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.

A Tweet in the Life

I saw an interesting use of twitter recently. NHS Highland use their account (@NHSHWhoWeAre) to showcase services by having members of staff tweet about their working lives for a week. The “week in the life” that caught my eye was by the Caithness & Sutherland Speech & Language Therapy Team. I was interested to read about the diversity of roles members of the team undertook so, in a similar vein, I have decided to blog about my own clinical week “twitter-style” – each entry 140 characters or less!

Tuesday

Working on research proposal this morning: my first attempt at a qualitative study. Great support from NHST and SDHI – hope I get funding.

Two multi-disciplinary sessions this afternoon – first with Dietitian and second with Clinical Psychologist. Teamwork in CMHT is essential.

Joint initial assessment with Dietitian – teenager with suspected ASD and a long standing food phobia. Sharing knowledge and resources.

Working with Psychologist supporting young man with Asperger’s – blunt communication style having significant impact on family relationships.

Wednesday

Met with Social Worker from Early Years Service this morning – having difficulty communicating with young mum with post-natal depression.

Lunch meeting to organise Phase 2 of Communication Champions training with Richmond Fellowship. More staff want to do training – RESULT!

Visit to client with PTSD – mute for 10 yrs. Been using iPad to communicate for 3 months: family relationships and confidence improving.

Thursday

Quick visit to some Communication Champions first thing to provide guidance on support plan for resident with complex communication issues.

Meeting with young woman new to CMHT – CPN and Psychologist want a second opinion re: Asperger’s Syndrome. Difficult differential diagnosis.

Start afternoon with home visit. Client with Bipolar Disorder has language difficulties following ECT. Conversation flowing more easily now.

Off to local library for afternoon clinic: clients love this city centre venue – library staff even provide tea, coffee and biscuits for us.

Friday

Getting ready for a long clinic this morning – 9:30 to 1:30 – looks like lunch will be optional again!

Client with schizophrenia referred with very poor speech. Change of antipsychotic medication and speech much improved. Happy I’m not needed.

Assessing young woman with Asperger’s: confused because information doesn’t seem to apply – direct her towards resources for women with AS.

Seeing client with PTSD and low self-esteem. Dissatisfaction with voice contributing to problems: working to improve acceptability.

Client with history of alcohol dependency and anxiety reports sudden expressive language difficulties. Minor impairment having major impact.

Finish day meeting with student nurse who wants to learn about Asperger’s Syndrome – mutual love of The Big Bang Theory useful for examples.

And that was the week (or the tweet) that was.