Ageing and autism spectrum conditions (ASC) By Dr. Wenn B. Lawson PhD AFBPsS MAPS

Transcription

1 Ageing and autism spectrum conditions (ASC) By Dr. Wenn B. Lawson PhD AFBPsS MAPS

2 What to expect from this talk Autism and ageing: briefly explores five key areas - memory, movement, sensory profiling, language and autonomy. Drawing on ASC research with regard to ageing, typical (NT) seniors present differently to adults with ASC. Packaged in an individual with their unique personality and circumstances, ASC is not an issue where one size fits all. Each person will need individual support, though there will be certain traits and issues that apply to all seniors with ASC. It is these traits in common that guide this presentation. It is hoped this talk may help reduce anxiety about autism and ageing, building hope for now & the future.

3 ASC Ageing similarities to non-asc, but also differences. Brain is different to typical; Research = e.g. four main differences between ASC seniors & ASC children. These are: Older ASC people more likely to read facial expressions. Less likely to have memory issues (brain plasticity increases over time) Have different sensory profiles E.g. sensory changes, with exposure. ASC adults: less likely to be in crowded classrooms; may choose to avoid sensory overwhelming situations. (Sokhadze, et al. 2012; Casanova, 2013 ). Have different language and mobility issues to either ASC children or NT seniors Will (hopefully) have moved from struggling to come to terms with who they are to a place of acceptance (Wylie, Lawson & Breardon, 2015).

4 Memory In ASC, literality, influenced by memory dictates routines and expectations, rather than negotiation, common sense, appreciation of change and/or accommodation of other as well as self. Short-term memory may present problems but guiding daily interactions memory will mean not easily given to forgetting. The ASC brain may increase in plasticity with age, which is the opposite to the NT brain.

5 Processing delay Have heard you but need to take time to process: resulting in others repeating information or raising their voice! Might cause individual to switch off, fail to notice, mis-hear information and so on. Give us time!

6 What if you were not able to forget? What happens if people change their minds? What happens if verbal information is confusing? What if you couldn t feel your bodily functions and didn t have: Appetite? Bladder & bowel connection? Feelings of tiredness connecting you to time to sleep? Implications: MEMORY Not able to forget = change feels wrong

7 Can we help build new memories? That was then, this is now Object permanence Issues = Out of sight, out of mind? Visuals, technology, role play, news letters, etc. Remove the bias in memory with facts using interest particular to the individual. Object Permanence means knowing something still exists even when out of sight. Technology often enables connection to social understanding without interference from body or facial expressions.

8 Movement not just about activity but noticing and responding with appropriate motor action. More likely to battle catatonia and freezing physically when under duress, than our non- ASC peers. Possibly result of sensory system over load. Senses ultimately speak to muscles. Movement facilitates brain connections and learning. Movement is often reduced in ASC elders. Sensory and motor systems talk to each other; if these are less connecting due to less varied activity, physical & cognitive decline may increase; movement lessens depressive symptoms.

9 Lack of motivation to join clubs, socialise etc. is dominant in ASC. If we lose friends, we lose a lifetime! Not so easy to reconnect and make new friends. Huge need to work, live and love within particular interest or passion. Outside of thisdisconnection! In ASC elders we see an increase in Mental health issues; immune disorders, physical disorders and immobility. These maybe delayed, prevented or remedied with motivation and appropriate intervention.

10 Sensory Profiling: Many ASC seniors live with sensory dysphoria and are easily over or under whelmed according to the demands of daily life. This is due to fluctuating capacity and is not so readily seen in our NT peers Not always beneficial to reduce/increase sensory loadings but it is necessary to find ways to accommodate them.

11 Language: being pre-verbal is more common in ASC seniors compared to NT peers. Will mean communication needs presenting in differing formats to accommodate differing learning styles. For those who access language: sentences, conversation, appropriateness, propriety and interest are factors in how smoothly (or not) communication is fostered.

12 Autonomy: remembering more likely than forgetting, helps developing social awareness, but tempered by possible increases in depression and anxiety = changes in circumstances. Building positive self-worth and autonomy counteracts poor mental health. Movement and mobility for seniors with ASC is an area often over looked. So often seniors with ASC, unlike NT seniors, are not equipped socially and will lack motivation to go outside, get involved with their world or tell others what it is they need. Wiley, Lawson & Bearden (2015). Nine Degrees of Autism: Routledge, UK. Discover and use means for motivation..

13 Age appropriate expectations I might be 66, 79, or 97 (physically) but what age am I emotionally? What is my cognitive and social age? We may look younger than our years.

14 If I m 70 with an emotional/cognitive/social age of a six year old, is it really appropriate to try to make me responsible for my own hygiene, health, daily routine and other adult pursuits? Obviously not. I m going to need parenting for much longer. Who will take on this role? My own family may be too old, too tired or not equipped for the job.

15 Autonomy - freedom from external control or influence; independence Independence: This becomes INTERDEPENDENCE Knowing how to request help, where to go and how to use it? Different personalities ; Some things work better than others. Shy, outgoing, rigid?

16 Personality types and impact upon social interactions Personality changes little over time Will my personality fit the lifestyle changes expected for an aged person? Where do family & professionals get training to support ageing ASC individuals Will technology advances help those with ASC who are elderly? What of home design and functional ability in aged ASC care? Who will train the ageing ASC individual? Will generic venues work for ageing in ASC? Active but odd aloof Seniors with ASC Formal stilted passive

17 Getting older gracefully? What happens when parents or care givers are not there? 1. Dental/medical/psychological apts. 2. Education/housing/aids & equipment 3. Leisure/ holidays/social interactions 4. retiring support 5. Sex ed. And travel support 6. Support with budgeting, organising things and general do this, don t do that. For whom? In the NT world the process of ageing is less complex because it happens over a similar time period for all.

18 ALOOF? Highly embarrasable? Avoid the limelight? Easily anxious? Tactile avoidant Might not answer to name? Might not answer the door? Might not answer the phone How will I be able to seek help & support as I age?

19 Questions to ask? What helps me to feel comfortable? Getting to see & know the same person on a regular basis? In my home or some appointed location? Noisy or quiet environment? Do I prefer a set list of questions or being asked without warning or processing time? Am I suspicious of internet communications ( ; Skype; MSN?) and prefer face to face arranged engagements or am I more comfy with distance and structures that I set up?

20 Passive or unmotivated? What could you do that would mean I want to go too? How can you discover my interests or motivations? How can you help me identify and label my needs? How can you walk beside me to help support me in getting access? How do we keep momentum and maintain the support?

21 Active but Odd or socially inept Maybe I d be happy to be part of a group who support my interests?

22 The art of communication All of the process s of ageing require appropriate communication. I need to understand about the changes of after retirement. I need to understand what it means to move beyond being at work/home etc. I need to understand why it s good to look after my health, my budget, my home, my sleep and my social connections. I need to understand before I can do!

23 Being unable to speak? Just because I might not talk it doesn t mean I don t think. I might need augmented or facilitated communication to help me communicate my needs. A National Insurance Disability Scheme could help fund my future or setting up a Trust account, working with an appropriate charity.. Whatever it takes to secure the future for us we need to explore it now, not later!. We also need trained professionals who get ASC and what it means to age with time for us.

24 Resources People who will care! Lawson (2015) Older Adults & Autism Spectrum Conditions. JKP: London Homes designed for ASD & ageing; Technology to communicate our dreams, desires, goals and needs. ASC individuals benefit from having ipads & appropriate software enabling them to share at a pace, place and in a space that suits them.