Sunday 12 May 2019

What are other traits associated with Autism?

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 four in which I have been discussing different aspects of Autism. The first three parts of this series focused on The Triad of Impairments. You can access Part One here, Part Two here and Part Three here.

As well as the Triad of Impairments there are other traits that are often associated with and seen in individuals who have been diagnosed with Autism. Before I go on, please keep in mind that many of these traits are seen in typically developing children, the difference is the intensity in which the traits present. I'll be referring to children who have been diagnosed with Autism but many of these traits are also seen in adults who have been diagnosed with Autism.

Children with Autism, at times, don’t notice when or understand why, another child is crying, has been hurt or when they hurt someone’s feelings. It isn’t because they lack the capacity to have those emotions, they have a developmental delay in that area. Likewise, some children with Autism are not aware when they are smothering other children with affection. This isn’t deliberate, they are not aware that other children have had enough.

L still struggles to understand when and why others, including us, are sad, upset or angry. Hugs are definitely on L’s term! O on the other hand still needs to be reminded that other children, including her brother, do not like extra long squishy hugs even when they are trying to push her away.

Children with Autism are prone to over the top emotional outbursts – meltdowns – and these can and do occur on a regular basis and can be very, very intense. Meltdowns can occur when the child is experiencing sensory overload, when routines are changed, when they are in physical discomfort, when they are stressed and due to many other situations. A meltdown may occur for no apparent reason and may be unexplained. 

During a meltdown the child may lash out at those nearby, they may thrash their body around, they may say things to those around them, they may scream and shout or they may just sob uncontrollably. During a meltdown, a child is not in control of their body and often they will have no recollection of what they did or said once the meltdown is finished. During a meltdown, you will not be able to reason with the child as they physically can not hear you. The best thing that you can do during a meltdown is be nearby for reassurance and to ensure that the child doesn’t injure themselves.

The pain threshold in children with Autism can vary from very high to very low. Those with a very high pain threshold are simply not aware that they should tell a parent or carer when they are injured or sick. L’s pain threshold is super high to the point that in 2017, we stopped counting at 17 different incidents that he did to himself through play or exploring his environment. These ranged from sticking objects in his ears - we're up to the count of 5 different occasions -  a concussion and possible skull fracture from falling out of the school bus on the first day of school, getting his head stuck in a toilet seat, getting his fingers stuck in a science toy, he had a permanent lump on his forehead for about 8 weeks when he kept hitting it in the same spot accidentally over and over, he’s knocked his top two teeth out, he has impaled a garden hoe between his toes and many others. L makes life interesting. His catchphrase is now “I’m okay, there no blood!” and he now has a favourite nurse and is known by name in the accident and emergency departments and ENT departments at four hospitals in two states of Australia!

Many children with ASD are unable to differentiate between hot and cold temperatures. You’ll be able to easily recognise these children – they’re the ones wearing winter clothes all year round or they will be butt naked all year round. L does not feel the cold and if we let him, he’d get around in a pair of jocks in winter. His all-time favourite winter onesie is a Pikachu thick onesie. During summer, this gets hidden from him.

Many children with ASD have little to no awareness of safety and/or danger and seem to be fearless. They will do things that even adults will shake their heads at. They may run off from their parents or carers. They don’t do this deliberately – quite often it is to get away from a sensory input or they will see something that they want to look at and it will not occur to them to tell an adult where they want to go.

Many children with Autism may struggle with complex multiple step instructions. Their brain will hear the first step, process what that step involves and by the time that they have completed the first step, they’ve forgotten the rest.

In many cases a child’s processing time will be much longer than that of their peers. They may not answer you or respond to you straight away as their brain is processing what you are saying or asking of them.

Children with ASD may be prone to “w” sitting. W-sitting describes when a child is seated on their bottom, with their knees bent and legs splayed out to their sides in what looks like the letter "w.“ Children with ASD will often prefer a w-sitting position to sit in as opposed to other more challenging and tiring positions. The reason for this is that when seated in a w-sitting position a child does not need to engage their abdominal muscles. When seated in the more conventional cross-legged position, a child must engage their abdominal muscles to stay upright. Sitting in a w-sitting position provides a very stable base for the child's trunk and hips and therefore allows a child to move easily to play on the floor. However, the movement is generally in a forward and backward motion as opposed to moving and turning from side to side. 

One of the issues with the w-sitting position is that it does not allow or permit a child to perform trunk rotation, or twisting and turning, and lateral weight shifts, side to side motion, to reach toys on either side of the body. The development of trunk rotation and weight shifts over to one side and to the other is vital in children as both assists in maintaining a child’s balance while running and walking as well as when climbing and playing on play equipment. It is also necessary for being able to cross our mid-line when writing, drawing, turning pages on books, dressing themselves and other similar skills. Sitting in a w-position on a long term basis may cause orthopaedic issues in a child's hips, knees and feet as well as tightness in the leg and hip muscles.

Sleep disturbances and sleep disorders are quite common among children who are on the spectrum. It is unclear why but one train of thought is that children with Autism simply do not produce enough Melatonin. Melatonin is a natural hormone that is produced and secreted in our bodies by a very small gland found in the brain. During the day the pineal gland is inactive, however when the sun begins to go down it is kicked into action and Melatonin, or the Dracula of Hormones is released! 

Melatonin is important in helping to regulate our circadian rhythm or our internal body clock, and regulating our cycle of sleep and wakefulness. Melatonin levels in our body vary in our twenty four hour cycles. Normally our bodies production of Melatonin is reduced by simply being in bright light and the levels increase at night time. We have receptors in the back of our eyes that when they receive light, they send a signal to the pineal gland which then suppresses the production of Melatonin. When natural light decreases, Melatonin levels are gradually increased and they remain high while it is dark. When the receptors are again exposed to light in the morning, Melatonin production is suppressed and our Melatonin levels drop.

There are many other traits that may be seen and are associated with Autism. Not all individuals diagnosed as ASD will exhibit these traits and no two individuals who have been diagnosed with ASD present the same.

Autism really is a spectrum!

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I would love to hear your thoughts on my blog. I do read all the comments that are posted. Thanks so much for stopping by. Jen xx