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The emotional cutlery drawer of spoons, and the ‘social hangover’ (ASD, ASC, Asperger’s)

The emotional cutlery drawer of spoons, and the ‘social hangover’ (ASD, ASC, Asperger’s)

One of hardest difficulties to deal with when autistic can be the ‘social hangover’ – the after-effects of socialisation that deplete an autist’s energy. Let’s explore this concept further.

Image showing three spoons, to show the spoon theory, in an autism context.

The spoon theory was developed by Christine Miserandino.

The spoon theory

Firstly, it’s important to realise that ALL autists use many, many ‘spoons’ or energy units when they socialise; and that includes socialisation with their family.

Not heard of the spoon theory? It was developed quite by chance by Christine Miserandino, who has lupus, and uses ‘spoons’ to explain how to ration one’s energy. The spoon theory, a kind of disability metaphor, states that a person with a reduction in energy levels (emotional or physical), starts the day with a certain number of spoons.

Each spoon represents a burst of energy; so showering, getting dressed etc requires small numbers of spoons, as does conversing with close friends and family at home. Some activities, for example, meeting a group of friends or colleagues, being interviewed, chatting in a public place, require lots of spoons (for an autist, or autistic individual).

Autistic communication and social interaction issues

Therefore, autists often find that, due to their autistic challenges – e.g. social communication and social interaction issues, as well as sensory challenges – great chunks of their energy may be used up more quickly than that of their neurotypical peers and family members.

And what happens when an autist socialises – even with friends or family that they love and enjoy spending time with? They use up lots of spoons!

The spoon theory in practice

Let’s take an average day for a busy working autist Mum, and let’s say she has 12 spoons of (mainly emotional) energy that day, which was Christine Miserandino’s original proposition.

Get up and complete the morning duties and the school run. Two spoons.

Do a few hours at her part time job. Four spoons.

Do the school run and complete the afternoon family duties. Two spoons.

Cook tea and manage the child’s bedtime regime. Two spoons.

Converse with her family. Two spoons.

Image showing 16 spoons, to show the spoon theory, in an autism context. (ASD ASC)

Sixteen spoons? Which lucky autistic individual has 16 spoons at their disposal?

That’s all her energy used up.

But what if something unexpected happens – e.g a phone call from a relative that was emotionally draining; a long chat at the school gates with a fellow parent; an impromptu talk with the teacher; or a neighbour wanting to chat? These require spoons, and our theoretical autist Mum has none left. In an ideal world, she would realise her spoon allocation had ‘run over’ that day, and would plan for a quieter day the next day, to recalibrate. Maybe using self care tools like headphone-time listening to music, reading a book, having a nap, or whatever works for her.

The social hangover

And what if our Mum wanted to arrange some social time with a friend or family? Dinner perhaps, a little shopping spree, time at the park with the kids, a trip to a local attraction? It’s likely this would use up a massive part of her daily spoon allowance.

(Especially as there’s very likely to be background music, extra lighting, or noisy chatter thrown into the sensory melting pot.)

So, she’d have to plan for both a low-spoon day on the day of the social visit, and probably the next day too, to recalibrate.

If her spoon-management wasn’t up to speed, our autist would likely suffer from a ‘social hangover’, whereby she’d need downtime from most conversation and interaction, and probably sensory stimulation, until she recovered. (Otherwise autistic shutdown may ensue.)

The emotional cutlery drawer is finite

So, it is important for friends and family members of autists (kids and adults alike) to realise that, no matter how much they may want to see you or converse with you, the autist’s energy bank (or emotional cutlery drawer!) is finite.

Days out, family parties, Christmas events, visiting relatives and the like can be exhausting for autists. It’s important to plan one’s social calendar carefully in relation to the rest of the week, to limit social hangovers.

And imagine what a social hangover is like for an autistic child, who maybe can’t grasp their emotional cutlery draw needs, or explain or understand why they’re mentally exhausted? Family members of autistic children ideally need to factor in enough down time, so the child doesn’t get too run down or spoon-deficient.

We’d love to hear your thoughts on the matter!

Please also read our ‘Aspie super power days blog, which details how autists may also be in a ‘spectrum within a spectrum’, e.g. with slow days, fast days and recovery days.

Aspie-superpower days – why autists may be on an ‘autistic spectrum within a spectrum’? We look at the different ‘autistic’ days…

 

 

 

If an autistic person were a tree: visualising autism & an autistic individual’s ‘being’

If an autistic person were a tree: visualising autism & an autistic individual’s ‘being’

A picture showing a tree to explain autism, asc, asd, Asperger's

Making sense of autism – if an autist were a tree…

Here’s our musing on what autism is, and how to visualise it, in terms of an autistic individual’s ‘being’. 

Far too many clinicians and family members are confused about what autism is, and what autism looks like.

Autism is a neuro-developmental condition, and if a person was a tree, we could visualise their autism as the trunk of the tree – autism runs through the tree like a stick of rock, and it was there from the first time the roots began to grow.

The big branches could be significant co-morbid conditions, such as Learning Disabilities, Fragile-X Syndrome and intellectual difficulties and disabilities. The smaller branches could be co-morbid conditions such as mental health challenges, anxiety, Sensory Processing Disorders, Obsessive Compulsive Disorder, etc.

The foliage is the individual autist’s personality and traits, and their ability to ‘mask’, or blend into a neurotypical world.

Why use this analogy? Because old-fashioned autism spectrum disorder (ASD)-related terms like ‘high functioning autism’ confuse the issue – hence, it’s not uncommon to come across individuals saying unhelpful things of autistic individuals, such as: ‘He/she doesn’t LOOK autistic; or ACT autistic’.

Autism – running through the core

This is because, an autist without issues like Learning Disabilities, Fragile-X Syndrome and intellectual difficulties and disabilities; e.g. someone who has so-called ‘high functioning autism’, or Asperger Syndrome; may not have the co-morbid conditions that give away the autistic way in which he/she understands and experiences the world. (With thanks to follower for Ethan, for his comments/input.)

But autism is there, running through their core.

If we consider autism like this, it answers the question of why autism cannot always be seen; e.g. when a family member queries that their relative could be autistic, or when a teacher can’t see any issues, because the ‘foliage’ is masking the child’s feelings.

Do you agree? We’d love to hear your thoughts…

Interested in finding out more? Why not read our blog on the diagnostic criteria for autism?

A little disclaimer – here at Spectra.blog we don’t claim to be experts about Autism Spectrum Conditions / Disorders; the information we post here is based purely on our own exposure and experiences.

 

A balanced discussion: Are C-Sections Contributing to Autism Spectrum Disorders? (1) – there’s no conclusive evidence; and (2) let’s stop making women feel guilty!

A balanced discussion: Are C-Sections Contributing to Autism Spectrum Disorders? (1) – there’s no conclusive evidence; and (2) let’s stop making women feel guilty!

An American health website recently posed the question to its followers and readers – Are C-Sections Contributing to Autism? (Ref 1). A facet of this contentious story is that C-sections alter the microbiome in the child; microbiomes being microorganisms that, among other things, protect us against germs and produce compounds like vitamins.

A smiling baby - investigating the link and causative factors between babies, deliveries, C sections and autism

It follows then, according to supporters of the ‘C-Section and autism theory’, at least, that disrupted gut flora may act as a trigger for autism spectrum conditions (ASCs). The individual behind the recent discussions surrounding this debate is natural-birth pioneer, Dr. Michel Odent; he’s said to believe that the following factors may be partly responsible for rising autism diagnosis rates by ‘triggering a genetic predisposition for autism’:

|The use of synthetic oxytocin to induce labour
Changing environmental conditions in the womb
The increasing trend of elective C-sections

 

 

Baby deliveries and autism

There are certainly some robust-looking studies supporting Dr Odent’s theories. One Swedish, 2015 study (ref 2) aimed to investigate the association between the mode of baby deliveries and autism spectrum disorder (ASD), and utilised data from 1982-2010; the full cohort consisted of 2,697,315 children, and it was found that, in this study at least, children born by C-section were approximately 20% more likely to be diagnosed as having ASD. (The average percentage of individuals diagnosed with autism spectrum conditions is usually quoted as being around 1 – 2.5%).

HOWEVER – the Swedish study did state, in a rather confusingly worded manner, that C-Sections have not been conclusively shown to be causative of autism. Instead, the researchers made a nod to genetic or environmental factors, stating: ‘The association [that the study children born by C-section were approximately 20% more likely to be diagnosed as having ASD] is due to familial confounding by genetic and/or environmental factors.’

LET’S MAKE IT CLEAR – WE’RE NOT NAYSAYING THESE AUTISM THEORIES!

Showing a young child's sandy toes. To illustrate a discussion on whether autism and delivery methodology - are C-sections linked to autism?But, as with any story, there are many theorists and theories. If you want to read more, the UK’s Guardian asked ‘How long can humanity survive now?’ in a 2017 feature with Dr Odent, now retired.

The feature, putting forward opposing views to Dr Odent’s, cited ASD specialist Paul Wang as stating: “A foetus with developmental issues may have low muscle tone that can interfere with moving into proper position for natural delivery. In this and other ways, the foetus plays a crucial role in initiating and advancing natural labour.”

The Guardian also pointed out that the difficulties associated with autism – e.g. motor planning, hypo or hyper sensory differences, and communication impairments – may make it difficult for the ALREADY AUTISTIC BABY in the womb to engage in the birth process in the ‘standard’ way.

“Suggesting that inducing labour or delivering a baby via caesarean may lead to autism is irresponsible…”

Dr Carole Buckley, the Royal College of General Practitioners’ clinical representative on autism, was disturbed by Dr Odent’s hypothesis linking C-Sections to autism in his book: ‘The Birth of Homo, The Marine Chimpanzee’, telling the Guardian: “There is no evidence to support the claims in the book, and it is extremely unhelpful of Dr Odent to make them. Suggesting that inducing labour or delivering a baby via caesarean may lead to autism is irresponsible. It will only increase anxiety and feelings of guilt or inadequacy that women often feel when they need intervention to give birth to their babies.”

We have to agree with Dr Carole Buckley’s views on autism and C-Sections…

A child and a dog. To illustrate debate on the Causes of autism - links with c sections?

A further note to consider within this discussion is the link proposed by some individuals that ‘toxic exposures’ to the mother while her baby is in utero have been cited as a risk for autism spectrum conditions on numerous occasions.

This includes the ASC profile ‘Asperger Syndrome’.

These ‘toxic risks’ include air pollutants and also overload or regulation [or metabolism of] metals, such as zinc and copper.

However, while there’s plenty of useful information online and in print to help us form our own decisions and make choices, the most likely outcome does seem to be this one, as proposed by Craig Newschaffer, director of the A.J. Drexel Autism Institute at Drexel University: “There could conceivably be some biological mechanism [‘causing’ autism] that might be activated by a range of different complications – people have suggested inflammation, or hormone pathways.” In other words – this is a multifactorial issue.

Craig Newschaffer also told the New York Times that while it’s very important for the public to be aware that there are environmental risk factors in the development of autism, “Pointing a finger at mom is not the endgame of this kind of research. The endgame isn’t going to be about individual decision making, but more about informing policy.”

References:
Ref 1 – Dr Mercola: Are C-Sections Contributing to Autism?
Ref 2 – ‘Association Between Obstetric Mode of Delivery and Autism Spectrum Disorder: A Population-Based Sibling Design Study, Eileen A. Curran et al. 
JAMA Psychiatry:2015;72(9):935-942. 

Interested in finding out more? Why not read our blog on the diagnostic criteria for autism?

A little disclaimer – here at Spectra.blog we don’t claim to be experts about Autism Spectrum Conditions / Disorders; the information we post here is based purely on our own exposure and experiences.

UPDATED – Autism: Social communication, sensory issues and repetitive thought patterns or behaviours… The key features of autism, from a diagnostic perspective

UPDATED – Autism: Social communication, sensory issues and repetitive thought patterns or behaviours… The key features of autism, from a diagnostic perspective

This blog post marks a new, occasional series counting 100 autism FAQs. This article includes some info about the main diagnostic factors used for autism spectrum conditions (or ASCs – diagnostically referred to as ‘autism spectrum disorders’, or ASDs).

(1)Social communication, repetitive thought patterns or behaviours and sensory issues

The common, key features of an autism spectrum condition are: (1)social communication and social interaction issues, (2)restricted or repetitive thought patterns or behaviours and (3)sensory challenges.

(1)Issues with expected social communication and social interaction may affect the autist’s ability to adapt into so-called mainstream society; these issues may also affect the person’s care and support needs, in terms of their employment, and social integration. This area is likely to affect their anxiety levels too, as many autists are prone to anxious episodes. BUT – many autists are at peace with the differences that their social communication and social interaction issues bring. They may for example very much enjoy their own company; and the fact that they’re not compelled to take part in the social minutiae of daily integration is not necessarily a bad thing, if it leaves the autist more time to enjoy their interests, and close friend or family interactions!

An aspie’s point of view: “Expected social communication and social interactions are probably the areas where I feel most challenged by my autism. Large groups of people, places where ‘chit-chat’ is expected, or anyone that I am expected to talk to, but don’t know what to talk about – these are all anxiety-inducing areas! But yes, my aspie perspective (perhaps considered anti-social by outsiders) does leave me more time or ‘head-space’ to enjoy my interests and be selective about who I chat to, and most importantly, WHEN.”

(2) Restricted or repetitive thought patterns or behaviours – sometimes referred to as ‘Flexible Imaginative Functions’ – can manifest in autists in different ways – from hyper-focussing on an issue or becoming seemingly obsessive about a special interest, to adopting repetitive processes or patterns. The NAS states – “Obsessions, repetitive behaviour and routines can be a source of enjoyment for autistic people and a way of coping with everyday life. But they may also limit people’s involvement in other activities and cause distress or anxiety….”
(Read more from the NAS HERE).
Restricted thought patterns or behaviours ARE often limiting to an autist; and to others, especially neurotypical people, they may seem annoying or confusing .
(Read about self-stimulatory behaviours, or stimming, HERE).
However, there’s often an element of control, ‘safeness’ or comfort in the regularity of repetitive behaviours that helps an autist feel calm. They’re just part of an autist’s ‘make up’, after all! And once one has identified that one engages in repetitive thought patterns, especially non-helpful ones, there are ways to help break the pattern, or at least notice that it exists! (For example, some advocates of brain-training concepts like the Lightning Process, which involves learning how to use one’s brain to improve body health, maintain that all of us, no matter what our neurology, can-retrain the brain to stop ‘playing’ unhelpful, repetitive patterns.)
There’s also the argument that this rigidity of thought seen in autists does lend itself, in some individuals at least, to good planning, ‘pattern spotting’ (leading to good problem-solving), and organisation; a great workplace skill, and an often-great personal attribute, as well.

An aspie’s point of view: “Yes, restricted thought patterns or behaviours can be limiting. Probably one of the greatest challenges is the fact that autists like (and need) their routines, and the tiniest change can literally throw our whole day out from a mental or emotional perspective. One thing that wasn’t planned for, that is seemingly inconsequential to outsiders, can throw me from being calm and in a good place to extremely anxious and even angry. My family knows not to touch my office chair, move things in my handbag, or go anywhere near my well-organised jewellery box!”

(3)A further key factor is the relevance of sensory issues in autists, e.g. over or under-sensitivity to sounds, touch, light, temperatures etc; this can affect them greatly. The National Autistic Society (NAS) states – “Many people on the autism spectrum have difficulty processing everyday sensory information. Any of the senses may be over or under-sensitive, or both, at different times. These sensory differences can affect behaviour, and can have a profound effect on a person’s life.”
(Read more from the NAS HERE).
However, autists are also renowned as sometimes experiencing amazing phenomena that stem from their sensory differences, from the way they hear and experience music, to their definitions of colours and sounds. While sensory differences are often an undoubted difficulty in terms of going about one’s daily life with autism, with all of life’s noise, colour and ‘busyness’, at the same time, there are some positives to be taken from the unique sensory experiences that some autists may have, particularly where an enjoyment of music is concerned.
(Read our ‘autism and music’ blog HERE. And check out further details on synesthesia HERE).

An aspie’s point of view: “It is important to point out that as the NAS states, any of the senses may be over or under-sensitive at different times for autists. This leaves me feeling reasonably capable on some days, but very challenged on others. On challenged days (over-sensitive), I find noise difficult – less so than lighting. Every little noise can be grating and annoying, making me wince and cringe. There’s a very real risk of sensory overload or ‘over-whelm’. Some things – the sound of someone eating, a clock ticking – can be incredibly annoying. On under-sensitive days I specifically listen to loud rock music, extremely loud, as it helps my brain to recalibrate. I am super lucky to be able to feel and enjoy music in a way that I don’t believe many people, and especially some neurotypicals, are able to.”

NB – Autism was formerly defined by what was coined the ‘triad of impairments’, a concept introduced in the late 1970s. (Wing and Gould.) Read our blog questioning whether the term is outdated HERE).

A little disclaimer – here at Spectra.blog we don’t claim to be experts about Autism Spectrum Conditions / Disorders; the information we post here is based purely on our own exposure and experiences. 

 

Clarity – explaining the diagnostic criteria for autism spectrum disorders (autism spectrum conditions) – inc. Asperger Syndrome

Clarity – explaining the diagnostic criteria for autism spectrum disorders (autism spectrum conditions) – inc. Asperger Syndrome

As an update to a previous BLOG that was written (pre-ICD-11), we have updated the info on the diagnostic criteria for ASCs (Autism Spectrum Conditions) or ASDs (Autism Spectrum Disorders) as follows:

Despite many training providers, resource materials, clinicians and families referring to the OLD methodology of using the autism diagnoses: ‘severe’, ‘high functioning,’ and ‘Asperger’s Syndrome’, these terms NO LONGER fall within current diagnostic guidelines.

The OLD ICD-10, (ICD being short for: ‘International Statistical Classification of Diseases and Health Related Problems’, the most commonly-used diagnostic manual in the UK), listed Childhood Autism, Autistic Disorder, Atypical Autism, Asperger Syndrome & ‘Pervasive developmental disorder, not otherwise specified’, as the main autistic categories. However this too is now out of date.

With the launch of the latest ICD-11 in summer 2018, only ‘Autism Spectrum Disorder‘ is stated, with varying sub-descriptions – see graphic. These are the terms that diagnosing clinicians should use. (It’s possible that some may continue to use the older terms, until their own continued professional development has caught up with the new guidelines).

In America, within the DCM-5 diagnostic manual, clinicians are also advised to also use the broad term Autism Spectrum Disorder, but with a numerical note of severity, and / or the additions of ‘With or without accompanying intellectual / language impairment,’ dividing the ‘severities’ from 3 to 1. (e.g ‘Autism Spectrum Disorder level 1’ is seemingly akin to an Asperger’s-type diagnosis, under the ‘older’ system).

But what if you were diagnosed with an older autism spectrum diagnostic term, e.g. Asperger’s – do you still keep that diagnosis? The answer is emphatically, yes. Autists identifying as having Asperger Syndrome often feel comfortable with their own diagnostic ‘label’, and the term ‘Aspie’ is widely used and liked (by many autists).

And WHY do resources like this one keep using the phrase ‘Autism Spectrum Disorder’ instead of Autism Spectrum Condition, which is obviously preferable? It is because anyone researching autism spectrum conditions needs to use the correct terms to inform their searches, and currently, the diagnostic guidelines use ‘Disorder’, and not ‘Condition’. We may not like the term Disorder, and we may choose to use ‘Condition’ personally, but diagnostically and from a research and clinical point of view, ‘Disorder’ is used, and informs our research.

Finally, what about Hans Asperger’s links with the Nazis? Briefly, we advise reading author Steve Silberman’s ‘Neurotribes‘ book, for a well-written piece of autism back-history. (You can read an article here summarising the recent ‘Asperger’ revelations. “Asperger it seems was playing a very complicated game of appearing to be anti-Nazi, but meanwhile signing… death warrants,” Silberman has said.) Do #actuallyautistic individuals want a moniker associated with the Nazi regime? That’s an interesting debate for us to tackle at ‘Spectra.blog’ another day!

A little disclaimer – here at Spectra.blog we don’t claim to be experts about Autism Spectrum Conditions / Disorders; the information we post here is based purely on our own exposure and experiences.

You may also like: Is Autism’s Triad Of Impairments outdated? (ASC / ASD / Asperger’s) – and  ‘Them V Us – disparity in the autism spectrum condition ranks (ASD/ASC/Asperger’s).’