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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).’

‘Well, we’re all a little bit gay, aren’t we?’ Questionable responses to one’s inner coding, one’s DNA, one’s hard wired neurology. (Autism, ASC / ASD / Asperger’s)

‘Well, we’re all a little bit gay, aren’t we?’ Questionable responses to one’s inner coding, one’s DNA, one’s hard wired neurology. (Autism, ASC / ASD / Asperger’s)

It’s the 21st-century – 2017 to be precise. I have told my friends and family that I am gay; I only realised myself, relatively recently – their responses run along a similar vein.

They are generally a mixture of ambivalent, surprised and somewhat perplexed; and more than once, I am told ‘well you are obviously only mildly gay’, and ‘well we’re all a little bit gay aren’t we?’

Despite my protestations to the contrary on both of those counts, the friends and family remain unconvinced, and in most cases, the subject is barely brought up again. Within the wider family, any hint of conversation around the subject of my ‘gayness’, or anyone else’s for that matter, feels like it’s swiftly dropped. (‘We don’t talk about that in these circles, you know’. seems the inference. ‘It’s too awkward. We’d have to look back on the heterosexual challenges you have faced in life, with the hindsight that you are and have always been gay; and maybe if we look too closely, we would feel awkward that no-one noticed your struggles. Or that we closed our eyes to it, or put it down to your quirkiness. ‘Cause we’re all a little bit quirky, right?’

This story is not quite true. I have substituted the word autistic for gay, for the sake of comparison.

In the 21st-century, such responses (like those detailed above) to one’s inner coding, one’s DNA, one’s hard wired neurology, seem so dated and cold, do they not? Do they seem dismissive too?

To make another comparison…. is one mildly pregnant? Are we ‘all a little bit pregnant’? Of course not. Sometimes we share traits with pregnant women, but that doesn’t make us mildly pregnant.

The aforementioned story is an interesting and arresting comparison, in any case.

 

 

Let’s talk about autism spectrum conditions (ASCs). Autism is autism. Yes, some individuals need less (or even zero) support in place to function fairly successfully in a neurotypical world than others. The label ‘high functioning’ would likely be hung around their metaphorical necks.

“What if autists have autism running through their core, like Brighton rock?”

Other autists with increased support needs, and co-morbid conditions such as learning difficulties, would likely be labelled ‘low functioning’ or, depending on their perceived communication abilities and health challenges, the dreaded ‘extremely autistic’. What if we stopped thinking about mild or severe, and high or low functioning? What if autists have autism running through their core, like Brighton rock, and their co-morbid conditions, health issues, sensory and social challenges simply accessorise or populate their condition, and make it more or less debilitating, and ‘dis-abling’? (Because, yes, autism is classed diagnostically as a disability.) This ‘frame’ makes the modern way of looking at autism (without functioning labels and even without the diagnostic term ‘Asperger Syndrome’, for so-called high functioning autists who did not have learning delays present in infancy) seem infinitely sensible.

But back to our early opening story – why is it hard for friends and families to grasp the idea that a loved one is autistic – and the author of this blog is musing specifically about late autism diagnosis (including the decreasingly given ‘Asperger’s’ profile) – e.g autism diagnosis in adulthood. (Read our post on confusion in diagnoses of autism HERE).

It’s important to clarify that questioning HOW autistic someone is (‘Aspergers? Oh, I see, just MILDLY autistic…’), dismisses the autist’s struggles.

 

And it’s important to emphasise that pedalling the old chestnut ‘We’re all a little bit autistic’ is patronising (and untrue.)

We need to realise that autism is widespread – everyone knows people who are autistic, including family members, friends, work colleagues (and yes, even those quirky celebrities we’re all fascinated by) – even though the individual may not (yet) know themselves that they have autism.

So to conclude – when your loved one tells you they’re autistic, it is important to give the disclosure the respect and acceptance it deserves.

(You may like to check out our blog about what to expect during your adult autism diagnosis HERE. And also our blog on ‘what next?’ after autism diagnosis, HERE).

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

NOT walking in your shadow. Tips for breaking free from negativity and autistic shutdown (ASD / ASC / Asperger’s)

NOT walking in your shadow. Tips for breaking free from negativity and autistic shutdown (ASD / ASC / Asperger’s)

This blog is really about positivity. The author has been in something of an anxious, autistic ‘fug’ for a few weeks – a shutdown. Retreating, wallowing – it’s not a bad thing, it’s not something to feel too concerned about; it’s usually a necessarily evil for an autistic individual, when life has got ‘too much’. (Although long term shutdown IS concerning). For this autist, shutdown, while not pleasant, is an important period, as it always serves as a reminder, or a wake-up call.

Essentially, shutdown, for someone with an autistic spectrum disorder / condition (ASD/ASC), can be described as feeling like a computer that’s not equipped with update software – it simply has too many apps or browsers or programs open. Autistic shutdown is when you need to start closing down your programs, to conserve energy.

(We covered the process in more detail on THIS BLOG, so please click to read more about autistic shutdown. We also covered the process of heading to shutdown in THIS BLOG, so we hope you find these useful.)

Anxiety tests

Incidentally, performing regular anxiety tests can be a useful indicator for an autistic person, in terms of whether they’re heading for shutdown. THIS SITE offers a good stress/depression/anxiety test, assessing elements like whether the individual is unable to relax, is ‘touchy’ and easily upset, irritable, easily startled, fidgety, intolerant of interruption etc. It’s a quick, confidential online Q&A that gives good feedback, and doing a test like this regularly is a good gauge (for anyone – autist or neurotypical!), to assess their mental state.

ANYWAY. As mentioned, this post is about positivity, and moving forward from the low times.

What gets an individual on the autistic spectrum out of shutdown?

(1)Removal of the stressor, of cause of the anxiety.

(Fine in theory – but for most people, autist or neurotypical, anxiety has many causative factors – it’s hard to pinpoint individual elements, let alone remove or adapt them). However sometimes, maybe working too many hours, a toxic personal or work relationship, a health issue etc, can be addressed, and the stressor can be removed or reduced.

(2)Self-care

This point is important. Relaxation, reduction of sensory or social challenges, as much sleep as is possible, indulgence in one’s interests (e.g. music), down-time / me-time, etc. Self-care (at all times, e.g. not just when in shutdown) is key to maintain emotional equilibrium for all autists, and anyone, in fact.

(3)Talking therapies, mindfulness, meditation etc

Many people, again autist or neurotypical, benefit from talking therapies like Cognitive Behavioural Therapy (CBT), to help re-set negative thought patterns. (Those on the autistic spectrum are especially prone to repetitive thought patterns.) Mindfulness, meditation and such holistic practices may also help.

(4)Time

Sometimes, time just helps. Our autistic PC simply has too many apps or browsers or programs open, so just working through the re-booting process is beneficial.

(5) Life cull

As mentioned, this post is about positivity, and this author saw a phrase recently which helped enormously: Let go of what does not serve you.

This ‘life cull’ applies to things, possessions, places, hobbies and people. Individuals on the autistic spectrum can get overwhelmed easily by socialisation and sensory sensitivity, and we’re often ‘people pleasers’ (especially, it seems, autistic females – something author Tania Marshall has described.) Sometimes we need to ‘let go’ of things in our lives, to maintain wellness.

This explanation is from the website Peaceful Mind, Peaceful Life

“One of the hardest yet most rewarding lessons I’ve experienced is learning to let go of what doesn’t serve me. In theory, I’ve always understood it, but in my ego mind, I’ve always thought that it is me who knows what’s best for me. So, when the Universe would send me messages to step away from certain people, situations or places, and I just wasn’t ready to, I ignored it, sending me into constant tailspin. I let go of people who brought me down, of places that made me feel low, of habits that didn’t bring forward my best self, and it was really freaking challenging.”

So, number 5 on our list is ‘life cull’. If you’re an autist (or your loved one is) struggling to recalibrate, reinvigorate or get out of a shutdown or ‘low’ period: why not make some changes?

Step away from people, situations or places that do not serve you. It can be hard, especially letting go of routines and relationships / friendships – but: are they serving you?

Don’t forget to read our AUTISTIC SHUTDOWN BLOG!

Music that moves you

Something that helps this author is finding moving music; music that changes our state. A new song by a UK songwriter really ignited the fire, recently: Barbed Wire by Tom Grennan, with the lyrics –

‘From a youthless man who’s walked a lonely road… he holds himself together with these barbed wire gates. Don’t let people hold you back; gotta stand tall and aim higher; don’t touch the barbed wire. If you walk in your shadow, led by shepherds, then you know.’

The songwriter has said Barbed Wire as a concept is the idea of a path you shouldn’t tread, and was written when he felt trapped and isolated.

Although it was written from that sad place, it is very euphoric and brilliantly produced, best turned up loud. It certainly lifted this author up!

There’s something to be said about NOT walking in your shadow, and not letting people hold you back. In a low spot, a ‘fug’ or an autistic shutdown, finding the spark that changes your thought processes is key to getting out of the shadows. Listen to the track far below, and also see our own video to accompany this blog.

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

(3) #mygrandchildisautistic?! Why is routine so important to the autistic child? Why do autistic children struggle at occasions / parties? We answer grandparents’ questions on autism

(3) #mygrandchildisautistic?! Why is routine so important to the autistic child? Why do autistic children struggle at occasions / parties? We answer grandparents’ questions on autism

This is the third in a new series of articles aimed at helping families and grandparents learn more about autism, and also support the parents of a newly diagnosed autistic child, and of course the child themselves.

But firstly, why do we use the hashtag – #mygrandchildisautistic?! – with its implication of questioning surprise?

Because, to generalise, this is the first generation of grandparents whose grand-kids are gaining autism diagnoses in larger numbers than have been seen previously. Of course, many children are diagnosed and have been diagnosed with autism spectrum conditions (ASCs) over the years; but the current generation of parents in their thirties and forties would not have witnessed great numbers of children gaining autism diagnoses when they, the parents, were school age, in the 1980s and 1990s. Thus, a great many (current) grandparents did not see their own generation, or their children’s generation, gaining autism spectrum diagnoses in large numbers.

Today, many more parents are gaining their own autism diagnosis as adults, after researching ASCs in their children. But, thanks to a lack of exposure to diagnosed autism, and the fact that many grandparents don’t see their grandkids daily to witness the (often subtle) signs of autism in children, there can be a lack of understanding and knowledge when parents of newly diagnosed children share the news with families and care givers.

Here, we aim to answer come commonly asked questions that grandparents and other family members may ask of their young family members.

Why is routine so important to the autistic child?

The autistic brain can feel ‘dis-ordered’ – hence the diagnostic term ‘autism spectrum disorder’ – and this element of disorder changes day to day and occasion to occasion, and also environment to environment, for the autist. (Read our ‘What is autism’ blog HERE).

With life’s multiple elements of unpredictability, many autists find solace in structure. Each autist is different of course, with a different set of challenges, however all autistic individuals will face challenges in the fields of communication and social interaction, as well as some degree of sensory difficulty. It is when the difficulties or challenges stack up, and are not counter-acted by skill-sets to manage them, that autistic anxiety ramps up; and autistic behaviours that are problematic for the autist, and sometimes others around them, manifest. (This is why we use a set of scales in our Spectra.blog logo, e.g. to represent this ‘balance’ of challenges versus skill-sets).

Following routine means that the autist is limiting surprises, unexpected sensory challenges, or new social situations. Depending on their level of processing challenges and executive functioning difficulties, un-planned-for occurrences can de-rail the autist’s day. What most autistic individuals like, is to know what is happening, and when. Grandparents and care-givers can help this autonomy and synergy by keeping to set routines, bedtimes, nap times, meal-times, and even meal-types. Autists often experience sensory challenges that make meal-times tricky, in terms of aversions to textures and tastes of food. Sticking to plans, which may include shopping ahead for preferred brands of food for example, so they’re ‘in the cupboard’, helps keep the autist in control. It’s worth mentioning on the subject of food that many autistic children have food intolerances, stress-related digestive disturbances, or are sensitive to food additives, E-numbers and the like. Sticking to the parents’ rules about sweets and snacks will also help maintain mental and physical equilibrium for the autistic child.

All children love birthday parties, fun social occasions and the like, don’t they? If the child is seemingly anxious and grumpy at such an occasion, they’re probably just tired, aren’t they?

Tiredness certainly affects us all, no matter what our age! But let’s use a scenario… imagine going to a networking meeting (or family wedding, for example), in a foreign country, with people, many of whom you like very much, who are speaking a language you don’t know well. You have perhaps learned some key phrases, and have a guidebook (or digital app/translation device). But often, when you’re conversing, despite the occasion being fun, you miss what’s been said, a quickly-told joke goes over your head, or you spend so long looking up a translation that you forget what the other person’s intention was. By the end of the occasion, your brain has worked far harder than usual.

This is what EVERY conversation may be like for an autistic child. They are not just conversing – they’re processing, and trying to navigate social rules and body language that confuse them too. Plus, at an occasion or party, there’s very likely to be background music or chatter thrown into the sensory melting pot. This can result in a ‘social hangover’, whereby the autist NEEDS downtime from all conversation and interaction (and probably sensory stimulation) until they recover. (Otherwise autistic shutdown may ensue.)

Every further conversation and interaction once their ‘social bandwidth’ has been used up is exhausting the autist further. So, parties, visits from relatives, play-dates, Christmas (or any other religious or seasonal occasion) meals and gatherings, and anything that’s socially taxing, especially with people the autist doesn’t see frequently, whilst fun, can be catastrophically draining. It’s nothing like simply being tired. Grandparents and caregivers can help by factoring in lots of downtime, quiet periods, possibly ‘screen time’ if this is what the parents agree with, and any sensory tools that help reduce anxiety, like a weighted blanket or set of noise-cancelling earphones. (It’s worth mentioning also that many autistic children are not fans of being videoed or photographed, so families should ideally ask the child first, before filming or snapping away!)

You can read the first feature in this #mygrandchildisautistic?! series, including the following questions, HERE

*Why does he / she need a label?
*All children his / her age do (certain autistic behaviours) – it doesn’t make them autistic…that’s normal isn’t it?
*It seems like the parents of the child let them dictate a lot, in terms of washing, bathing, food choices, and the clothes they wear. Why is this?

You can read the second feature in this #mygrandchildisautistic?! series, including the following questions, HERE

*Surely behaviours like meltdowns are just like tantrums – how can we tell them apart?
*If the school and the wider family don’t see any autistic behaviours in the child, how can he / she be autistic?
Read our ‘Foundation Posts’ HERE. And check out our post on discovering ‘Aspie strengths’ HERE.

Please note that as we always say in each blog post, 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 do not claim to be experts on any form of autism.