This is an issue of equality, not biology or neurology. The life expectancy of autistic people is devastatingly low – yet it shouldn’t be.

Death has been on my mind for most of my life. The uncertainty and relative unpredictability of it has made it an attractive topic for a hyper-focused deep-dive; seeking answers, clarity and a desire to find a crumb of certainty.

Some of those thoughts have led to dark places and some have been refreshingly liberating. It does not surprise me that autistic people are nine times as likely as our non-autistic peers to die by suicide. We are more likely to experience traumatic life events including bullying and adverse childhood experiences. We are less likely to be in work – and it is well known that unemployment increases risk of suicide. Autistic people have higher rates of mental illness. We experience multiple social factors that relate to increased suicidality such as needing to rely on food banks or being isolated and/or lonely.

Suicide is an issue of inequality. Death due to suicide is not evenly distributed across genders, social class, geographical area, and ages. The Samaritans have plenty of data about this – and are a source of support if reading this blog is distressing, or for any occasion where you need to reach out…and do please reach out. There IS support, and suicidal feelings and thoughts can and should be spoken about. It IS possible to get through that moment when you’re desperate or on edge. Talking or texting or emailing can help make sense of feelings and thoughts that seem indescribable, and there is ongoing support out there. You don’t have to be suicidal to seek help.

Suicide is not the only reason why autistic people die younger than our non-autistic peers. Some of the social issues we face like unemployment, poverty and isolation impact our health. Many of us have lived with toxic stress.

A certain amount of stress is essential, but toxic stress in infancy and childhood can lead to increased vulnerability to a range of mental and physical health conditions and health-harming behaviours over the life-course, including depression, anxiety, cardiovascular disease, diabetes, stroke, alcoholism and drug abuse.

Autistic children are not only more likely to experience ACEs (adverse childhood experiences), their sensory experiences are likely to be different to those of their non-autistic peers and may result in Sensory Trauma.

This combination of factors can lead to us experiencing poorer mental and physical health outcomes, and in itself may be significant in why we have a lower life expectancy than our non-autistic peers. Add to that the difficulties we may have in noticing, recognising and communicating what is happening in our bodies due to our interoceptive processing differences and increased risk of trauma, it does not surprise me that our physical and mental health outcomes are poor.

So what happens if we are able to pick up on what is happening inside our bodies and wish to communicate that to the relevant professionals? It is well recognised that autistic people face numerous barriers when accessing health services.

Research shows that autistic people have high levels of co-occurring mental health conditions, yet a number of case reports have revealed that autistic people get the wrong mental health diagnosis and are less likely to agree with a mental health diagnosis because they didn’t feel their healthcare professional understood their condition or how to communicate with them properly.

An event causing Sensory Trauma to an autistic person may be perceived as inconsequential by non-autistic people in the same environment – if perceived by them at all. The autistic person’s reaction may be viewed as “challenging behaviour”, overemotional, or maybe not even accepted or believed – simply because the event may not be recognised as traumatic to other people. The invalidation and mislabelling that accompanies this may – as in my case – lead to an autistic person doubting their genuine experiences and eventually mistrusting their own judgement and expertise on their health and life. They may avoid seeking help or speaking out about their physical and mental health experiences, or they may not receive the medical treatment they require – or even receive unnecessary and harmful treatments and interventions for conditions they do not have.

A study in Ireland reported 80% of autistic people had difficulty visiting the GP. Whilst people with a learning disability can access yearly GP health checks and liaison nurses in hospitals, the same is not true for autistic people, with large areas of the UK having neither.

Autistic people have significantly lower life expectancies than the rest of the population. A statement from the UK government in 2021 quotes the data reported by the British Journal of Psychiatry that autistic people will live 16 years fewer than their non-autistic peers. Another report compares the range of average life expectancy for autistic people from 39.5 years to 58 years, to the global average of 72 years.

Whilst there are numerous examples of autism’s co-existing physical and mental health conditions, I do not believe research should be focused on identifying whether there is a biological or genetic component to this or not. Too frequently I hear anxiety or some other condition described as “part” of autism and therefore to be expected and accepted. It is time these ideas were challenged. Autistic people, whether they also have a learning disability or epilepsy or gastrointestinal disorder or are like much of the human race – simply average or thereabouts – deserve to have a good quality of life.

We know that epilepsy often co-occurs with autism. We know that people who experience epileptic seizures have a reduced life expectancy. But whether epilepsy and autism share a genetic component that make them more likely to occur together is largely irrelevant to an autistic person’s life (unless you were considering terminating the person before birth, in which case it becomes very relevant). What is relevant is that the person can access the services they need and receive the support they require to understand, self-manage and accommodate their epilepsy. And that will come about by designing services and treatment that meet the needs of a wider range of people. It will come about by welcoming different ways of communicating and believing sensory experiences that are different to those of your own. It will come from adjustments to how society does things, so that more people can take part.

I am waiting to find out why my life expectancy is reduced. It seems ironic that after years of battling suicidal thoughts, I am now being handed death on a plate. I am certain that the mislabelling of my own mental health and the consequent medication has played a major part in my incurable physical health condition. But I cannot escape the trauma (both sensory and event based) I have experienced – the body most certainly does keep the score. The effects of toxic stress on my developing body and mind must have played a part too. The invalidation and gaslighting and self-doubt kept me unwell and unable to seek support. My muted interoception meant I did not always know I was in pain or what it was I was feeling – and my heightened tactile sense system meant I responded completely proportionally to excruciatingly painful light touch, but to others who experienced things differently I was interpreted as over-reacting – both these experiences adding to the inaccessibility of support. Even the design of hospitals and surgeries, and the sensory overload that comes with all that white brightness, and noise makes them inaccessible. When I do step inside, my overwhelm can reduce my ability to tap into the flexible thinking, reasoning and organising I require to navigate the communication requirements of finding the right place, at the right time and telling the right person, the right stuff about me!

This is a sad blog to be writing. Sad for me, yes. Sad for the autistic community. If we were any other marginalised group in society, would our reduced life expectancy be kept so quiet? What if gay people were thought to have had a long life if they made it to 55? Surely society would be doing something these days, even though they may not have in the past. How about if it wasn’t a marginalised group? What if it was white men, like the ones who dominate the research and the institutions involved in researching autism? I am certain there would be uproar and demands to change things. Reaching 60 years old should not be almost unheard of for any group of people, anywhere in the world in this day and age.

This is a complex topic with lots going on. It needs further research that listens to and values the input of autistic people from all walks of life. But I do not think we will find answers by looking inside the bodies and minds of those autistic people to find out what is supposedly “wrong” with them, so we can make them “better”. We need to look more widely and be disgusted and offended and outraged that any group of people is expected to have utterly appalling mental and physical health outcomes that reduce their lives to a fraction of what they should have been.

Actress, director, mother and wife Helen Shaver talks about her life and her career.

Autistic people can be more at risk of being bullied than their peers. However, your child may not be able to communicate this to you.

In this guide you will find information about what bullying is, the signs to look out for and how it may affect your child, and what you can do to help them.

You can also read about how to take your complaint further, if you are not satisfied that your child’s school has done enough to stop the bullying. 

What is bullying?

The is no definition of bullying in legislation. Anti-bullying organisations suggest that bullying could involve:

• name calling
• making fun or teasing
• spreading rumours 
• ignoring or leaving out
• threatening or humiliating
• pushing, pulling, hitting, kicking or other physical acts
• taking or interfering with money or other items.

The internet and mobile phones mean bullying can now happen both during the school day and out of school hours. Online or cyber bullying includes bullying via text messages, emails, websites, online gaming, instant messaging and social networks.

Autistic children and bullying

Autistic children and young people can be more at risk of being bullied than their peers because of the different ways they communicate and interact with others. Their peer group will often notice these differences more and more as they get older. 

Because autistic children and young people find it hard to read facial expressions and body language, they can’t tell when someone is being friendly or if they are trying to hurt them. This means they may misunderstand the intentions of their peers. They can also be easy targets in the playground as they sometimes prefer to play alone.

As a result, other children find it easy to pick on them as they do not have a support structure around them. Other children may also pick on them if they see them doing ‘odd’ things such as hand flapping or making inappropriate comments.

Autistic children and young people can also display some bullying behaviours. They may become aggressive when a game is not being played the way they want and then try to control the situation. They may also become frustrated at being ‘left out’ in the playground and try to ‘make’ children become friends with them.

How to tell if your child is being bullied

It’s not always easy to tell if your child is being bullied and they may not always realise they are being bullied. This may be because they have difficulty understanding the intentions of others and their communication difficulties can make it harder for them to tell you or school staff about an incident. 

As a result, you may need to look for other clues as to whether or not your child is being bullied. They may:

• come home with dirty, damaged or missing clothes, bags or books, with bruises or scratches, without money they should have or asking for more money the next day
• arrive at school or get home late because they have changed their route to or from school
• be reluctant to go to school and make excuses to miss attending 
• seem to be stressed, depressed, unhappy or unwell 
• show a deterioration in concentration or the standard of schoolwork
• show an increase or change in obsessional/repetitive behaviour

Your child may also show sudden changes in behaviour, which may be due to bullying. This might be increased anxiety, difficulty sleeping or outbursts at home. Your child may mimic the acts of bullies at home by bullying their siblings because they don’t understand that this behaviour is unacceptable. To your child, they are simply acting out what their peers are doing.

The effects of bullying on your child and what you can do to help

The long-term effects of bullying can be serious. Research suggests bullied children can end up with long-lasting insecurities, behavioural issues and low self-esteem, as well as poor concentration.

They may refuse to take part in social situations because they are afraid of being bullied or they may experience stress-related illnesses.

You may need to build up your child’s self-esteem at home. Praise for specific pieces of work or good days at school can help remind your child that being autistic helps them to be good at things. You could make an achievement book or board with photographs and pieces of work to remind them of this, keeping it in an easy to access place for reference.  

You could also tell your child about successful and famous autistic people and find out about or read their personal accounts.

Some children or young people may need professional help to boost their self-esteem and confidence. You can try searching our Autism Services Directory for details of counsellors who work with autistic children.

Alternatively, contact national counselling bodies, such as the National Counselling Society or the British Association for Counselling & Psychotherapy but check that individual counsellors have knowledge of autism. If your child would like support from someone over the telephone, they can call ChildLine.

Social groups are a good way for your child to meet others with similar difficulties and experiences, this can help to make them fell less isolated. Search our Autism Services Directory for information about social groups in your area. Your child might also find social skills training helpful.

My child is bullying others

If your child is bullying others, think about what they are trying to do or communicate. It could be that they are trying to get attention, fit in, or follow suggestions made to them by other children and consequently be completely unaware they are hurting others. 

They may benefit from social skills training or help on how to ask others to play with them. You could also ask your child’s school to set up some structured play activities for your child.

You may also need to teach your child another activity they could try if they do get frustrated. For example, you do not hit, but you find someone and show them your help card (this is a piece of card with help written on it for those who have difficulty communicating) or kick a ball.

It is important to explain to autistic children that they don’t have to be friends with everyone in their class. They may not realise that they don’t need to be friends with everyone in their class/school.

You could use a social story such as:

We are all classroom colleagues. A colleague is someone who works with you and may also be your friend. Like your mum or dad, you will work alongside people you like and people you don’t like. If we don’t agree, that’s interesting but we will learn to work it out and develop rules to keep everyone’s body, feelings and belongings safe.  Gray 2001

What can I do if my child is being bullied?

Talk to your child and try to:

• speak to them without getting angry or upset
• listen carefully and give your full attention  
• make sure your child knows that you believe them, it’s not their fault and they are not alone
• discuss with your child what they want to happen and what they want (or don’t want) you to do 
• agree a way forward with your child

Some autistic children and young people will find it difficult to talk to you face-to-face and will find it easier to write about the incident or draw a picture about what happened.

You could try using a diary system, emailing, or have a box to leave questions in and write replies. These forms of communication may take longer, but you may get more information from your child this way. You could ask siblings if they have seen anything and make notes of what they say.

If keeping a diary of the incidents make sure you record:

• who was involved
• what happened 
• what action the school took (if any).

Your child may not realise they are being bullied. Try to help them understand the difference between behaviour that is friendly or bullying. Explain that when behaviour hurts or harms someone either physically or emotionally, it is bullying.

Talk to school staff

Once you have spoken to your child, make an appointment to talk to your child’s class teacher and:

• ask for a copy of the school’s anti-bullying policy to see what has put in place 
• be specific and make a note of what the teacher said and what action they agreed
• try to remain as calm as possible so that lines of communication stay open with the school and your concerns are listened to 
• ask if the school has suggestions of practical things you can do to help
• after meeting the class teacher, send them a letter outlining what was agreed so that everyone involved has a clear understanding of the situation and future actions. 

The class teacher and other staff at school may not be aware of the problem, however, this does not mean it does not exist.

Approaches to help your child

When you see your child’s class teacher, it may be useful to put forward some suggestions of what you and the school could do to help.

Using maps

Make a map of your child’s world and identify the areas where they feel most and least vulnerable. This could include a map of school as well as the route to and from school. It can then be used to identify areas that the school needs to be aware of. 

Social skills and communication training

Your child may benefit from social skills and communication training to help them learn to recognise when someone is being nice or nasty. You may find it helpful to use a favourite television programme to illustrate this, such as  Mr Bean and The Simpsons. These programmes have over-exaggerated body language and facial expressions, which can be a good teaching tool.

Teaching your child what to do if they are upset at school

You may also need to teach your child what to do if they are upset by an incident at school. You could give them a reminder to stick in their school diary, such as a prompt to go and see a certain teacher, or to write a note and leave it in the bully box (if the school has one) if an incident takes place.

Break times and lunchtimes

The school playground is one of the places where autistic children and young people can be most vulnerable. Unlike their peers, who find the playground the most relaxing time of the day, they can often find unstructured periods of time difficult as they are not sure what is expected of them. As a result, they may be alone in unsupervised areas of the playground.

It can be useful for your child’s school to bring some structure to break times/lunchtimes. For example, your child’s school could: 

• provide lunchtime clubs 
• let your child go to the library 
• let your child use a computer during breaks 
• set up structured playground activities for your child and a couple of their peers so that your child gets to socialise, but also knows what is expected of them.

Buddies, befriending and friendship

A buddying or befriending scheme in the playground may also help to reduce bullying. School could identify some buddies for your child in the playground so they can widen their friendship group.

Some schools have a friendship bench where children and young people can sit if they need someone to talk to or play with. A circle of friends can teach other children about autism and also helps autistic people with social skills.

Raising awareness of autism through lessons

You could ask your child’s class teacher to teach other children about autism in a way that is sensitive and does not single out your child. Most schools now teach children about different faiths, disabilities and race. The teacher could plan a lesson that explains autism.

Bullying box

Schools need to be aware that autistic children don’t always want to tell a teacher face-to-face about bullying. A bullying box enables pupils to report incidents of bullying secretly. This also means they have more time to think about what they want to say.

Outside help for schools

School may also be able to get some outside help with putting into action anti-bullying measures. Please speak to your local education authority who may have resources and professionals who can help.

Taking the issue seriously

It can be helpful to identify a team of people that your child can rely on rather than depending on just one member of staff. Ideally, this team should include staff who are around at different times during the day. School staff need to be aware of what to do when an incident is reported.

Consistency is important to autistic children. If they feel they have not been taken seriously or a staff member has not done what they were supposed to do, they may become more frustrated and upset. They may also be reluctant to report future incidents if they feel there is little point in doing so.

Despite preventative measures, bullying can still happen. It is important that your child’s school take your concerns about bullying seriously and that your child has a point of contact. Any half-hearted measures may make the situation worse. For example, the school should make it clear to bullies that their actions are not acceptable and their behaviour policy should clearly outline the consequences of bullying.

A whole school approach

Studies have shown that schools taking a whole school approach to bullying often report a general reduction in bullying. This approach includes:

• providing all pupils with anti-bullying lessons as part of the curriculum
• encouraging children to tell someone when they are being bullied
• including all staff and pupils in preventing bullying
• having clear posters and literature to emphasise the zero-tolerance approach of schools to bullying.

Getting extra support

Your child may require an assessment of their special educational needs in order to get extra help in school. You can find out more on our extra help in education pages.

Dealing with cyberbullying

Autistic children and young people find social networking, forums, emailing, instant messaging, texting and online gaming an easier way to socialise. They can help children build up self-esteem and confidence with positive interactions and can encourage them to interact with others.

However, your child may not be able to recognise cyberbullying as easily as their peers. As a result, you may want to monitor their use of the internet or mobile phones. Be aware of any changes in your child’s behaviour. If they suddenly don’t seem keen to get onto the computer, then this could mean some bullying has taken place. Here are some suggestions of how you can make things safer: 

• get to know more about the technology and social media your child uses
• understand the risks, and take an active interest in how and with whom they are interacting
• use parental settings for mobile phones, laptops, tablets or games consoles
• use filters for applications
• use privacy settings for online gaming and social media sites 

Try making an agreement with your child about how devices must be used. Establish appropriate behaviour online and help your child to identify when they or others are being bullied online. Encourage your child to share any messages that are nasty or upsets them with you.

As part of the agreement you may want to ensure that your child understands that:

• they must never disclose personal information
• everything posted online can be traced back to the individual
• online or offline, everyone must be treated with respect
• they should think before they post – written communication can be misconstrued

Health and safety

You may be concerned about your child’s welfare and would like to keep your child off school until the situation has been dealt with. However, you must remember that, legally, you have to make sure your child receives education, normally by sending them to school. 

If you think your child is too unwell because of stress for example, then you should get a medical note from your child’s GP or another NHS medical professional with whom they are registered. You should also let the school and local authority or education authority know about this and discuss arrangements for alternative education for your child.

Taking matters further

If you are not happy with the response you get from the class teacher and you have also talked to the head of year, then talk to the head teacher (and board of governors if you live in England, Wales or Northern Ireland). If necessary, you can involve your local authority or education authority (or governing body if your child attends an independent school).

Bullying behaviour that becomes a criminal act, such as theft, damage to property or physical assault, can be reported to the police. Local Police may also offer or take part in anti-bullying initiatives.

Exploring other options

You may decide to take your child out of school completely and instead send them to another school or home educate them.

Your next steps

• Contact our charity’s Education Rights Service that can provide information, support and advice on education provision and entitlements for autistic children and young people
• Read Autism and bullying
• Read Autism Bullying and Me, the really useful stuff you need to know about coping brilliantly with bullying by Emily Lovegrove, Jessica Kingsley Publishers, May 2020
• Read The Department for education’s advice for schools and parents/carers on cyberbullying (England only)
• Read A Comprehensive Cyberbullying Guide for Parents – which equips parents with the tools necessary to recognise and prevent cyberbullying
• Visit the Anti-bullying alliance for tools and information about cyberbullying and SEN
• Visit Bullying UK which offers practical information and advice to young people and their parents
• Visit CEOP: Child Exploitation & Online Protection which offers advice and help to children and parents on online safety
• Visit Kidscape which aims to equip young people, parents and professionals with the skills to tackle bullying and safeguarding issues across the UK
• Visit KidSMART for information on how to get the very best out of the internet and use technology safely
• Visit Northern Ireland Anti-Bullying Forum which brings together over 25 regional statutory and voluntary sector organisations, all committed to tackling the bullying of children and young people in schools and communities in Northern Ireland
• Visit Respectme (Scotland) – an anti-bullying service funded by the Scottish Government

“Warcraft 2 is a must-have for any serious real time strategy fan. Despite being around for a good many years, Warcraft 2 still boasts excellent, fun, and entertaining gameplay.”

Once upon a time, Blizzard Software created a game. This game was called Warcraft. While not an insanely popular blockbuster like DOOM or Wolfenstein 3-D, it achieved a cult following, and made a considerable profit for Blizzard. Using this money, it began development on Warcraft 2.

Warcraft 2 started the massive online movement of real time strategy games. Later, the formula was improved and refined by Command and Conquer, Starcraft, Red Alert, and others, but most real time strategy games can find their roots in Warcraft 2. If you’re not familiar with the genre, you basically control every aspect of a colony or group. This is usually executed with the mouse pointer, in conjunction with the keyboard.

At the time of its release, Warcraft 2 was revolutionary. It was the first which allowed you to develop multiple units, instead of having to wait for each one to finish. It also boasted a 150 character limit for each player, up to eight players, a significant upgrade. Everyone in the gaming engine, there were tweaks and upgrades to the format that were not surpassed until the releasal of Starcraft.

In Warcraft 2, you control one of two races, either humans or orcs. Each race has their own distinctive feel, and different types of characters. Your job in most stages is to build up a base and conquer the enemy forces, whether they be orcs or your own rebellious forces.

You do this by harvesting timber, mining gold, and syphoning oil. Timber is used to build most of the structures in the game, such as farms, barracks, and castles. Each structure comes with a benefit; ability to produce archers, ability to produce knights, more wood production, ect. Gold is used primarily in commissioning troops. However, gold is also needed to build structures. Oil is used mainly for water devices, such as ships.

The units are fairly well-balanced in the single player campaign. For each unit, their is a counterunit which can bring it down. Ogres are stronger then Knights, but they can not heal themselves. Archers are stronger than Orc Slingers, but don’t have as much range. The game’s characters are in a constant give and take which ensures that a single player game relies mostly on skill.

However, in multiplayer, the advantage clearly goes to the Orcs. Ogres, an Orc unit, has the ability of bloodlust, which substantially increases their attacking speed. A squad of nine can make quick work out of even the biggest village.

Outside of this flaw, the multiplayer experience is extremely fun. Campaigns between players can become long and drawn out epic affairs, with the advantage constantly swinging back and forth. On a large map, games can last more than three hours. However, there are also smaller maps, which can be played in as little as thirty minutes.

Graphically, Warcraft 2 somehow manages to still look fresh. The characters are not extremely well-detailed, but they’re clean, crisp, precise, and most importantly, do not carry any slowdown with them. Likewise, the sounds are deep and majestic, carrying an orchestrated tint to them. The effects leave something to be desired though; most are heard in the first three or four stages, and repeated throughout the game.

Warcraft 2 is a must-have for any serious real time strategy fan. Despite being around for a good many years, Warcraft 2 still boasts excellent, fun, and entertaining gameplay. It can be found in most major computer stores, in the bargain bin, next to copies of Everquest and Diablo for ten bucks. It’s a steal of a deal.

‘Autistic burnout’ is the intense physical, mental or emotional exhaustion, often accompanied by a loss of skills, that some adults with autism experience. Many autistic people say it results mainly from the cumulative effect of having to navigate a world that is designed for neurotypical people.

Burnout may especially affect autistic adults who have strong cognitive and language abilities and are working or going to school with neurotypical people.

Here we describe the emerging picture of this phenomenon, how autistic adults might be able to recover from burnout and how to prevent it from occurring.

What is the experience of autistic burnout like?

Like many aspects of autism, burnout varies greatly from person to person. Some autistic people experience it as an overwhelming sense of physical exhaustion. They may have more difficulty managing their emotions than usual and be prone to outbursts of sadness or anger. Burnout may manifest as intense anxiety or contribute to depression or suicidal behavior. It may involve an increase in autism traits such as repetitive behaviors, increased sensitivity to sensory input or difficulty with change.

Burnout can sometimes result in a loss of skills: An autistic woman who usually has strong verbal abilities may, for example, suddenly find herself unable to talk.

How did the concept of burnout arise?

Few studies have formally investigated autistic burnout. Autism researchers have only become aware of burnout as a phenomenon over the past five years or so. They have learned about it directly through discussions with autistic participants in person or online.

The concept reflects the growing self-advocacy movement in the autism community, which has led to an increasing focus among researchers on adults with autism and their inner experiences. But it’s not entirely new: Some researchers point out that children with autism can have meltdowns or lose skills when overwhelmed by the demands of a difficult environment.

What causes burnout?

Burnout is often a consequence of camouflaging, or masking, a strategy in which autistic people mimic neurotypical behavior by using scripts for small talk, forcing themselves to make eye contact or suppressing repetitive behaviors. These strategies can help autistic people in their jobs and relationships but require immense effort.

It can also result from sensory overstimulation, such as a noisy bus commute; executive function demands such as having to juggle too many tasks at once; or stress associated with change.

How do autistic people recover from burnout?

That depends on the person and on what burnout is like for them. A first step is for autistic people to remove themselves from the situation that triggered the burnout. This could be as simple as going back to a hotel room to rest alone after a day of unpredictable social interactions at a conference. Others may need longer to recover. Some autistic people have described burnout that is so severe its effects have persisted for years. Burnout may occur more frequently and be more difficult to recover from as people get older.

Is it possible to prevent burnout?

A key strategy for preventing burnout is self-knowledge. Autistic people can learn over time which situations are most likely to trigger burnout for them. They can also watch for signs that they are getting close to burnout: Some autistic people describe feeling disconnected from their bodies or experiencing tunnel vision in this state.

Armed with this awareness, they can develop strategies to avoid burnout, such as leaving a social event early or planning a recovery day after a trip before returning to work. They can also ask for accommodations that make it easier for them to avoid burnout, such as preboarding an airplane or working from home part of the time.

On March 21, 2017, CNN published an article on a new study from the American Journal of Public Health that found the average life span of an autistic person is 36 years. I wasn’t shocked by this news. I know how dire things can be for so many of us on the spectrum, but that number struck me for a very specific reason. I had just turned 35 the previous month.

Since I learned this news, I’ve been anticipating the milestone of turning 36 with a mix of confusion, dread, and a host of other feelings I can’t quite articulate. I’ve had more existential episodes than usual, brooding about the meaning of life. It’s been a lot like a midlife crisis — except that (I kept thinking) my own midlife might have happened as long as half my life ago. The average age of death for autistic people who live to adulthood might be older than 36 (and as of now, there is still no age-specific data). Still, the figure from the research journal haunted me.

At some point between that moment and now, I made a pair of promises to myself:

1. I had to make it to 36.
2. Once I did, I needed to do something to mark this morbid accomplishment — perhaps writing something to help the next generation of autists approach their own birthdays just a little easier.

The good news is that I have officially, as of 8:35 am Eastern on February 7, made it.

The bad news is that living while autistic doesn’t always leave one with much energy to write all of the meaningful things that you want to write to improve your life and the lives of other people like you.

Turning 36 scared the shit out of me. I want the fact that autistic people die so much earlier than the average American to scare the shit out of you too.

Here’s why that number is so low — and all the ways I’m lucky to have made it to 36

Some caveats. First: Not all studies on autism and mortality agree on the average age of our deaths. If you think I’m being overly dramatic by picking one that appears to cite the youngest age, here are some other recent studies with more positive results. One says 39 is the average life span; another says 54. By “positive,” though, I mean “studies that determined autistic people live longer, on average, than 36, but still found that we die significantly earlier than our non-autistic counterparts.”

Second, whenever I write about autism, there’s always someone who shows up to point out that I’m not really autistic enough to count or that I’m not the kind of autistic person that people are thinking about when they think of the tragedies and pressures that face people on the spectrum.

Because I can speak, work, and maintain a semblance of a social life — and because I am able to hide my most severe symptoms from other people — they assume that I am too “high-functioning” to be considered autistic. Before that happens here, let me say that, yes, I am probably at a lower risk of death than many autistic people. Not because I’m “higher-functioning” or because my autism is mild, but because I happened to be born into a certain body and a certain set of circumstances.

For example, the study that CNN cites, “Injury Mortality in Individuals With Autism,” primarily focuses on — as you can guess from the title — death from injury. As a child, I was never a wanderer (as many autistic children are), which put me at a low risk for drowning and other related deaths. I’ve had seizures, but I don’t have epilepsy (as many autistic people do), which puts me at a lower risk of death.

I also don’t have to worry that my incredibly supportive parents will murder me for being too much of a burden to them. That  makes me luckier than others with my condition. More than 550 disabled people have been murdered by their parents, relatives, or caregivers in the past five years in the United States, according to the Autistic Self Advocacy Network.

“We see the same pattern repeating over and over again,” ASAN says of the grisly phenomenon. When disabled children are killed, the media focuses on the “burden” that the murderer faced in having to care for them. People sympathize with them instead of the victim. And in the worst cases, this can lead to lighter sentencing.

There are also ways that I am safer than many of my fellow autistic people that we don’t yet have the statistics for but that I can definitely see in the world right now. As a cisgender white woman, I do not worry that I’ll be killed by the police like 15-year-old Stephon Edward Watts or 24-year-old Kayden Clarke. Nor will I have to suffer the serious long-term health effects that this kind of constant fear and dehumanization can have.

The stress of living with autism is exhausting

You can’t entirely separate my incredibly privileged and lucky autistic ass from these devastating statistics. Autistic adults who don’t have a learning disability, like me, are still nine times more likely to die from suicide than our non-autistic peers. Autistica, a UK charity, explores some of the complex reasons that might be behind this alarmingly high suicide rate in a report on “the urgent need for a national response to early death in autism.” Or you can just take a look at my own laundry list of issues to get the general idea:

I’m tired all the time. The coping mechanisms that I developed as a bullied and undiagnosed child — from learning to mimic the behaviors of people who are more naturally likable than me to holding entire conversations where I reveal nothing about myself for fear of being too enthusiastic, too annoying, too overbearing, or simply too much — are not great for managing a remotely healthy life or building self-esteem. The effort it takes to fit in is increasingly exhausting as I get older.

All that hard work to make other people more comfortable around me feels more and more pointless. I appreciate that I have people in my life who have assured me that I can just be myself, but unlearning almost 36 years of shitty coping mechanisms and performances also takes a buttload of work. My sleeping patterns, due to anxiety and possibly to autism itself, are erratic at best.

I value the social and career gains that I made when I had more energy and inclination to blend into society. I’ve wanted to be a writer since I was old enough to read, and I’m now lucky enough to survive on writing alone. But with it has come chronic anxiety, which seems to increase exponentially. There is, however, one calculation that I’m always doing in my head: whether my contributions to my family, friends, and the world are at least equal to all that I feel like I’m taking from it. I always feel like I’m at a deficit.

I repeatedly have to tell people I’m not a math savant. I’m tired of watching people who aren’t on the spectrum tell shitty versions of our stories while I can’t find the funding or the audience to tell my own. I’m tired of watching people get feels and inspiration from shows like The Good Doctor while they can’t seem to give a shit about autistic people in real life.

I’m so, so sick of watching people pay lip service to the value of autistic life while funding research into prenatal testing for autism at one end and supporting euthanasia for autism on the other, all in the name of preventing suffering. As if these measures that suggest that autistic birth should be prevented  —  or that they have a duty to die if they are too much of a “burden” on their loved ones — don’t make me feel worthless.

Even when I’m not actively struggling with any of the above, there’s the constant stress and anxiety. My resting heart rate is in the 90s. My body aches in ways that I can’t entirely attribute to age. My energy level appears to be similarly deteriorating.

This should not be a good enough outcome for any autistic person. We all deserve better than this.

So what do I want you to do about it?

I’ve spent my whole life being told that non-autistic people are so brilliant and intuitive when it comes to social issues. Like many autistic people, though, I haven’t always felt like I’ve seen much empathy, compassion, or understanding. And the evidence is starting to suggest that we’re not wrong about the level of judgment and stereotyping we face.

If you want to understand people on the spectrum, I’d recommend starting with some of the following: Listen to us. Invest in our work. Invest in science and actions that actually make our lives better now instead of chasing a hypothetical cure. Don’t kill us. Think twice about sympathizing with the parents who do kill us. Don’t rush to armchair-diagnose every mass murderer with autism — like what happened with the most recent Florida school shooting. Give your money to marginalized autistic people instead of charities like Autism Speaks, which dedicate only a small percentage of their budget to programs that will actually help autistic people. Think about how hard we’re working to exist in your world and consider meeting us halfway.

Tell us we don’t bore you. Tell us we don’t drain you. Look at us somewhere other than the eyes — we’re really not comfortable with eye contact and are tired of being forced to make it for your benefit — and tell us that we deserve to be alive.

And then act like it.

Many people with autism experience a triad of trauma: neglect at home, abuse from trusted adults and bullying at school or work.

The bullying began early. When she was just 5, Kassiane Asasumasu remembers other children taking her belongings and lying about it because they knew that she was face-blind and would not be able to tell on them. At a slumber party when she was 10, girls poked her, froze her underwear and made a game of seeing how many times they could make her cry. Her post-slumber-party meltdown lasted 48 hours. The following year, classmates locked her in a locker — and then she got in trouble for kicking the door open.

“Most of my childhood memories are of other kids being mean to me,” says Asasumasu, who was diagnosed with autism when she was 3. “I cried every day of elementary school.” Some days, she cried so hard that she threw up. Even when she didn’t give in to tears, the insults gutted her.

In middle school, teachers told her mother they thought she was at risk of suicide, but beyond that, she did not feel that the adults in her life ever supported her. Her teachers encouraged her to ignore her tormentors, but she was unable to do so. At home, where she says her seven siblings often blamed her for their transgressions, her parents punished her rather than them. “You’re the one always getting in trouble,” says Asasumasu, who is now 37, “for what everybody else did.”

Experiences like Asasumasu’s are a terrible reality for many autistic people. Studies suggest that children on the spectrum are up to three times as likely as their neurotypical peers to be targets of bullying and physical or sexual abuse. Such maltreatment can cause severe stress and trauma, yet it often goes unrecognized or unreported. Therapies to help treat trauma in people with autism are mostly experimental, so these individuals are often left to fend for their own safety and health. “Children with autism who have experienced maltreatment or some form of violence are a very vulnerable population, not only because they’re more likely to experience these maltreatment experiences, but we also know very little about how to best support them,” says Christina McDonnell, assistant professor of clinical psychology at Virginia Polytechnic Institute and State University in Blacksburg.

One important way to develop better support systems, she and other experts say, is to listen to autistic people about how society harms them. “What we need to do is some of the hard work to find out what’s happening in these systems that allows this to take place,” says Catherine Corr, assistant professor of special education at the University of Illinois at Urbana-Champaign. “And I think information from folks who have lived that would be really beneficial to understanding how systems have failed them.”

Maltreatment is an umbrella term that includes neglect and emotional, physical and sexual abuse. That children with disabilities are particularly vulnerable to maltreatment has been replicated in studies going back decades. Studies specific to autistic children are much scarcer. As a graduate student studying child abuse in 2014, McDonnell observed developmental problems, including autism, in a significant proportion of children with maltreatment cases under investigation by U.S. state social-services departments. But she saw a disconnect in the scientific literature: Studies of traumatic stress in instances of maltreatment rarely considered the children’s autism diagnoses. And autism researchers had barely begun to explore the possible maltreatment of their study participants.

The few studies that had been done offered mixed results. Some suggested that children with autism are more likely than their typical peers to be neglected or abused, and more likely to be involved with child protective services, the state departments in the United States tasked with overseeing children’s well-being. Others did not show an association between autism and an elevated risk of abuse, although the studies had limitations — including being small or using outdated definitions of autism.

McDonnell and her colleagues decided to investigate the link and tapped into autism surveillance data, as well as records from the South Carolina Department of Social Services. They compared patterns of abuse and neglect for nearly 5,000 children with and without autism born from 1992 to 1998. They found that nearly one in five autistic children in the state, and one in three with both autism and intellectual disability, have been reported to be maltreated. Even after adjusting for factors such as low family income and limited parental education, children with autism remain up to three times as likely as their neurotypical peers to experience maltreatment, the team reported in 2018. “We were alarmed by those numbers and how high they were,” McDonnell says.

Neglect in particular is a problem for children with autism, as well as for those with intellectual disability. Neglect is the most common type of maltreatment documented by child protective services, says Kristen Seay, assistant professor of social work at the University of South Carolina in Columbia. Exacerbating the problem is the fact that children with autism often have needs that families with few resources may find difficult to meet.

McDonnell’s team found that autistic children are also vulnerable to physical abuse. Primary caregivers in the immediate family are the most common perpetrators of the abuse, but a broader range of offenders — including family members, babysitters and childcare providers — may be more likely to target children with autism or intellectual disability than other children.

A similar story emerged in Tennessee. Researchers there analyzed data from an autism monitoring site run by the U.S. Centers for Disease Control and Prevention, and found that having autism more than doubles a child’s chances of referral to child protective services. The study included more than 24,000 children born in 2006 and found that 17 percent of the 387 autistic children had been the subject of calls to the state’s child abuse hotline, compared with 7 percent of the others. Despite the higher number of reports, however, child protection professionals investigated the caregivers of only 62 percent of the autistic children, compared with 92 percent of typical children. “We really need to have a heightened awareness that this represents a tremendously vulnerable population,” says lead researcher Zachary Warren, a clinical psychologist at Vanderbilt University in Nashville.

When Nancy Nestor’s son P. was 3, a year before he was diagnosed with autism, he came home from preschool, went to his room and, as he played, muttered to himself, “Stupid P. Stupid P.,” over and over. (We are using P.’s first initial only, to protect his privacy.) At the time, P. did not know what ‘stupid’ meant, but Nestor was heartbroken. She spoke with his teacher, who was shocked. The teacher had not heard students using that word and promised to listen for it — and put an end to the problem. But Nestor continued to worry: Her son did not talk much, so he could not tell her if the bullying continued. “Nobody wants to hear someone refer to their child as stupid, especially a child that can’t talk,” she says.

In the years that followed, P. occasionally encountered bullies, including a group of boys in high school who threw their balled-up paper lunch bags at him and told him to throw them away. But he also received compassion and support from classmates, teammates (he was on the track team) and coaches. Now 22, P. attends community college and lives at home. Nestor still listens to him talk to himself to find out what is happening in his life.

Physical attacks by peers may leave autistic children with wounds on their faces, shoulder displacements and large scratches on their body, says Daniel Hoover, a child and adolescent psychologist at the Kennedy Krieger Institute in Baltimore, Maryland. In a 2018 review of studies, Hoover and a colleague found that children with autism are bullied three to four times as often as those without disabilities, including their own siblings: 40 to 90 percent of children with autism are bullied, compared with 10 to 40 percent of typical children, according to various studies.

Parents sometimes notice instances of bullying that their autistic children might not. When P. was in elementary school, for example, his peers made him the designated prisoner in a game of ‘cops and robbers.’ A middle-school yearbook years later included a picture of him in a stockade during a field trip to Colonial Williamsburg, a museum in Williamsburg, Virginia. The selection stung Nestor because multiple adults must have had to approve that picture, which she felt preserved P. as the “weird kid” for posterity. “It’s not bullying, but it sure is on that slippery slope,” Nestor says. “He didn’t understand. He was just happy to be included.”

The opposite can also happen: Some research suggests that children with autism tend to consider a broader range of behaviors offensive than their parents do. About two years ago, Hoover worked with an autistic teenager who was devastated because a boy at school had made fun of the New England Patriots, his favorite professional football team. All the peer had to do to set him off was say, “Deflategate,” referring to the allegation that the team’s quarterback, Tom Brady, had ordered the deflation of footballs used in a playoff game in 2014. The boy “couldn’t even function; he could not get over it,” Hoover says. To an outsider, trash-talking a football team might seem more like banter than bullying. But for this boy, it was extremely upsetting.

Some people with autism find even everyday experiences stressful because they see the world literally and may not pick up on the nuances of what people say or do, causing them to lose their ability to trust when people say one thing but do something else. “There’s a kind of chronic potential trauma of being in a world where you understand 50 percent of what’s going on most of the time because you’re missing all these social cues, so you’re feeling constantly out of the loop and having chronic stress around that,” says Connor Kerns, a psychologist who runs the Anxiety Stress and Autism program at the University of British Columbia in Vancouver, Canada.

Studies show that children who are introverted or anxious are even more likely to experience trauma from maltreatment than are those who are more socially active and outgoing. Lacking a social network may exacerbate the problem. Autistic children without intellectual disability may be particularly vulnerable, experts say, because they are more aware of and socially sensitive to interpersonal nuances than those who have intellectual disability. On top of it all, many autistic children are quick to react strongly when treated poorly. “They blow up, they freak out, they run, they yell, they get angry,” Hoover says. “And that might set them up as targets some more because they get a huge reaction out of the kids.”

Abusers have their own reasons for choosing autistic children as targets. Chief among them is that children on the spectrum often lack the communication skills to report abuse — or to be believed if they do. Seay remembers one young girl with a developmental disability who told her family that she was being sexually abused at school. The girl’s parents told the school administrators, but both parties doubted her story until a typically developing sibling reported that the same thing had also been happening to her. A physical exam of the sibling corroborated her account. “Individuals who exploit and abuse children know which children are more likely to be a good victim — to not say anything, to have difficulty communicating what is going on, and then even if they do, it’s going to be said that the child has lied before,” Seay says. Compounding the problem is the fact that autistic children are exposed through service systems to many different adults, raising the chances of encountering someone who will mistreat them.

Abuse of autistic children may also persist either because educators are not trained to recognize its signs in these children or because they are afraid of making things worse for the children if they say something, Corr says. “Often times, there is this fear that by reporting a child to the child-welfare system, a child with a disability will actually be worse off,” she says. “If folks in child welfare aren’t necessarily trained to think about kids with disabilities, what will happen to that kiddo once they enter that system?”

In one of Asasumasu’s earliest and most painful memories, she is a 3-year-old facing a teacher who wraps her legs around the preschooler’s chair to prevent her from going anywhere. The teacher gives instructions: “Sit. Stand. Look at me.” If Asasumasu follows the instructions, she earns a fraction of an M&M. If not, the teacher pulls her body into position or forces her eyes open.

The technique, part of a standard type of autism therapy, has become contentious. Critics have compared it to gaslighting in abusive relationships because it teaches children to comply and perform specific behaviors for rewards instead of speaking out when they feel uncomfortable. Many adults have been vocal about their traumatic memories of undergoing this type of treatment as children. “My earliest memories are of adults prying my eyes open and making me look at them,” Asasumasu says. “To this day, if somebody says, ‘Look at me,’ it’s like, ‘I’m never looking at you again.’”

Maltreatment can cause lasting damage, leading to severe stress, depression, anxiety and post-traumatic stress disorder (PTSD). Most studies have not shown an increased incidence of PTSD among autistic people. That may be because the PTSD criteria were not written for people with autism or because trauma in this group is more likely to lead to anxiety, depression and other mental health issues than to PTSD, Kerns says. What’s more, there are no reliable tools for screening autistic children for trauma, which is defined as an event or events that affect a person negatively, sometimes in an ongoing way.

Meanwhile, researchers are crafting therapies. Hoover, for example, is adapting a technique called trauma-focused cognitive behavioral therapy. The 12-week program aims to get children talking about what happened to them and to teach them how to manage their fears around those experiences. Because many children with autism may not understand verbal instructions or remember what they are supposed to practice outside of therapy, Hoover created visual schedules for them to keep at home and ramped up involvement by caregivers. The modified program also enlists children’s special interests — say, Spider-Man or Harry Potter — to help them tell their stories.

The modified method appears to help — at least anecdotally, Hoover says. Parents are reporting positive results, and autistic children who undergo the therapy are showing improved scores on the UCLA Child/Adolescent PTSD Reaction Index, a self-report questionnaire that screens for PTSD in children and teenagers. Hoover is writing a manual for the technique and says he gets multiple inquiries each week from centers around the world that want training. He and his colleagues have been collecting data on the therapy from several dozen children for the past year, and they have plans for a controlled trial.

McDonnell, meanwhile, is preparing to measure the potential benefits of the standard trauma technique on children with autism. Other teams are trying community and grassroots programs that aim to teach people about abuse, sexuality and other topics to help them stay safe.

Many autistic people come up with their own strategies. Adrienne Lawrence, a 36-year-old attorney and author in Los Angeles, California, learned she has autism about a year ago. But she has long known that she operates on logic rather than nuance to decipher her world. If, for example, a man trying to date her tells her his mother died, she assumes that simply means his mother died, and she misses that he is trying to sleep with her by playing on her sympathy. If he apologizes and says he will not lie again, she assumes he means it. The reason autistic people face so much abuse, Lawrence says, is that so many non-autistic people lie, not that autistic people miss those lies.

Lawrence has always created rules to help her navigate the world and has adopted new ones since learning she is on the spectrum. For example, she has developed specific guidelines to help her spot and avoid sexual harassment, which she has experienced at work, including specifying which types of behavior are appropriate in different situations. “Previously, I would use my 10 years of criminology study to do a statistical and logical analysis in my head as to whether it was safe to enter a man’s home, considering the facts particular to the specific situation. Now I do not rely so heavily on stats and logic but simply ensure meetings are in public places.”

For Asasumasu, life started to get better in high school, when she learned to fight back. She also befriended students she calls “weird” and “scary,” which kept bullies away. She now studies aikido, a defensive martial art that helps her wait to assess a situation before judging whether it is a threat, though she has continued to experience abusive relationships into adulthood.

Like Lawrence, she relies on pattern recognition to predict and avoid abuse. “Somebody who is rude to waiters and mean to pets is definitely going to try to hit you at some point,” she says.

Ultimately, Asasumasu says, it is society, not autistic people, that must change. “We should be able to deal with the fact that there’s more than one way of being,” she says. “For all the kinds of civility you hear in the general world, you never hear, ‘Hey, maybe don’t be a jerk to people who are different from you.’”