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Comedian Amy Schumer discusses her husband’s autism diagnosis in her latest comedy special. Getty Images

Imagine being married to someone who insists on doing the laundry on a specific night every week and flies into a rage if any of their routines are disrupted.

Or having a spouse who can’t understand what you’re saying if you’re in a noisy, crowded room.

Those are some of the many challenges facing people with partners who have autism.

Comedian Amy Schumer recently sparked a national conversation about the topic when she revealed during her latest stand-up routine that her husband of 13 months had received a diagnosis of the neurodevelopmental disorder, which typically makes social interactions challenging.

“I knew from the beginning that my husband’s brain was a little different than mine,” she said in her show, “Growing,” which is now streaming on Netflix.

Schumer elicited laughs when she mimicked the befuddled reaction of husband Chris Fischer to a tumble she took while on a walk, explaining that inappropriate facial expressions are an autistic trait.

And she extolled her spouse’s inability to lie, even if he offends others.

“He says whatever is on his mind. He keeps it so real, you know? He doesn’t care about social norms, what you expect him to say or do,” Schumer said. “All the characteristics that make it clear that he’s (autistic) are all of the reasons that I fell madly in love with him.”

The diagnosis is now known as autism spectrum disorder, a term that acknowledges the wide range of symptoms and abilities among individuals.

The most severely affected are unable to speak and require around-the-clock care.

Others can be intellectually gifted even though they might be wedded to rigid daily routines or hypersensitive to sound, light, and other sensory stimuli.

Communication is a common challenge.

Many with autism fixate on activities and topics that interest them. They can talk at length about their favorite subject without giving others a chance to speak.

People with autism also might have trouble understanding what others are saying, whether the message is verbal (they may take figures of speech literally and fail to recognize sarcasm) or in the form of body language.

One of every 59 children has autism, according to 2018 estimates by the Centers for Disease Control and Prevention. The condition affects four times as many boys as girls.

Although genes and environmental factors, such as parents’ advanced age at time of conception and premature birth, are thought to increase the risk of autism, scientists haven’t yet pinpointed a cause.

Although Schumer finds the humor in what autism has brought to her marriage, many others find that it exacts a toll.

Gail, a resident of the western United States who requested anonymity, thinks autism creates an emotional gulf that the neurotypical partners in a relationship keenly feel.

“Unless you can turn yourself into a robot and be OK with not having a connection with your spouse, there will always be a void,” she told Healthline. “All humans need that, especially from your spouse, and when you don’t get that it’s a lonely road.”

So different are the styles of communication in marriages where one person has autism that “it’s as if they’re speaking different languages,” said Grace Myhill, director of The Peter M. Friedman Neurodiverse Couples Institute, a Massachusetts program that trains therapists on working with people with autism.

The usual approaches to bridging communication gaps just don’t help, she told Healthline.

“You can’t just say ‘Be more empathic’ when your partner is upset. They often don’t know how to do that,” Myhill said.

People with autism often have difficulty understanding others’ points of view, creating rifts that they exacerbate by saying whatever’s on their mind instead of measuring the effect of their words.

“They don’t understand that you don’t say what you’re thinking,” Gail said.

Gail notes that her husband’s unfiltered comments have included matter-of-factly telling her she stinks when the deodorant has worn off at the end of a day.

And because he only sees the world through his eyes, he doesn’t understand what he did wrong, so he doesn’t apologize.

His rigid adherence to routine includes reserving Friday nights for doing laundry. He’ll stay up to the early morning hours to make sure clothes are folded perfectly. Unprovoked outbursts can occur when structures like this are interrupted.

“He says things that are unrepeatable to our children and to me. It’s earth-shattering,” Gail said. She now lives in a different state from her husband and is worn down to the point that she’s considering ending their 34-year marriage.

The sensory overload people with autism often experience also can factor into couples’ conflicts.

A noisy party and the effort it takes to make conversation, for example, can make the individual with autism anxious and less attentive to their partner.

Karen Lean had specified in her online profile on a dating website that she didn’t like loud bars.

“The amount of energy I have to spend to process sensory information makes social information even harder to take in,” the Boston resident told Healthline.

Lean, who has received a diagnosis of autism, notes that she can’t pay attention to facial expressions, posture, and gestures when there are auditory distractions.

But Lean says hers is a “dream relationship” because her new husband willingly accommodates her needs.

If she has trouble making sense of what he’s saying because there’s background noise, he’ll repeat himself. If she still doesn’t understand, he’ll turn to face her so she can see his nonverbal cues.

“I don’t feel like autism is challenging us. I feel like we have adapted — and beautifully,” Lean said.

Some women who reached out to Healthline to share how autism has affected their marriage indicated that they experienced an epiphany once they learned about the disorder: Finally they had an explanation for their spouse’s perplexing behavior.

“Huge lightbulb moments following diagnosis. All of our issues from the past made sense and the puzzle fell into place,” said Diana Anderson of Spokane, Washington.

Before her 55-year-old husband got an autism diagnosis three years ago, Anderson couldn’t understand why he’d agree to do something she asked and then not follow through.

Now she realizes that what she thought was passive-aggressive behavior is actually forgetfulness, a characteristic of autism.

Nor could Anderson fathom her husband’s response when she told him her cousin had died. He announced he was going downstairs to watch television and invited her to join him.

“‘Are you kidding me?’” she recalled saying.

What’s more, Anderson says she coached her husband on what she wanted him to say to her in those cases, but “he still didn’t understand my needs or how to react appropriately.”

And yet their 31-year marriage not only has survived, it is thriving following some sessions with a psychologist who specializes in working with couples affected by autism.

The touch-sensitive man who used to flinch when Anderson would affectionately tuck a lock of hair behind his ear has now learned to give his wife a long hug when she returns after a day at the office.

Anderson credits the success in part to her husband accepting his diagnosis and agreeing to work on their relationship.

And now that she understands he doesn’t mean to hurt her feelings, she says she’s learning not to react defensively.

“We can joke about our different brains,” she told Healthline. “I know how his brain works and I know he comes from a different perspective than I do, and I accept that.”