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Co-morbidity and autism spectrum conditions, or ASCs (ASD, Asperger’s)

Co-morbidity and autism spectrum conditions, or ASCs (ASD, Asperger’s)

Nearly three-quarters of children with autism spectrum disorder (or ASD – ‘disorder’ being a diagnostic term) also have another medical or psychiatric condition, according to autism studies (Simonoff et al, 2008).

This is called ‘co-morbidity’. Co-morbid conditions to ASDs – also known more favourably as autism spectrum conditions, or ACS – include anxiety disorders, attention-deficit/hyperactivity disorder, depressive disorders, Fragile X syndrome, gastrointestinal symptoms, intellectual disability and developmental delays.

Here at Spectra.blog, we don’t tend to focus on the more negative sides to autism. Many people already seemingly regard autism as a terrible disease, rather than the difference in processing and seeing the world that autism is! But we can’t get away from the fact that the common ‘co-morbids’ that are associated with autism and Asperger Syndrome can be at the very least, debilitating, and in many cases, considerably life-changing. So here, we have detailed some of the most common.

Anxiety disorders & autism

One study found that thirty nine per cent of adolescents with ASD had criteria for ‘A lifetime history of an anxiety disorder.) (Mazefsky et al, 2013).

According to raisingchildren.net.au, for children with ASD, anxiety might show up as stimming more often, asking questions over and over again, hurting themselves, or having trouble getting to sleep. They state that about 40-60% of children with ASD also have anxiety.

A well-known anxiety disorder for example is Obsessive compulsive disorder (OCD); people with OCD behave in repetitive and compulsive ways.

Boy draws, to illustrate childhood autism articleAn oft-quoted study on autism and co-morbid conditions states: ‘Psychiatric disorders are common and frequently multiple in children with autism spectrum disorders. Co-morbid conditions can appear at any time during a child’s development. Some might not appear until later in adolescence or adulthood. Sometimes these co-morbid conditions have symptoms that affect how well ASD (autism spectrum disorders) therapies and interventions work.’

Attention deficit hyperactivity disorder (ADHD) & autism

According to the National Autistic Society (NAS), ADHD is common in people with autism. The NAS asked experts from The South London and Maudsley Hospital to explain how ADHD can affect children and adults, and the article may be found at the NAS website. The experts stated that while ASD and ADHD share some common characteristics, like the autist not seeming to listen when people speak, interrupting, or intruding on other people’s personal space, if someone has ADHD, they predominantly struggle with impulsivity, hyperactivity and inattention.

Depression and dysthymia & autism

Studies definitively link depressive symptoms with ASD. One study examined the potential relationship between co-morbid depression or anxiety in adolescents with [as was then described as] high-functioning ASD, and found that 32% of adolescents with ASD met criteria for ‘A lifetime history of a co-morbid depressive disorder’.

Two females talking _ to illustrate communication between NTs and autistics: ASC ASD‘Findings of co-morbid depressive and anxiety disorders in this study support previous research indicating that these disorders are common among individuals with ASD’, the researchers found.

Likely linked to the individual’s constant struggle to ‘process’ and socialise in a neurotypical world, depressive symptoms like low mood, lack of motivation, trouble sleeping and poor appetite are common signs in autists. It is proposed that depressive symptoms increase with one’s awareness of one’s own autistic social difficulties.

(An interesting research document can be found here (Rai, 2018). The author states: ‘Individuals with ASDs, especially those without intellectual disability, had a greater risk of a depression diagnosis in young adulthood than the general population and their non-autistic siblings.’)

Dysthymic Disorder & autism

Dysthymia, also known as Dysthymic Disorder or Persistent depressive disorder (PDD), is a relatively unknown condition of chronic depression.

Woman- to illustrate that Autistic burnout - Burnout is a physiological symptom of system overload

Dysthymic Disorder can be characterised as a chronic low-grade depression.

According to healthychildren.org, Dysthymic Disorder can be characterised as a chronic low-grade depression, persistent irritability, and a state of demoralisation, often with low self-esteem.

However there’s little information available regarding its prevalence with autism. Anecdotally though, it does seem to be fairly common in autistic individuals.

Fragile X syndrome & autism

Fragile X is a genetic disorder and intellectual disability, and children with the condition have trouble communicating. ASD is relatively common in children with Fragile X, so ASD can be described as a co-morbid condition of Fragile X. You can read more about it at the Fragile X Society’s website – they state: ‘Fragile X Syndrome is the underlying cause of up to 1 in 20 diagnoses of autism’ – and more information may be found here – Budimirovica et al, 2011.

Gastrointestinal symptoms & autism

Common gastrointestinal symptoms for people with ASD are constipation, abdominal pain, diarrhoea and stomach bloating. One recent study (Hsiao, 2-14) found evidence of ‘Emerging evidence for a gut-brain connection in autism, wherein GI [gastrointestinal] dysfunction may contribute to the pathogenesis or severity of ASD symptoms.’

Proposed reasons for GI symptoms in autists include altered gut bacteria, low fibre intake, intolerance and food sensitivities, as well as some autist’s restricted diets. Stress is well-known to affect digestive health, and this is undoubtedly a further relevant factor.

Intellectual disability and developmental delays & autism

As opposed to the theory that intellectual disabilities are highly co-morbid conditions of autism (a seemingly common preconception or myth!), it could be conversely said that individuals with intellectual disability are definitively at risk for ASDs.

(While some figures point to an estimated 38% of children with ASD having an intellectual disability – see carautismroadmap.org this by no means indicates that autism = intellectual disability. This pre-conception, that ALL autists are intellectually challenged, is something that autists face consistently.

A study (Sappok et al, 2013), describes intellectual disability as being: ‘Diagnosed when a child who is six years or older and has an IQ below 70, as well as difficulties with daily tasks. In children under six years, the term ‘developmental delay’ is used when children have significant cognitive and language delays.’

In terms of how common intellectual disability is in children with ASD, about one per cent of the general population is thought to have an intellectual disability, and about 10% of individuals with intellectual disability have ASD or autistic traits.

However, a much higher percentage of individuals with ASD have Intellectual Disability. (The resource carautismroadmap.org states that in studies, 38% of children with ASD were found to have intellectual disability.) Since America’s Centers for Disease Control (CDC) has been measuring prevalence rates of ASD and co-occurring intellectual disability, the rate of individuals with ASD who DO NOT have co-occurring intellectual disability has been rising. Eg there are now more individuals WITHOUT intellectual disability being diagnosed in the USA.

Anorexia nervosa & autism

Could anorexia nervosa be considered a co-morbid condition of autism? We have left it until last in our article, as the condition isn’t currently widely considered to be a common co-morbid condition of ASD. But should it be? The latest research certainly pinpoints a link. The charity Autistica said ‘findings’ suggest one in five women presenting to UK clinics with anorexia may also have autism; health watchdog the National Institute for Health and Clinical Excellence (NICE) conservatively said in response that more research is required.

Autism’s propensity for rigidity and obsession

Woman with eyes closed _ to illustrate article on communication between NTs and autisticsIt is proposed that some autists develop anorexia due to autism’s propensity for rigidity and obsession, e.g. developing a set of rules about calorie intake. Autistica’s director of science, Dr James Cusack, is calling for new guidelines from NICE.

The two conditions have been researched over the years. The document: ‘Autism Spectrum Disorder in Anorexia Nervosa: An Updated Literature Review’ has the main study resources. The ‘Current Psychiatry Reports’ review finds that ‘Studies consistently report over-representation of symptoms of ASD in AN. Co-morbid AN and ASD may require more intensive treatment or specifically tailored interventions.’

Spectrum News reports that: ‘People with anorexia often have difficulties making friends and sustaining social relationships even before the onset of their condition. Because high levels of social discomfort and withdrawal persist even after they begin eating regularly and return to a normal weight, these social difficulties are not likely to have been caused by anorexia or malnutrition.’

Other co-morbid conditions associated with autism

There are a number of other co-morbid conditions associated with autism that include Epilepsy, Tourette Syndrome, Dyslexia, Dyspraxia, and Downs Syndrome – here are some resources, for further reading:

The National Autistic Society

Synapse (Australia)

Maski et al, 2011

special-learning.com

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

Read a further blog here –

Autism Foundation Posts – Spectra.Blog’s FAQs and key posts and articles on autism spectrum disorders

Autistic masking – everything you wanted to know about ‘passing’ or ‘camouflaging’ as an autist

Autistic masking – everything you wanted to know about ‘passing’ or ‘camouflaging’ as an autist

We have written a lot about autistic masking, but haven’t dedicated a single article to it – so here it is.

Autists commonly experience difficulties in key areas including communication, socialisation and sensory challenges. (It’s also common for those on the autism spectrum to experience emotional rigidity and repetitive thought processes or behaviours.)

Many autistic individuals, subconsciously or otherwise, end up masking

Looking at the areas of socialisation and communication, it begins to become clear why many autistic individuals, (subconsciously or otherwise), end up masking – e.g. presenting oneself differently in one’s behaviour, in order to hide certain traits, or mimic neurotypical behaviours.

So it is a way of ‘fitting in’ and meeting people’s expectations.

Autistic masking – getting through the day at work, in school, and at home

A side on image of a white female used to illustrate autism articleMasking may sound quite superficial, but it is in fact necessary to get through the day for many autists; for example, earning a wage in order to feed the family; therefore fitting in at work, meeting social conventions and carrying out the required workplace tasks (often without relevant support).

In places of education, this ‘fitting in’ is usually required in order to access the education on offer without confrontation or revealing one’s struggles, as well as to meet social conventions, potentially avoid punishments, and avoid standing out or being ostracised or bullied.

Masking uses up valuable energy units

In everyday life, masking may be required a lot of the time to simply achieve life’s daily requirements; e.g chatting to a cashier at the supermarket, being friendly towards the neighbours, or mingling at a family function. That is not to say that the autistic individual doesn’t want to be friendly, and chat to the cashier, neighbour or family member – just that this very action takes a lot of mental processing, and energy units. 

Autism is after all a condition of processing, so every interaction for the autist takes up energy units. If the autistic individual had a completely full tank of energy units, then chatting to the cashier, family member or neighbour would probably not represent such a problem.

But if most of the energy units have been allocated with daily executive functioning, there’s very little processing data available, making communication of any kind an effort.

Autism – extensive processing effort

Autistic individuals may develop a set of social skills or ‘mask’ that helps them fit in with others,.

Autistic individuals may develop a set of social skills or ‘mask’ that helps them fit in with others,.

Rather than simply seeing Mary the neighbour and having a chat, the energy-depleted autist is likely to be going through a mental tick list as they see the neighbour. ‘Who is that? It’s Mary. I need to say hello to Mary. Should I ask her how her pet is? What’s her pet’s name? Will she say hello to me first?’ 

Each thought process takes mental and processing effort – the autist may even rehearse the conversation in his or her head as they approach, to make sure it sounds appropriate. Remember, they’re doing this for the neighbour’s benefit, not for their own. How exhausting!

The autist’s natural (and probably preferred) state would be NOT to say hello on this occasion, just to go home and recalibrate after the day’s challenges. But in order to meet social convention, the autist will probably be friendly, and try to ‘pass’ as a neurologically-appropriate individual.

(Hence why autistic masking is also known  as ‘passing’. In clinical terms, it is also described as camouflaging.)

Interacting with other people can be draining

Multiply this effort dozens of times each day, and we see that due to the autist’s differences in processing and communication, interacting with other people can be draining. Hence a ‘mask’ is used to appear neurotypical, or to simply pass as a functional individual who’s following social convention.

Two men walking, to illustrate autism articleRemember, this isn’t a reflection on the autist’s desire to interact with the other person – the autist may very much want to communicate with them – it’s simply relative to the amount of mental processing required to do so, when the energy bank is already depleted from processing everything else in the environment that afternoon. (E.g the bright sunlight, the din of background noise on the bus, and the busy neighbourhood.)

Being the best version of one’s self

Autistic masking doesn’t just take place with non-family members – autists may mask around their close friends, spouses, parents, children and other family members too, not because they can’t be themselves, but because they love their close friends and family members so much that they don’t want to cause concern and make the family member worry that there’s something wrong. Maybe the autist, if feeling low, anxious or tired, just wants to appear as the best version of themselves? Like maximising your appearance, putting on a smarter outfit, or putting on make up.

Two females talking _ to illustrate communication between NTs and autistics: ASC ASDIn an ideal world, no masking would be required around loved ones. A family member, knowing their autistic loved one had just done the school run, returned from the office, been shopping or had generally had a tiring day, would knowingly stick their thumb up with a smiling, enquiring face, to silently question, ‘Are you ok?’

And the autist would smile and stick their thumb up to reply, ‘Yes, I’m okay, thank you for understanding and pre-empting my mental exhaustion, spoon depletion and social hangover, but I’m just not up to talking right now, or at least not taking about non essential things.’ And all would be well. But families aren’t all like that, are they! It’s simply a matter of education and awareness, however.

(It’s important to note that young children don’t have that awareness of their parents’ sensitivities, as described above – so the autistic parent is likely to mask, so as not to concern their child.)

Hence, the autist masks to make their families feel happy, often at their own expense, not because they’re unhappy about being themselves, but because they care.

Childhood autistic masking

Three girls are shown to illustrate that echolalia can be an early sign of autism.

It is thought that autistic girls ‘mask’ more than boys.

It’s worthwhile mentioning childhood masking, specifically. Autistic women mask more than men, and it would seem that autistic girls mask more than boys. Masking is a way of navigating reality – remember, it may be subconscious – and for autistic girls, it’s a valuable tool to fit in with peers. But successful masking can lead outsiders to be so convinced of the individual’s ‘typicality’ that their autism goes unnoticed. Additionally, it’s common for a child (of either gender) to ‘mask’ at school and ‘let it all out’ when they return home to the safety of their own surroundings, and people who ‘get’ them.

The website Spectrum News, reporting on a study, states: ‘[Researchers found that] boys with autism might be overactive or appear to misbehave, whereas girls more often seem anxious or depressed.’

It is also interesting to note that masking can include the hiding of self-stimulatory behaviours (stims), like fidgeting or tapping. The autistic individual may bite their cheek, clench their fists or flex and relax a muscle – all things that probably go unnoticed, but help to self-regulate the autist.

Masking – good or bad?

In summary, autistic masking in small measures is maybe not bad thing, to help one’s self esteem, and feel like less of an outsider. However, too much masking, which can occur long-term when the autist is not yet diagnosed with an autism spectrum condition (ASD), can be hugely depleting; it is also associated with mental health challenges like anxiety and depression. Once ASD diagnosis occurs, it does also throw up the question, who’s the real me? And too much masking can lead to social hangovers, shutdown and autistic burnout. 

It could be said that getting the balance right between self-care and being true to one’s autistic-self, and fitting into a predominantly neurotypical society and masking along the way, is the eternal holy grail for most autistic individuals.

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

Why not also read our blog on autistic communication differences:

Talking Taki-Taki – discussing communication differences between autistic individuals and neurotypicals; and why NT’s find autists ‘different’ (Asperger’s / ASD /ASC)

Autistic burnout – what it it and how can we prevent it? (Autism / Asperger’s / ASC)

Autistic burnout – what it it and how can we prevent it? (Autism / Asperger’s / ASC)

Do you know the phrase ‘burning the candle at both ends’?

Autistic burnout is when the candle is being burned at both ends without enough replenishment to counteract the areas in which an autistic individual especially struggles, or uses up the most energy units – e.g. social, communication and sensory. Everyone, no matter what their neurology, experiences low mood, tiredness and potentially has the capability to burn out – but autistic burnout is slightly different, in that it usually relates to the autist’s deficits and challenges.

Candle - to illustrate that Autistic burnout - Burnout is a physiological symptom of system overload

Burning the candle at both ends?

The autistic individual (especially, it seems, if female), tends to use up a lot of energy on ‘autistic masking‘, or fitting in (you can read more about energy exertion in our blog about the spoons theory.)

Most autists face some kind of difficulty with fitting in, especially if they are undiagnosed and unaware of their autism, or if they are young and still getting to know social conventions. Avoiding autistic burnout only becomes easier once you know what self care tools you need in your toolbox!

Going back to masking; what would be classed as ‘fitting in’? Maybe engaging in expected conversation at work, appearing unperturbed by sensory difficulties when shopping, and managing the challenges of certain socialisations, e.g. extended family get-togethers or office parties. This ‘masking’ is often required in order to hold down a job, access education services or maintain relationships, and can be an automatic reflex, rather than something calculated. However, the processing power and social energy required to maintain the mask can be very depleting.

Ryan Boren writes eloquently about autistic burnout as follows – “Periods of burnout caused problems at school and work. I would lose executive function and self-care skills. My capacity for sensory and social overload dwindled to near nothing. I avoided speaking and retreated from socializing. I was spent. I couldn’t maintain the facade anymore. I had to stop and pay the price.”

What tends to happen to autists who are responsible for others is that this important element continues to function during burnout – eg. their duties as a parent or carer – but other everyday functions have to be ‘turned off’. Communication may deplete, sensory overload is common, self care skills (perhaps including seemingly simple things like taking care of one’s appearance) become of less importance – essentially, this computer’s operating system is shutting down, so only the essential tasks remain ‘on’. In autistic burnout, the individual may become withdrawn, their voice may become more monotone due to the sheer effort of communicating (some autists may even become non verbal), and they are likely to be very sensitive to sensory input. Many autists experience anxiety, symptoms of low mood, dysthymia or depression during their lives, and during burnout, these conditions could well resurface.

How long does autistic burnout last?

Autistic burnout may last days, more likely weeks, and perhaps a couple of months. Anyone in more longer term burnout than this would likely need a great deal of support in their lives, to become strong and well again. (Severe levels of total burnout are likely to be linked to some kind of large-scale life milestone, or occurrence  – the individual would likely not be able to continue to go to work, or stay their place of education, until they recover sufficiently.)

Woman- to illustrate that Autistic burnout - Burnout is a physiological symptom of system overload

Burnout is a physiological symptom of system overload.

So here’s our take on autistic burnout. Treat lower level autistic burnout as something akin to a migraine. Would we expect someone with a migraine to go to work, merrily do the shopping, look their best and casually chat about trivia? No, they would likely head to bed, and rest.

Burnout is a physiological symptom of system overload. The individual generally needs time to recuperate in a low-demand environment, with as few challenges in the areas of communication, sensory triggers and socialisation as possible.

How is autistic burnout avoided?

Autistic burnout may be avoided by knowing yourself (as an autist), knowing what triggers you, how often you must rest or have social downtime, reducing social activities when you’re feeling sensitive, using self care tools like headphone time when you need to recalibrate…. and removing things or people from your life that deplete your energy bank, rather than fill it up.

In children who don’t yet have this level of self awareness, reducing demands, allowing the child choices in their decision making, reducing socialisation and sensory triggers, and generally allowing rest or down time could be beneficial. (With liaison with their educators.)

Individuals in more severe stages of burnout could need all of the above, as well as talking therapies, health and nutritional support, and the support of any education or work places, to allow the autist to recover and plan any return.

We’d love to hear your thoughts on the matter! Why not read another of our blogs on autism – this one focusses on communication…

Talking Taki-Taki – discussing communication differences between autistic individuals and neurotypicals; and why NT’s find autists ‘different’ (Asperger’s / ASD /ASC)

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. Please share our articles if you find them useful!

What’s echolalia; and is it an early sign of autism or Asperger’s?

What’s echolalia; and is it an early sign of autism or Asperger’s?

Echolalia, a beautiful-sounding word from the combined Greek words for ‘echo’ and ‘speech’, is the repetition of another person’s spoken words. But is it an early sign of autism? Read on!

It’s a valuable part of processing speech for everyone, but for many young autistic individuals, echolalia becomes more than that – part of their persona, and in many cases, part of the ‘mask’ that helps them fit in with others, including with neurotypical (NT) people. So, echolalia can indeed be an early sign of autism.

Examples of echolalia?

Three girls are shown to illustrate that echolalia can be an early sign of autism.

Echolalia can be an early sign of autism.

A simple example of echolalia is if the child replies ‘Are you hungry?’, when asked that exact question. (Or perhaps just the last word – ‘hungry’).

“But all children repeat words and phrases – mimicry is just experimenting with different sounds to hone social language skills. It is a normal stage of language development,” explain incredulous friends and family members to the concerned parent whose child exhibits a lot of echolalia.

Yes. But as with piecing together all autistic signs, it is about spotting patterns and frequencies; looking at the other elements of the child’s vocabulary; noticing how their peers talk in the same situation; and noticing whether echolalia is being used to help the child process language. Experts indicate that echolalia, as part of typical language development, has generally decreased drastically by the age of three, for typically developing children.

Immediate echolalia and delayed echolalia

Autism clincians describe both immediate echolalia and delayed echolalia; immediate echolalia could include our earlier example, e.g. if the child replies ‘Are you hungry?’ when asked that same question. It is sometimes an issue of processing (autism is after all primarily a condition of ‘processing difference’.) The child may be ‘buying time’, while they’re processing the words and their meaning. (Remember, if they’re autistic, that there are many things to process in that moment, and ‘blocking out’ the rest of their environment – e.g. the noisy running tap, the bright bathroom light, the music in the background – may require a few beats of conversation longer. Repeating a question gives them a little more processing time.)

Catch-phrases and film lines

Delayed echolalia can take the form of a catch-phrase, song lyric or a line from a TV show. Many people of all neurologies do this of course, but the ‘social norm’ is to make the phrase relevant to the conversation or situation. If the child has, for example, seen the TV show, they could be remembering the episode; but sometimes it is a phrase someone else has remembered, and makes no real sense comprehensively; it just sounds good!

Two girls are shown to illustrate that echolalia can be an early sign of autism.

Echolalia, a beautiful-sounding word from the combined Greek words for ‘echo’ and ‘speech’, is the repetition of another person’s spoken words.

It can also be a phrase the child has actually heard in real life, often linked to a strong emotion. Maybe they were told off by a teacher, or their parent shouted something in frustration; or maybe the phrase is from a pleasant birthday party, or a foreign holiday (e.g. even a foreign phrase, when the child doesn’t speak the language).

To infinity and beyond…

“All children repeat words and phrases,” reminds the helpful friend or family member, as the five year old jumps off the sofa quoting a phrase from a super-hero film. Yes, but in what situation, and what’s the frequency; are they ‘stuck’ on the phrase like a broken record? Is it said once, five times, ten times maybe? And is it when they’re pretending to be the character, or at tea time? Detective skills are required here, to spot the patterns and frequencies.

What’s behind the echolalia?

Also, it’s useful to work out what benefit the echolalia has to the child – just a nice, fun sound or phrase that is comforting, or makes them happy? Or a tool to compensate for a lack of language skills?

If it is the first example, bear in mind that autists like ‘sameness’, and things they know; many will watch a favourite film multiple times, and enjoy the predictability. Maybe a phrase is just part of their appreciation for something predictable in a film. (Also, autists are notorious wordsmiths – just look at some of the most quirky and creative songwriters out there, and ponder whether they have / had autistic traits!)

And, if the echolalia is a fun sound or phrase that is comforting, is the comfort needed for good reasons, e.g. as we’d hug a teddy because it feels nice; or, of more concern, because the child is stressed or anxious – if it’s the latter, how can the ‘stressors’ be lessened?

Also, if it’s the second scenario, and the child is over the age of three, could speech and language therapy be a consideration?

Autistic masking

Autistic individuals may develop a set of social skills or ‘mask’ that helps them fit in with others,.

 

Going back to something we mentioned previously, echolalia may form part of a ‘mask’ that helps the autistic child, or youngster with Asperger’s, fit in with others, including with neurotypical (NT) peers. This element can make it hard for some outsiders to see an issue with a child who may be autistic, but doesn’t have a diagnosis.

‘To infinity and beyond!” shouts the autistic child repeatedly to his or her playmates, as they play space rockets and space-men. It may look as if he or she is interacting with his peers, and that they’re all enjoying the game collaboratively – but are they? How are the other children conversing – what vocabulary are they using? And is the child using echolalia as a mask or ‘fitting-in’ strategy, because he or she is struggling with conventional or typical communication styles?

An undiagnosed autistic child has many cues and signs that he or she presents; but noticing them takes the aforementioned detective work, sometimes.

The websites autism-help.org and speechandlanguagekids.com have some really useful tips, articles and factsheets on echolalia.

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. Please share our articles if you find them useful!