Monday 22 April 2019

What is Stimming?

One word or term that you may have heard when people speak about Autism is Stimming. But it is an aspect of Autism that many outsiders do not fully understand and it can be considered a taboo subject as not many outside of the Autism community fully understand what stimming is all about or why people stim.

Stimming or Stim is short for Self Stimulatory Behaviour and under the DSM-5 (the diagnostic tool for diagnosing Autism Spectrum Disorder) it is classed as a repetitive behaviour.

Before we get into the nuts and bolts of stimming and why individuals who have been diagnosed with ASD, have a think about the things that you do when you're stressed or under pressure or bored even.

Everyone, regardless of if they have an ASD diagnosis or not, has at some stage in their life done a little bit of stimming. Some people tap their foot while seated at their work desk or at their school desk. You may have chewed on the top of your pen or pencil during examinations at school or university or during meetings. During meetings do you draw on paper or fiddle with your pens/pencils or ruler? Some people tap their fingers over and over on their work desk. These are all stims.

In most cases, a stim will come and go when you need it. You may only stim when you are stressed or under pressure or if you're bored. And just because you stim occasionally does not mean that you are on the spectrum.

For individuals who have been diagnosed with ASD, stims are there for good. And this isn't a bad thing.

Stimming is a way in which individuals who have been diagnosed with ASD are able to regulate their own emotions or calm themselves in stressful or exciting or other environments. And just as babies may suck their thumbs to relax or soothe themselves, some stims serve the purpose of soothing or comforting an individual.

Stimming is also a way in which individuals who have been diagnosed with ASD are able to gain sensory input.

Stimming can look like bouncing on the spot, flapping hands, wiggling fingers in front of their own face, stroking their hair, spinning, rubbing their clothing, fidgeting with their clothing and so on. Stimming may sound like humming or making noises.

Both L and O have a variety of different stims that they use. And when you get to know O and L, you'll see that depending on the emotional state that they are in, they have a stim for their different emotions. O and L's different stims tell us when they are frustrated, excited, nervous, happy, scared, overwhelmed, contented and so on.

O and L stim to help themselves to calm down when they are anxious. They both stim when they are in sensory overload. They both stim to express different emotions. Stimming assists O to focus on one thing and gets her mind away from the sensory overload going on around her at school.

O has told us that if she can bounce her feet in class, then she can keep her mind still so that she is able to concentrate on what her teacher is saying. While doing her homework in the afternoon, O needs to move. When she is moving, she does her homework in record time.

O and L don't stim for the sake of it, they stim because they need to. Stimming is a necessity. And this is also the case for others who have been diagnosed with ASD. Stimming for individuals who are on the spectrum has been likened to breathing. Stimming is just as natural and just as important.

In most cases, individuals who stim should not be stopped, unless the stim is inappropriate or they are in danger of injuring themselves or others. It is important to remember that if a child, or an adult is exhibiting a stim that is inappropriate, they are not being malicious. They're just doing the stim out of habit.

If the stim is inappropriate, then you can attempt to redirect the child to another more appropriate action. You could attempt to replace the perceived negative stim with a more positive stim but you do need to explain to the child why the stim that they were doing was inappropriate. If you find that you are needing to stop a child from stimming, you do need to provide the child with an alternative to the stim as in more cases than not, the child will replace the stim themselves and possibly with another inappropriate stim.

If you find that you are needing to stop a child from stimming, you also need to figure out what the child is trying to tell you. Stimming can be considered a communication form - expressing emotions.

But if the child is not hurting themselves or others and the stim is not inappropriate, why stop them?

And if you spot a child or an adult spinning or flapping or bouncing, please do not stare. They are expressing or regulating their emotions or assisting themselves to remain calm.

Respect the Stim!

Wednesday 17 April 2019

Triad of Impairments Part Two - Impairment in Social Interaction

Earlier this year, I was asked to present at a professional development session for early childhood educators. The presentation? All about Autism and Sensory Processing Difficulties.

The presentation was received so well that I thought that I would use part of my presentation on my blog as I'm often asked questions about Autism and O and L. So here goes!! 

This is Part Two in which I'll focus on Impairment in Social Interaction. You can access Part One - Communication Impairment here!

Individuals who have been diagnosed with Autism commonly have difficulties in three main areas, known as the Triad of Impairments. These areas are ....

2. Impairment in Social Interaction
3. Restricted and Repetitive Behaviours, activities and interests.

Before I begin to discuss the next area, Impairment in Social Interaction, keep in mind that many of these traits are present in typically developing children. The difference in those diagnosed with ASD, is the intensity in which these traits present. In a child with ASD, the traits are much, much more intense and they are ongoing. I’m going to refer to children with Autism but all of these traits may be present in Autistic adults as well.

Children may have difficulty in reading the intentions and motivations of their peers. They may have difficulty in displaying and responding to non-verbal communication from their peers – eye contact, body language, facial expressions, tone of voice, gestures and so on. They may have difficulty in recognizing social cues – when to talk, when to stop talking, how close to stand to people, personal space and so on. These are all considered to be hidden communication skills and they can be very difficult for a child with Autism to understand and interpret.

Children may have difficulty in understanding social interactions and the hidden communication that occurs during social interactions. This can be especially tricky when people say one thing, yet do or mean another.

Children with Autism can at times seem to be very distant. They can appear to be emotionally disconnected from their parents, siblings and their peers. They may not react any differently to a scowl then they would to a laugh or a smile. It is important to understand and remember that they are not emotionally disconnected, they simply may not yet have developed the ability to understand or pick up on social cues as efficiently or as quickly as typically developing children.

Children may have difficulty in initiating play and/or responding to others. Children with ASD may seem disinterested in engaging with play with other children. It’s not that they don’t want to, they may not know how to. They may not understand or know how to turn take or share. They may have difficulties in developing and maintaining friendships with others that are appropriate for their age level. Due to their social impairments, children may prefer solitary play.

Children with Autism often have difficulty establishing and maintaining friendships, as they have difficulty reading the intentions, the motivations or the reactions of others. They may not openly share their interests and engage with others or they may appear disinterested. Often it’s their lack of communication skills, not a lack of desire, which prohibits this engagement.

Children may have reduced eye contact – eye contact can be very uncomfortable for those diagnosed with ASD. However, some individuals learn very early on that eye contact is socially accepted so they will make fleeting eye contact or they will make eye contact and stare straight through you.

Without these social skills individuals diagnosed with ASD may appear socially inept or disinterested when in fact they have major deficits in being able to interpret and respond appropriately. Many individuals who have been diagnosed with ASD, O and L included, want to be social however they struggle in this area.

Stay tuned for Part Three - Restricted and Repetitive Behaviours, activities and interests.

Friday 12 April 2019

What Acceptance means to me.

My name is O and Mummy asked me what acceptance meant to me because this month, April, is Autism awareness and acceptance month worldwide.

The word acceptance to me means accepting and respecting other people's differences. Acceptance means that people are embraced by others - differences and all. Acceptance means that I belong - as I am - in the community that I live in. Acceptance means that we shouldn't have to change who we are just so that we can fit into what other people think is normal, even though there really isn't a normal way of being.

When people accept others as they are, they are saying "You are you and I am me, and that's okay. Different is good."

When people accept me and my little brother for who we are, they've made a conscious effort not just to know what we do but also to understand and accept us for who we are and the things that we do. My friends who accept me know that I wear my headphones not to stand out but because too much noise hurts my ears and my brain. They know and understand that sometimes I hide under my desk because my classroom is too busy for my brain.

I want to live in a world in which acceptance is not just a goal, but it is an actual reality. A world in which neurodiversity is just another way which makes people unique. A world in which everyone will agree that diversity is a part of what makes our world a beautiful place. A world in which everyone who is different in some way, feels like they belong. There are too many people and not just people who have Autism, who don't feel like they belong or don't feel like they are welcomed by the communities in which they live.

I think that acceptance will take time. Everyone needs to practice acceptance, especially adults because some adults have forgotten what it is like to be different. Kids, when they are really young, are good at accepting other people for who they are but some adults don't like differences. And some adults are really good at projecting their thoughts onto kids, even the negative thoughts. When this happens, the kids don't accept others when they are different. I've felt this from some kids that I go to school with and it makes me really sad and worried for the future.

I think that everyone, but mostly adults, needs to consciously practice acceptance for it to become part of their everyday routine. Because every time we practice acceptance towards something that makes us uneasy, we will create new neural pathways and strengthen the old neural pathways that are in our brains that tell us difference in others is a good thing. And if kids see adults practising acceptance, then they will also be more accepting of others.

That's what acceptance means to me.

Sunday 7 April 2019

What is Sensory Processing?

In previous blog posts I have spoken about the sensory processing difficulties that both O and l have. But it recently occurred to me that to have an understanding of Sensory Processing Disorder, you first need to have an understanding of how we all process sensory input. And that is a topic that I haven't written a post about yet. So here goes!

Sensory processing occurs all the time in all of us, regardless of whether you have been diagnosed with sensory processing difficulties or not. We are all constantly taking in information from around us and from within our bodies.

We all have individual unique sensory processing styles. The way that we respond to different sensory inputs may change across the space of a day according to many different factors – stress, fatigue, illness, hunger and so on. And the way that one person responds is not necessarily how another person would respond.

There are four stages in sensory processing that occurs in every one of us, well most of us, every day. They are ....

1. Awareness – This is the awareness that something is touching you. The process begins when we become aware of a particular sensation. These sensations can come from the environment around us or from within our bodies.

2. Attention – Something is touching your arm. After we become aware of the sensation, our brain needs to decide whether we need to attend to the sensation or not. Our brain determines what sensory information needs our attention and what should be ignored.

3. Interpretation – You are being touched on the arm with a feather. Our brain interprets the sensation and determines its quality. The brain will compare the sensation with old ones that we have experienced before.

4. Reaction – You are being tickled on the arm with a feather which makes you giggle and squirm. The brain determines what reaction to make. The reaction may be emotional, physical or cognitive.

A good example that illustrates the three different reaction types is when a person spots a spider. An individuals cognitive response could be “spiders are dangerous,” an emotional response could be “I am afraid that the spider will bite me,” and the physical response could be “I will jump and run away from said spider.” Or they might respond with all three reactions!!

These four stages are happening every day and quite often we are not aware of it – the sensory processing is automatic.

In individuals who have sensory processing difficulties, their brains misinterpret sensory inputs and as such all four stages of sensory processing are affected. Sensory processing difficulties can also affect a few of an individuals senses or all of their senses.

So what are our senses? Take a moment to write down or say out loud all of our senses. Here's a few photos of my little superheroes enjoying some sensory input so that you can't cheat and just read on. But keep in mind that we have eight different senses!!

So, how did you go?

Hopefully you would have got the first five easily - taste, sight, hearing, touch and smell.

The last three are slightly trickier as they are our hidden senses! Our three hidden senses are those that we don’t consciously think about or are aware of on a daily basis.

The sixth sense is our vestibular sense - this sense provides our bodies with information as to where our head and body are in space. It helps us to keep our balance as we move about.

Our seventh sense is proprioception.
This is our body sense that tells us where our body is in relation to the rest of us. It also tells us how much force to exert when performing different activities like hugging someone, shaking hands, cracking an egg open and so on.

Then we have an eighth sense - our
interoception sense. This is a relatively unheard of internal part of the sensory system and consists of all of the internal sensations that we feel on a daily basis when we're hungry, thirsty, anxious, nervous or when we need to go to the bathroom. Any sensations that originate from within our bodies all stem from the sense of interoception. Receptors in our body organs and skin, are constantly sending information about the inside of our bodies to our brain.

So there you have it, sensory processing in a nutshell!!

Tuesday 2 April 2019

Autism is A Spectrum

If you have been following my blog then you'll know that ASD is the abbreviation for Autism Spectrum Disorder. But what does the term spectrum refer to?

The term spectrum describes the range of difficulties that people who have been diagnosed with Autism may experience and the degree to which the traits present. Some people may be able to live relatively “normal” lives, while others may have accompanying learning challenges and require continued specialist support throughout their lives.

However when people hear the word "spectrum" many tend to think of the Autism Spectrum as linear, similar to the diagram below. I'll use the old terms of high functioning Autism and low functioning Autism to explain.

A diagnosis of level 1 is equivalent to high functioning Autism or Asperger's as it was formerly known. A diagnosis of level 3 is equivalent to low functioning Autism.

When viewing the spectrum as linear, it gives the impression that an individual can be a little Autistic (high functioning) or a lot Autistic (low functioning) and this in itself poses a problem as an Autistic person’s difficulties are then viewed as linear.

“Oh you’re only a little Autistic because you can have a normal conversation so therefore you don’t have any struggles. You’re fine.”

Likewise an individual can be seen as being very Autistic and not being able to function at all.

But both of these scenarios couldn’t be further from the truth.

The Autism spectrum looks a little more like this … a continuum in which individuals who have been diagnosed with Autism can be either side of the continuum in different areas at the same time.

When thinking about Autism as a continuum, an individual can be highly gifted and yet be aloof in their Social and Emotional Interaction. An individual who is non-verbal may be gifted but not able to verbally express their thoughts and be hyper sensitive to external sensory inputs.

L has a diagnosis of level 1 and level 2 ASD – he is average in his IQ, he is quite social, he was non-verbal up until the age of 3 years and even now will revert to selected muteism when stressed, upset or in sensory overload, his gross motor skills are above average, his fine motor skills are still developing and he is both over sensitive and under sensitive to different sensory inputs.

O has a diagnosis of level 2 ASD and is considered academically gifted, she is aloof in her Social and Emotional interactions with her peers, she is very verbal and has always been very verbal, she is very awkward in her gross motor skills yet her fine motor skills are advanced and she too is both over sensitive and under sensitive to different sensory inputs.

And this is the case for the majority of individuals who have been diagnosed with ASD. Not all individuals sit purely on one side of the continuum. Individuals may have a very uneven profile of skills in that they may have very good skills in some areas and poor skills in others.

Autism Spectrum Disorder really describes many different traits or ways in which the brain processes information. Each person who has been diagnosed with Autism will have a set of traits all in different areas of the spectrum. The areas where they don’t have a trait will function no differently to that of an individual who isn’t on the spectrum, but they may be affected by external circumstances – for example sensory input or during social interactions.

Please keep this in mind when speaking with or interacting with individuals who have been diagnosed with Autism. Please don't assume that an individual who is ASD level 1 has no struggles at all or that an individual who is ASD level 3 is not competent at thinking for themselves. Remember, Autism is known as a spectrum for a reason.