Is autism a disease? – Facts and myths about the autism spectrum

The autism spectrum refers to a variety of ways of developing and functioning, which may be associated with different needs, experiences and ways of communicating and perceiving the world.  It is a lifelong neurodevelopmental disorder that affects communication, social interactions, sensory processing and behaviour. This means that a person on the autism spectrum may have individual support needs, depending on how they function and the difficulties they experience.  (Source: World Health Organisation. ICD-11 – Autism spectrum disorder. https://icd.who.int/browse/2024-01/mms/en#/http://id.who.int/icd/entity/437815624)

The question ‘Is autism an illness?’ continues to crop up very frequently – both in conversations amongst parents and in the media or online. This is primarily due to persistent myths and confusion between terms such as ‘illness’, ‘neurodevelopmental disorder’ and ‘disability’.

The way we talk about autism matters. It affects not only how people on the spectrum are perceived, but also decisions regarding diagnosis, treatment and day-to-day support.

In this article, we explain what autism really is, debunk the most common myths and answer the questions parents ask most often.

What is the autism spectrum?

Autism spectrum disorders  (ASD – Autism Spectrum Disorder) is a neurodevelopmental disorder, meaning a different way in which the nervous system develops and functions. It is not a disease that develops over time, nor is it something that can be cured or prevented. (Source: American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). https://www.psychiatry.org/psychiatrists/practice/dsm) 

Autism primarily affects:

• a way of communicating,
• social functioning,
• processing of sensory stimuli,
• patterns of behaviour and interests,
• the way we learn and respond to change.

The word ‘spectrum’ implies a wide range of variation. Two people on the autism spectrum may have a similar diagnosis, but completely different needs, difficulties and strengths. One person may be able to function entirely independently, whilst another may need constant support in their daily life.

That is precisely why modern diagnostic approaches do not assess individual symptoms, but rather the overall picture of how a child or adult is functioning.

How does a disease differ from a neurodevelopmental disorder?

This is one of the most commonly misunderstood concepts.

Autism is therefore not a disease, but that does not mean there are no challenges. For some people, it involves a significant need for support with communication, education and day-to-day living.

Fact: autism is not an illness

Autism is not a disease, as it does not meet the basic criteria for defining a disease.

This means that:

• there is no single aetiological factor responsible for its development,
• you cannot catch it,
• there are no periods of remission and relapse,
• There is no treatment that can cure autism.

Autism is a permanent neurodevelopmental condition that is present throughout a person’s life. As a person gets older, their needs, the ways in which they cope with difficulties and their level of independence may change, but the autism itself does not disappear.

However, this does not mean that people with autism do not need help. On the contrary – appropriately tailored support can significantly improve their quality of life, communication skills, independence and ability to function at home, at school and in society.

Myth: autism needs to be treated

One of the most widespread myths is the belief that autism should be treated in the same way as other illnesses.

In fact, autism as such is not treated, as it is not a disease. (Source: National Institute for Health and Care Excellence. Autism spectrum disorder in under-19s: support and management (CG170). https://www.nice.org.uk/guidance/cg170)

The support provided by specialists focuses on promoting development and alleviating specific difficulties that may hinder day-to-day functioning.

Support may include, amongst other things:

• the development of communication,
• social skills training,
• sensory integration therapy, where indicated,
• learning to be independent,
• psychological support for the child and the family,
• adapting the school environment to the child’s needs,
• pharmacological treatment aimed, for example, at reducing tension or controlling aggressive or self-harming behaviour.

The aim of therapy is not to change a person’s personality or to ‘fix’ someone with autism. Its purpose is to make day-to-day life easier, to develop strengths and to minimise the difficulties that affect quality of life.

What conditions can be treated in a person on the autism spectrum?

One of the most common misconceptions is the belief that, since autism is not an illness, a person with autism does not need any medical help. In reality, autism itself cannot be cured, but it is possible and worthwhile to treat any co-occurring difficulties if they affect day-to-day functioning.

The most common comorbid conditions include:

• anxiety disorders,
• depression,
• ADHD,
• sleep disorders,
• epilepsy,
• difficulties with eating and picky eating,
• severe emotional distress,
• aggressive or self-injurious behaviour in severe autism.

Each of these difficulties requires an individual assessment and – where necessary – appropriate treatment or therapy. (Source: Hyman S.L., Levy S.E., Myers S.M. Identification, Evaluation, and Management of Children With Autism Spectrum Disorder. Pediatrics, 2020. https://publications.aap.org/pediatrics/article/145/1/e20193447)  

The primary aim of support is not to change a person with autism, but to improve their quality of life, health and ability to cope with everyday life.

Does every person with autism need therapy?

No. Not every person with autism needs the same kind of therapy or support.

The scope of support should be based on an individual’s needs, age, difficulties and goals, rather than solely on the fact that they have been diagnosed.

Some children require intensive support from the very earliest years of their lives. Others need only a consultation, adjustments to their school requirements or occasional support from a psychologist.

The support plan may include, amongst other things:

• psychological therapy,
• speech and language therapy,
• social skills training,
• educational support,
• psychiatric consultations,
• educating parents on how to support their child at home.

Well-chosen support focuses on specific difficulties whilst at the same time developing the child’s strengths.

Fact: autism is a different way in which the nervous system functions

Autism refers to differences in the development and functioning of the nervous system. It affects the way a person perceives information, communicates and responds to their surroundings.

People with autism may:

• process sensory stimuli differently,
• need more predictability and routine,
• have difficulty understanding certain social norms,
• demonstrate exceptional interest and highly specialised knowledge in selected areas.

At the same time, the extent of the difficulties varies greatly. For some people, autism is mainly associated with a different style of communication, whilst for others it has a significant impact on their day-to-day functioning and independence.

That is why the modern approach to autism takes into account both individual abilities and the need to provide appropriate support.

Myth: all people on the spectrum are the same

This is one of the most common myths.

The term ‘spectrum’ refers precisely to a wide variety.

People with autism may differ from one another in terms of:

• method of communication,
• level of independence,
• social functioning,
• sensory sensitivity,
• interests,
• educational needs,
• the scope of the necessary support.

Some people talk a great deal and are keen to connect with others. Others communicate using alternative methods or need more time to build relationships.

There is no single ‘typical’ presentation of autism. That is why a diagnosis always involves a comprehensive assessment of functioning, rather than a single symptom.

Fact: autism does not mean a lack of emotions

One of the most harmful stereotypes is the belief that people on the autism spectrum do not experience emotions or are incapable of love.

That’s not true.

People with autism experience emotions – often very intensely. The difficulties may relate primarily to:

• recognising one’s own emotions,
• naming feelings,
• expressing emotions in a way that is understandable to those around them,
• coping with emotional overload.

A lack of eye contact, limited facial expressions or an unusual way of showing feelings do not mean that those feelings are absent.

Parents often describe situations in which a child appears indifferent, yet is actually deeply affected by changes, conflicts or difficult events. This is precisely why, during the assessment, specialists evaluate not only the child’s outward behaviour, but also how the child functions in various situations.

Myth: autism is the result of parenting mistakes

This is a myth that has been unequivocally debunked by modern scientific research.

Autism is not caused by:

• parenting mistakes,
• a lack of closeness with one’s parents,
• parenting style,
• the use of screens,
• how to feed a baby.

Current understanding suggests that autism has complex neurodevelopmental and genetic causes. This means that parents are not to blame for their child having an autism spectrum disorder. (Source: National Institute of Mental Health. Autism Spectrum Disorder. https://www.nimh.nih.gov/health/topics/autism-spectrum-disorder)  

Upbringing is of immense importance for a child’s development of skills, independence and well-being, but it is not a cause of autism.

Fact: autism can be diagnosed at any age

Although the first symptoms of autism spectrum disorder appear in early childhood, a diagnosis is not always made straight away. For some people, the difficulties only become more apparent as social and educational demands increase.

Autism can be diagnosed:

• in a young child,
• of school age,
• during their teenage years,
• in an adult.

A delayed diagnosis does not mean that autism developed later. More often than not, it indicates that earlier symptoms were not properly recognised or were effectively masked.

This applies in particular to people who did well academically but struggled with social relationships, felt severely overwhelmed by stimuli, or spent many years adapting their behaviour to the expectations of those around them.

When should you take your child for a consultation?

Every child develops at their own pace. A single symptom does not necessarily indicate autism, but if difficulties persist for a long time or occur simultaneously across several areas of functioning, it is worth consulting a specialist.

It is worth booking a consultation if your child:

• has difficulty communicating or understanding what is being said,
• avoids contact with their peers or does not know how to make friends,
• shows a strong need for routine and reacts badly to change,
• is hypersensitive or insensitive to sounds, light, smells or touch,
• performs repetitive movements or tasks,
• has very specific, narrow interests,
• is experiencing difficulties both at home and at nursery or school.

An early consultation is not solely intended to confirm or rule out autism. Above all, it enables a better understanding of the child’s needs and – if necessary – allows for further support to be planned at an early stage.

What does the diagnosis of autism involve?

A diagnosis of autism spectrum disorder is not based on a single test or a brief observation of the child. The diagnostic process involves assessing a range of areas of development and functioning in various situations.

A comprehensive assessment usually includes:

• a detailed interview with the parents or carers,
• an analysis of the child’s development to date,
• observation of behaviour during diagnostic sessions,
• the use of standardised diagnostic tools,
• an assessment of the child’s behaviour at home, at nursery or at school,
• ruling out other causes of the difficulties observed,
• a discussion of the results and the preparation of recommendations for parents and the educational institution.

The aim of the assessment is not only to determine whether a child meets the diagnostic criteria for autism spectrum disorder. It is equally important to identify their strengths, individual needs and the forms of support that will work best in their day-to-day life.

Why does language matter?

The way we talk about autism affects how people with autism and their families are perceived.

Describing autism as a disease may reinforce the misconception that it is a condition requiring ‘treatment’ or that a person with autism is, first and foremost, ‘ill’.

It is far more accurate to refer to autism as a neurodevelopmental disorder. This approach allows us to recognise both the difficulties faced by people with autism and their abilities, interests and potential.

It is worth bearing in mind that the way we refer to people on the spectrum can also vary. Some people prefer the term ‘autistic person’, whilst others prefer ‘person with autism’. It is best to respect a person’s individual preferences, if these are known.

What is worth bearing in mind about the autism spectrum?

Autism is not a disease, but a lifelong neurodevelopmental disorder that affects the way a person communicates, processes information, forms relationships and perceives stimuli from their environment. It cannot be cured, but appropriately tailored support can significantly improve the quality of life, development and day-to-day functioning of the child and their family.

The most important thing is to move away from myths and base our approach on current medical and psychological knowledge. Early consultation, a reliable diagnosis and individually tailored forms of support help us to better understand the child’s needs and create the conditions for them to develop in line with their abilities.

If you notice that your child is having difficulties with communication, social interactions, responding to change or processing sensory input, it is worth consulting a specialist. The consultation is not solely intended to confirm or rule out autism – above all, it helps to identify the causes of the difficulties observed and to plan appropriate support.

Frequently asked questions about autism

Is autism a mental illness?

No. Autism is not a mental illness. It is a neurodevelopmental disorder present from early childhood, which affects the development of communication and social relationships, as well as the way information and stimuli are processed.

Can autism be cured?

No. Autism cannot be cured, as it is not an illness. However, it is possible to effectively support the development of a person with autism and help them cope with the difficulties that affect their day-to-day functioning.

Is autism a disability?

Not always. A diagnosis of autism spectrum disorder does not automatically mean a disability. For some people, however, the difficulties are so significant that they may justify obtaining the relevant certification and accessing additional forms of support.

Do vaccinations cause autism?

No. Current scientific research does not support a link between vaccinations and autism spectrum disorders. This is one of the most thoroughly investigated myths about autism.

Does using mobile phones, tablets or watching television cause autism?

No. Using electronic devices does not cause autism. Spending too much time in front of a screen may affect speech development, concentration or sleep quality, but it is not a cause of autism spectrum disorder.

Does every person with autism need therapy?

No. The level of support should be tailored to the individual’s needs. Some children require regular therapy, whilst others primarily need appropriate adjustments at home or at school, as well as periodic specialist consultations.

What conditions can be treated in a person on the autism spectrum?

Autism, as a neurodevelopmental disorder, cannot be cured, but co-occurring difficulties such as anxiety disorders, depression, ADHD, sleep disorders, epilepsy or eating problems can be effectively treated or managed. A support plan should always be tailored to the individual needs of the child or adult.

Is an online test enough to diagnose autism?

No. Online questionnaires can help to highlight certain symptoms, but they cannot be used to make a diagnosis. A diagnosis of autism spectrum disorder requires a comprehensive assessment carried out by suitably qualified specialists.

Can autism only be diagnosed in a teenager or an adult?

Yes. For some people, their difficulties only become more apparent as social or educational demands increase. A later diagnosis does not mean that autism developed later – it usually simply means that it had not been recognised before.

How should we refer to them – ‘a person with autism’ or ‘a person who is autistic’?

Both terms are used. Some people prefer the term ‘autistic person’ because they see autism as part of their identity. Others prefer the term ‘person with autism’. It is important to respect a person’s individual preferences and to remember that respectful communication is what matters most.

Summary

Autism is not a disease, but a lifelong neurodevelopmental condition and one of the forms of human diversity. The facts show that people on the autism spectrum can lead fulfilling lives, build relationships, work and pursue their passions – provided they receive appropriate support and social understanding.

Moving away from myths in favour of reliable knowledge is a crucial step towards a more inclusive and empathetic society.

Bibliography

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