The allistic world seems to think about autism as a single, profound thing that adversely affects the brain and makes it do the wrong thing. But we know autism as a way of being that affects the totality of our experience, and we reject the idea that Autistic people are defective humans whose brains are simply malfunctioning. In fact, it seems that there is a particular set up of very specific characteristics that affect many of us, and these characteristics lie beyond the cardinal traits of autism itself. I tend to think of these as “add-ons” to autism. They may certainly pose challenges to us, but they are not necessarily or completely a detriment. And they’re not entirely defined or described as being part of being autistic, despite the significantly higher rates of these very specific comorbidities in autistic individuals.
So what types of things are part of the “constellation” of autism?
Sensory Processing Differences
Firstly, I believe we must address sensory processing differences. Because, in my eyes, it is definitely considered an autistic thing that a multitude of us experience, but it’s not necessarily evaluated in a diagnostic setting. However, it’s certainly possible that non-autistic people have sensory processing differences, and they may even receive a diagnosis of SPD, or Sensory Processing Disorder, or a different type of sensory difference. It is very well known that many autistic people process sensory information differently than typical non-autistic people do. Our difficulty with environments that include loud noises, many people talking at once, bright lights, background noise, and the like are almost stereotypical at this point due to how common these issues are. And because our meltdowns and shutdowns are often considered so shocking and inappropriate by allistics (non-autistics), the allistic (non-autistic) world seems to have taken note of “sensory overload”. Sensory regulation is very difficult for many of us, so autistic people can use strategies like noise cancelation or noise reduction headphones, dark sunglasses, and stimming to help process sensory information with less distress and discomfort.
Mental Health Disabilities
Next, we will talk briefly about mental illness. Autism is not a mental illness; it is a neurodevelopmental disability. However, autistic people have high rates of comorbid mental illness. This can include a multitude of mental health disabilities, including OCD (Obsessive Compulsive Disorder), forms of depression and other mood disorders, anxiety disorders (very high rates), and countless others. This does not mean that there is anything inherently wrong with Autistic people or the brains of Autistic people. More likely is that ableism, prejudice, shame, abuse, bullying, trauma, and other factors contribute to the likelihood of dealing with mental health disabilities during one’s lifetime, combined with some degree of predisposition. Mental health disabilities may also be more common in Autistic people due to differences in the way that Autistic people process, regulate, and understand their emotions. While it is not a mental illness but a neurological disability often mistaken as a mental illness, Tourette’s Syndrome can also co-occur with autism.
This next point is related to the Sensory Processing Differences that are mentioned above. Poets sometimes talk very mystically about how the senses could be perceived in novel ways, but many Autistic people literally do perceive the senses unlike others typically do. A large number of Autistic people have the neurological trait of Synaesthesia. In short, Synaesthesia is often described as the senses in the brain being “crossed,” resulting in people who can taste music, strongly sense that numbers have a gender and personality, perceive the letters of the alphabet as each having an individual color, and many many other possibilities in how one can understand the world through a unique wiring of the brain. I don’t think it’s clear exactly how this particular set up of the brain relates to the set up of the autistic brain, but it is certainly fascinating that such a high number of us see the world so uniquely.
Epilepsy — a number of neurological disabilities that produce seizures — are not well understood, unfortunately. I believe this is one of the worst things that can co-occur with autism. I personally do not experience epilepsy, as a disclaimer. Seizures can be very dangerous, and even though some medications can help treat epileptic conditions, there is no real cure and not everyone can be helped by medication. Some people seek treatment through surgery or diet changes to try to control their seizures. It is also important to avoid triggers for seizures, such as lights (bright lights, flashing lights, patterns, etc.), lack of sleep and fatigue, drinking alcohol, certain foods, and certain noises. Epilepsy can also be deadly, and avoiding triggers and getting adequate treatment is no joke.
ADHD, known as Attention Deficit Hyperactivity Disorder
A person can be Autistic and have ADHD. Like autism, ADHD is a neurodevelopmental disability: a case of the brain functioning in a different way than is typical. It isn’t inherently bad, but — as with autism — people who have ADHD face challenges based on how they learn, perceive things, process information, and understand themselves and the world. While the treatment of ADHD is controversial, it does not negate the fact that ADHD exists. As with autism, no one knows the exact cause of ADHD for certain, but both are generally believed to be mostly genetic by those who subscribe to the neurodiversity paradigm. Like autism, ADHD has its own cluster of
Forms of Hypermobility and Connective Tissue Disorders
In the general population, people who experience these forms of hypermobility (ranging from hypermobility syndrome to more severe connective tissue disorders, such as Ehlers-Danlos syndrome) are very, very rare. Yet in the Autistic population, the rates are a lot higher, resulting in many instances of these traits among us. (And that is with frequent under-diagnosis and misdiagnosis of these disorders!) Hypermobility and connective tissue disorders are genetic. They do not go away with age, and they can become worse over time. As it progresses, it can make it hard for people to walk normally or to walk very far, and it can cause them a great deal of pain. Such disorders involve problems with overly flexible joints and ligaments. In addition, the skin itself may be affected. It can be unusually stretchy, unusually fragile, or bruises or scars in an atypical way. In very severe manifestations of the illness, the cardiovascular system can be affected in serious — and even life-threatening — ways.
Have you heard of prosopagnosia? Did it sound like a strange way to experience the world that was hard for you to imagine? Many Autistic people don’t need to imagine, because this is normal for us! Prosopagnosia is the name for a neurological condition also called face-blindness: it is an impaired ability to recognize faces. Some people acquire face-blindness through a brain injury, a brain lesion, or some other problem with the brain, but Autistic people who are face-blind have a kind of prosopagnosia that they were born with. When we look at a person’s face, it’s not that we see a void or a black hole or something outlandish like that; we simply do not have the same recognition system for faces that people without prosopagnosia have. As a result, it’s hard for us to interpret, map, process, and recall faces. But if don’t recognize people the same way most do, how do we know who’s who? The answer is, sometimes we don’t! For example, I often see people in town who recognize me and come up to me to say hello. Problem is, I typically have no idea who they are! But, there are some strategies to help identify a person when you don’t recognize them. For example, the thing that helps me recognize a person the most is their hairstyle and hair color. Aside from that, I also use their height, body shape, clothing, and gait to help determine who they are. Strategies like that can help, but they are not infallible. Prosopagnosia provides a challenge to many people in many instances, but essentially it is a different way of seeing the world around you.
This has been a summary of just a few of the parts of the “constellation” that can extend from autism. Some can be incredibly difficult and pose serious health hazards, such as Epilepsy or Ehlers-Danlos Syndrome, while others can be more intriguing, such as the unusual sensory perceptions of Synaesthesia. Other ideas about characteristics related to autism include sleep disorders, learning differences, and gastrointestinal problems, however we have not discussed these in depth here. Some are considered controversial, such as the possible connection between gastrointestinal disorders and autism. It is important to note that none of the things we discussed in this post or mentioned in this paragraph cause autism — for example, gastrointestinal disorders do not cause autism. The various characteristics described here are simply very likely to co-occur with autism. It is a testament to the very complex and unique way that every autistic brain functions and forms connections. With regard to the severe health hazards posed to Autistic people by conditions like Epilepsy and Ehlers-Danlos Syndrome, we must emphasize that this is where funding for quality scientific research needs to go. It must be diverted away from “validating” torturous therapies, looking for “cures”, and seeking ways to detect autism in the womb in order to avoid the birth of Autistic people, and rerouted ASAP towards helping actual Autistic people with the multitude of challenges we face in this world, including the serious health conditions that can co-occur alongside our autism.