Autism: Not Child’s Play

World Autism Awareness Day on 2nd April marked the start of a month of activities aiming to develop understanding of autism and Asperger Syndrome. So I have decided to dedicate this month’s blog to talking about the work I do as a Speech and Language Therapist with and for people with autism spectrum conditions.

One of the things that often surprises people is that I work with autistic adults. Autism is something children have isn’t it? Certainly many internet searches and much media coverage could lead to you this conclusion, but strangely enough autistic children grow into autistic adults, and for many people, particularly with Asperger Syndrome, it is not until adulthood that the diagnostic process begins. This doesn’t mean that they have somehow acquired autism, but rather that it is not until adulthood that their differences start to interfere with living a “normal” life. Quirks are no longer considered “a phase he is going through”. Academic promise does not necessarily translate into vocational success. The shy girl who was praised for keeping her room immaculate is now told she has anxiety problems and OCD.  You get the picture.

The autistic adults I meet are accessing mental health services, so on that basis they are usually struggling with their mental wellbeing. Most often this is the result of living either with an undiagnosed autism spectrum condition, or with a poor understanding of the diagnosis they have received earlier in life. As a result, these individuals have not learned why they act, think and communicate in the ways they do, and have failed to develop a positive sense of self. They can feel that they are the only person who experiences these challenges, and have no or few strategies to deal with the confusing and complicated world around them.

As a Speech and Language Therapist I play an important role within our Community Mental Health Teams for not only diagnosing autism spectrum conditions in adults, but also in providing support after that diagnosis and promoting improved mental wellbeing. One of the most exciting developments I am currently involved with is a post-diagnostic group aiming not only to educate but also empower, and to create a supportive social network of people with Asperger Syndrome in a local area. It is early days yet with this pilot project but the feedback from participants so far is good and relationships are beginning to develop. Ultimately, people living with autism spectrum conditions will learn the most from other autistic people because they will always know more about how it really feels and what really works, but if I can play a part in helping people make those connections then I can be proud of doing my job well.

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A Sensational Life

A change of topic from my 3 best things this week as I have not been doing my normal clinical work. Instead have been attending a course on Sensory Integration and I would like to share my thoughts on what I have learned with you.

What do you think of as a sensory based difficulty? It is far more than a hearing or visual loss. Our understanding of the sensory aspects of the world in which we function tends towards the more traditional senses of sight, hearing, taste and smell but we seldom consider the significance of information we gain from touch and movement.

Sensory issues are being increasingly recognised as being a core part of Autism Spectrum Conditions and these is very well described by Cynthia Kim in her blog Musings of an Aspie, but I wonder how many other individuals who access Mental Health services experience sensory processing and integration difficulties.

The reason I say this is that I now have a very different understanding and perspective on the link between our sensory processing and emotional state. Our brains receive and start to process sensory information in the same areas that control our emotional and physiological responses. An unexpected loud noise will initially elicit a “flight or fight” reflexive response from us but it will subside if we don’t actually need to act to protect ourselves. But how would you feel and function if your neurological system could not integrate this sensory information sufficiently to allow you to return to your normal level of arousal within a short period of time? Or if this level of high arousal was elicited by activities that others did not find stressful such as the movement of riding on a bus or the feeling of the label on the T-shirt you are wearing? And what would it do to your ability to use your higher cognitive skills and therefore your thinking patterns?

This is a very simplistic summary of how sensory integration difficulties could impact on our mental health and well-being but a good place to start. By using “sensory glasses” to consider human behaviour and interpreting what we observe in relation to neurological processing of this information, sensory integration seems to me to offer an exciting new perspective on the way we can provide meaningful support people who experience mental health difficulties.