AUTISM
One spectrum, many perspectives
Autistic experiences are individual. Perception, communication and everyday life can feel very different from one person to another. What feels straightforward to one person may take considerable energy for someone else.
NEURODIVERSITY
Understanding experiences and needs
There is no single way to be autistic. Perception, communication, interests and ways of responding to strain differ from person to person. A neurodiversity-affirming perspective takes these differences seriously and asks what each person needs.
CLINICAL CONTEXT
Autism in diagnosis and research
Diagnostic classifications provide a shared framework. They describe areas of diagnostic features, but do not fully capture an individual person’s experience or needs.
GERMANY · MORBIDITY CODING
ICD-10-GM
Germany still uses ICD-10-GM as its official classification for morbidity coding. It lists, among others, childhood autism (F84.0), atypical autism (F84.1) and Asperger syndrome (F84.5) as separate categories.
WHO · INTERNATIONAL CLASSIFICATION
ICD-11 · 6A02
ICD-11 groups autism under a single spectrum diagnosis. Additional codes specify, among other things, intellectual development and functional language. ICD-11 has not yet been officially introduced for morbidity coding in Germany.
DIAGNOSTIC DOMAINS · GROUPED DIFFERENTLY
ICD-10-GM: three areas
Reciprocal social interaction, communication, and restricted, stereotyped and repetitive patterns of behaviour and interests are described separately.
ICD-11: two core domains
ICD-11 brings reciprocal interaction and social communication together within one domain. The second covers restricted, repetitive and inflexible patterns of behaviour, interests or activities; sensory features may also be included.
Both systems consider developmental history and the impact on everyday life. Individual traits or a questionnaire alone do not establish a diagnosis.
A DISCUSSED PROFILE
PDA / Extreme Demand Avoidance
PDA (Pathological Demand Avoidance), also referred to as Extreme Demand Avoidance, describes a profile of pronounced demand avoidance discussed in some of the literature. It is not a separate diagnosis in ICD-11 or DSM-5-TR. Definitions and measures are inconsistent, and the evidence base is limited. Avoidance should therefore be understood in its individual experience and context rather than interpreted automatically as deliberate refusal.
OTHER DIAGNOSES
Co-occurring conditions
Autism can occur alongside other conditions. The WHO lists ADHD, anxiety disorders, depression and epilepsy, among others. These conditions are not part of the autism criteria; they may also influence a person’s experience and need to be considered separately by a professional.
CURRENT RESEARCH
Autistic abilities and support needs vary and can change over the course of life. Research examines different developmental trajectories, co-occurring conditions, and factors that facilitate or hinder participation. For PDA, definitions and measurement remain contested; robust conclusions are currently limited.
Clinical sources
BfArM · ICD-10-GM 2026 · BfArM · ICD-11 implementation · WHO · ICD-11 CDDR · WHO · Autism fact sheet · PDA · systematic review · PDA · research review 2024
SELF-UNDERSTANDING
Who are you when you do not have to be anyone else?
Understanding can begin with distinguishing your own needs and boundaries from external expectations. Over time, it may become clearer which everyday situations are especially demanding, what brings relief, and what conditions help you rely less on other people’s expectations.
Perhaps you have spent a long time trying to belong, meet expectations or keep your difficulties from showing. These strategies of adapting are often described as masking and can take a great deal of energy. When they lead to exhaustion, overwhelm or significant distress, we can look together at the experiences connected with them and the needs that may have moved into the background. The aim is not to ask you to adapt even more, but to take your perspective seriously and understand what supports you.
EVERYDAY LIFE & EXPERIENCE
Looking at different areas
Perception, communication, energy and the experience of change can vary in everyday life.
01
Perception & sensory input
Sounds, light, touch or many simultaneous impressions can affect people in different ways and take energy.
02
Communication
Direct language, clear agreements or more time to respond can be helpful. Misunderstandings can arise on both sides.
03
Energy & regulation
Overload can build over time. Withdrawal and breaks may help reduce sensory input and contain the strain. Which forms of regulation bring relief differs from person to person.
04
Structure & change
Predictability can provide orientation. Transitions and short-notice changes may take more energy and create additional strain.
05
Interests & resources
Intense interests can bring enjoyment, in-depth knowledge and a sense of competence. During difficult periods, they can provide orientation and be an important resource.
06
Self-understanding
A better understanding of yourself, together with psychoeducation about autism, can help you make sense of your personal needs and boundaries.