Difference between revisions of "AutismTalks"
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* 30-50% of referrals are autistic! Why so many? | * 30-50% of referrals are autistic! Why so many? | ||
* There is an element of needing to address the autism to find out where you are | * There is an element of needing to address the autism to find out where you are | ||
== Regulation and Sleep == | |||
Managing Meltdowns | Managing Meltdowns | ||
Revision as of 23:31, 13 March 2024
Reading
12Jan24
- Autism and Everyday Executive Function
- Exploring Depression and Beating the Blues
12Jan24: Succeeding With Autistic Teenagers
General Setting
Overall outlook
- 1/3 each of serious issues that take years to recover, of mental health with in-teen recovery, and of relatively few difficulties
- But puberty can reconfigure social skills etc to the extent that maybe 10% post-adolescence are not sufficiently inside the autistic cluster to be diagnosable anymore
- Maybe that covers me :) I definitely have some autistic traits but am some way outside the cluster of formal diagnosis nowadays - perhaps when I was 20 it was a different story?
Why austistic teenagers have so many strikes against them
- Autistic teenagers tend to have high cortisol levels in the evening - indicative of a build-up of stress over the day - this impairs sleep. Compounded by a failure of wider regulation.
- Autism is associated with an Autonomic Nervous System (ANS) is out of equilibrium because of over-activated Sympathetic (SNS), under-activated Parasympathetic (PNS)
- Couple that with puberty hormones that increase depression, anxiety and risk-taking behaviours.
- Amygdala (mid-brain emotional processing) structurally & functionally different in autism, over-response to threat/negative situations, also less effective pathways to pre-frontal cortex
- Puberty rewiring takes longer in prefrontal cortex, limbic system, visuoperceptual - can run even into the 20s
- Then there is also the transition and change that comes with puberty - these are often the biggest stressors for autistic people in any case
- "Two-Hit Model": disruption in neural development in the womb, but then also at teenage time there are hormones + rewiring problems + increasing complexity of demands
So they have to work so much harder than NT teenagers: respond with compassion! Offer validation and support. Adjust expectations - and allow times for rest, recuperation and fun.
Camouflaging
- Autists can end often acquiring social inclusion by masking/mimicing - observe, analyse and imitate successful social patterns. "Fake it till you make it".
- This is exhausting! Looks "cured" but it's surface sociability - ultimately can be very maladaptive - you haven't resolved anything
- In teends, can end up with school-vs-home characters - Jekyll and Hyde
- Eventually the wheels come off and a problem surfaces through which autism is eventually diagnosed
- The list is long: anxiety, depression+self-harm, BPD has BIG crossover, Anorexia, mutism, gaming addiction, gender dysphroia, ....
Focus on the positives
- Honest, determined, expert, perfectionist
- Kind, speak your mind, reliable friend
- Liked by older adults
But there are difficulties too...
- Making friends, being teased
- Managing feelings, knowing what someone is thinking, showing the affection others expect
Autism isn't "bad"
- It's a different form of perception, thinking, learning and relating.
- Need to explain this to others!
- Many many famous autists in all fields of arts and science: Anthony Hopkins, Jung/Skinner, VanGogh, Einstein, etc
Importance of understanding stress and CBT type ways of dealing with it
Psychological reaction to being different in teenage years
- Depression 71% - low self-esteem, isolation, recluse
- Imagination 64% - fantasy world, role play games
- Denial and Rigidity 50% - inflated self-esteem, narc
- Imitation 70%
School
Learning profiles for autistic adolescents
- different styles
- 50% visualisers (more than I might have thought!) - "engineers"/"artists"
- 20% verbalizers - textbooks - very very good with words - good with complex prose - "authors" - hyperlexia - can self-teach to read
- that's me, that is
- processing time can be an issue - "emulation" for social/emotional - but can get auditory/written processing issues (don't think that's an issue for Isabel)
- silence can be helpful
- don't interrupt processing - they hate being interrupted, although they often interrupt themselves!
- good at pattern spotting
- distraction by peers talking can be tricky (auditory processing)
- group activities can be challenging: different perspectives, teamwork skills
- fear of making mistakes
Executive Function
- Planning, organising, getting started, knowing how long it takes, distraction, losing things, multi-tasking
- Attention regulation is tricky
- A secretary can be useful - marry them or pay them!
- Psychological behavoural/cognitive methods don't help. You need techniques - structure/systems.
- ADHD and autism is a difficult mix - medication can help
Social
- socialising is hard work! Need a safe place
- even one friend makes thing easier
Exhaustion and burnout is a real risk. Prevention is better than cure!
- Prune the curriculum - choose your battles
- Homework management - maybe we just don't do it?
Sport
- Solitary practice?
- Golf, swimming, cycling - athletics - martial arts - dancing
- Autistic girls may enjoy team sport
Emotional
over sensitive to Exteroception - outside world - sound/sight/touch/smell/taste and emotions in other people
- Me too!
insensitive to Interoception - inside world - pain/heart/breathing/hunger/temperature and emotions in oneself
- Mind-body practices can be great - Yoga, Meditation, Headspace
- Measurable effects on 8 brain regions - all associated with autism
Alexithymia - The inability to recognize or describe one's own emotions
- It's not good! It's a potential precursor of mental conditions
- Present in 80% of autistic population
- A very strong risk marker for addiction
- Can use music or art to express
- Poety, lyrics, novel writing
- Consuming art
- Visual prompt for talking about emotions (categorisations)
Anxiety and Depression - very common problems with autistic adults
Emotional Toolbox - broaden range of techniques, many categories:
- Self-awareness - interoception, self-regulation
- Physical tools - well-being, energy release
- Sensory tools - comfort, able to learn
- Relaxation tools - feeling calm
- Pleasure tools - feeling good!
- Social tools - feel connected, gain help, combat loneliness
- Medication - help with anxiety, depression
- Inappropriate - self-harm, illegal drugs, misuse of legal drugs, hurting someone
- Thinking - adaptive thinking techniques
- Maladaptive: catastrophizing, suppression, avoidance - all characteristic of autism
- Adaptive: self-soothing, other perspectives, disclosure, optimism, get compassion/affection from others
Self-Identity
Often comes from peer rejection & criticism rather than inclusion & compliments - need to mask and pretend
Suffer from alexipersona - a lack of vocab to describe personality characteristics
Need to develop a positive vocabulary around personality and abilities
- personality: kind, caring, loyal, honest, determined, brave, humour
- abilities: drawing/art, memory, expertise, ...
Self-affirmation pledge
- I am not defective - I am different
- I will not sacrifice my self-worth for peer acceptance
- I am capable of getting along with society
- I will ask for help when I need it
- I will be patient with those who need time to understand me
- I will accept myself for who I am
Gender Dysphoria
- 30-50% of referrals are autistic! Why so many?
- There is an element of needing to address the autism to find out where you are
Regulation and Sleep
Managing Meltdowns
- Explosion - can cleanse the system/clear the air
- Depression attack - an emotional implosion - can be intense but are fortunately brief
- DO: stay calm, affirm & validate the emtion, one person, minimal speech, confirm it'll pass, safe place for solitude
- DON'T: interrogate, focus on punishment/consequences, jolly up or use comfort/affection
Self-Harm
- ???
Sleep and Autism
- Racing thoughts and ruminating inhibit falling asleep
- Can wake next day in terrible mood when went to sleep OK
- Can end up switching day/night cycle and becoming a recluse
- Melatonin can help - defective metabolism and secretion of melatonin are associated with autism