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How autistic people & their talking therapist / hypnotherapist can create a therapeutic relationship

How autistic people & their talking therapist / hypnotherapist can create a therapeutic relationship

How autistic people & their talking therapist / hypnotherapist can create a therapeutic relationship – a guest blog by Kathy at Arrive Therapy.

If you’re considering cognitive therapy or hypnotherapy as an autistic person – maybe to help with areas such as anxiety, self-efficacy, confidence, relaxation, self-esteem, social anxiety etc – you may be concerned about whether it’s for you.

In our blog ‘Can hypnotherapy, Hypno-CBT and mindfulness tools help autistic individuals’, I wrote about possible barriers to taking up talking therapy or Hypno-CBT for autistic individuals – these included (but aren’t limited to) –

 

1. A barrier to a good working alliance (therapeutic relationship) with the therapist, due to autism’s ‘socio-communication’ characteristics.

2. Difficulties with interoception (our ‘body feelings’) may reduce awareness of sensations and emotions.

3. Issues of cognitive flexibility may affect one’s ability to consider alternative possibilities (e.g. in terms of thoughts, beliefs and behaviours).

4. Sensory sensitivities may affect the efficacy of practiced tasks between sessions.

In this blog, let’s look a little more at autism’s ‘socio-communication’ characteristics, and how that may affect an autist’s choice of talking therapist or hypnotherapy practitioner. Obviously if you’re a fan of spectra.blog you’ll know that autism is widely considered to be a set of neurology configurations affecting the individual’s processing abilities, at varying levels – hence the term ‘spectrum’ in the diagnostic phrase, ‘autism spectrum disorder’ – so, no two autists are the same!

 

Is autism hyperfunctioning of neural circuitry?

One interesting theory (developed by Kamila and Henry Markram, and Tania Rinaldi) proposes that autism is a mental overload. The Intense World Theory proposes that autism may be described by hyper-perception, hyper-attention and hyper-memory, with the brain’s major functions working at increased capacity that leaves little ‘energy’ for social interactions.

The Intense World Theory also supports the idea that rather than a lack of empathy (a common myth), autists experience over-sensitivity in the field of empathetic responses. Many autists agree with the concepts behind these theories, and the idea of hyperfunctioning of neural circuitry, and a state of over-arousal for autistic individuals. The lack of energy’ (or spoons – see this blog for a definition) for social interactions extends to talking therapy too!

Socio-communication and autism

Whether or not you agree with theories like this, socio-communication characteristics (or difficulties) are definitively a key area for autistic people. Modern theorists agree that the ‘issue’ doesn’t just lie with the autistic person however, but cite a double empathy concern.
This considers the fact that two or more individuals of differing neurologies (e.g. autistic and neurotypical or non-autistic) often communicate in a different way than two or more people with a similar neurology will do. (Autists are for example often drawn to other autists, or ‘sensitive’ types. It is usually a subconscious ‘attraction’ based on neuroception.)

Many aspects of autistic social presentation are described by diagnosing clinicians as being ‘atypical’ in autistic individuals, including abnormal facial expressivity, irregular use of gaze, lower rates (or unusual timing) of expressive gestures, and unusual speech patterns.

These communication differences sometimes mean that autistic people may find socialisation difficult if it feels out of their control, includes large numbers of people, is worsened by sensory issues, or relates to areas that are difficult for them – for example, induces social anxiety, shame or embarrassment.

Autistic bandwidth

(Of course, some autistic people, although this isn’t exclusive to autists, are non-verbal, or can communicate verbally at different levels on different days. This warrants a different conversation and another blog post – one for another day!)

Autists may also sometimes feel ‘overloaded’ – through the experiences of their day, the surrounding environment, and any number of factors that have consumed their ‘emotional bandwidth’ on that day, or at that time.

Talking at length with them, and talking at all sometimes, can be an extra drain on their bandwidth and resources.

Hence, because autists may communicate in subtly different ways, talking therapists may need to adjust their processes to suit the individual.

Why autism’s ‘socio-communication’ characteristics are not a barrier to Hypno-CBT therapy

 

If you’re considering cognitive therapy or hypnotherapy as an autistic person – maybe to help with areas such as anxiety, self-efficacy, confidence, relaxation, self-esteem, social anxiety etc – you should work with a therapist who understands autism.

Some examples of what you should expect as an autistic client, if you’re seeking Hypno-CBT include:

1. The hypnotherapist knows that your body language (something that behavioural hypnotherapists take into account a great deal in their therapy) may present differently. E.g. your facial expressivity, use of gaze, expressive gestures etc may be different, and not indicative of what you’re feeling.

2. The hypnotherapist knows that your speech patterns may also not be indicative of what you’re feeling. As autists, sometimes we may seem ‘flat’ and neutral, when in fact we are very content or happy.

3. Your therapist knows that you may need extra processing time – this may be to find a certain word, visualise a scene, or process an emotion.

4. The hypnotherapist is aware that initially, the social anxiety presented by working with a new person (a stranger initially) may exacerbate the issue they would like help with. Understanding these issues and putting the client at ease means the required working alliance or relationship can progress.

5. The room (if it is a face to face meeting) is sensory friendly – the hypnotherapist can find out in advance any requirements regarding lighting that may need to be met. Factors like traffic noise, buzzing electrical devices and conversations from the next room, could all affect the working alliance for autistic people, in terms of distractions.

6. (It is important to note that working online, e.g. via Zoom, may be preferable for autistic people, as the online environment may be deemed to be more comfortable and ‘safer’, from a neuroception point of view.)

I hope this blog has helped allay fears about developing a therapeutic relationship or working alliance with the therapist, due to autism’s ‘socio-communication’ characteristics. We will look at some of the other areas listed at the start of the blog in forthcoming articles!

Read more about therapy and autism at Arrive Therapy’s Hypno-CBT blog.

#neurodiversity#autism#autismacceptance#neurodivergent#actuallyautistic#asd#autistic#neurodiverse#autismspectrum#aspergers#differentnotless#autisticpride#autisticadults#inclusion#anxiety#highlysensitiveperson#hsp#empath#highlysensitive#highlysensitivepeople#empathproblems#selflove#nothingaboutuswithoutus

Using self-efficacy, presence, insight and cognition when dealing with a heightened autistic child

Using self-efficacy, presence, insight and cognition when dealing with a heightened autistic child

Using self-efficacy, presence, insight and cognition when dealing with a heightened autistic child – a guest blog from Kathy at Arrive Therapy (Hypno-CBT & cognitive behavioural therapy):

Green graphic stating - Efficacious - in control of your actions, reactions & boundaries Present - aware of your emotions, and of the importance of Now Insightful - understanding the effect of your beliefs and self-talk Cognitive - aware of your neuroception & processing styleOur ethos is based on four pillars, which are, in order to make EPIC life changes:

Efficacious – in control of your actions, reactions & boundaries

Present – aware of your emotions, and of the importance of Now

Insightful – understanding the effect of your beliefs and self-talk

Cognitive – aware of your neuroception & processing style

 

However, it can be hard to put this rather abstract concept into practice; so let me give you an example. I support and advocate for autistic people as well as families of autistics, and this is a real life scenario from a parent support group that I am involved in.

“I wish you would die, Mum”

A child (it could be a neurodivergent child, or it could by a neurotypical child – the principles are the same); is quite angry. He or she is saying something like this to his parent (or relevant care-giver): ‘I wish you would die, Mum’. Our first instinct is often to react with what our parent would have said to us; this usually takes on one of two forms.

The angry parent. ‘Don’t talk to me like that.’

The hurt parent. ‘After all I do for you! I am so upset you’d say that to me’.

Are we using dated parenting phrases?

If we are using words our parents said to us (who were using words their parents said to them, etc etc), we quickly start using Victorian parenting phrases when we’re in the 21st century!

The more Adult (and ‘detective’ or curious) way of looking at it is to ask: what’s the child afraid of? Autistic individuals can’t always express their feelings (they can swirl around inside us, being felt, and not expressed ) – maybe here, for this child, they’re afraid of rejection – they feel a connection has been lost with the Mum – they’re fearing rejection and they protect themselves by creating the rejection first.


So, sometimes you can almost reverse what a frustrated child is saying, to work out what feeling is driving their words. Saying something Adult to them like: ‘Well that’s a sad way to feel, that must feel difficult, but I am not going anywhere, and I love you. Let’s talk when you have calmed down’ attempts a reconnection , and doesn’t enforce the rejection.
Let’s look at how we used the EPIC ethos here:

Efficacious – in control of your actions, reactions & boundaries.

You didn’t react in a knee-jerk way. You responded in an Adult way. You didn’t let your own experiences dictate the conversation / situation. You halted an unhelpful reaction.

Present – aware of your emotions, and of the importance of Now.

You’re a parent of a hurting child – you let that response (or role) lead the way. You focussed on the moment – in which the child is heightened – and suggested discussing it later – this means neither of you will be so reactive and heightened at that time.

Insightful – understanding the effect of your beliefs and self-talk.

‘Don’t talk to me like that’ and ‘After all I do for you.. I am so upset you’d say that to me’ are your beliefs about how a child should speak to their parent and vice versa. But are they really YOUR beliefs, now, as a parent? Or are they your parents’ beliefs? Does your self-talk tell you to instil more discipline?

Cognitive – aware of your neuroception & processing style.

If you wanted to yell: ‘Don’t talk to me like that’ or similar, you were probably triggered – this is your neuroception at play. It probably took you to an unsafe place – somehow, you felt defensive, even child-like. If you felt more ‘fight or flight’ than engaged, you were not in a safe place to explore someone else’s hurt. By recognising this instinctive reaction, you reduced your own feeling of unsafety or defensiveness.

I hope that this example has been useful to showcase how we can be more relational with our children, and can be more Adult in our reactions! Kathy Carter.
(Kathy’s book Autism from A to Z’ is available on Amazon.)

Read the Hypno-CBT Arrive Therapy blog HERE.

#mindfulness #healing #selflove #wellness #cognitivebehaviouralhypnotherapy #hypnoCBT #hypnotherapy #neurodiversity #autism #adhd #neurodivergent #actuallyautistic #autismacceptance #autismparenting

Can hypnotherapy, Hypno-CBT and mindfulness tools help autistic individuals? YES – and here’s why…

Can hypnotherapy, Hypno-CBT and mindfulness tools help autistic individuals? YES – and here’s why…

I am a firm believer that individuals of all neurologies can benefit from development tools and therapies such as CBT, hypnotherapy, Hypno-CBT, mindfulness and other focused attention work.

But if you’re considering cognitive therapy or hypnotherapy as an autistic person – maybe to help with areas such as anxiety, self-efficacy, confidence, relaxation, self-esteem, social anxiety etc – you may be concerned about whether it’s for you.

It’s true that some autistic individuals believe that these practices may not work for them, and I believe this may be because of a fear that the hyper-focus and rumination that autists commonly experience may lead them to focus too much on unhelpful cognitions, as opposed to helpful ones.

Experts agree that autistic young people and adults can benefit from cognitive behaviour therapy, or CBT (Source: Journal of Rational-Emotive & Cognitive-Behavior Therapy).

Concerns among autistic people (and their families) regarding the efficacy of CBT and Hypno-CBT could include:

A barrier to a good working alliance with the therapist, due to autism’s ‘socio-communication’ characteristics.

Difficulties with interoception (our ‘body feelings’) may reduce awareness of sensations and emotions.

Issues of cognitive flexibility may affect one’s ability to consider alternative possibilities (e.g. in terms of thoughts, beliefs and behaviours).

Sensory sensitivities may affect the efficacy of practiced tasks between sessions.

However, researchers in the above study agreed that while adaptions may need to me made to meet the characteristics outlined above, this behavioural modality can be effective for autistic people.

Addressing trauma

Firstly, let’s point out that anyone with unresolved trauma issues is best-placed seeking assistance from a professional talking therapist, rather than just utilising self-development and mindfulness tools. It isn’t wise to try to deal with trauma issues oneself; trauma and PTSD should be addressed in a safe, professional space (this would include sessions with a Cognitive Behavioural Hypnotherapist, or other suitable clinician, either on Zoom or face-to-face.)

In mindfulness and stillness, we’re seeking (from a neuroception point of view), Immobilisation Without Fear. However, the traumatised brain often automatically goes to a defensive state. Tools like meditations and focused attention exercises, while being beneficial to aid ‘presence’ and calm one’s autonomic nervous system, as stand-alone tools are no substitute for talking therapy for traumatised individuals. It’s fair to say that individuals with unresolved trauma often find self-directed meditation difficult, unless they’ve first undergone therapeutic work.

However, if an individual is undergoing therapy, or is a non-trauma-affected person embarking on a self-improvement path, mindfulness and focussed attention exercises can be additionally beneficial. (I am developing a database of free audio resources on this site, found on the Arrive Therapy blog pages).

I believe that the day to day issues that many highly sensitive and neurodivergent individuals experience that are connected with anxiety, excessive rumination (self-talk), issues of self-worth and social communicative issues can all be addressed with tools such as CBT, Hypno CBT, mindfulness and focused attention work.

Reducing anxiety and depression symptoms

Studies back up the fact that mindfulness helps – research shows that depressive symptoms and anxiety disorders are the most common psychiatric concern for autistic individuals, and mindfulness-based work has widely been found to be effective in reducing anxiety and depression symptoms, in studies.

In terms of mindfulness, I have heard autistic people say things like: “I don’t want to be mindful of my thoughts – I am trying to get away from them.” However, I’d challenge this viewpoint. Yes, we autists can experience excessive self-talk – rumination; ‘looping’ thoughts, stuck record syndrome, you name it – but ‘escaping’ our thoughts, and of course dealing with them in other ways, eg. through compulsions or self-medicating, don’t necessarily help. From personal experience, the best way to manage ‘obsessive’ tendencies (remember, autists in particular may thrive on sameness and repetition), is to learn how to develop presence, observe our thoughts, and let them go. This is a learned skill, like riding a bike. CBT techniques can be especially helpful in this regard, and teach us to utilise more beneficial thinking styles.

Mindfulness can definitely help; do try this 14 minute, anti-anxiety meditation / focussed attention exercise; it’s designed to help individuals recalibrate and gain some presence. (Click the image and it takes you to the meditation).

If you’d like more info, please email Kathy on arivetherapy@protonmail.com to discuss your queries.

Visit the Arrive Therapy Hypno CBT blog here.

Read more here about how autistics and their therapists can develop a therapeutic alliance.

#neurodiversity #autism #adhd #autismacceptance

#neurodivergent #actuallyautistic#asd #autistic #neurodiverse

#autismspectrum #aspergers #adhdawareness #differentnotless

#autisticpride #autisticadults #inclusion #anxiety #adhdlife #adhdsupport

#highlysensitiveperson #hsp #empath #highlysensitive #highlysensitivepeople #empathproblems #selflove

Resources (Live links to the URLs included in the new ‘Autism from A to Z’ book by Kathy Carter)

Resources (Live links to the URLs included in the new ‘Autism from A to Z’ book by Kathy Carter)

The book Autism from A to Z by Kathy Carter

This page contains the URLs included within the book ‘Autism from A to Z’ by Kathy Carter; a new, practical guide and information resource collating the most popular articles from this website. It has been created for families and professionals, and curates the latest thinking, information and first-person insight regarding autism spectrum conditions. The websites below are listed within their relevant chapter headings.

A is for autism

http://tiny.cc/BEvans 

‘The Metamorphosis of Autism’ – A History of Child Development in Britain, by

Bonnie Evans.

http://tiny.cc/IntenseWorld

‘The Intense World Theory – A Unifying Theory of the Neurobiology of Autism

Intense World.’

http://tiny.cc/IntenseWorld2

‘Information gain in the brain’s resting state: A new perspective on autism.’

http://tiny.cc/WRAY

MJA – ‘Language disorders and autism.’

http://tiny.cc/Mottron

‘Is it autism? The line is being increasingly blurred.’

http://tiny.cc/DMurray

‘Attention, monotropism and the diagnostic criteria for autism.’

http://tiny.cc/GNSoke

‘Prevalence of Co-occurring Medical and Behavioral Conditions/Symptoms Among 4- and 8-Year-Old Children with ASD.’

http://tiny.cc/SpeechApraxia

‘The Hypothesis of Apraxia of Speech in Children with Autism Spectrum Disorder.’

http://tiny.cc/RChapman

‘Multiply-Disabled Autism and Intersectional Feminism.’

http://tiny.cc/cashin-triad

‘The triad of impairment in autism revisited.’

www.tiny.cc/­­_ICD11

ICD-11 for Mortality and Morbidity Statistics.

www.tiny.cc/DSM-5

DSM-5™ Diagnostic Criteria.

 

A is for Asperger’s


www.tiny.cc/Neurotribes  
NeuroTribes: The Legacy of Autism and How to Think Smarter About People Who Think Differently (Amazon).

 

A is for Anxiety

www.tiny.cc/kerns

Connor Kerns/Scholar Google.

www.tiny.cc/Oliveira   

‘Effects of Oral Vitamin C Supplementation on Anxiety in Students.’

www.tiny.cc/harvard-health

Harvard – ‘The gut-brain connection’.

www.tiny.cc/v_Postorino

‘Anxiety Disorders and Obsessive-Compulsive Disorder in Individuals with Autism Spectrum Disorder.’

 

A is for autism and ADHD

www.tiny.cc/YLeitner

‘The Co-Occurrence of Autism and Attention Deficit Hyperactivity Disorder in Children – What Do We Know?’

www.tiny.cc/asd-adhd

Harvard: ‘Is it ADHD—or Autism?’

www.tiny.cc/GordonLipkin

‘Anxiety and Mood Disorder in Children With Autism Spectrum Disorder and ADHD.’

www.tiny.cc/NICE_adhd

NICE – ‘Attention deficit hyperactivity disorder: diagnosis and management.’

 

B is for burnout

http://tiny.cc/RyanBoren

Autistic Burnout: The Cost of Masking and Passing.

 

C is for co-existing conditions

http://tiny.cc/GNSoke

‘Prevalence of Co-occurring Medical and Behavioral Conditions/Symptoms Among 4- and 8-Year-Old Children with ASD.’

www.tiny.cc/simonoff  

‘Psychiatric disorders in children with autism spectrum disorders.’

www.tiny.cc//MaxfieldSparrow

‘Are Co-occurring Conditions Part of Autism?’

www.tiny.cc/mazefsky

‘Association Between Depression and Anxiety in High-Functioning Children with Autism Spectrum Disorders and Maternal Mood Symptoms.’

www.Tiny.cc/Chadd

CHADD – ADHD and Autism Spectrum Disorder.

www.tiny.cc/steensel

‘Anxiety disorders in children and adolescents with autistic spectrum disorders: a meta-analysis.’

www.Tiny.cc/Dheeraj_Rai

‘Association Between Autism Spectrum Disorders With or Without Intellectual Disability and Depression in Young Adulthood.’

www.tiny.cc/Fragilex

‘What Can We Learn about Autism from Studying Fragile X Syndrome?’

www.tiny.cc/chaidez

‘Gastrointestinal problems in children with autism, developmental delays or typical development.’

www.tiny.cc/Sappok

‘Emotional Development in Adults with Autism and Intellectual Disabilities.’

www.tiny.cc/ASrivastava  

‘Intellectual Disability and Autism Spectrum Disorders: Causal Genes and Molecular Mechanisms.’

www.tiny.cc/Anorexia

BBC News – ‘Autism-anorexia link ‘must be acted on.’

www.tiny.cc/Anorexia-Nervosa

‘Autism Spectrum Disorder in Anorexia Nervosa: An Updated Literature Review.’

www.tiny.cc/AutismAN  

‘The invisible link between autism and anorexia.’

www.tiny.cc/synapse-Comorbid

‘Co-morbid disorders with autism and Asperger’s.’ 

www.tiny.cc/Comorbidities

Common neurological co-morbidities in autism spectrum disorders.

http://tiny.cc/Definition_Disabilities

NHS Data Dictionary.

 

C is for communication

www.tiny.cc/ASD-communication

‘Neurotypical Peers are Less Willing to Interact with Those with Autism based on Thin Slice Judgments.’

http://tiny.cc/Crompton

Paper: ‘Autistic peer to peer information transfer is highly effective.’

 

E is for eye contact

http://tiny.cc/eye-contact

‘For Those With Autism, Eye Contact Isn’t Just Weird, It’s Distressing’.

 

F is for Films and media representations

http://tiny.cc/autism_films

‘More than Rainman.’

http://tiny.cc/autism_films2

‘Interacting with autism – Rainman.’

tiny.cc/autism_films3

Autism Mythbusters – media portrayal.

tiny.cc/autism_films4

‘The Good Doctor’s Autistic Protagonist Is a Jerk, and That’s an Important Step Forward.

http://tiny.cc/autism_media

Autism Mythbusters – media portrayal.

 

I is for Infuencers

http://tiny.cc/messi

Como o autismo ajudou Messi a se tornar o melhor do mundo.

http://tinycc/ethanF

Ethan Fineshriber You Tube Channel.

http://Tinycc/Greta_T

School strike for climate – save the world by changing the rules.

 

J is for judgements

http://tiny.cc/SENsupport

NAS – Extra help at school in England.

 

J is for jigsaw puzzle piece

http://tiny.cc/jigsawpuzzle

Do puzzle pieces and autism puzzle piece logos evoke negative associations?

 

L is for labels / language

http://tiny.cc/ASAN

ASAN – Identity-First Language

 

L is for learning styles

http://www.tiny.cc/learning_styles

ARI Learning Styles & Autism

 

M is for masking

http://tiny.cc/masking_gender

SN – The costs of camouflaging autism.

 

M is for meltdown

http://tiny.cc/Ross_Greene

Book – The Explosive Child.

http://tiny.cc/rebeccaklaw

Paper: Thoughtful Response, Rebecca Law.

 

M is for music

 

 

http://tiny.cc/specialbrain

If Music Gives You Goosebumps, You May Have A Very Special Brain.

http://tiny.cc/speech_song

‘Neural systems for speech and song in autism’

http://tiny.cc/syn_lorde

Why does every musician suddenly have synesthesia?

http://tiny.cc/syn_pharrell

Pharrell Talks Synesthesia with Psychology Today.

http://tiny.cc/syn_joel

PT – He’s Got A Way About Him.

http://tiny.cc/syn_autism

Synesthesia’s mysterious ‘mingling of the senses’ may result from hyperconnected neurons.

http://tiny.cc/Bogdashina

NAS – Synaesthesia in autism

 

N is for Neurodiversity

tiny.cc/jessicaA

Autism & Sport.

http://tiny.cc/mencap_autism

Autism and Asperger’s syndrome

http://tiny.cc/NSN

National Symposium on Neurodiversity at Syracuse University.

http://tiny.cc/ABailin

Clearing Up Some Misconceptions about Neurodiversity.

http://www.tiny.cc/1stImpression

How Many Seconds to a First Impression?

http://tiny.cc/Trevisan

Facial Expression Production in Autism: A Meta-Analysis.

http://tiny.cc/ambiguous_looks

SN – People with autism sometimes give ambiguous looks.

http://tiny.cc/JSinger

What is Neurodiversity?

 

P is for PDA

http://tiny.cc/PChristie

Book – Understanding Pathological Demand Avoidance Syndrome in Children.

 

R is for rights

http://tiny.cc/NASsafeguarding

NAS – Safeguarding autistic people.

http://tiny.cc/N_I_C_E

Violence and aggression: short-term management in mental health, health and community settings.

http://tiny.cc/RCPsych

Restricted interventions in in-patient intellectual disability services.

http://tiny.cc/mortality-ASD

Mortality and causes of death in autism spectrum disorders: an update.

http://www.tiny.cc/MortalityAutism

RACGP – Injuries the largest cause of death for people with autism: Study

http://www.tiny.cc/NICEpathway

Autism spectrum disorder overview (pathway).

http://www.tiny.cc/NAS_CAMHS

You Need to Know – document.

 

S is for stimmimg

http://tiny.cc/KLindsmith

Stimming 101, or: How I Learned to Stop Worrying and Love the Stim.

 

S is for spoons

 

 

http://tiny.cc/spoonstheory

Stop appropriating the language that explains my condition.

 

 T is for toxins

http://tiny.cc/MMRautism

NHS – vaccinations

http://tiny.cc/MMautism2

Measles, Mumps & Rubella.

http://tiny.cc/TeethHeavyMetals

Baby teeth link autism and heavy metals, NIH study suggests.

http://tiny.cc/PKarimi

Environmental factors influencing the risk of autism.

http://tiny.cc/adjuvants

Christopher Exley: Using bad science to demonize aluminum adjuvants in vaccines.

http://tiny.cc/aspergian

Behind the Anti-Neurodiversity Articles: An Unholy Alliance of Usual Suspects.

http://tiny.cc/C-sect

Are C-Sections Contributing to Autism?.

http://tiny.cc/C-sect2

Association Between Obstetric Mode of Delivery and Autism Spectrum Disorder.

 

W is for Lorna wing

http://tiny.cc/LornaWING

BMJ obituary – Lorna Wing.

 

X is for expressive language

http://tiny.cc/eXpressive / http://tiny.cc/EXPRESSIVE

Expanding Expressive Language for Individuals with ASD.

http://tiny.cc/RECEPTIVE

ASA – Strategies to develop Receptive Language

 

Z is for ZZZZ

 

http://www.tiny.cc/AutismSleep

RA – Essential Guide to Sleep Problems and Autism: Summary.

http://tiny.cc/SLEEP

AAA – A guide to autism in the early years.

http://tiny.cc/Siclari

The neural correlates of dreaming.

http://www.tiny.cc/AmygdalaASD

Heightened Level Of Amygdala Activity May Cause Social Deficits In Autism.

http://www.tiny.cc/AHalladay

Anxiety, the amygdala and autism.

http://www.tiny.cc/A_Avino

Neuron numbers increase in the human amygdala from birth to adulthood, but not in autism.

http://www.tiny.cc/Connectopathy

Connectopathy in Autism Spectrum Disorders.

http://tiny.cc/Daoust

Dream content analysis in persons with an autism spectrum disorder.

 

 

The autism chasm – medicalised words versus neurodiversity concepts; and dated paediatric processes. When will we reach a level of understanding?

The autism chasm – medicalised words versus neurodiversity concepts; and dated paediatric processes. When will we reach a level of understanding?

It’s no surprise there’s some confusion and frustration between the neurodiversity proponents and the parents of autistic children going through assessment.

As an autistic adult who supports the neurodiversity concept, and a parent of a neurodivergent child, this author regularly witnesses a gaping chasm.

black and white graphic to illustrate black and white thinking styles for autism blogThe neurodiversity supporters, who are often autistic adults, or parents whose kids ALREADY HAVE a diagnosis of autism, are sometimes further along their journey of education and awareness than many parents of children undergoing assessment. That’s because the language of the clinicians and ‘experts’ in the parents’ lives (e.g. school SENCOS, teachers, Local Authority spokespersons, paediatricians, etc) is DIFFERENT and DATED.

Monotropism and autistic inertia

Neurodiversity proponents use concepts and language like ‘monotropism’ (atypical patterns of attention that describe issues that doctors would call hyper-focused interests, or obsessions – source: www.tiny.cc/DMurray); ‘autistic inertia’ (to describe issues that doctors would state as including executive function); and words like ‘traits, aspects, facets’ etc, to describe common autistic features; meanwhile, Drs, use medicalised words like ‘symptoms’. Most famously, neurodiversity proponents describe a ‘neurology’, or at worst a condition, while Drs use the word ‘disorder’.

Autism pity memes or ‘warrior mom’ memes

Head on over to social media, and neurodiversity groups discuss issues like monotropism and autistic advocatism. Meanwhile, on the parents’ support groups, families and carers may post about how their son’s ‘strange noises’ are irritating; why their family dinner was a disaster because the child was ‘unbearable’ (read: overwhelmed); or a ‘pity meme’ or ‘warrior mom’ meme about bringing up an autistic child. (The two groups aren’t mutually exclusive – there are many, many parents learning about neurodiversity on these groups and pages, and many, many helpful individuals who support the neurdiversity paradigm helping out the parents on their support group pages, e.g. with info about supporting the kids in question.)

The thing is, we as parents can’t get away from the medicalised language. It’s how our kids (and ourselves) are diagnosed with autism. It is clear why parents at the start of their journey follow the terminology that their (often outdated) doctors use. It’s not only all around them, it is a REQUIREMENT to understand it, and use it when conversing with the so-called experts surrounding a child. No matter how many neurodiversity articles you read and absorb, the dated phrasing is around you at every turn, if you’re within the NHS assessment system, or British social and local authority pathway (UK-centric).

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

In the course of just two days, I recently had a couple of enlightening experiences (again, this is UK based). A paediatrician told me he could only recommend onward neurodevelopmental assessment for a child if indicative signs were pervasive across all periods, and were witnessed by him at the child’s FIRST paediatric meeting. Have these doctors not heard of autistic MASKING? Literally 10 minutes (which is the time the Dr spent with the child directly, as opposed to with the parents) in a room, and a Dr can decide ‘no signs of autism are apparent’ in a child, and discharge the child, when the parents have waited many, many months to be seen? It is non-sensical.

(Families, remember – these stickler NHS paediatricians usually need to see two examples of ‘autistic behaviours or traits’ to recommend onward neurodevelopmental assessment. If the school aren’t witnessing anything (which could mean the teachers in question aren’t experienced in the field, or don’t realise that what they’re seeing represents autistic processes and traits), and the paediatrician doesn’t see anything at the first meeting, you WILL likely need further evidence. This could include private diagnosis, or presumably could even include supportive letters and evidence from other adults that are responsible for the child, e.g. group leaders or tutors. It is NOT FAIR that a paediatrician can choose not to refer a child on for assessment just because insufficient signs of ‘pervasiveness’ were apparent in the tiny window you were granted on that day.)

(Read more about children’s autism diagnosis HERE).

Haven’t they heard of AUTISTIC MASKING?!

There’s clearly a massive skills gap with some paediatricians who are generalists (e.g. don’t specialise in neurodevelopmental conditions), or have more experience of individuals that ARE autistic, but also have support needs, e.g. who present differently, with less masking. They NEED to know about autistic masking, and that not all autists display all their traits at once – and they need to stop relying on questions like ‘Does he/she hold eye contact?’ and ‘Does he/she line toys up?’, as if these are the key factors that would allow forward assessment for an autistic child.

The second experience I had in the space of those two days was that a local authority representative mentioned the ‘levels’ of autism, e.g. 1, 2 and 3. (This describes, at level 1, someone with so-called mild symptoms, who doesn’t need much support. Those with level 2 or 3 autism are said to have so-called moderate to severe symptoms, and require more substantial support.)

Autistic functioning labels

Using these descriptions (and the word ‘symptom’) is fine medically/diagnostically, as it relates to the (American) DSM-5’s description, which advises diagnosing clinicians to use the broad term Autism Spectrum Disorder (ASD), for diagnosis, with numbered sub-categories as described. BUT, no autistic adult uses these sub-categories. Neurodiversity advocates campaign for ALL such functioning labels (e.g. also including ‘mild autism’ and ‘severe autism’) to be disbanded.

Read more here – https://spectra.blog/news-views/autism-labels-and-language/

So, the parent trying to find their way along a journey where (they hope) that an autism diagnosis will allow their child support, are barraged with medicalised jargon and dated views on autism. Yet, as they try to self-educate about modern concepts of neurodiversity and neurodivergence, they are faced with yet more language that is confusing, and is the opposite of what their so-called experts use. (Remember, the experts are bound by law and the jurisdictions of their diagnostic manuals.)

The neurodiversity proponents have it right

What’s the answer? In this author’s opinion, the neurodiversity proponents have it right. Their concepts about supporting difference (not disorder), and of celebrating the benefits of neurodivergence along with recognising the challenges it may bring, are no-brainers. Of course it makes sense. But the educators and ‘experts’ are still on their own journey. They’re surrounded by medicalised textbooks and training courses. Some had next to no training on autism in the first place, and may not have had much exposure to autistic individuals who have little in the way of support needs. So education is KEY. But alongside this, it’s important to educate ourselves about the WHOLE PICTURE – the diagnostic guidelines, the medicalised jargon we can’t bear, the dated paediatricians who have no obvious understanding of what it’s like to experience the world as an autistic person.

I wrote the book ‘Autism from A to Z’ to address some of the issues touched on here. I wanted a tome that helped experts and professionals (as well as families and carers, and autists themselves) to understand some of the finer points of modern-autism thinking, from an #actuallyautistic perspective. But equally, I needed to outline the diagnostic facts, for individuals at the start of their journey. It launched at a UK-based SEN event (The Autism Apprentice’s Special Educational Needs (SEN) Information Day at The Appleyard, Sittingbourne, Kent on 20th March 2020). #autism #autismawareness #SEN #Kent

BUY AUTISM FROM A TO Z HERE.

Here are a few reviews:

‘Autism from A to Z is full of information that people new to the autistic world would find extremely helpful when either discovering themselves, or supporting a loved one or client.”

EM, Kent Autistic Trust

The book Autism from A to Z by Kathy Carter“Autism A-Z is easy to digest – I love how its compartmentalised in alphabetical order to find areas easily. The content is the most up to date inclusive of diagnostic changes. Autists are amazing and unique and this book consolidates information and experience supporting this view point. Autists, Parents and Professionals will benefit from having a copy.”

TH, Independent Cornwall Autism Network

‘I recommend this book for anyone new to autism. Autism from A to Z  is refreshingly free of ‘politics’; it simply states the facts and points the way towards further study. It is a very positive book, which promotes self-care and mutual respect for differing views. It’s a very good starting point for further study, and is written by someone with personal experience; I found myself hooked.’

LA, autistic adult

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

Exploring what being ‘authentically autistic’ means

Exploring what being ‘authentically autistic’ means

Woman with eyes closed _ to illustrate article on communication between NTs and autisticsI read the recent psychology article on being ‘authentically autistic’ with interest. The current climate seems the most accepting to date, in which to be authentic in this way. The current ‘#bekind’ movement, the increasing acceptance of minority groups, and the increasing awareness of autism as a neurodivergency, certainly means this is the most accepting era that autistics have experienced, to date. But of course, that doesn’t mean it’s perfect. There is a LONG way to go, in terms of autism education and awareness, although great steps have been taken. (For example, with the recent news about the UK’s NHS mandatorily training of their staff in autism and learning disability. (Isn’t it surprising that this wasn’t in place previously!)

However, alongside this positivity, there is a flip side – for example – there are a great many individuals supporting behavioural therapy to suppress their families’ autistic traits; plenty of people who (inaccurately) describe their autistic children as ‘vaccine damaged’; and a large, ambivalent group whose paths do not cross with autism, who are unsurprisingly uneducated about the neurology.

Examining this author’s ‘authenticity’, I was diagnosed in my 40s, and as an autistic adult, my friends and family know about my diagnosis. In my professional capacity, of course I present as an actually autistic person; but it’s not something I shout about on a day-to-day basis, and yes, there are many people on the peripheries of my social experiences – e.g women I nod and smile to at the school gates, friends of friends – who do not know I am autistic. (Read about the author HERE).

Am I being unauthentic by not sharing it widely? I do not think so. I see some autistic individuals who must have quite extrovert personalities, and seemingly ‘put it out there’ at the first opportunity, e.g. chatting to random people in a queue, or letting staff members at an event or facility know they’re autistic. It’s admirable, and it helps raise awareness of autism, particularly the fact that autism is everywhere; we’re your friends, teachers, friends’ spouses, colleagues, etc.

woman in black and white - to illustrate autism article re black and white thinking stylesHowever, that level of sharing does not come naturally to me; I’m not the sort of person to disclose personal info on a whim, unless it is relevant. And frankly, with the large group of people in the world I mentioned who are still uneducated, I don’t want to have a quick, superficial conversation with them about my own autism when I am buying coffee, or travelling on public transport. I don’t want to wear a funny T shirt with an autism slogan. I don’t see that it promotes acceptance – awareness maybe, but of what? Awareness without understanding isn’t necessarily useful. I’d welcome an actual conversation and will gladly help to educate them if they’re open to this; but a quick, transitional encounter isn’t for me.

With the people in my outer periphery of associates, of course I would discuss my autistic needs at the appropriate time, but I don’t put it out there for no reason; does this make me less authentic? Some people would say so. Likewise, I don’t advertise lots of other personal details to other people, for example my age, my religious tendencies or gender identity. I feel this situation or choice regarding sharing and over-sharing is more to do with extrovert versus introvert, then authentic autistic versus non-authentic autistic.

Here’s how I believe I am being authentic. To this author, being authentic means that the people who need to know, know about my autism. I’ve for example started an adult education course, and of course I am open there about my autisticness, which is very liberating. Although I work for myself, if I were to apply for a job within the workforce, I would definitely disclose it to bosses and colleagues. I definitely prioritise autistic self-care, and if that means not going to a social engagement, leaving a family event early, or explaining to family or friends that I am feeling overwhelmed, facing shutdown or am ‘peopled out’, so be it. As a late diagnosed autistic, I masked for years (unintentionally), it’s what we do to fit in. But now I am conscious of not masking, as much as I can, as it’s too depleting.

Picture of an angry woman. Asking: Are autistic mums enrared at Tony Attwood’s disparagement humour? Is it Good-natured fun, or bullying, exploitative and offensive?One of the problems with being #authenticallyautistic is that this means showing our true feelings and emotional states, as they relate to autism; and if we are late diagnosed, this is not something we are likely to have done previously. The fact we are late diagnosed probably means we have been camouflaging or masking for years, and these behaviours are entrenched. One of my biggest challenges regarding not masking is for example simply keeping up the expected levels of social courteousness when I am overwhelmed or tired. It’s usually strangers; for example the clerk on the end of the phone at your bank; the fellow dog walker; the shop assistant; the bus driver; all of the people we engage with regularly, and sometimes engage in pleasantries and small talk with. Being authentically autistic would sometimes mean I would be seen as being incredibly rude; e.g. not smiling, not looking at their faces, and refusing to talk, if that’s what my emotional state made me want to do. That’s not kind, so I ‘mask’ with them, not to make myself fit in, but so as not to upset others. So in this example, I am not being authentically autistic and showing my true feelings and emotional state, as this may upset others, and spoil their day.

To summarise, I think we should all be as authentic as possible, whatever our neurologies. Some days, that may be more authentic than others! We can only ever do our best.

The book Autism from A to Z by Kathy CarterA little disclaimer – here at Spectra.blog we don’t claim to be experts about autism.
The information we post here is based purely on our own exposure and experiences.