Understanding & caring for individuals on the Autism Spectrum Prof Rita Jordan PhD OBE Emeritus Professor in Autism Studies University of Birmingham, UK Kilronan School, Feb. 20, 2012

Current Diagnosis ICD:10 & DSM:IV - based on underlying ‘triad’ of difficulties: –social & emotional understanding –communication –flexibility in thinking & behaviour ASD part of PDD –autistic disorder (classical autism) –Asperger syndrome –atypical autism/ PDD-NOS DSM V coming (2012?) –future of Asperger syndrome? –some excluded from help?

Sensory Issues evidence that at extremes both over- and under-responsive to different senses ‘over-responsive’: sensory avoiding; ‘under-responsive’: sensory seeking shield from sensitivities and/or desensitise attach meaning to perception - reduce ‘bombardment’ of meaningless stimulation aware of variability - use proximal blocks give environmental control to individual if possible reduce overall stress teach to monitor and manage levels of arousal

A Developmental Disorder – compensation – secondary 'handicaps' – transactional process

Psychological Functioning in ASD perception/ sensation –‘chicken & egg’ –no socially meaningful patterns –idiosyncratic –‘backgrounding’ difficult attention –mono attention –joint attention & monitoring –social signals

Psychological Functioning in ASD (2) sense of self –intersubjectivity fails to develop –‘experiencing self’ & consciousness socialisation –social brain dysfunctional –sensory cues dominate memory –paradoxical - rote vs meaningful –slow & accurate - not reconstructed –needs cues

Psychological Functioning in ASD (3) concept development –abstract as verb not adjective - fuzzy concepts feelings & emotions –understanding then symbols –external cueing of own feelings flexibility & self control –comes from understanding –plan do reflect sequences & consequences communication –language & communication separate –all aspects –pragmatics

Wendy Lawson: Teenage Years negative view : –began to recognise that I was different beginnings of despair –started to form over attachments obsessive behaviours increased –sent off to the Guides and Youth Group obsessed about earning badges, but couldn’t form friendships age 17yrs. first attempt at suicide beginning of history with the mental health system

But things can get better Kanner (1973): –follow up of 96 adults –significant improvement often in mid-late teens as individuals more aware of their problems & motivated to address them –special interests important in providing work & occupation and in fostering social contacts

Working Towards Adult Life work (meaningful occupation) enjoyable leisure accommodation (changing needs?) ‘friends’ - informed choice intimate relationships? sex? contact with relatives ‘belonging’ holidays - varied experiences income of one’s own independent & self-advocacy skills

Teaching Consequences less able - single track more able - –railway - no turns –2 clear termini with no connections –choice point emphasised Moment of choice Problem Taught alternative

Preparation in Teens to avoid challenges provide sustainable forms of structure –moving towards mental structure but some still needed reduce stress and keep occupied daily aerobic exercise build optimism for problem solving through CBT & realistic valuing structure social engagement with peers e.g. Legotherapy ‘Circles of Intimacy’ not rigid social rules

Dealing with Loss & Disappointment loss of a person –replace the function & place in the life of the teen –connect ‘happy memory’ pictures with future plans loss of a goal –start early in teaching alternative routes to a goal –teach disappointment in supportive settings

Fostering ‘Realistic Optimism’ use ‘ecological curriculum’ approach to life and social skills –accurate appraisal of self –see plan for future coping help them notice good things that happen teach ‘mindfulness’ & avoid –too much worry over future –too much anger & distress over past