Amy Pearson Autistic people do not lack  empathy. Some autistic people might really   struggle to understand the thoughts and feelings  of other people, but we see that among the general   population. What we do know is that autistic  people and non-autistic people sometimes struggle   to understand each other. And Damian Milton  has explained this through something called   the “double empathy problem,” which explains  difficulties in communication between autistic   and non-autistic people through showing  that social communication is bidirectional. So, when we communicate with others, we draw  upon our own experiences, different contexts   that we might have had, and all of that influences  how we interpret what other people say. Because   autistic people and non-autistic people have had  differing experiences of the world growing up,   it can sometimes mean that their communication  is misaligned. So, it might make it difficult   to understand each other and lead to  breakdowns in communication. In addition,   some autistic people experience something  called alexithymia, which is a difficulty in   understanding your own internal emotional states.  And that can sometimes make it more difficult to   recognise and understand the emotions and  feelings of other people, whether that be   interpretations coming from things they say, or  interpreting their facial expressions [pause]. Autism is not a boy thing, it is not limited  to boys or males, but historically, a lot of   the research that had driven our understanding  of autism has been conducted with young boys,   so both Kanner and Asperger’s original sample had  mostly male participants. And what this meant was   that our idea of what autism looks like was based  on a very limited sample of a presentation that   we see in young males. Now, this doesn’t mean  that all young autistic boys look the same,   either. What we’re starting to realise, as  research delves more into the presentation   of autistic people, is that autistic people  are incredibly varied, or heterogenous. So,   they tend to differ from each other as much  as they differ from neurotypical people. One of the difficulties we have seen  in recent years is that relying upon   a particular presentation of autism has  led to underdiagnosis across particular   groups of people, so autistic women  and girls and non-binary people,   autistic Black people and other people of  colour. And gradually, we’re starting to   develop a better understanding of what autism  looks like outside of young males [pause]. It is not possible to grow out of autism.  Autism is a neurodevelopmental difference,   which means that it is present from  birth, and it is something that you   will experience across the lifespan. We do  know that autistic people sometimes differ   across the lifespan in how they present  their autistic characteristics. So,   this might mean that when people are particularly  young, they might appear more visibly autistic   to outsiders, and as they get older and  learn how to cope with their environment,   they may appear less visibility autistic to  people who are externally observing them. We also know that many autistic people experience  something called “masking,” and this is the   suppression of aspects of identity and particular  autistic traits or characteristics. And this can   be to fit in within social situations, make  friends and socially affiliate with others,   but it can also be to avoid social stigma.  Autistic people experience negative judgments from   others because of beliefs about autism, and those  myths and misconceptions that people hold. So,   many autistic people try and suppress  appearing autistic to others, so that   they aren’t judged negatively and don’t have bad  experiences with other people because of that. What this means is that some autistic people  may appear less visibility autistic, and some   autistic people might vary in their presentation  that makes them appear less visibility autistic   to begin with. But we know that masking has  a really negative effect on autistic people,   and this is something we need to conduct  much further research into in future   in order to understand the impact of  suppressing autistic characteristics   on wellbeing and mental health [pause]. There isn’t a yes or no answer to this one,   unfortunately. In some ways, we all have autistic  characteristics, and this is because autistic   characteristics are human characteristics.  The traits that we associate with autism are   seen across the population, whether someone is  autistic or not, and there is no hard cut-off   line for someone becoming autistic. Autism is  diagnosed often via how we externally present   to a clinician, or whether we meet particular  diagnostic criteria, grounded in a behavioural   assessment, a developmental assessment,  understanding our lives and our backgrounds. Now, what this means is that we can’t really  say for sure, based on how we view people,   whether they’re autistic of not. There’s no set  right or wrong answer there. Sometimes we like to   make sense of difference by trying to relate  to people. So, when non-autistic people say,   “Aren’t we all a little bit autistic?” what  they often mean is, “I experience things that   are similar to that, and I’m trying to  find a way to relate to you.” However,   this can minimise some of the struggles  that some autistic people experience,   making them feel like they can’t  ask for reasonable adjustments,   or that the difficulties they experience won’t  be taken seriously if they ask for help. So,   we need to carefully consider what we mean when  we ask, “Are we all a little bit autistic?” We   all experience differing characteristics, and  we’re all human, but it is worth acknowledging   that some people tend to find certain things more  difficult than others, and it’s important that we   find ways to support people without minimising  some of the struggles that they face [pause]. The idea that the autism spectrum is linear is a  complete misnomer, and goes against the idea of   a spectrum. So, when original discussions  around autism as a spectrum arose, there   was very much a consensus among Psychologists  that autistic people were very heterogeneous,   that they differed from each other in many  different ways, that some people had social   difficulties that meant that they might not be  interested in social communication with others,   and some people were really socially interested.  Others had particular sensory difficulties that   others didn’t experience, and some people  struggled with language, while others didn’t,   which meant that we saw a huge amount  of difference across autistic people. So, the idea of the spectrum was meant to capture  this difference, that autistic people could   present in a range of different ways that would  make them different from neurotypical people or   non-autistic people, but also from each other.  Now, as time went on, the narrowing down of our   understanding of autism meant that we tended  to split people into two different sections.   People who we classified as high functioning,  and these were autistic people who usually   had spoken verbal language, autistic people who  had lower support needs, so didn’t need as much   help with their daily living, in comparison to  autistic people who maybe had far more support   needs and needed a lot of help with their daily  living, and maybe didn’t use spoken language. Now, functioning labels can be quite problematic,  firstly, because they are quite offensive. So,   if we call someone high or low functioning, it’s  putting an assumption on their capabilities and   their capacity to understand the world around  them, but the second reason is that functioning   labels aren’t very specific. They don’t tell us  very much about a person and what they need. So,   if we say that someone is low functioning, we  assume that that might tell us about their needs,   their communication skills, but it doesn’t tell us  as much as we could gain by saying something like,   “This person is non-speaking,” or,  “They need a lot of help with their   daily living.” And the same goes for people  who have been historically classified as   high functioning. These people might have  really struggled with their mental health,   might have experienced difficulties throughout  their lives, and the assumption that we can judge   how much support they need based  on a label, is really unhelpful. So, instead of conceptualising autism as a line,  from low to high, we can think about autism as   being characterised by what is called a “spiky  profile.” So, all autistic people have differing   strengths and difficulties across multiple  domains, so, things like their language,   executive function, sensory experience, and if  we want to provide support for people that is   really meaningful, we need to consider how those  differ across an individual. So, think about that   constellation of characteristics, rather than  conceptualising people on a straight line.