Introduction to the Autism Spectrum
The definition of autism is very narrow: autism is a developmental disorder that affects communication and interaction. Many pediatric patients did not fit well into this narrow definition so practitioners used different terms, such as Asperger’s and childhood disintegrative disorder, to create a treatment plan and for coding. Today, mental health and developmental professionals use the term ‘autism spectrum disorder’ to describe the infinite continuum of the type and severity of developmental issues faced by people with autism spectrum disorder.
Anxiety is a normal part of development, but research confirms that people with autism experience elevated levels of anxiety in comparison to their typically developing peers. An extensive review of the literature by White et al (2009) revealed that up to 84% of individuals with autism meet the criteria for clinically diagnosed anxiety disorders.
Due to characteristic communication difficulties, an autistic person may have severe anxiety issues but have a decreased ability to express it. As noted by Howlin (1997), “…the inability of people with autism to communicate feelings of disturbance, anxiety or distress can also mean that it is often very difficult to diagnose depressive or anxiety states.”
Anxiety may manifest in an autistic person through:
- Social phobia
- Excessive worry/rumination
- Obsessive-compulsive behavior
- Hyper-vigilance, or seeming “shell shocked”
- Avoidance behaviours
- Rigid routines and resistance to change
- Stimming and/or self-injurious behavior
- Controlling behaviors – oppositional defiance
- Shut down
Dealing with change
People on the autism spectrum can find change very stressful. Due to the behavioral, information processing, and sensory aspects of their diagnosis, many people on the autism spectrum often prefer familiar environments with a predictable routine. Restricted and repetitive interests, sensory processing differences and heightened anxiety can make even small changes stressful. Planning ahead and preparing for changes in everyday routines and activities is important:
Secondary Conditions Adds Color to the Spectrum
People with ASD can have other conditions that can widen the spectrum even further. These secondary conditions include:
- Speech and language difficulties
- Intellectual disability
- Sleep problems
- Attention problems
- Anxiety and depression
- Difficulties with fine and gross motor skills
How you can support them;
- Get awarded: having the right knowledge and awareness about autism can help you recognise the signs and have more confidence in interacting with an autistic person. Many people depending on where they are on the autism spectrum, live as high functioning adults. The signs and symptoms of Autism Spectrum Disorder may be hard to recognize in a high-functioning person, whereas low functioning signs and symptoms are more recognizable.
- Communicate: Autism presents itself in a variety of ways, and our interactions may vary depending on where the person is on the autism spectrum, but some common guidelines for building rapport do apply. First and foremost, like anyone you are communicating with, be respectful. Finding common ground for communicating is key and doing so may take time and patience with a low functioning autistic individual. In contrast, a high-functioning autistic individual may be more literal in their communication. It’s also common for a person with autism to have less direct eye contact during conversation and to fixate on a particular topic during a conversation. Simple actions like a gentle redirection to the next topic can help move the conversation along. Whatever your interaction, be mindful that an autistic person’s communication style may be very different than ours. However, patience and finding common ground are ways to start building rapport.
- Pay attention: Sensory issues are a common challenge for people with autism. If you are interacting with an autistic person knowing what these sensory issues are will be helpful to you. Some of the sensory challenges an autistic individual may experience are high sensitivity to touch, sound, light, taste, and smell. Avoiding large, crowded spaces, or bright colors can help create a soothing environment for a person with autism and avoid sensory overload. Sometimes boundary issues like touching and closeness within personal space can occur because of a delay in understanding common social norms. This can be easily addressed by simply asking the person to step back or creating some distance between the two of you. Modeling social norms when communicating with a person with autism helps create a structured, positive environment.
- Support co-workers with autism: Individuals with autism can add different perspectives and strengths into the workplace. An individual with autism can have challenges as well, such as anxiety, communication, time management, and/or staying focused. If an issue arises at work it’s important to show respect, patience, and compassion. Don’t hesitate to try and get to know the person better to gain a deeper understanding of their specific strengths and challenges. Remember, each individual’s experience with ACD is different.
- Support family members or friends caring for person(s) with autism: Autism is nothing to be ashamed about. Chances are you already know family or friends that are autism caregivers. Just like with other caregivers, one of the best ways to show support is to give them a break from their daily routine. Let your family and friends know that you want to support them as an autistic caregiver and discuss ways you can help the caregiver. Making meals, cleaning, yard work, and childcare are great ways to support a caregiver. Remember, even a small amount of support to a caregiver can go a long way.
Autism Spectrum Disorder is lifelong and impacts emotions, sensory experience, and social interactions. As autism diagnosis rates continue to increase, it’s important that we educate ourselves about the disorder. In doing so, we’ll be better equipped to build relationships, understand sensory awareness, offer support to family and friends, and learn how to support autistic colleagues in the workplace.