M3 Autism - potential challenges and supportive approaches

Transcription

1 #NPPG2016 M3 Autism - potential challenges and supportive approaches Lorraine MacAlister, Training Consultant, National Autistic Society

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3 Autism Potential challenges and supportive approaches Lorraine MacAlister

4 Understanding autism Autism affects how people perceive the world and interact with others Autistic people see, hear and feel the world differently to other people Autism affects people differently and to varying degrees

5 Terminology Autism is a spectrum condition All autistic people share certain difficulties, but being autistic will affect them in different ways Variety of terms used to diagnose autistic people Autism Spectrum Disorder Autistic Asperger syndrome Demandavoidant Preferred terminology People with autism People on the autism spectrum

6 Key areas of differences Social communication and interaction Restricted and repetitive patterns of behaviours, activities or interests Sensory sensitivities

7 Autistic perspective rules! We Aspies have a weird relationship with rules. In some ways we love them.they prevent chaos and confusion and stress. They create calm when the world feels messy and unpredictable....on the other hand, we can take them a little bit overboard. Rules about healthy eating can become food rituals that restrict social activities; rules about homework can become perfectionism that causes great anxiety Jennifer Cook O Toole The Asperkid s Secret Book of Social Rules, 2012

8 Key facts and statistics More than 1 in 100 people are on the autism spectrum Unknown cause possible genetic or environmental influence More males diagnosed than females Approximately 50% of people on the autism spectrum also have a learning disability Co-occurring conditions

9 Women and girls Questions being raised about ratio Increase in referrals to clinics noted Potential male gender bias Girls less likely to be identified with autism Different manifestations of behaviour May have been more able to hide their difficulties I spend much of my life masking Autistic woman

10 Women and girls Autistic women and girls may be more likely to: Be more socially aware and want to have friends Be more involved in social play but led by peers Follow social actions through delayed imitation Have rich imaginary or fantasy worlds and escape into fiction Have similar interests to other girls, therefore not seen as unusual Gould, J. & Ashton-Smith, J. (2011) Missed diagnosis or misdiagnosis: girls and women on the autism spectrum.

11 Things not to say to an autistic person

12 Stress, anxiety and autism Irregular arousal levels and chronic stress - many autistic children experience constant stress - can go to 0 to 10 very quickly - coping mechanisms can become overwhelmed Processing time - delay in processing language and situations - taking time to work out what other people want - worrying about feeling rushed Expectations Catastrophising - can lead to stress and anxiety or increase as a result New places Change People, situations, noise, animals

13 Energy accounting Use the concept of an energy bank account Many actions or tasks can cause an energy withdrawal Need to ensure we then make an energy deposit to replenish the energy account to balance the books Energy depletion can lead to physical and mental health problems Withdrawal Socialising Change Making a mistake Sensory sensitivity Daily living skills Sensitivity to other people s moods Being teased or excluded Deposit Solitude Special interest Physical activity Animals and nature Computer games Meditation or mindfulness Sleep

14 Spending time with other people Why can spending time with other people be difficult? Instinctual understanding of how to do it and why Different interests to other people Past experiences Understanding the social rules (or secret rules!) Social anxiety Expectations from other people Understanding what friends are understanding the social fluff

15 Spending time with other people Do I actually want to spend time with other people? Successful social interaction may vary from one person to another Time on your own, alternative ways of communicating with friends, recovery time following time with others all potentially important for autistic teens I have about five people that I spend any time with outside my immediate family I like these people very much, but find that after around two hours I have run out of things to say, have exhausted myself with performing and need to leave, go home and have a nap Sarah Hendrickx Women and Girls with Autism Spectrum Disorder, 2015

16 The autistic perspective

17 Sensory differences The brain locates, sorts and orders sensations, somewhat as a traffic officer directs moving cars. When sensations flow in a well-organised or integrated manner, the brain uses those sensations to form perceptions, behaviours and learning. When the flow of sensations is disorganised, life can be like a rush-hour traffic jam. Dr. A. Jean Ayres, 2005

18 Sensory differences potential impact Daily life coping with different environments Stress and anxiety Toileting Restricted eating

19 Environments Think about the environment for each of the senses Low arousal settings aiming for a sense of calm and order What can I see? What or who can I smell? What are those noises? Ooh that feels awful / wonderful! How do I get there? What does that taste like? I m not sure where I am in this space!

20 Toileting difficulties Basic toilet training skills Develop anxiety and fears about using toilet Constipation, withholding and soiling Smearing Going to the toilet in inappropriate places Using different toilets Have a restricted diet Wetting in the day Wetting at night

21 Restricted eating Many autistic children have restricted diets ARFID - Avoidant & Restrictive Food Intake Disorder (DSM V, 2013) Disguising foods Trying new foods

22 Supportive approaches Adapting communication Use clear, literal language Express yourself calmly Allow extra processing time Avoid making lots of eye contact Be open to different communication styles Realistic expectations Everyday tasks and activities place different demands on a person's understanding and skills Adapt expectations for the individual Break down tasks into manageable steps Explain what needs doing

23 Supportive approaches Autism friendly environments Decrease stress triggers Work together to create structure Consider sensory needs Relaxation techniques Low arousal approaches Low arousal environments will reduce the chances of stress Social contact Sensory - noise levels, temperatures, visual input

24 Supportive approaches Support with emotions and wellbeing Engage with people s interests Coding systems to express emotions Energy accounting Avoid unclear & confusing language Find ways to express emotions OK I need help I need to leave Reflective thinking Be aware of your own stress levels Consider whether you are a source of over-arousal 1-5 anger scale 5 clear the area! 4 need to leave 3 check I m ok 2 not ok 1 ok

25 Questions

26 For further information please contact the NAS helpline or website NAS Autism Helpline NAS Website Thanks for listening!