What is Autism? 什麽是自閉症?

I have plenty of topics I want to cover, but there’s no point in that if we don’t know what autism is. Some of you may be familiar with how some doctors describe it. What I want to do is a little different. I will go over the current medial diagnostic criteria for ASD, but I will also try to explain more from an autistic perspective. Many of the behaviors listed as symptoms are from non-autistic people observing us without really taking the time to understand us. While some of our behaviors and thought processes may seem odd, they all have a purpose and a reason.

So I will go over each common symptom or characteristic of ASD, and hopefully give you more information than just what the behavior looks like.

SOCIAL & COMMUNICATION CHALLENGES

About 1/3 of autistic people are nonverbal. This doesn’t mean that they don’t communicate. They may speak through a machine or write. This has to do with the unique way our brains are made. Autistic people who don’t speak verbally can have wonderful things to say if you take the time to listen. There are even some of us, like me, who are verbal, but become nonverbal in certain situations if we are too overwhelmed. If I’m too overwhelmed by my environment or my emotions, speaking is too difficult and I just text people instead.

Eye contact can be difficult for many of us. Some people are just fine with this. You will find some autistic people that will have no problem looking at you in the eye and feel completely comfortable with it. I on the other hand have to tell myself to constantly look at people, because if I don’t, they think I’m not listening. The ironic part of this is that it’s actually harder for me to concentrate if I’m constantly telling myself to sit still and look at you. I listen less, and I think less. Then because I can’t concentrate, I feel stupid. When we don’t look at you, we’re not being impolite. We’re trying to listen, and that is how we do it. When I’m thinking, I can look away and bring up a visual memory bank and walk around in it. That stops when I look at you.

Body language and facial expressions can sometimes confuse us. Sometimes we will even study them as someone would study a subject in school. Because of this, our expressions and body language can appear forced or just wrong. We might choose the wrong expression at the wrong time. We never do this intentionally. We’re just trying to communicate in a language that doesn’t really make sense to us, but seems to be used by everyone else around us.

I have major difficulties with understanding the emotions of others around me. Often this gets labeled as “lacking empathy” or “problems with empathy”. This isn’t true, and it’s insulting. I feel compassion and empathy. What I have problems with is imagining another person’s situation or understanding their feelings in the moment. I just need someone to explain this to me. This is what many of us need, and many people just refuse to take that time. Rather than give us the information we need, they label us “selfish, arrogant, rude, or uncaring”. None of these are true, and are very hurtful.

Another common problem is not understanding the intentions of others. It can be something simple like not “reading between the lines” when someone is talking to you, or something more serious like not recognizing a dangerous person. This is connected with not understanding people’s emotions and not understanding body language. We rely on people explaining things to us, and lying is foreign.

I’ve found that many of us have difficulty identifying and describing our own emotions. This can make friendships and intimate relationships difficult. The other person feels disconnected from you. It’s not that we don’t want to tell you. We just literally don’t know. We’re not lying when we say when don’t know what we’re feeling.

Having conversations in general can be difficult. We can often not understand the natural rhythm. When do we talk vs when does the other person talk? This often happens because we don’t pick up on the subtle social cues like body language, or certain phrases that are hinting something. We also will often be silent until a topic of interest is brought up and then we won’t stop talking. We will gravitate to people that share our common interests so that we can have a specific thing to discuss. It’s our way of connecting with people. So, if we’re overloading you with a bunch of unwanted information, please understand that we are trying to connect with you.

RESTRICTIVE / REPETITIVE BEHAVIORS

This is how the medical model categorizes these behaviors, but I don’t like this. I understand why they say this. The diagnostic criteria was created just from observing the behaviors of children and contrasting them from “normal” children. Now that we have adults on the spectrum who can tell you their experience, I think this should be adjusted. I would rather these be categorized as the ability to intensely focus on one single thing for long periods of time, and neurological differences in how we process and respond to sensory input.

A common one in this category are unusual repetitive movements called stimming. The only reason it’s called unusual is because they are not movements that non-autistic people do, and we tend to do them more often. So you might see people bouncing their leg, tapping a pencil on a desk, and biting their nails if they’re nervous, but no one thinks it’s odd or concerning. However, if people see us rocking back and forth, waving our hands, or spinning in circles, then that’s labeled as odd and concerning.

I’ll do a whole blog post on this later, but there are a few main reasons for stimming. 1) Emotional regulation: We can either stim as an expression of emotions, or as a way of releasing emotions that feel too overwhelming. 2) Sensory regulation: We can swing between hypersensitive and hyposensitive. So stimming can be used to either block too much sensory input, or give ourselves sensory input if we feel that it’s lacking. 3) Communication: If someone is hitting themselves, then they are communicating that they are not ok. If they are jumping and flapping their hands, they are communicating happiness. So there are many reasons for stimming, and each person will have their own stims and their own reasons. You may not understand them, but stimming is important to us and it does have a function.

Echolalia is another common one for autistic people. My son does this a lot. It can seem annoying to have someone constantly repeat words and phrases, but it’s how many of us learn. My son learned most of his language by repeating and imitating words and phrases from TV shows. I will often repeat conversations that I find effective, which is a form of echolalia. We do this to learn, to play, and to interact with people.

We will often have highly intense interests. Some we will keep throughout our lives and others we will rotate through. We will learn every single detail about it until we feel we’ve exhausted that topic, and then we move on to the next. I’ve often been called “The Human Encyclopedia” for this reason. It’s not really that we’re super smart, although some of us are, but it’s more that we obsessive learn our interests. This can be considered a restrictive behavior, but I prefer to call it an intense focused interest. We will often call these our “special interests”.

Many of us can be highly sensitive to our environment. I am one of those people. Lights can be too bright. Sounds can be too much. Textures of clothing and food can make me want to run away. I notice the flickering of certain lights that no one notices. I hear noises that people don’t hear, and don’t filter out the background noises that everyone else seems to be able to do. I like or dislike food based on texture. I don’t understand why certain clothing is made a certain way. I don’t understand why you don’t feel the stitching the scratches my skin and the tag that feels like wood. Our brains are different and we sense and feel things differently. So it only makes sense that we would react differently.

Predictable routines. Most of us like predictable routines. I’m not as insistent on this one as other people. I’ll naturally create a routine for myself and I like that I know what’s going to happen next. This is why many of us like our routines. In this chaotic world, having a predictable routine is comforting. Some autistic people will also have OCD and their routines will be extreme. For these people, do your best to respect their routines and needs. It doesn’t need to make sense to you. Just know that it brings them comfort and reduces their anxiety.

SOME FUN STUFF

Many people have a misconception that we are all savants. That is rare. We will likely have something we are good at, just like anyone else, and it will probably have something to do with one of our interests. For example, I’m an artist, and I’m good enough to at least sell some of my paintings. I think in pictures and not words. It’s why I’m good at painting, but it also means I have trouble explaining things, especially emotions. How do you explain what you’re feeling in the moment if all you have in your head are pictures?

Because I think in pictures, I have a visual map of where everything is in my house. I can have you name an item, and then I can tell you it’s location at this exact moment. I can even do this for other people’s houses if I’ve been there recently. I’ve had friends call me to help them find things.

Typically we will be excellent at one thing and bad at another. Some of us see visual patterns everywhere, others collect large amounts of data, and other easily see how things connect. We all have our strengths and weaknesses. Support and encourage our strengths, and help us through our weaknesses, just as you would any other person you cared about.

 

我想討論很多話題,但是這樣做並不意味著我們首先不知道自閉症是什麽。你們中有些人可能對某些醫生的描述很熟悉。我想做點不同的事情。我將介紹ASD(自閉症譜系障礙)的當前醫學診斷標準,但我還將嘗試從自閉症人的角度對其進行更多解釋。被列為症狀的許多行為是來自非自閉症人觀察我們而沒有真正花時間了解我們。儘管我們的某些行為和思維過程看起來很奇怪,但它們都有目的和原因。

因此,我將討論ASD的每種常見症狀或特徵,並希望為你提供更多信息,而不僅僅是行為的外觀。

《社會和溝通挑戰》

自閉症人中約有1/3是非語言人群。這並不意味著他們不溝通。他們可以使用機器為他們説話,也可以寫作。這與我們大腦的獨特製造方式有關。不會口頭説話的人可以説些很棒的話。你只需要花時間聼。甚至我們當中有些人説話,但在某些情況下會變成非語言。我做這個。如果對周圍的環境或情緒不知所措,那麽説話就太困難了,我只給別人發短信。

對我們許多人來説,眼神交流可能很困難。有些人對此很好。你會發現一些自閉症人在看著你是毫無問題,並且對此感到完全自在。但是,我必須告訴自己,要不斷地觀察別人,因為如果我不這樣做,他們會認為我沒有在聼。具有諷刺意味的是,如果我不斷告訴自己看著你,我很難集中精神。我少聼,也少想。然後,因為我無法專心,所以我感到愚蠢。當我們不看你的時候,我們就不會不禮貌。我們正在嘗試傾聽,這就是我們的方式。但我在思考的時候,我可以將視綫移開,並擁有自己的視覺記憶來探索。儅我看著你時,那停止了。

肢體語言和麵部表情有時會使我們感到困惑。有時我們甚至會像有人在學校學習科目一樣學習它們。因此,我們的表情和肢體語言可能顯得强迫或完全錯誤。我們可能在錯誤的時間選擇了錯誤的表達方式。我們永遠不會故意這樣做。我們只是試圖以一種對我們來説沒有意義的語言進行交流,但是似乎被我們周圍的其他所有人所使用。

在理解周圍其他人的情緒方面,我遇到了很大的困難。通常,者被標記為【缺乏同理心】或【存在同理心的問題】。這不是真的,這是侮辱。我感到同情。想象一下別人的處境或立即了解他們的感受是我遇到的問題。我只需要有人向我解釋一下。這是我們許多人所需要的,許多人拒絕花時間解釋。他們沒有給我們提供我們需要的信息,而是給我們貼上”自私,自大,粗魯或漠不關心“的標簽。這些都不是真的,並且是非常有害的。

另一個普遍的問題是不了解他人的意圖。它可以是簡單的事情,例如不了解某人所説的話的真實意圖,也可以是更嚴重的事情,例如不了解某人的危險。這與不了解人們的情感和肢體語言有關。我們依靠人們向我們解釋事情,而説謊是外國的。

我發現我們很多人都難以識別和描述自己的情緒。這會時友誼和親密關係變得困難。對方感到與你斷開連接。不是我們不想告訴你。我們只是不知道。當我們説我們不知道自己在想什麽時,我們並沒有在撒謊。

通常進行對話可能很困難。我們常常不了解自然節奏。我們什麽時候説話,他們什麽時候説話?發生這種情況通常是因為我們不了解肢體語言等微妙的社交線索,也不是在人們暗示某些内容時注意到他們。在提出感興趣的話題之前,我們通常也會保持沉默,然後我們才不會停止講話。我們將吸引那些與我們有著共同利益的人們,以便我們有一些具體的話題要談。這是我們與人聯係的方式。因此,如果我們給你增加了很多不必要的信息,請理解我們正在嘗試與你建立聯繋。

《限制性/重複性行為》

醫學模型就是這樣對這些行為進行分類的,但是我不喜歡這樣。我了解他們為什麽這麽説。僅通過觀察兒童的行為並將其與【正常】兒童進行對比來創建診斷標準。既然我們有自閉症的成年人可以告訴你他們的經歷,我認為應該對此進行調整。我寧愿將它們歸類為【長時間專注於一件事的能力,以及我們在處理和響應感覺輸入的方式上的神經學差異】。

在這一類別中,常見的事不尋常的重複運動,稱為【stimming】。**對不起,我還沒有找到這個詞的很好的翻譯。如果你的翻譯質量不錯,請告訴我。** 之所以將它們稱為【異常】,是因為它們不是非自閉症人所作的動作,而且我們傾向於更頻繁地執行它們。因此,你可能會看到人們蹦蹦跳跳的腿,在書桌上敲鉛筆和在緊張的情況下咬指甲,但沒人會覺得這很奇怪或令人擔憂。但是,如果人們看到我們來回搖擺,揮動我們的手或在圈子中旋轉,那麽這被標記為奇怪而令擔憂。

稍後,我將在整個博客文章中進行介紹,但是stimming的主要原因有幾個。1)情緒調節:我們可以stim作為情感的表達,也可以作為釋放壓倒性情緒的一種方式。2)感覺調節:我們可以在超敏和低敏之間搖擺。因此,stimming可以用來阻止過多的感官輸入,或者在我們覺得缺乏的情況下為自己提供感官輸入。3)溝通:如果有人在打自己,那麽他們在溝通,表示自己問題。如果他們跳跳並揮舞著雙手,那就是在傳達幸福。因此,stimming的原因有很多,每個人都有自己的stims和自己的原因。你可能不理解它們,但是stimming對我們很重要,并且確實具有功能。

對於自閉症人來説,迴聲【echolalia】是另一種常見的情況。我兒子經常這樣做。讓某人不斷重複單詞和短語似乎很煩人,但這通常是我們中許多人學習的内容。我兒子通過重複和模仿電視節目中的單詞和短語來學習大部分語言。我會經常重複自己認為有效的對話,這是一種迴聲。我們這樣做是為了學習,娛樂並與人互動。

我們經常會有非常强烈的興趣。我們一生都會維護某些利益,而其他利益則不會。我們將學習有關它的每一個細節,直到我們覺得已經用盡了該主題,然後再繼續進行下一個。因此,我被稱為【人類百科全書】。我們並不是超級聰明(儘管我們中的一些人確實如此),但更多的是,我們癡迷於學習自己的興趣。這可以被視為【限制性行為】,但我更喜歡將其稱為【强烈關注的興趣】。我們常稱這些為【特殊利益】。

我們中的許多人可能對環境高度敏感。我就是那些人之一。燈光可能太亮。聲音可能太多。衣服和食物的質地會讓我想逃跑。我注意到沒有人注意到的某些燈光的閃爍。我聼到其他人聽不到的聲音,也無法瀘除其他人似乎都能瀘除的背景噪音。我喜歡或不喜歡基於質地的食物。我不了解為什麽要以某種方式製作一些衣服。我不了解為什麽你不會感覺到劃傷我皮膚的針脚和像木頭一樣的標簽。我們的大腦是不同的,我們對事物的感覺和感受是不同的。因此,只有采取不同的反應才有意義。

可預測的例程。我們大多數人都喜歡可預測的例程。我不像其他人那樣堅持。我自然會為自己創建一個例程,並且我喜歡我知道接下來會發生什麽。這就是為什麽我們很多人喜歡我們的例程。在這個混亂的世界中,擁有可預測的例程令人感到安慰。一些自閉症人也會患有强迫症,他們的生活習慣會更加極端。對於這些人,請儘最大努力尊重他們的常規和需求。它對你沒有意義。只是知道,它可以使他們感到舒適並減輕焦慮。

《一些有趣的東西》

許多人誤以為我們都有特殊能力。那是罕見的。就像其他任何人一樣,我們可能會擁有我們擅長的東西,並且這可能與我們的興趣之一有關。例如,我是一名藝術家,而且我至少可以賣掉我的一些畫作。我的想法是圖片而不是文字。這就是為什麽我擅長繪畫,但這也意味著我在揭示事物(尤其是情感)方面遇到困難。如果你的所有想法都在圖片中,你如何解釋當下的感受?

除了將我的想法當作照片之外,我還在腦海中繪製了一張視覺地圖,以了解房子中所有物品的位置。你可以命名一個項目,然後我可以告訴你它的確切位置。如果我最近去過那裡,我什至可以為別人的房子做。我有朋友打電話給我,以幫助他們找到事情。

通常,我們會在一件事上表現出色,而在另一件事上表現不好。我們中的一些人到處都會看到視覺模式,其他人將收集大量數據,而另一些人則很容易看到事物之間的聯係。我們都有優點和缺點。就像你關心的任何其他人一樣,支持和鼓勵我們的優點,並通過我們的缺點幫助我們。

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