Autism spectrum - is it linear or not? Experts separate fact from fiction

One in 36 children are believed to have autism spectrum disorder (ASD). Photo / Getty Images

Diagnosis and self-diagnosis of the condition have rapidly increased, but too many assumptions are still being made about autism. These are the 10 myths that need to be debunked.

Eighty years ago, autism was thought to affect only one in 2500 – yet today one in 36 children are believed to have autism spectrum disorder (ASD). And a study in 2021 found a 787 per cent increase in the number of diagnoses in the UK between 1998 and 2018.

What experts can’t decide on is whether this exponential rise is due to a deeper understanding and greater awareness of the condition leading to more people being diagnosed; or whether it’s genuinely affecting more people in today’s modern world. Or a combination of all the above. What is clear is that over the decades since autism was named, many myths have shrouded those affected.

We talked to the experts to sort the facts from fiction.

10 autism myths that need to be busted:

Autism is a linear spectrum

Historically, there was a belief that the condition graduates from “least” to “most”. But that’s now outdated. “It’s more of a constellation of different features,” explains Francesca Happe, a professor of cognitive neuroscience at King’s College London. “We now see autism as more of a colour wheel than a rising linear graph, as everyone is so different.”

Autism only affects boys

“It’s true that many more boys than girls are diagnosed as autistic,” says Happe. “Boys are diagnosed younger and more frequently, but that’s often because girls may exhibit different social and communication patterns. For example, they might present as ‘clingy’ rather than ‘aloof’ and sometimes learn to ‘mask’ behaviours.”

It would equally be a mistake, however, to start believing that just as many girls are affected as boys simply because of better “camouflaging” or “masking” abilities, says Dame Uta Frith, an emeritus professor of cognitive development at UCL. “It remains true that more boys are affected,” she confirms. “Statistically, it used to be that we thought autism affected four males to every female, but we now estimate that it’s more likely to be three to one.”

Autistic people lack empathy

There may be difficulties interpreting non-verbal cues and body language, says Happe. “But most autistic people have lots of emotional empathy.”

“We sometimes use the word ‘mentalising’,” explains Frith. “In very simple terms, this means the ability to track another person’s mental state, by picking up on unsaid things such as body language. “I think confusion has arisen because while it can be common for autistic people not to have strong mentalising abilities, it’s not the same as not having empathy. For instance, a psychopath would commonly have excellent mentalising skills – but very poor empathising ones. It’s all quite nuanced.”

Some autistic people will have intellectual or language disabilities, others will have average intelligence, and some will have a very high IQ. Photo / 123rf

Autism affects intellect

People on the spectrum are neither all prodigies with Rainman-like memories or intellectually disabled, so broad generalisations just don’t work, insists Happe. “Some autistic people will have intellectual or language disabilities, others will have average intelligence (maybe with a spiky profile across tests), and some will have a very high IQ.”

“Autism does affect how people think, and autistic people process information differently from non-autistic people,” explains Dr Rosa Hoekstra, a reader in global perspectives on neurodevelopmental disabilities at King’s College London. “But in terms of intellectual ability, then no generations can be assumed. Autism occurs on the full spectrum of intellectual ability.”

Autistic people aren’t sociable

“Although some social interactions can be puzzling for autistic people, many are very sociable, and you can be autistic and an extrovert,” says Happe.

“Social anxiety is not a characteristic of autism,” adds Frith. “However, people who have some kind of social anxiety have started saying things like ‘I’m a little bit autistic’. And it may be that many people who have autism are also socially anxious, but not necessarily because of the condition.”

“Some autistic people are socially isolated and feel lonely, but it’s not true that autistic people are not interested in making social connections,” adds Hoekstra.

Autistic people lack emotions

They might have a different way of expressing emotions, but it’s certainly not true that they’re lacking. “For some autistic people, it can be hard for them to identify and then express their own emotions in a way that is commonly understood (which is known as ‘alexithymia’), explains Happe.

In Greek, alexithymia loosely translates to “no words for emotion”. But this is also true for some non-autistic people. For instance, it’s estimated that one in 10 people has alexithymia, whereas one in five autistic people have alexithymia.

Autism can be ‘cured’

“Autism is now recognised as a different, not deficient, ‘neurotype’, which doesn’t need to be ‘cured’ and should be respected,” says Happe. But this doesn’t mean measures to improve life in general can’t be put in place.

“Many autistic people have co-occurring challenges like epilepsy, sleep problems, or anxiety and depression – these do need treating to improve quality of life,” she adds.

Frith suggests that there are times when a person might “lose” their autism diagnosis, meaning that it might have been accurately diagnosed when they were younger, but because they have become so adept at managing or “masking” their symptoms as an adult, they would not be diagnosed at a later stage in life.

Fundamentally, however, many autistic people do not want to be cured, as autism is part of their identity.

There’s also no evidence to link autism to vaccination. Photo / 123rf

Autism is a result of bad parenting… or the MMR jab

All the experts say this is a notion that should have long died away. “Autism is a complex condition with a strong genetic component, so while it can affect more than one person in families, it’s not caused by parental behaviour in any way. Genes may be inherited from parents, or there may be new genetic mutations not inherited from the parents,” says Frith.

And neither does autism have any affect on people’s ability to parent themselves.

“Autistic people can also be excellent parents,” says Megan Freeth, a psychology professor from the University of Sheffield. “Autistic mothers (i.e. those who were themselves diagnosed as autistic) tend to experience feelings of intense connection and love with their children.”

Fears that the MMR jab can lead to higher incidence of being on the spectrum have also been rigorously discredited. “There’s also no evidence to link autism to vaccination; the original studies suggesting this have since been retracted as false and misleading,” Happe clarifies.

Autistic people are violent

“While some people with autism may exhibit challenging behaviours, it’s usually an attempt to communicate or escape an overwhelming situation,” explains Happe. “Many autistic people are extremely sensitive to sensory stimulation, such as bright light, light touch or loud noises, and others who have communication difficulties will experience understandable frustration.”

“More children with autism may suffer what we would call ‘tantrums’,” says Frith. “But that’s likely due to frustrations and overwhelm, and not what I would call ‘violence’.”

Autism only affects children

Most autistic people are adults and autism is a lifelong condition, confirms Happe. “Because diagnostic criteria have broadened, some autistic people are getting their diagnosis for the first time in midlife or later; a recent study of GP records suggested one out of 10 autistic adults over the age of 50 are undiagnosed.”

One of the benefits of being diagnosed, especially after a late diagnosis, is it allows a person who has been self-critical for many years to be more self-compassionate.