Autism Is Much More Than Just the Diagnostic Criteria

Today, there’s a lot of discussion about what autism actually means. Thanks to increased awareness since the 1990s, more and more people are aware that you can be autistic even with fluent language and strong intellectual abilities. These days, manyh people also recognize that difficulties with social interaction, sensory challenges, and repetitive interests and routines are common aspects of autism. However, many people still fail to understand that cognitive challenges can also be a part of autism—and that these challenges can often be the most challenging for those of us on the spectrum. There’s a good deal of research supporting this, with authors like Tony Attwood and Christopher Gillberg writing extensively about these cognitive challenges in their books.

Highly Individual

The specific cognitive challenges experienced by an autistic individual are highly individual. However, a common challenge is executive dysfunction. This can manifest as difficulty starting and finishing tasks, planning ahead, and quickly adapting to changes or unexpected events. So, an autistic person, even knowing something is inappropriate to say, might struggle to stop themselves. It’s genuinely hard to rein it in! Executive dysfunctions can also mean being unmotivated and struggling to even begin tasks, even if the person knows how to do them. Deficiencies in executive function are extremely common in ADHD, but these challanges can absolutely occur in autism as well!

Requires Different Cognitive Abilities

Autism can also involve difficulty processing large amounts of information. Tony Attwood writes in his book that an autistic person might struggle to keep up in conversations with multiple participants. The person may find it easier to follow one-on-one conversations, but when more people join in, it can become overwhelming for an autistic brain to manage. Sure, in some cases, this can be partly because autistic people have more opportunity to steer the conversation toward their pecial interests when interacting with just one person. But often, an autistic person has trouble interacting with more than one person at a time simply because it requires different cognitive skills to navigate group dynamics.

Can Struggle with Learning

Some autistic individuals also experience learning difficulties. I remember when I was relatively newly diagnosed and met other autistic people (back then the diagnosis was called Asperger’s Syndrome) who had previously attended special education classes and received adapted math instruction. My first thought was: “Math challenges can’t possibly be related to autism—it’s not mentioned in the diagnostic criteria!” But how wrong I was! Tony Attwood writes that some autistic people are remarkably gifted in mathematics, while others can struggle significantly to learn it. And when you think about it, it makes sense. Autism, at its core, is about being different. An autistic person can have a very uneven cognitive profile and, despite normal intelligence, have a very hard time learning certain things, whether it’s math or anything else!

Poor Sense of Direction

Autism can also involve prosopagnosia, or face blindness, as well as a poor sense of direction. An autistic brain (which also applies to ADHD) can struggle to wind down, and many autistic people are sensitive to stress and have sleep difficulties. I often feel embarrassed that I don’t recognize people I “should” recognize. And those people often have trouble understanding why, since “we talked for several hours the day before!” I also have a terrible sense of direction and sometimes struggle to find my way around, even in Stockholm, where I’ve lived for 24 years. I have to visit a place many times before I remember the route, and, most importantly, I have to do it alone. If I’m talking to someone, I don’t have the energy left to memorize the way.

Difficulty with Tasks Requiring Automatic Processing

Finally, autism can involve challenges with tasks requiring automatic processing. This means that autistic people may need to spend a lot of energy on activities and tasks that others perform automatically. This can range from household chores to greeting others (because saying “hello” isn’t always natural for an autistic person—some of us have to consciously spend mental energy on it). These difficulties can make everyday life challenging and may mean needing to rest and avoid certain things. The exhaustion an autistic person experiences after certain activities can be far more significant than others realize! I saved energy by picking up the mail from the floor once a week instead of every day when I had an old-fashioned mailbox. Sure, I could have done it every day, but it would have negatively impacted my quality of life, so I chose to save my energy!

Increasing Awareness is Key

And that’s exactly what’s so important to remember: autism is so much more than just the diagnostic criteria! We tend to focus on the external manifestations—the social challenges, repetitive behaviors, and sensory sensitivities—but behind all of that often lies a complex world of cognitive challenges. And even if these aren’t explicitly included in the formal diagnostic criteria, they can be a central part of autism. Those of us on the spectrum need to understand how cognition works in autism so we don’t blame ourselves for not being able to cope with or accomplish everything society and those around us expect of us. But other people also needs to understand this, so we can get the support we need!

Leave a comment or read other people’s comments on this post. By submitting a comment, you agree to my comment rules.

Book Me

Please reach out to me via the contact form if you’d like to book me for a lecture on autism or an interview about my life with autism. You can find more information about me and my lectures here.

Don’t be afraid to reach out for help if life feels hopeless! Here’s a list of helplines and phone support services in the US you can contact if you need assistance. For people outside the US this page lists helplines for people in need of immediate mental help support during a mental health crisis.