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Autism subtypes

Before DSM 5 came in 2013 that there were different diagnoses of autism. After that time it all came under one umbrella of one name - Autism Spectrum Disorder. However, we still point out that autism is a largely heterogeneous condition. And that no single autistic person is the same as another. In addition to the very difference of the autistic person throughout life, despite the diagnosis being the same. And clinicians and researchers have been trying for a long time to understand the different subtypes of autism.

But what new autism subtype am I going to talk about? some may ask. Actually, it is not a new subtype. On the contrary. It has been around for a long time. For instance, if we look at a photograph we can try to observe two autism subtypes. An autism that grows in an environment with diverse and adequate responses to the neurobiopsychosocial needs of autistic people throughout life. And then we have an autism that grows in a completely opposite environment.

I think that many of you, even those who have difficulty in identifying autism, will have no difficulty in being able to tell in the picture where there is an autism subtype and another one. Maybe you can even identify the subtype according to the different architecture itself, besides the colour of the roof in some houses compared to others.

If we think that between 1% and 2% of the world population is diagnosed with Autism Spectrum Disorder. We can think, for example, that in the photograph accompanying this text, there will be autistic people in any of those dwellings, regardless of the habitability and other conditions of each one!

78 million people worldwide are diagnosed with Autism Spectrum Disorder. That's 1 in every 100 children. And if you hear a lot about autistic people in the United States or Europe and think that the largest number of autistic people are in these continents, you are wrong.

The largest number of autistic children and young people live in developing or low- and middle-income countries, including more than a million children in South Asia and sub-Saharan Africa, while the highest rates of childhood autism are seen in the Middle East, Central Asia and North Africa.

Much of the dialogue around autism focuses on the US, Canada and Western Europe. This is understandable, as they are the most responsive countries to conduct research. They are also the countries with the most and best health resources. But it is also possible to think that we often forget that much of the world's childhood autism is concentrated in regions where health resources are limited.

For example, India has the largest number of autistic children (851,000), followed by China (422,000), Nigeria (207,000), Pakistan (172,000) and Indonesia (159,000). In contrast, around 150,000 children with autism live in North America and fewer than 140,000 in Western Europe.

The fact that large numbers of children on the autism spectrum live in resource-limited countries means that new and improved global health policies are needed to ensure that they can access care and support. Both fighting autism stigma and providing resources for autistic people around the world must be a priority for all of us.

More autistic children live in poor households compared to children without autism. One in four (25%) autistic children live in a poor family. More than half of autistic children (53%) live in low-income households, versus 41% of children without autism.

And just as autism does not cease to exist after you stop being a child. The likelihood that these children who are autistic and living in poverty will go on to become autistic young people or adults who continue to live in poverty is enormous.

All of us individually, but also the health bodies responsible for providing a response in this area of mental health. As well as the successive governments of the various countries, whether developed like ours, but also all the others, need to think in a responsible way about mental health and public policies.

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