Frequently asked questions
Short answers to frequently asked questions – with links to the detailed articles.
Understanding autism
What is autism?
Autism is a variation in development which, according to an expert overview, lasts a lifetime. It shows mainly in social communication and interaction and in recurring, not very flexible behaviours, interests or activities. How autism shows differs greatly from person to person. In medical classifications the diagnosis is called "autism spectrum disorder".
Is autism an illness?
In medical classifications, autism is listed as "autism spectrum disorder" among the disorders of neural and mental development. The concept of neurodiversity, by contrast, understands autism as a form of natural diversity of development and rejects seeing deviations from the norm as faults that must be corrected. Both views exist side by side; they do not rule out that people on the autism spectrum need support.
Do vaccines cause autism?
No: large studies find no link between vaccines and autism. A 2014 meta-analysis evaluated five cohort studies with a total of 1,256,407 children and five case-control studies with 9,920 children and found no link, including for the measles-mumps-rubella vaccine or for thiomersal. A Danish cohort study of 657,461 children found no increased autism risk for children vaccinated with MMR. A paper published in The Lancet in 1998, often cited, was retracted by the journal in 2010.
In detail: Do vaccinations cause autism? What the studies show
Is it ‘people with autism’ or ‘autistic people’?
There is no uniform answer. Surveys in Great Britain and the USA found that people on the autism spectrum, parents and professionals prefer different terms; "autism" itself was widely accepted. In its own German texts, Autismus Wissen writes "Menschen mit Autismus" and "Menschen im Autismus-Spektrum". This is an editorial house decision, not an objectively right form; in English texts both forms may appear. In personal contact, it is best to ask for the preferred term.
In detail: Language and terms: autistic, autism spectrum disorder, neurodivergence
What does neurodiversity mean?
Neurodiversity describes the natural diversity of human neurological development. As a paradigm, it does not understand deviations from the norm as faults that must be corrected; it is closely linked to the social model of disability. The word was coined in 1998 by Judy Singer and Harvey Blume. The concept does not replace assessment and does not say that nobody needs support.
Do people with autism lack empathy?
That is not true in such general terms. A meta-analysis of 51 studies found differences only in some areas of empathy, not in others, with strong variation between studies. Misunderstandings between people with and without autism also run in both directions ("double empathy"). Research on this is not complete.
In detail: Empathy and autism: a widespread misunderstanding
Assessment & diagnosis
At what age can autism be diagnosed?
According to the 2016 guideline, an autism diagnosis made before the age of two stays stable within the spectrum; where symptoms are clear, it should be made even then. For infancy there are no reliably established features for prediction. A diagnosis is also possible later, into adulthood.
What are the first signs in toddlers?
From the second year of life, the 2016 guideline named, for example, little eye contact, rarely pointing to share something, little reaction to their own name, lack of pretend play and loss of skills already acquired. Such signs are not a diagnosis, and good eye contact does not rule out autism. If you are worried, talk to the paediatric practice. Parents' concerns should be taken seriously.
How does an autism assessment work?
An autism assessment is not a single test but a process over several appointments. Professionals gather information from conversations about developmental history, reports from nursery, school or earlier treatment, behaviour observation, physical examination and autism-specific procedures. A central part is checking whether other causes explain the observations better. In the end there should be not only a diagnosis but also concrete recommendations.
Who makes the diagnosis?
According to the 2016 guideline, the comprehensive assessment should take place in a centre specialised in autism. For children and adolescents, the diagnosis should be made with the involvement of a specialist in child and adolescent psychiatry or a specially qualified professional in child and adolescent medicine; for adults, with the involvement of a specialist in psychiatry and psychotherapy or in neurology and psychiatry.
How long do I have to wait for an assessment appointment?
This cannot be said in general; it depends on the centre and the region. The 2016 guideline named long waiting times for assessment appointments at specialised centres. We have not read current figures. Ask every centre about the waiting list and whether a referral is needed.
Are online autism tests reliable?
Screening questionnaires are not suitable for diagnosis but serve as an indication for further clarification; according to an expert overview, their specificity in the clinical context is low. The 2016 guideline stated that a diagnosis can neither be made nor ruled out on the basis of screening instruments, and named several questionnaires circulating on the internet as not supported by studies. For today's freely available online tests we have read no evaluation. A conspicuous result does not replace assessment; an inconspicuous one does not rule out autism.
In detail: Screening questionnaires and online tests: what they can and cannot do
Can you still get a diagnosis as an adult?
Yes. Autism begins in the developmental period, but sometimes the features only become clear when life's demands increase. In principle, assessment follows the same path as for children; a particular challenge is reconstructing early development afterwards. According to an expert overview, asking relatives and looking at old documents help with this.
What happens after the diagnosis?
The 2016 guideline stated that, when the diagnosis is communicated, age-appropriate explanation of the condition should be given. It described detailed explanation, early planning of the help needed and a fixed contact person as helpful. According to the 2021 guideline, a diagnosis does not automatically mean that therapy is needed permanently.
How can I prepare for the assessment?
The 2016 guideline named what is asked in assessment, for example current symptoms, development, education, hobbies and friendships, help so far and family history. At least one close person who has known you since childhood should be involved; documents such as school reports, nursery reports or doctors' letters also help. The absence of such documents does not necessarily prevent the diagnosis in adults.
Shaping everyday life
What helps with sensory overload?
For coping, the 2021 guideline named, among other things, avoiding strong sensory stimuli such as noise, smell and light, as well as structure and predictability. At school and work, ear protection, a low-stimulus extra room and breaks were named. Caution applies to "toughening up": a self-advocacy association pointed out that exposure sometimes only leads to an exhausting habituation to endurance.
Parents & family
How are siblings of children with autism doing?
A meta-analysis found on average more social, emotional and behavioural difficulties than in siblings of children without autism. This is an average finding and not a verdict on the individual child. Differences between families can be large; older reviews also describe studies without a difference. Siblings above all need attention, age-appropriate explanations and time of their own.
How do I tell my child they have autism?
The 2016 guideline stated that, when the diagnosis is communicated, an explanation adapted to age and stage of development should be given. Fears and feelings of guilt should be addressed specifically. Adolescents should, where possible, help decide who is involved. Concrete ways of talking are marked in the detailed article as suggestions of the editorial team.
Daycare, school & education
What is disadvantage compensation?
Disadvantage compensation (Nachteilsausgleich) is meant to enable pupils with autism to show their actual ability without lowering the subject requirements. The conditions are changed, for example through more time, a quiet room or a different form of assessing performance. Who decides and which documents are needed is regulated by each federal state itself; in Bavaria, depending on the type of school, the school head or the school authority decides, as a rule on application.
Why is my child not going to school?
In a British online parent survey (486 children with autism; parents volunteered themselves, so selection bias is possible), 43 percent of children missed at least 10 percent of school days in a month. The most common reason was not "truancy" but school refusal in the sense of staying away that is linked to emotional distress when attending school. It helps to understand the reasons precisely and to bring school, family and professionals together early rather than increasing pressure.
In detail: School avoidance and school absenteeism in autism
Do pupils with autism experience bullying more often?
In a meta-analysis of 34 studies, the pooled share with experiences of being a victim was 67 %, and the risk was higher than for classmates without disability and with other disabilities. The numbers differed greatly between studies and come mainly from Western countries. Bullying is never the fault of the affected child (assessment by the editorial team).
Therapies & support
Can autism be cured?
According to an expert overview, autism lasts a lifetime. The German guideline of 2021 described no treatment that cures autism; it set out help for individual goals, such as social interaction or accompanying conditions, and stated that procedures proven ineffective should not be used. In the editorial team's view, promises of a cure are a warning sign of dubious offers.
Which therapies help in autism?
According to the 2021 guideline, an autism diagnosis does not automatically mean that therapy is needed. If support makes sense, it should follow clearly defined goals agreed with those affected, be reviewed regularly and be limited in time. Which procedures are better or worse supported for which goal depends on the goal and the age. The guideline expired on 23.03.2026.
Are there medicines for autism?
The 2021 guideline stated: there is no medicinal therapy that improves social interaction and communication; medicines should not be used for this goal. Medicines can, however, be helpful for accompanying conditions, for example ADHD. Treatment belongs in medical hands. The guideline expired on 23.03.2026.
What is early intervention (Frühförderung)?
Early intervention is a service for children with disabilities and for children at risk of a disability, from birth until starting school. Under § 46 SGB IX it includes medical and non-medical services, for example social-paediatric, psychological, curative-educational and psychosocial services as well as counselling of the persons with parental responsibility. Together with curative-educational services they are provided as a complex service.
Adults on the spectrum
What is masking?
Masking (in research mostly camouflaging) means strategies by which people on the autism spectrum adapt to an environment shaped mainly by people without autism, for example by deliberately making eye contact or preparing topics of conversation. People report that they want to avoid exclusion in this way. In several studies, stronger camouflaging was linked to more anxiety and depression; this is an association and not proof of cause and effect. Respondents also reported exhaustion.
What is autistic burnout?
"Autistic burnout" is a term that people on the autism spectrum themselves talk about a lot and that research has only recently begun to study. One study describes it as a state of chronic stress and a mismatch between demands and abilities when suitable support is lacking; signs are long-lasting exhaustion, loss of skills and lower tolerance for stimuli. It is not an officially defined clinical condition.
How do people experience a late diagnosis?
A systematic review of 26 studies summarised two big themes: experiencing constant struggle (including the difficult path to diagnosis, inconsistent support and stigma) and disclosure (emotional reactions and developing an identity on the autism spectrum). The diagnosis can give understanding, acceptance and community, but stigma, regret and lack of support afterwards remain a problem for many.
Are girls and women diagnosed later?
In childhood, clearly more boys than girls receive an autism diagnosis. A large Swedish study of 2,756,779 people found that the ratio evens out with increasing age at diagnosis; by age 20 it was about 1.2 in 2022. This suggests that many girls and women are not diagnosed less often but later. The study did not examine why this is so.
In detail: Women and autism: why the diagnosis often comes later
Should I mention my diagnosis at work?
That is your decision; there are reasons for and against. The 2021 guideline recommended advising employers and supervisors before work begins; informing colleagues can be considered with the person's involvement. We have read no source on a general duty to disclose a diagnosis. If unsure, get advice, for example from the integration office or the EUTB.
Pathways & orientation
Do you get a severe disability card with autism?
An autism diagnosis does not automatically lead to a degree of disability (GdB). The competent authority determines the GdB on application; what matters is how strongly autism impairs participation in everyday life. From a GdB of 50, a person counts as severely disabled and can receive a severe disability card. Legal status and details are in the detailed article; in an individual case, counselling services help.
In detail: Severe disability card and degree of disability for autism
Can a child with autism get a care grade?
The care grade does not depend on a diagnosis but on how independent a person is in everyday life. The law asks whether someone has health-related impairments of independence or abilities and therefore depends permanently, probably for at least six months, on the help of others. For children, independence is compared with that of children whose development is age-appropriate. Autism is not named in the law; the decision is made in the individual case.
What is integration assistance (Eingliederungshilfe)?
The task of integration assistance is to enable people entitled to lead an individual life that corresponds to human dignity and to promote their full, effective and equal participation in life in society. Benefits go to people with disabilities who are substantially restricted in equal participation or at risk of such a substantial disability. The benefits include, among others, medical rehabilitation, participation in working life, participation in education and social participation.
In detail: Integration assistance under SGB IX: benefits and responsibility
What to do if an application is rejected?
A notice you disagree with can be challenged with an objection (Widerspruch). The objection must be submitted within one month after the notice was announced, in writing or for the record, to the body that issued the notice. If the notice lacks instruction on the legal remedy, this period does not start to run. This is not legal advice; get support from a counselling service if needed.
When does someone count as having reduced earning capacity?
Under § 43 SGB VI, a person is partially reduced in earning capacity if, because of illness or disability, they cannot work for at least six hours a day under the usual conditions of the general labour market for an indefinite period, and fully reduced if they cannot work for at least three hours a day. What matters is capacity, not the diagnosis (assessment by the editorial team). Legal status 10.10.2026; not legal advice.
In detail: Reduced earning capacity pension and basic income support: what the law regulates
What is the difference between a lasting power of attorney and legal guardianship?
With a lasting power of attorney (Vorsorgevollmacht) you yourself authorise a person to manage your affairs. A legal guardianship (rechtliche Betreuung), by contrast, is ordered by the court, and only if it is necessary; this is in particular not the case to the extent that an authorised person can manage the affairs just as well. Legal status 10.10.2026; not legal advice.
In detail: Power of attorney, care directive and legal guardianship: recording your wishes
Professionals & practice
What does a school assistant do, and what not?
A school assistant (Schulbegleitung) is meant to make participation in lessons and school life possible. The 2021 guideline recommended deploying it individually, for clearly defined goals and for a limited time, reviewing the need regularly and promoting the child's independence. According to a municipal guide, the tasks include, for example, orientation in everyday school life and communication aids; they do not include, among other things, teaching itself and primarily relieving teachers.
Science & research
How common is autism?
A large systematic review evaluated studies from 34 countries: as a median across the studies, the figure was about 1 in 100 children. The individual studies, however, come to very different results; the authors attribute this, among other things, to how well known autism is in a region and how well assessment is available. The numbers therefore cannot simply be read as the "true" prevalence.
Where does autism come from?
Autism has a strong hereditary component: twin and family studies estimate that differences between people in autism are largely explained by genetic factors. There is no single "autism gene"; rare gene variants with a large effect and common variants with a small effect each contribute to the risk. For the earlier idea that "cold" parenting causes autism, there is no scientific basis.
What is the S3 guideline on autism?
In Germany there are two major S3 guidelines on autism: Part 1 on diagnostics and Part 2 on therapy. Both were developed interdisciplinarily and are intended for children, adolescents and adults. According to the overview of the professional society DGKJP, the therapy guideline was valid "until 23.03.2026" and the diagnostics guideline "until 04.04.2021"; both have thus expired. Their contents do not automatically become wrong, but formally they no longer count as the current state.
In detail: The S3 guidelines on autism: content and validity status
Why are more boys than girls diagnosed with autism?
A meta-analysis found a ratio of about 4.2 to 1; in high-quality studies it was closer to 3 to 1, and the authors saw indications that girls are less often diagnosed although they meet the criteria. A Swedish register study found that the ratio evens out with increasing age at diagnosis. Why this is so has not been clarified.
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