irritable bowel syndrome (IBS). These issues can sometimes cause pain that non-speaking autistic people struggle to communicate, leading to sudden behavioral changes.
Sleep Disorders: Over half of autistic individuals struggle with sleep. This includes difficulty falling asleep, frequent waking, and poor sleep quality, which can exacerbate other challenges like anxiety and emotional regulation.
Learning and Motor Coordination Differences
While autism itself is not a learning disability, it frequently co-occurs with conditions that affect learning and physical movement.
Dyspraxia (Developmental Coordination Disorder): Many autistic people experience difficulties with fine and gross motor skills. This can manifest as clumsiness, poor handwriting, or difficulty with tasks like tying shoes or catching a ball.
Specific Learning Disabilities: Conditions like dyslexia (difficulty reading), dyscalculia (difficulty with math), and dysgraphia (difficulty writing) are also common.
Tic Disorders: Conditions like Tourette's Syndrome occur more frequently in the autistic population.