About Autism Spectrum Disorder

Autism Spectrum Disorder refers to a common neurological condition that appears from childhood or in early stages of development and manifests in varying degrees, with various characteristics, behaviors, and impairments (personality, social, verbal, and communicative) that accompany the person throughout his life. In other words, ASD manifests differently in different people, each individual unique with their own capabilities and difficulties. While some people on the spectrum can experience difficulties and impairment of basic functions, others will successfully integrate socially and face specific challenges from time to time.

As ASD is not a disease but a neurological condition, therapeutic emphasis is on understanding and accepting the condition, developing life skills, personal accommodations and professional support based on the needs and abilities of the patient.

How common ASD is

It is impossible to know the exact rate of new ASD diagnoses in Israel because not every case is reported to the right ministry. However, the number of people diagnosed has definitely gone through the roof in the last few years, and it keeps going up every year (an average of 23%).

Data collected by Alut show:

• There are about 46,000 individuals in Israel who have been diagnosed with ASD; about 37,000 of them are children and adolescents, and about 8,700 are adults.
• At least 1 in 88 children in Israel is diagnosed with ASD.

A new study that examined data of 3.5 million children between the ages of one and 17 found that:

• The overall incidence of ASD between 2017 and 2021 doubled.
• The incidence among children aged 2–3 increased by 4.4.

As part of the diagnosis process, the level of difficulty in each area must be determined. Each area can be labeled as mild, moderate, or severe, based on how bad the symptoms are and how hard it is for the child to fit in with other people in everyday life.

Symptoms and behaviors in women and men

Whereas the main symptoms of autism, such as difficulty in social communication, occur in both sexes, it was found that:

• Women with ASD occasionally display more difficulty in emotional regulation and emotional intensity in comparison with men.
• Women with ASD tend to use concealment mechanisms more often than men and tend to mimic ‘normal social behavior, making it occasionally difficult to diagnose them. It’s not that they do not have social difficulties but that their desire to socially integrate reinforced the social mechanisms more than their male peers until a difficulty was impossible to discern.
• Because women are more inclined and drawn to the social sphere, there are also cases of isolation and aversion to social interaction.
• Men with ASD lean more towards repetitive and limited patterns of behavior and interests.
• Men with ASD tend to excel in such areas as visual-spatial strength, while women are stronger in language and memory.
• Children with ASD are frequently have interests that are identical to other children of their age, such as celebrities or music. The only difference is the way their interest can become an actual obsession. At the same time, many parents cannot pay attention to this and miss the abnormalities.

These differences indicate the need for diagnostic and therapeutic approaches that are adapted to men and women with ASD to provide optimal support for each group.

Diagnosing Autism Spectrum Disorder

ASD is identified and diagnosed according to criteria appearing in DSM-5 (the American Psychiatric Diagnoses Book) and refers to two areas:

• Communication and social interaction.
• Limited and repetitive interests and patterns of behavior.

If you suspect that your child has autism spectrum disorder, it is important to consult a pediatrician and proceed from there, if necessary, for further diagnosis. In addition, if you have always felt different and abnormal about yourself, you might want to seek a diagnosis regardless of your age.

Always worth remembering: early diagnosis is critical for the effectiveness of therapeutic results, but diagnosis at an older age is also significant because proper therapy can improve function and help acquire social skills.

Diagnostic difficulties

Studies point to difficulties in diagnosing girls and women on the autistic spectrum, the main reasons being the lack of awareness among professionals of the unique manifestations of autism in women (possibly due to the fact that the majority of studies conducted to date have primarily focused on men with ASD), gender stereotypes and less acceptable behavior patterns of women with ASD. In addition, young female children or adolescents with ASD are quiet and less likely to outwardly display their special needs. As a result, many of the female children and women with ASD are not diagnosed in time and do not receive therapy and support they needed.

Optimal therapy

The most critical window of opportunity is in the early years. Intense and various treatments, including parental training, provided at the time, often improve the function of both child and parent. Furthermore, the more professional care and support that is provided, the more likely it is to significantly influence and improve the child’s quality of life and social skills.

Even in the case of adults, it is not worth ignoring any difficulties in the field of social communication, such as understanding social situations, obsessive behaviors, communication difficulties and a feeling of being different. Seek a diagnosis, find out if you have ASD, and if necessary, get treatment, effective tools and professional help that will help you deal with life's challenges.

Assisted in the preparation of the article: Ido Michaeli-Assor, speech pathologist, Autism Department at the Ministry of Health and director of the "Shavim" Center in Jerusalem.