Autism is a developmental illness that strikes early in life, creating profound deficits in affected people's ability to appreciate social aspects of life. As a result of their language, sensory and empathy deficits, even relatively high functioning people with autism are not able to develop in the usual spontaneous manner, and typically end up with a variety of significant developmental social and communicative deficits in later life:
- Problems with Figurative Language. People with mild cases of autism end up having life-long difficulty navigating through social situations, but are likely to develop language and to be able to function independently to some extent. Though they can use language to communicate with other people, their use of language is stunted and lacking in finesse. Their core communication deficits make it impossible for them to learn language in the normal manner which relies heavily on social context and non-verbal communications. Instead, they must learn language intellectually. Because of this they are highly literal in how they use and understand language, in stark contrast to the figurative manner in which most other people use language. People with autism often have difficulty starting conversations, or easily participating in conversations that others start. Small talk is all but impossible for them. Sarcasm and irony and other forms of communication where one thing is said while another is meant are completely lost on them. They lack an appreciation for body language and nonverbal communication, and thus cannot pick up on hints and clues that people drop to indicate interest or disinterest. Idioms and figurative language are particularly difficult. If you were at a party and said, "I've got to go see a man about a horse" to indicate that you needed to visit the restroom, a person with autism would literally think you were going to see a man about a horse. Similarly, the use of a phrase like, "all his oars aren't in the water", to describe someone's lack of good judgment or intelligence would likely sail over the head of an person with autism. Only thorough deliberate introduction of figurative language in a therapeutic context can people with autism learn to use figurative language.
- Stilted, Scripted Conversation. In addition to difficulty with figurative language, people with mild autism show other communication deficits. Their conversation tends to come across as "scripted", pedantic, artificial or somehow inauthentic or unspontaneous. They are likely to speak in a monotone, and to sound monotonous. There is little animation to their speech. Some people with autism engage in "TV talk", literally reciting entire scripts of dialog from television programs, commercials and movies. Others will talk incessantly about particular areas of interest, quite blind all the while to social cues their audience may be sending that they are coming across as boring.
- Social Isolation. People with autism's difficulty communicating leads them to become highly socially isolated, encapsulated in their own private mental worlds, and all but completely unaware of their surroundings. This tendency towards isolation is particularly a problem for the more severe cases of autism whose communication deficits are more profound, and who have fewer resources for appreciating the existence of or reaching out towards the social world. People with autism will often resist interaction with other people who try to communicate with them. They may fixate on objects or parts of objects and advert their eyes from other people. They may require several prompts before they will even respond to their names.
The most severe cases of autism are completely isolated. They may not use language at all, or they may be very limited in their ability to communicate. Such individuals do not respond when prompted. They often tantrum when others try to interact with them. They seem unable to stop their self-stimulatory behaviors and may even become aggressive, causing injury to themselves or others. People with very severe autism may require around-the-clock supervision and/or institutionalization.
Autistic deficits are varied, complicated and perplexing, affecting people with autism in fundamental and profound ways and making it all but impossible for them to interact socially. As a result of these deficits, people with autism are deprived of their natural ability to physically interact, socialize and communicate with others.