Autism Spectrum Conditions Nursing in Practice Conference Matthew Trerise Training & Liaison Lead Bristol Autism Spectrum Service(BASS)

Transcription

1 Autism Spectrum Conditions Nursing in Practice Conference Matthew Trerise Training & Liaison Lead

2 Who are we? A specialist team with two broad areas of activity in Bristol, B&NES, North Somerset & South Glos: Diagnostic assessment service + 6 weeks post diagnostic support + needs assessment Weekly advice services in each area we cover Workforce support to agencies across the care pathway (including health, social care, voluntary sector organisations, employment & criminal justice) involved in providing services to this client group. Partnership working with mainstream organisations i.e. Avon & Somerset Police, JobCentre Plus, HMRC Significant contributions to National Autism Strategy & NICE Guidelines

3 Definition Autism (ASC) is a pervasive developmental disorder, and as such is a lifelong condition. Asperger syndrome IS an autism spectrum condition essentially describes high functioning end of autism spectrum i.e. people with autism, but with average or above IQ and no significant language delay Autism is NOT a learning disability or a mental health problem

4 What causes ASC? The simple answer is we do not know the exact cause of ASC. However we do know that: Prevalence studies of autism indicate that 1.1% of the population in the UK may have autism(brugha et al 2012) It appears to run in the family There is a strong link between ASC and inherited genes but there may be other factors too But there is no evidence that the MMR vaccine causes ASC Perhaps most simplistically, it is a different wiring in the brain resulting in a different way of thinking

5 Diagnosis A diagnosis of autism is made with reference to two main concepts. (ICD-10 F84, DSM ) Social communication and social interaction ASC Restricted, repetitive patterns of behaviour, interests, or activities These must be life long, present since early childhood and pervasive (affecting many aspects of the person s life).

6 Recognising autism in clinic Typically, people with autism: Find unstructured social situations confusing & may avoid them Find it hard to make small talk Find it hard to intuitively work out what others are thinking and/or feeling often misinterpreted as a lack of empathy Have difficulty forming/maintaining friendships

7 Recognising autism in clinic Have unusually strong, narrow interests Do certain things in a very inflexible, repetitive way Very good at picking up details and facts Frequently tend to turn conversation back to themselves or to their special interests Have a strong preference for order, and a dislike of change Slower processing speed for verbal communication can appear not to understand

8 Recognising autism in clinic Difficulties with non-verbal communication: Eye contact, avoids or stares not necessarily absent, just different in quality Voice lack of flow or rhythm, monotonous speech, too loud, too quiet Lack of use of gesture to emphasise what saying Unusual mannerisms Some people have learnt non-verbal communication so difficulties can be masked

9 Recognising autism in clinic Motor abnormalities Unusual gait Motor stereotypies Dyspraxia Sensory abnormalities Differences in the way the sensory systems (including: touch, hearing, sight, taste, smell, proprioceptive & vestibular) process information May be hyper- or hypo- sensitive in any or all of these systems

10 Understanding autism biology/genetic theory of mind executive functions cognition behaviour central coherence social impairments communicative impairments repetitive behaviours

11 Communication tips Use clear, unambiguous language avoid metaphors, irony and sarcasm Try and avoid open questions Keep information concise and factual, write it down! If there is a delay in response from the individual when asked a question, WAIT as it may be a processing difficulty and they probably will respond. Use of scales can be effective i.e. I am anxious in a group - on a scale of 0(agree) -10(disagree) Bristol Autism Spectrum Service (BASS)

12 General tips Find out how the individual prefers to receive information (e.g. written summaries or verbally) Don t assume people will know what you are thinking or feeling Try to get confirmation that the individual understands what you are talking about e.g. ask for a summary Be as predictable as possible and have no suprises! Bristol Autism Spectrum Service (BASS)

13 Paradigm Shift We focus a lot on difficulties and impairment, but: Realise it or not, people with autism already play a huge role in society and have done throughout history Industries/employers are now actively recruiting people with autism because of their skills We need people who think differently Basically, the world is just waking up to how important people with autism are!

14 Remember: So, in conclusion People with autism are amazing It s a privilege to be able to work with them They generally receive a very poor service This is not ok Be respectful, helpful & brilliant in your work with them

15 Thank you very much for listening The End.