Autism

Autism is primarily characterized by differences and difficulties in social interaction and communication, alongside restricted or repetitive patterns of interests, activities, or behaviors (stimming), and, in many cases, distinctive reactions to sensory input. The specific presentation varies widely. Clinicians often consider assessment for autism when these characteristics are present, especially if they are associated with difficulty obtaining or sustaining employment or education, difficulty initiating or maintaining social relationships, involvement with mental health or learning disability services, or a history of neurodevelopmental conditions (including learning disabilities and ADHD) or mental health conditions. In most cases, signs of autism are first observable in infancy or early childhood and remain throughout life. Autistic people may be significantly disabled in some respects, but average—or, in some cases, superior—in others. Social and communication skills Autistic people may have differences in social communication and interaction, which can lead to challenges in environments structured around non-autistic norms. Diagnostic criteria for autism require difficulties across three social domains: social-emotional reciprocity, nonverbal communication, and developing and maintaining relationships. Social–emotional reciprocity Common early signs of autism include little or no babbling in infancy. Difficulties may also be apparent in traditional forms of reciprocal social interaction, such as games like peek-a-boo as well as in shared attention to objects of interest; Historically, autistic children were said to be delayed in developing a theory of mind, and the empathizing–systemizing theory proposed that while autistic people may have compassion (affective empathy) for others with similar autistic traits, they often have limited, though not necessarily absent, cognitive empathy. This may present as social naïvety, lower-than-average intuitive perception of the meaning or utility of body language, social reciprocity, or social expectations, including the habitus, social cues, and certain aspects of sarcasm, which to some degree may be influenced by co-occurring alexithymia. A 2019 meta-analysis found that alexithymia commonly co-occurs in autism (49.93%) and infrequently in neurotypicals (4.89%); the random effects risk ratio (6.50) was statistically significant (p Differences in verbal communication often become noticeable in early childhood, as many autistic children develop language skills at an uneven pace. Speech may emerge later than is typical or not at all (non-speaking autism), while reading ability may be present before school age (hyperlexia). About 25–35% of autistic school-age children are non-speaking or minimally speaking. The age at which speech develops and the complexity of early language development are significant predictors of verbal communication abilities in later life. Conversely, some autistic people make eye contact that others perceive as intense or unrelenting. They may recognize fewer emotions or interpret facial expressions differently, and may not respond with expressions expected by their non-autistic peers. They can also have difficulty inferring social context or subtext in conversation or text, resulting in different interpretations of meaning. Speech characteristics such as volume, rhythm, and intonation (prosody) can vary, Developing and sustaining relationships Signs of autism in childhood include less apparent interest in other children or caregivers, possibly with more interest in objects. Children on the autism spectrum are more likely than their non-autistic peers to be involved in bullying, most often as victims. Among autistic people who seek friendships, reduced friendship quality and quantity are often associated with increased loneliness. Autistic people also face greater challenges in developing romantic relationships than non-autistic people. Over time, many autistic people learn to observe and form models of social patterns, and develop coping strategies, such as "masking". Masking is associated with poorer mental health outcomes as well as delayed diagnosis, which can limit access to appropriate supports. It is increasingly argued that these characteristics should be accepted, which is supported by their recognized functions, such as self-regulation. Focused interests can also provide personal fulfillment and contribute to the development of specialized knowledge. on a cork coaster Repetitive behaviors Repetitive behaviors found in autism include rocking, hand flapping, finger flicking, head banging, and repeating phrases or sounds (including echolalia These behaviors may occur consistently or primarily when the person is stressed, anxious, or upset. They are also known as stimming. Other examples include playing with toys in ways others might consider limited or unusual Many adults learn to suppress (or "mask") these behaviors, which can increase their stress and anxiety. Resistance to change Autistic people may have a strong preference for routine, such as performing daily tasks in a specific order or showing distress in response to changes others may consider minor. They may become distressed if their routine changes or is disrupted. Sensory reactivity Atypical responses may arise in autistic people in response to certain sensory input, such as aversion to specific sounds or textures, fascination with lights or movement, or apparent indifference to pain or temperature. This is experienced by 90% of autistic people. They can be hyperactive or hypoactive in response to sensory input. Some underreact to pain and temperature while others have a stronger reaction to it. Self-injury Self-harm occurs about three times more often in autistic people than in non-autistic people. Behaviors can include head-banging, hand-biting, and skin-picking, and can lead to serious injury or, in rare cases, death. Several explanations have been proposed for the development and persistence of self-harm among people with developmental conditions such as autism. Communication difficulties may lead some autistic people to use self-injury to express needs, distress, or other feelings. or modulate pain perception, particularly for those with chronic discomfort or medical conditions. The propensity for elopement increases with the severity of the autism. and traffic injuries are among the dangers associated with elopement. It is described as distinct from but similar to occupational burnout and is often linked to the pressure to hide autistic traits in social interactions. It may manifest as a feeling of being "stuck": people find it challenging to begin a task, shift focus to a different activity, or disengage from an action, even when they want to. A meltdown may occur if, upon processing large amounts of information, an autistic person experiences anxiety or feels overwhelmed. Triggers may be sensory or social, and often include unpredictability, unmet basic needs, and emotional situations, which tend to accumulate. The otherwise rare savant syndrome, characterized by an isolated skill in a narrow area, is more common among autistic people, but studies of its prevalence have found different results. These special skills are related to prodigious memory. Most common are splinter skills, such as memorization of sports trivia or historical facts. Research has also reported enhanced performance by autistic participants on certain perceptual and attentional tasks. Other features Autistic people may exhibit traits or characteristics that are not part of the formal diagnostic criteria but can nonetheless affect their personal well-being or family dynamics. • An estimated 60–80% of autistic people have motor signs that include poor muscle tone, poor motor planning, and toe walking; difficulties in motor coordination appear common across the autism spectrum. • Unusual or atypical eating behavior occurs in about 70% of children on the autism spectrum, to the extent that it was once considered a diagnostic indicator. == Causes ==

The exact causes of autism are unknown, with genetics likely being the largest contributing factor. It was long presumed a single cause at the genetic, cognitive, and neural levels underpinned the social and non-social features, but autism is increasingly thought to be a complex condition with distinct, often co-occurring, causes for its core aspects. It is unlikely that autism has a single cause; including genetics, Research into causes is complex due to challenges in identifying distinct biological subgroups in the autistic population. Genetics Autism has a strong genetic basis, but the genetics of autism are complex and it is unclear whether autism is explained more by rare mutations with major effects or by rare multi-gene interactions of common genetic variants. Twin studies indicate that autism is highly heritable, with genetic factors explaining most of the risk and shared environmental effects playing a minor role. and having only small effects. Complexity arises from interactions among multiple genes, the environment, and heritable epigenetic factors (which influence gene expression without changing DNA sequence). Typically, autism is not traceable to a single-gene (Mendelian) mutation or chromosome anomaly, and no known genetic syndrome selectively causes autism. Syndromic autism is present in approximately 25% of autistic people. Research has suggested that autistic people with intellectual disability tend to have rarer, more impactful, genetic mutations than those found in people diagnosed solely with autism. A number of genetic syndromes causing intellectual disability may also co-occur with autism, including fragile X, Down, Prader–Willi, Angelman, Williams syndrome, and SYNGAP1-related intellectual disability. Research suggests that autism is associated with genes that influence neural development and connectivity. These are involved in key neuronal processes such as protein synthesis, synaptic activity, cell adhesion, and the formation and remodeling of synapses, as well as the regulation of excitatory and inhibitory neurotransmission. Studies have identified lower expression of genes linked to the inhibitory neurotransmitter gamma-aminobutyric acid, alongside higher expression of genes associated with glial (e.g., astrocytes) and immune (e.g., microglia) cells, correlating with higher numbers of these cells in post-mortem brain tissue. Genes associated with variation in the mTOR signaling pathway, which is involved in cell growth and survival, are also under investigation. Some hypotheses in evolutionary psychiatry suggest that autism-associated genes may persist because of proposed links to traits such as intelligence, systematizing abilities, or innovation. If parents have one autistic child, the chance of having a second autistic child ranges from 7% to 20%. The likelihood of being autistic is greater with older fathers than with older mothers; two potential explanations are the known increase in the number of mutations in older sperm and the hypothesis that men marry later if they carry a genetic predisposition and show some signs of autism. Evolutionary perspectives Research on the evolutionary advantages of autism and associated genes has suggested that autistic people may have contributed uniquely to human development, particularly in technological innovation (such as tool-making) and in detailed observation and analysis of the natural environment. Systematic reviews emphasize that these ideas remain speculative and that no single evolutionary explanation has been established. Social factors Social factors such as upbringing are not known to cause autism, but it is possible that increasing demands for flexibility and social interaction in education, or in one's personal and professional life, may cause people to exhibit pronounced difficulties that would not have led to diagnosis in a different setting. Proximity for children that have the same severity of autism can increase prevalence due to increased expression of symptoms of autism. This is seen in children with high-functioning autism. • The Enhanced Perceptual Functioning model of autism posits that superior and more independent functioning of auditory and visual perception is the root cause of the specific pattern of cognitive, behavioral, and neural performance observed in autistic people. While these cognitive accounts describe how autistic traits may manifest, they are generally viewed as explanations of the behavioral and cognitive consequences of the underlying neurobiological development rather than primary causes themselves. although no single factor is conclusive and study results are often inconsistent. These factors include advanced parental age, maternal health conditions (e.g., gestational diabetes, infections such as rubella, inflammation), exposure to certain medications (e.g., valproate While many environmental factors have been investigated, few have established links, Disproven refrigerator mother hypothesis Work on autism in the mid-20th century proposed the "frigid mother" or refrigerator mother hypothesis, according to which poor parenting or lack of emotional support from parents leads to autism. When it was proposed, the hypothesis contributed to considerable media attention about autism, which had previously been mostly ignored. The hypothesis has since fallen out of favor, and has not garnered support when studied. Early social experiences, such as caregiver interactions or deprivation, may shape the development of autism, potentially via gene–environment correlations, and are distinct from the discredited refrigerator mother hypothesis. In 1998, British physician Andrew Wakefield led a fraudulent, litigation-funded study that suggested that the MMR vaccine may cause autism. His co-authors have since recanted the claims made in the study. Wakefield was struck off the British medical register for "serious professional misconduct" after determination that his involvement in the study amounted to fraud, leading to the loss of his right to practice medicine. Two versions of the vaccine causation hypothesis were that autism results from brain damage caused by either the MMR vaccine itself, or by mercury used as a vaccine preservative. No convincing scientific evidence supports these claims. A 2014 meta-analysis examined ten major studies on autism and vaccines involving 1.25 million children worldwide; it concluded that neither the vaccine preservative thimerosal (mercury), nor the MMR vaccine, which has never contained thimerosal, lead to autism. Despite this, misplaced parental concern has led to lower rates of childhood immunizations, outbreaks of previously controlled childhood diseases in some countries, and the preventable deaths of several children. Anti-vaccine activists have spread false claims about the absence of autism in North America's Amish population due to lower vaccination rates. A 2010 study revealed that autism is present in 1 out of every 271 Amish children. == Mechanism ==

Classification The DSM-5 and ICD-11 are the two main frameworks for classification of mental disorders in use today. Autism spectrum disorder is classified in both as a neurodevelopmental disorder, with its definition encompassing a spectrum of highly varied presentations. Before the DSM-5 (2013) and ICD-11/ICD-11 CDDR (2019/2024), autism fell within a broader pervasive developmental disorder category that included labels such as Asperger syndrome and classic autism (also called childhood autism or Kanner syndrome). Because these diagnoses overlapped, the manuals unified them under "autism spectrum disorder" (ASD). Since 1980, the committees behind both manuals have aimed for greater convergence, incorporating biological research while keeping behavior-based criteria. ICD-11 instead records whether the person has co-occurring intellectual disability or language impairment. Some researchers have questioned whether existing criteria capture the full phenomenon, prompting proposals for prototype descriptions, transdiagnostic biological markers, or distinctions between common behavioral traits and rarer genetic or environmental factors. Others have proposed alternatives to the disorder-focused spectrum model that deconstruct autism into separate phenomena: a non-pathological spectrum of behavioral traits in the general population, and rare genetic mutations or environmental factors influencing neurodevelopmental and psychological conditions. Its fifth edition—DSM-5, released in 2013—was the first to define ASD as a single diagnosis, combining the previously distinct diagnoses of classic autism, Asperger syndrome, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified (PDD-NOS). The DSM-5 also revised the onset criteria to specify that symptoms appear in the early developmental period, noting that symptoms may manifest later when social demands exceed capabilities; the previous edition had required onset before age three. These revisions remain in the DSM-5-TR. ICD The World Health Organization's International Classification of Diseases (11th revision), ICD-11, was released in 2018 and came into full effect in 2022. Its classification of autism spectrum disorder () is based on whether intellectual impairment is present as well as the level, if any, of language impairment, as follows: == Management ==

There is no cure for autism. From the perspective of neurodiversity, "curing" or otherwise treating autism may not be an appropriate goal. Interventions targeting specific challenges or co-occurring conditions associated with autism are widely regarded as important. Perspectives on the goals of these interventions vary: the medical model of disability often focuses on addressing core characteristics such as social communication difficulties and restricted/repetitive behaviors. The neurodiversity movement supports interventions aimed at enhancing functional communication (spoken or non-spoken), managing related issues like anxiety or inertia, or addressing behaviors considered harmful, rather than seeking to alter core autistic features. but the development of evidence-based interventions has advanced. Several therapies can help autistic children, and they are typically tailored to the child's needs. The main goals of therapy are to lessen associated difficulties and family distress, and to increase quality of life and functional independence. In general, higher IQs correlate with higher responsiveness to interventions and larger intervention outcomes. Medications have not been found to reduce autism's core features, but may be used for associated difficulties, such as irritability or inattention. Non-pharmacological interventions Certain interventions, such as intensive, sustained special education, remedial education programs, and behavior therapy, are considered beneficial early in life for autistic children to acquire self-care, social, and job skills. Available approaches include applied behavior analysis, developmental models, structured teaching, speech and language therapy, cognitive behavioral therapy, social skills therapy, and occupational therapy. Another review reported a lack of adverse event monitoring, although such adverse effects may be common. Interventions for early childhood may be based on different theoretical frameworks, such as ABA (with its structured and naturalistic approaches) and Developmental Social Pragmatic (DSP) models. Sandoval-Norton et al. describe it as unethical and argue that it has unintended consequences, such as prompt dependency, susceptibility to psychological abuse, and overemphasis on compliance, which can create challenges in the transition to adulthood. A problem with unreported conflicts of interest in ABA research has been described, with potential effects on the quality of evidence. In response, some ABA advocates suggest that instead of discontinuing the therapy, efforts should focus on increasing protections and ethical compliance. A related type of intervention is parent training models. Similarly, teacher-implemented interventions that combine naturalistic ABA with a developmental social pragmatic approach have been associated with effects on young children's social-communication behaviors, although there is limited evidence regarding effects on broader autistic characteristics. Despite these efforts, autistic students can face significant barriers, sometimes leading to trauma or emotionally-based school non-attendance. This avoidance is often rooted in overwhelming sensory environments, social anxieties, communication breakdowns, bullying, or lack of adequate support and understanding, rather than defiance. UDL principles accommodate varied learning styles, sensory sensitivities, and communication preferences often present in autistic people. Accommodations may include providing quiet spaces as a retreat for people feeling overwhelmed. Autistic students may also need help initiating and maintaining social relationships with their peers if they wish to do so. Transitioning to adulthood, autistic people often encounter substantial barriers to securing and maintaining meaningful employment, leading to high rates of unemployment and underemployment compared to the general population. Challenges can include navigating traditional interview processes, difficulties with unspoken social rules in the workplace, sensory sensitivities to office environments (e.g., lighting, noise), and needs for clear, direct communication and structured tasks. Effective workplace inclusion involves implementing reasonable adjustments such as flexible working hours or locations, providing noise-canceling headphones, staff training, and mentorship programs. Autism-friendly workplaces not only allow autistic employees to utilize their unique skills and perspectives but also benefit employers through increased innovation, problem-solving capabilities, and employee loyalty. Pharmacological interventions Autistic people may be prescribed medication to manage specific co-occurring conditions or behaviors, such as ADHD, anxiety, aggression, or self-injurious behaviors, particularly when non-pharmacological interventions alone have been insufficient. Medications are not routinely recommended for autism's core features, such as social and communication difficulties or restricted and repetitive behaviors. More than half of autistic children in the United States are prescribed psychoactive drugs or anticonvulsants. Commonly used drug classes include antidepressants, stimulants, and antipsychotics. These drugs can have significant side effects and responses to them may vary. Some research suggests that risperidone and aripiprazole may also reduce restricted and repetitive behaviors, such as hand-flapping or body-rocking. A meta-analysis found no significant efficacy of these antipsychotics or SSRI antidepressants in reducing these behaviors. Stimulant medications like methylphenidate may reduce inattention or hyperactivity in some autistic children, particularly when ADHD is also present. Alternative medicine Alternative therapies have been researched and implemented, and many have resulted in harm to autistic people. Reports of death from botched chelation therapy as treatment for autism have been documented. Medical authorities have condemned bleach-based approaches, such as chlorine dioxide solutions marketed as Miracle Mineral Solution, as dangerous and ineffective. The British NHS also warns against CEASE therapy, which rejects vaccinations and recommends potentially harmful amounts of dietary supplements. There is also no evidence for the efficacy of hyperbaric oxygen therapy and its use is not recommended. Although sometimes used for autistic people, no reliable evidence indicates a gluten- and casein-free diet as a standard intervention. Autistic children's preference for unconventional foods as well as gastrointestinal problems and lack of exercise can lead to reduction in bone cortical thickness, and this risk is greater in those on casein-free diets, as a consequence of the low intake of calcium and vitamin D. Emerging evidence-based interventions Interventions for autistic adults have limited evidence; cognitive behavioral approaches and mindfulness are considered promising. Music therapy for autistic people likely improves overall autism severity, global functioning, and quality of life, but evidence is unclear for social and communication skills. Animal-assisted activities and therapies show promise in improving social communication, irritability, hyperactivity, and word usage in autistic people. Caregivers Families who care for an autistic child often experience greater stress. Parents may struggle to understand their child and to find appropriate care options. Affiliate stigma can also reduce quality of life, where negative attitudes toward the autistic child are extended to those close to them. Family members who are themselves autistic may be better able to understand the autistic child. == Prognosis ==

The prognosis after diagnosis of autism in childhood is poorly understood. Among children diagnosed before age 6, about 9 in 10 continue to meet diagnostic criteria one year later. Some report that those with limited support needs are likely to have lessened autistic features over time, while others argue that this perception is likely due to masking—hiding autistic characteristics to avoid stigma. Long-term outcomes vary, in part due to variability in presentation between individuals and across affected domains. Factors such as developing spoken language before age six, having an IQ above 50, and possessing marketable skills are associated with higher likelihood of independent living in adulthood. Mortality among autistic people is approximately twice that of the general population, particularly among those with co-occurring neurologic or psychiatric disorders. Autistic people are also at significantly increased risk of victimization, including bullying, sexual assault, and other forms of criminal abuse. A 2019 meta-analysis found autistic people to be four times more likely to have depression than non-autistic people. Rates of suicidality vary significantly depending upon what is being measured. and a third of all autistic people have experienced suicidal ideation at some point. Autistic people are about three times as likely as non-autistic people to make a suicide attempt. Almost 10% of autistic youth and 15% to 25% of autistic adults have attempted suicide. Rates of suicide attempts and suicidal ideation are the same for people formally diagnosed with autism and people who have typical intelligence and are believed to be autistic but have not been diagnosed. The suicide risk is higher for autistic people who are not cisgender males and do not have intellectual disabilities. == Epidemiology ==

Most professionals believe that race, ethnicity, and socioeconomic background have limited effect on the occurrence of autism. Research indicates that autistic people are significantly more likely to be LGBTQ than the general population. Autistic people are also significantly more likely to be non-theistic or non-religious. Co-occurring conditions showing overlapping clinical phenotypes in genes associated with monogenic forms of autism, dystonia, epilepsy and schizophrenia: Several conditions can co-occur with autism at a higher rate than in the rest of the population. This may be referred to as comorbidity, and may increase with age, causing difficulties for youth on the autism spectrum, and can make interventions and therapies more challenging. Features of autism and other diagnoses often overlap, and autism's characteristics can make traditional diagnostic procedures more difficult. This is sometimes known as diagnostic overshadowing. Common co-occurring conditions are: • ADHD is seen in between 25% to 32% of autistic people. Characteristics similar to those of ADHD can be part of an autism diagnosis. • Epilepsy occurs in about 10% of autistic people. The risk is higher for older autistic people and those with intellectual disability. • Intellectual disabilities are some of the most common co-occurring conditions with autism (30% to 40%). As autism diagnosis is increasingly given to people with lower support needs, there is a tendency for the proportion with co-occurring intellectual disability to decrease over time. • Various anxiety disorders can co-occur with autism, with overall co-occurring rates of 17% to 23%. • Rates of co-occurring depression in autistic people range from 9% to 13%. • Genetic conditions: About 10% of autistic people are diagnosed with a rare genetic syndrome such as Prader–Willi, Angelman, Fragile X, or 16p11.2 deletion syndrome. • Gastrointestinal problems are among the most commonly reported co-occurring medical conditions in autistic people, and occur at higher rates than in the general population. Frequently reported issues include chronic constipation, diarrhea, abdominal pain, gastroesophageal reflux, and functional gastrointestinal disorders. Gastrointestinal symptoms in autistic people have been associated with increased irritability, distress, sleep disturbances, and challenges in communication, particularly in children who have limited spoken language. The underlying mechanisms are not fully understood and are likely multifactorial, involving interactions between diet, gut motility, sensory sensitivities, stress responses, and the gut-brain axis. • Motor difficulties, including features of dyspraxia, are highly prevalent in autistic people, and there is a significantly higher rate of joint hypermobility/hypermobility spectrum disorders/Ehlers-Danlos syndrome in autistic people. • There is tentative evidence that gender dysphoria occurs more frequently in autistic people. Prevalence The World Health Organization notes that reports on prevalence vary widely. It estimates that about 1 in 127 children were autistic between 2012 and 2021 with a trend of increasing prevalence over time. This may reflect an underestimate of prevalence in low- and middle-income countries. Surveillance studies in community samples of adults suggest a similar share of the adult population would meet diagnostic criteria if formally assessed. particularly among women, though other unidentified environmental factors may exist. The Centers for Disease Control's Autism and Developmental Disabilities Monitoring Network reported that approximately 1 in 31 children in the United States is diagnosed with autism, based on data collected in 2022. For 2016 data, the estimate was 1 in 54, compared to 1 in 68 in 2010 and 1 in 150 in 2000. Sex ratio Males are about three times more likely to be diagnosed with autism than females. Several theories about the higher prevalence in males have been investigated. Prevalence differences may be mainly due to a result of differences in expression of characteristics between males and females, with autistic women and girls showing less atypical behaviors and therefore being less likely to be diagnosed with autism. == History ==

Etymology In 1911, Swiss psychiatrist Paul Eugen Bleuler coined the German term Autismus to characterize the social withdrawal he observed in people with schizophrenia. Rendered in English as autism, the term derives from the Greek word autos ("self"). Bleuler used the term for a symptom of adult schizophrenia: a person's retreat from reality into their own subjective world. He also mentioned "autistic thinking" as a fleeting, illogical thought process everyone experiences. In the mid-1920s, German psychiatrist Fritz Künkel categorized over 100 schizophrenic patients into four groups, one of which he labeled "autistic", highlighting disturbances in emotional life. In 1926, building on his work and Bleuler's, Grunya Sukhareva published an article about six boys who were musically gifted and had a tendency toward abstract thinking. She called their affects "flattened" and their tendency to avoid other children an "autistic attitude". Scholars have credited Sukhareva with making observations that closely mirror ASD as described by the DSM-5 and ICD-11. Her work expanded on the definition throughout her career while making great strides in differentiating ASD and schizophrenia nearly 30 years before the establishment of separate classifications for these diagnoses with the 1980 publication of the DSM-III. == Society and culture ==

likened her autism to a "superpower", crediting her success to her focused interests. The autistic rights and neurodiversity movements argue autism should be accepted as a difference to be accommodated instead of cured, although a minority of autistic people might still accept a cure. Social-science scholars study autistic people in hopes of learning more about "autism as a culture, transcultural comparisons ... and research on social movements". Focused interests are commonly found in autistic people and can include activism. Environmental activist Greta Thunberg has spoken favorably about her autism diagnosis, saying that autism can be a source of life purpose, as well as the basis of careers, hobbies, and friendships. Legal implications of diagnosis In Sweden, people with an autism diagnosis are required to provide additional proof of suitability to apply for a driver's license and may face barriers to entering military service. In the United Kingdom, an autistic police officer was rejected from firearms training, which a tribunal later ruled was illegal discrimination. In the United States, autism is generally a "disqualifying condition" for joining the military, but autistic people can apply for a medical waiver. Discrimination Discrimination against autistic people occurs in various forms, both directly and indirectly, in a variety of settings, professional, educational, or clinical. Such discrimination is often initiated after other people identify the autistic person as different from themselves, which may occur very quickly. have advocated a shift in attitudes toward the view that autism is a difference, rather than a disease that ought to be treated or cured. Critics have bemoaned the entrenchment of some of these groups' opinions, and that they speak to a select group of autistic people with limited difficulties. The neurodiversity movement and the autism rights movement are social movements within the context of disability rights, emphasizing the concept of neurodiversity, according to which autism is a result of healthy and valuable variations in the human brain rather than a disorder to be cured. The autism rights movement advocates including greater acceptance of autistic behaviors, therapies that focus on coping skills rather than imitating the behaviors of non-autistic people, and the recognition of the autistic community as a minority group. It has been argued that only autistic people with lower support needs should be included under the neurodiversity banner, as autism with high support needs "may rightfully be viewed as a disability". The concept of neurodiversity is contentious in autism advocacy and research groups and has led to infighting. By age 21, about 20% of autistic people in the US have a driver's license, compared to more than 60% of non-autistic people. They are less likely to start learning, likely to do it later than non-autistic peers, and less likely to proceed to the next stage. having a slower reaction time, A study in Spain found that children diagnosed with autism and their parents faced stigma and societal challenges. Cultural values can influence how a parent feels; many feel defeated because they think they failed as a parent. == See also ==