It's not always easy to spot real-life behaviour in the official diagnostic criteria for autism. Throughout life, we learn autistic masking and other coping strategies which can make diagnosis difficult. So let's delve into some of the DSM-5 criteria, compared to examples of some real-life representations.

Many movies and shows depict autistic individuals as savants with exceptional skills in a niche field or who are non-verbal and socially withdrawn.

Many movies and shows depict autistic individuals as savants with exceptional skills in a niche field or who are non-verbal and socially withdrawn. 

With the stereotypical image of autism in popular media, the representations we see are not the most accurate or inclusive. 

Additionally, the representation of autism is often portrayed as childlike, something I’ve discussed in one of my YouTube videos. 

These representations cause problematic misconceptions, as many of us do not fit the ‘autistic person’ seen on TV. 

We may look neurotypical on the outside, but our inner experience differs. 

Even I didn’t know I was autistic because of the stereotypes and medical definitions.

The Seven Signs Missed in Assessing Autism in Men

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is a rule book of diagnostic criteria from the American Psychiatric Association. 

Used internationally, the Diagnostic Criteria for Autism Spectrum Disorder is divided into two main parts.

https://youtu.be/-wPxKRyiR_gSitting with these are several diagnostic criteria used to assess people for autism.

The issue is, as we covered above, it’s not always easy to spot real-life behaviour in the official diagnostic criteria.

Throughout life, we learn autistic masking and other coping strategies to support us in navigating life. This can make diagnosis difficult, with many autistic people living their entire life undiagnosed or misdiagnosed.

Let’s delve a little further into some of the DSM-5 criteria, compared to examples of some real-life representations.

1. Deficits in social-emotional reciprocity (DSM-5) vs Being socially awkward (real-life representation)

Our reaction to social activities looks awkward, unsure, and unnatural:

• We often find it hard to engage in a conversation or talk too much and need to know when to stop.
• We hate small talk, do not know how to initiate conversation, and then go full firehose with information and facts even though it is inappropriate.
• We may not immediately know it’s inappropriate because we are emotionally out of sync with a group or a crowd and may miss social cues. This may appear like we laugh at inappropriate times or fail to pick up when things suddenly get serious.
• We often have delayed or subdued emotions, always seeming cool, calm, and collected on the outside at the time, as if nothing fazes us. Still, then much later, it comes out in different ways, possibly in a meltdown or shutdown.

The characteristics or behaviours create the stereotype that we lack empathy. However, we don’t lack empathy. We have and experience emotions, but they’re often expressed differently. Sometimes, they are delayed and come out later. 

As society expects these emotional reactions to be instant, we look like we don’t respond socially and emotionally to what is expected and are often misunderstood. 

2. Deficits in non-verbal communicative behaviours (DSM-5) vs Strange ways of interacting (real-life representation)

Lacking eye contact or overcompensating with too much eye contact. An odd tone or a weird way of speaking. Body language that seems strange to most people.

Our facial expressions can be hard to read, or we have little to no facial expressions, complicating this even more. 

Unfortunately, this affects relationships and can cause people to feel stressed, anxious, or uncomfortable.

This is the big one that must be noticed because this affects our development as an individual through different life stages.

3. DSM-5: Deficits in developing, maintaining, and understanding relationships (DSM-5) vs An overly logical person who doesn’t get people (real-life representation)

We tend to be analytical and may commit Social Faux Pas like responding to rhetorical questions, taking things too literally, missing subtleties of communication, or even strongly objecting to social convention.

Do we use too much logic? 

Everything comes with a cost. 

As we attempt to develop, maintain, and understand relationships, we compensate by analysing small interactions and becoming hyper-social. 

We may have periods of intense connection and then withdraw, which seems to come out of nowhere. These withdrawals occur when we crash and shut down. 

This makes maintaining relationships difficult.

4. Stereotyped or repetitive motor movements, use of objects, or speech (DSM-5) vs Stimming (real-life representation)

Stims come in many forms. 

Swings, roller coasters, massages, and even dancing and singing along to songs are popular activities for neurodivergent and neurotypical people because they feel good.

However, for us, stimming is not only for feeling good but because we need to stim to give ourselves sensory input for emotional regulation purposes. Unfortunately, from the outside, it manifests as strange or repetitive movements or behaviour.

I like to rock my legs and bounce my head. This could seem weird, especially in public places. However, once I put on headphones, even without music, it’s already normal because people think I’m enjoying the music.

I also like to twitch my shoulders as if they always want to be stretched. People may find this unnatural because it’s uncommon and strangely repetitive.

From the inside, our experience is that we do this because it feels good, but from the outside, this atypical behaviour may cause people to judge us or even affect their interactions with us.

5. Insistence on sameness, inflexible adherence to routines (DSM-5) vs We love rules too much (real-life representation)

We all love routines. However, autistic people take it to the extreme.

Our insistence on sameness and routine can be reflected in eating the same food daily, wearing the same outfit for years, and organising our time to the smallest detail. 

We dislike change in general and find it initially difficult to switch to new routines or even new products because we strongly believe that routines are awesome and become reliant on them. 

This reliance on routine is because it meets our needs so well that something new will probably not be as good as we already have.
 

Humans have a natural preference for the familiar. However, the extreme insistence on sameness is often highly correlated to anxiety and the desire to live in the same and predictable world. There are no unpleasant surprises in a world where everything is considered constant. This is why we like rules. We understand rules, and we can easily follow these rules compared to the complicated and unpredictable social world, which often needs to be clarified for us.

6. Highly restricted, fixated interests that are abnormal in intensity (DSM-5) vs Uneven skillsets (real-life representation)

Autism can manifest itself in a person who excels in specific areas at the expense of knowledge and skills in other areas. Yes, even for basic things like saying hello. 

We tend to have a fantastic memory and notice the minor details as we incorporate our intense interests into our routine and focus on that which lets us become experts. However, this memory and ability to see the small details can work against us because switching between tasks is hard when we are fixated on something. In addition, hyperfocus comes at the expense of others, leaving a very spiky skillset. 

This means we can be good at one thing and bad at others as we focus on our interests.

7. Hyper- or hypo reactivity to sensory input (DSM-5) vs Sensory sensitivities – oversensitive and under-sensitive (real-life representation)

Our modern world contains lots of sensory information: noise, crowds, lights, clothing textures, and colours.

Oversensitivity can come in extreme avoidance of loud noises, dislike of certain foods due to texture and taste, wearing only types of loose-fitting clothing, aversion to certain smells, etc. This is why some people dislike fluorescent lights or high-pitched noises.

Some people enjoy fragrance; however, I avoid fragrance and perfume halls. I immediately cover my nose, even in public, because I am sensitive to scents. I also avoid shopping centres due to the lights, sounds and smells.

Don’t tell someone you think they are autistic

Now that we have gone through the ‘checklist’ of signs to look for when diagnosing autism in adult men, you may have the desire to tell someone that they are possibly autistic. 

If you are thinking this, please stop.

It is IMPORTANT that you do not try to convince someone that they’re autistic. 

It is a deeply personal thing to realise you're on the spectrum. It’s highly tied to our identity as human beings.

I have friends who tick all these categories, but I do not tell them because it is not my place. 

If you continue to attempt to convince someone that they’re autistic, you will be saying, "There is something wrong with you. Everyone knows it, everyone knows it, you know it, and this disorder explains it.” That’s not a helpful message, and you wouldn’t want that.

Please let them positively discover it themselves because an unqualified friend cannot force it on us. Let us have the opportunity to experience a positive journey to self-rediscovery.

Are you asking, "How do I make him realise that he is on the spectrum?”

The answer is: Don’t go down that path.

If the person you are in a relationship with displays these signs, there are more effective strategies for creating the relationship you want without telling him that he is ‘on the spectrum’.

If you want to discover more about this topic, check out our website for the support and resources you need to navigate the world of autism.