Autism

Autism, or autism spectrum disorder (ASD), refers to a broad range of conditions characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication.

We know that there is not one autism but many subtypes, most influenced by a combination of genetic and environmental factors. Because autism is a spectrum disorder, each person with autism has a distinct set of strengths and challenges. The ways in which people with autism learn, think and problem-solve can range from highly skilled to severely challenged. Some people with ASD may require significant support in their daily lives, while others may need less support and, in some cases, live entirely independently.

Being Autistic

Social communication

Autistic people have difficulties with interpreting both verbal and non-verbal language like gestures or tone of voice. Some autistic people are unable to speak or have limited speech while other autistic people have very good language skills but struggle to understand sarcasm or tone of voice. Other challenges include:

  • taking things literally and not understanding abstract concepts
  • needing extra time to process information or answer questions
  • repeating what others say to them (this is called echolalia)

Social interaction

Autistic people often have difficulty ‘reading’ other people – recognising or understanding others’ feelings and intentions – and expressing their own emotions. This can make it very hard to navigate the social world. Autistic people may:

  • appear to be insensitive
  • seek out time alone when overloaded by other people
  • not seek comfort from other people
  • appear to behave ‘strangely’ or in a way thought to be socially inappropriate
  • find it hard to form friendships.

With its unwritten rules, the world can seem a very unpredictable and confusing place to autistic people. This is why they often prefer to have routines so that they know what is going to happen. They may want to travel the same way to and from school or work, wear the same clothes or eat exactly the same food for breakfast. 

Autistic people may also repeat movements such as hand flapping, rocking or the repetitive use of an object such as twirling a pen or opening and closing a door. Autistic people often engage in these behaviours to help calm themselves when they are stressed or anxious, but many autistic people do it because they find it enjoyable. 

Change to routine can also be very distressing for autistic people and make them very anxious. It could be having to adjust to big events like Christmas or changing schools, facing uncertainty at work, or something simpler like a bus detour that can trigger their anxiety. 

Autistic people may experience over- or under-sensitivity to sounds, touch, tastes, smells, light, colours, temperatures or pain. For example, they may find certain background sounds like music in a restaurant, which other people ignore or block out, unbearably loud or distracting. This can cause anxiety or even physical pain. Many autistic people prefer not to hug due to discomfort, which can be misinterpreted as being cold and aloof.

Many autistic people avoid everyday situations because of their sensitivity issues. Schools, workplaces and shopping centres can be particularly overwhelming and cause sensory overload. There are many simple adjustments that can be made to make environments more autism-friendly. 

Many autistic people have intense and highly focused interests, often from a fairly young age. These can change over time or be lifelong. Autistic people can become experts in their special interests and often like to share their knowledge. A stereotypical example is trains but that is one of many. Greta Thunberg’s intense interest, for example, is protecting the environment.

Like all people, autistic people gain huge amounts of pleasure from pursuing their interests and see them as fundamental to their wellbeing and happiness.

Being highly focused helps many autistic people do well academically and in the workplace but they can also become so engrossed in particular topics or activities that they neglect other aspects of their lives. 

Anxiety is a real difficulty for many autistic adults, particularly in social situations or when facing change. It can affect a person psychologically and physically and impact quality of life for autistic people and their families.  

It is very important that autistic people learn to recognise their triggers and find coping mechanisms to help reduce their anxiety. However, many autistic people have difficulty recognising and regulating their emotions. Over one third of autistic people have serious mental health issues and too many autistic people are being failed by mental health services. 

When everything becomes too much for an autistic person, they can go into meltdown or shutdown. These are very intense and exhausting experiences.

A meltdown happens when someone becomes completely overwhelmed by their current situation and temporarily loses behavioural control.  This loss of control can be verbal (eg shouting, screaming, crying) or physical (eg kicking, lashing out, biting) or both. Meltdowns in children are often mistaken for temper tantrums and parents and their autistic children often experience hurtful comments and judgmental stares from less understanding members of the public. 

A shutdown appears less intense to the outside world but can be equally debilitating. Shutdowns are also a response to being overwhelmed, but may appear more passive – eg an autistic person going quiet or ‘switching off’. One autistic woman described having a shutdown as: ‘just as frustrating as a meltdown, because of not being able to figure out how to react how I want to, or not being able to react at all; there isn’t any ‘figuring out’ because the mind feels like it is past a state of being able to interpret.

The exact cause of ASD is unknown. The most current research demonstrates that there’s no single cause.

Some of the suspected risk factors for autism include:

  • having an immediate family member with autism
  • genetic mutations
  • fragile X syndrome and other genetic disorders
  • being born to older parents
  • low birth weight
  • metabolic imbalances
  • exposure to heavy metals and environmental toxins
  • a history of viral infections
  • fetal exposure to the medications valproic acid (Depakene) or thalidomide (Thalomid)

An ASD diagnosis involves several different screenings, genetic tests, and evaluations.

Developmental screenings

Screening can help with early identification of children who could have ASD. These children may benefit from early diagnosis and intervention.

The Modified Checklist for Autism in Toddlers (M-CHAT) is a common screening tool used by many pediatric offices. This 23-question survey is filled out by parents. Pediatricians can then use the responses provided to identify children that may be at risk of having ASD.

It’s important to note that screening isn’t a diagnosis. Children who screen positively for ASD don’t necessarily have the disorder. Additionally, screenings sometimes don’t detect every child that has ASD.

Other screenings and tests

Your child’s physician may recommend a combination of tests for autism, including:

  • DNA testing for genetic diseases
  • behavioral evaluation
  • visual and audio tests to rule out any issues with vision and hearing that aren’t related to autism
  • occupational therapy screening
  • developmental questionnaires, such as the Autism Diagnostic Observation Schedule (ADOS)

Diagnoses are typically made by a team of specialists. This team may include child psychologists, occupational therapists, or speech and language pathologists.

There are no “cures” for autism, but therapies and other treatment considerations can help people feel better or alleviate their symptoms.

Many treatment approaches involve therapies such as:

  • behavioral therapy
  • play therapy
  • occupational therapy
  • physical therapy
  • speech therapy

Massages, weighted blankets and clothing, and meditation techniques may also induce relaxing effects. However, treatment results will vary.

Some people on the spectrum may respond well to certain approaches, while others may not.

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Alternative treatments

Alternative treatments for managing autism may include:

  • high-dose vitamins
  • chelation therapy, which involves flushing metals from the body
  • hyperbaric oxygen therapy
  • melatonin to address sleep issues

Research on alternative treatments is mixed, and some of these treatments can be dangerous.

Before investing in any of them, parents and caregivers should weigh the research and financial costs against any possible benefits.

Joining a support group can be very beneficial for you

Think you or someone you know could be autistic?

Reach out to the Parish Autism support team 

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