Introduction to Autism
- 1. Introduction to Autism Lesley Johnston RGN. RMN. BN. Cert. Health Informatics
- 2. What we will cover today Autism: what it is and is not Autistic spectrum Triad of Impairments How people with autism see the world Facts and figures Communication Introduction to: ◦ Autism and learning disability ◦ Understanding behaviour ◦ Anxiety and strategies for managing anxiety ◦ Challenging behaviour Approaches, therapies and interventions Asperger's and higher education
- 3. What is autism? Throughout this session we will use the term autism - although it is well known that autism occurs in differing degrees of severity and in a variety of forms. The terms Spectrum and/or Continuum of disorders or conditions are commonly used to group people together that have a shared difficulty in making sense of the world. Autism is a lifelong developmental disability that affects the way a person communicates and relates to people around them. Children and adults with autism are unable to relate to others in a socially meaningful way.
- 5. continuum Aspergers syndrome Autistic Disorder
- 6. What is autism cont. Their ability to develop friendships is impaired, as is their capacity to understand other people's feelings. People with autism can often have accompanying learning disabilities and/or mental health problems. The term spectrum condition means that, while all people with autism share certain areas of difficulty, their condition will affect them in different ways. Asperger's syndrome, is believed by many experts to falls at the higher-functioning end of the autistic spectrum.
- 7. Triad of Impairments All people with autism (and Aspergers) have impairments in social interaction, social communication and imagination. This is referred to as the triad of impairments – it is the degree that varies: Social interaction (difficulty with social relationships, for example appearing aloof and indifferent to other people); Social communication (difficulty with verbal and non-verbal communication, for example not really under-standing the meaning of gestures, facial expressions or tone of voice); and Flexibility in thinking and behaving (difficulty in the development of play and imagination, for example having a limited range of imaginative activities, possibly copied and pursued rigidly and repetitively).
- 8. It can be hard to create awareness of autism as people with the condition do not 'look' disabled: parents of children with autism often say that other people simply think their child is naughty; while adults find that they are misunderstood. All people with autism can benefit from a timely diagnosis and access to appropriate services and support.
- 9. Autism and learning disabilities People with Asperger syndrome and other forms of autism at the higher functioning end of the spectrum can have normal intellectual capabilities, and some are of above average intelligence. However, many people with autism also have significant intellectual disabilities but the two do not necessarily go hand in hand. Test: IQ 70
- 10. Communication For people with autistic spectrum disorders, 'body language' can appear just as foreign as if people were speaking ancient Greek! What do we mean by ‘body language’?
- 11. As soon as we meet a person we make judgements about them. From their facial expression, tone of voice and body language we can usually tell whether they are happy, angry or sad and respond accordingly. At one end of the spectrum People with Asperger syndrome can find it harder to read the signals that most of us take for granted. This means they find it more difficult to communicate and interact with others which can lead to high levels of anxiety and confusion.
- 12. People further along the autism continuum have difficulties with both verbal and non- verbal language. Many have a very literal understanding of language, and think people always mean exactly what they say. They can find it difficult to use or understand: facial expressions or tone of voice jokes and sarcasm common phrases and sayings; an example might be the phrase 'It's cool', which people often say when they think that something is good, but strictly speaking, means that it's a bit cold.
- 14. Try to adapt your communication - speak simply and directly, and say exactly what you mean. Also, whenever possible, include visual cues to your meaning.
- 15. Dispelling the myths Whilst autism, as a term, was only defined 50 years ago, it has probably been a part of the human condition throughout history. However, newly defined disorders inevitably lead to confusion, so here are a few pointers to what autism is and what it is not:
- 16. What it is A developmental disorder involving a biological or organic defect in the functioning of the brain; Occurs on average in four times as many males as females; 17 males to 1 female for high functioning/Asperger syndrome; 1 male to 1 female for profound learning disabilities. A spectrum disorder comprising individuals with profound learning difficulties through to people with average or above average IQ; Associated with known organic causes e.g. maternal rubella, tuberous sclerosis; Associated with epilepsy or seizure disorders in one third of individuals at adolescence; In many cases genetically linked (often a family member has autism) Associated with unusual responses to sensory stimuli; A life-long disability with a need for correspondingly life-long support in most cases.
- 17. What it is not The result of emotional deprivation or emotional stress; A wilful desire to avoid social contact; Due in any way to parental rejection or cold parenting; In any way class related; A mental illness; Misunderstood genius (although in a few circumstances some individuals have special abilities in narrow areas); Curable (although improvements can be made in all cases).
- 18. How common is it? Autism is much more common than many people think. There are over half a million people in the UK with autism - that's around 1 in 100. If you include their families, autism touches the lives of over two million people every day.
- 19. More facts and figures Over 40% of children with autism have been bullied at school. Over 50% of children with autism are not in the kind of school their parents believe would best support them. One in five children with autism has been excluded from school, many more than once. Nearly two-thirds of adults with autism in England do not have enough support to meet their needs. At least one in three adults with autism are experiencing severe mental health difficulties due to a lack of support1. Only 15% of adults with autism in the UK are in full-time paid employment. 51% of adults with autism in the UK have spent time with neither a job, nor access to benefits, 10% of those having been in this position for a decade or more. 61% of those out of work say they want to work. 79% of those on Incapacity Benefit say they want to work.
- 20. How does the world appear to people with autism?
- 21. “If I get sensory overload then I just shut down; you get what's known as fragmentation... it's weird, like being tuned into 40 TV channels”.
- 22. People with autism have said that the world, to them, is a mass of people, places and events which they struggle to make sense of, and which can cause them considerable anxiety. In particular, understanding and relating to other people, and taking part in everyday family and social life may be harder for them. Other people appear to know, intuitively, how to communicate and interact with each other, and some people with autism may wonder why they are 'different'
- 23. Working with people with autism: meet Scott and Marie Key messages for practice 1) Autism affects people in a huge variety of ways. 2) Professionals and others need to have empathy and to understand the perspective of the person with autism. 3) People with autism who are in employment often need some additional support. 4) Professionals should use the expertise of the person with autism and their family when providing support. 5) Good communication with people with autism is vital. This includes recognising behaviour triggers, using visual prompts and speaking in short, clear sentences. 6) Society disables people with autism, so we all need to make adjustments to include them.
- 24. What adjustments can WE make? Current Reality versus Desired Future ________________________________________________ In groups, list the CURRENT REALITY of how you behave and act in work in the context of working with people who suffer with autistic spectrum disorder. Why are you doing this job? Being honest, what are your priorities in work? What worries you? Do you have enough time………? How do you react to certain behaviours? Are there things you feel you don’t do well enough? __________________________________________________________________________________ We will come back to this later………
- 26. Understanding behaviour People with autism or Asperger syndrome may appear to behave unusually. There will generally be a reason for this: it can be an attempt to communicate, or a way of coping with a particular situation. Knowing what causes challenging behaviour can help you to develop ways of dealing with it.
- 27. Anxiety Anxiety is a real difficulty for many adults with autism or Asperger syndrome. It can affect a person psychologically and physically. There are different ways you can manage anxiety, from keeping a diary to learning relaxation techniques and getting support from others in a similar situation. Anxiety can happen for a range of reasons and people with autism or Asperger syndrome can vary in their ability to cope with it.
- 28. To understand emotion you need an imagination. One of the areas of difficulty for people with autism is not being able to imagine things, so understanding emotions can be difficult for them. People at the higher end of the autistic spectrum may understand some emotions and recognise the feelings that are associated with them. By helping someone to understand anxiety, you can help them to manage it better. Resources such as those sold by Incentive Plus as well as the Autism Research Centre's CD ROM, Mind reading, can help teach someone with autism about emotions.Anxiety can affect both the mind and the body, and produce a range of symptoms. The psychological and physical symptoms of anxiety are closely linked and so can lead to a vicious cycle that can be difficult to break. ……………..
- 29. Psychological Physical symptoms of symptoms of anxiety: anxiety: easily losing patience excessive thirst difficulty concentrating stomach upsets thinking constantly about loose bowel movements the worst outcome frequent urinating (going difficulty sleeping to the loo) depression periods of intensely becoming preoccupied pounding heart with or obsessive about muscle aches one subject. headaches dizziness pins and needles tremors. REMEMBER: it is extremely important to get medical advice to rule out any medical conditions.
- 30. Strategies for managing anxiety Try and be aware of what makes them anxious and how best to help them manage certain behaviours. Keeping a diary in which they write about certain situations and how these make them feel may help them to understand their anxiety and manage it better. Time and How anxious? date Situation How I felt (out of 1 to 10)
- 31. Create an anxiety plan when someone with autism is feeling positive about things. This is a list of things and situations that cause anxiety as well as solutions and strategies they can use to help them manage their anxiety levels. The plan can be adapted, depending upon how well someone understands anxiety……….. Situation Symptoms of Solution anxiety Going on the bus. Hearts beats fast; Have stress ball in sweat and feel sick. pocket. Squeeze the ball and take deep breaths. Listen to music.
- 32. Relaxation techniques – what the National Autistic Society says
- 33. Dealing with challenging behaviour This is a session all of its own……. Here is just one example. You work with an adult who becomes very aggressive when the TV schedule for his favourite programme changes. What can you do?
- 34. Approached, therapies and interventions While there is no 'cure' for autism, there are a number of approaches that people use to help with various difficulties they may experience. Some people make adjustments to their diet, for example, while others may benefit from speech and language therapy. Different approaches have been known to work for some people with an autism spectrum disorder, but they have not been evaluated on a long-term basis.
- 35. Beware!! Before using any particular approach, find out as much information as you can about it. Any approach should be for the benefit of the person with autism and based on a multi disciplinary decision. It must build on their strengths, help to discover their potential, increase motivation and provide opportunity. Ask yourself: What does the approach claim to do? How does it work and who will it benefit? How was it developed? How many people have been treated and what was the outcome?
- 36. Asperger's and higher education
- 37. SO…….What adjustments CAN we make? Back to Current Reality versus Desired Future _________________________________________ You have listed the CURRENT REALITY of how you behave and act in work. Why are you doing this job? Being honest, what are your priorities in work? What worries you? Do you have enough time………? How do you react to certain behaviours? Are there things you feel you don’t do well enough? _________________________________________________________________________ Now - list the DESIRED FUTURE against each point.
- 38. ….the last word goes to Dr Asperger “Not everything that steps out of line, and thus 'abnormal,' must necessarily be inferior.” - Hans Asperger (1938) Thank you for listening