Autism Masking

Let's talk about masking, in particular Autism masking.

But first, everyone masks at one point in time. You may only show your work side of your personality in the workplace - a form of masking. You may hide your true feelings about something so as not to upset others - again masking. You may be emotionally and mentally exhausted but don't tell people around you because you don't want to worry them - again similar to masking.

You weren't taught how to do these things, it just happens. How exhausted at the end of the day do you feel?

Now imagine masking every inch of your being, every single day. 

Autistic individuals, at times, realise that to fit in with their peers, they have to mask their own traits. They may realise that if I have an emotional overload then my peers will judge me, I may get into trouble.

Masking is detrimental to an Autistic individuals emotional, mental and physical well-being.

You may see one behaviour, extremely well behaved compliant individual in one setting, and the complete opposite in another.

Please, please understand masking. Don't dismiss the individual, or their family. Take the information on board and ask, how can we assist.

Autistic individuals are expected to fit into a world, a system, that isn't designed for them. Rather than expecting them to fit in, make accommodations.

Provide an Autistic individual with the support so that they feel comfortable to unmask.

The Mask.

There is one aspect of my children's autism that people really struggle to comprehend and understand.

"But they look so confident and calm."

It's called Autism Masking. And yes it is very real.

People struggle with the concept that a child can hold it together all day - that a child is quite capable of holding in all of their anxiety and frustration - and appear to be perfectly okay on the outside. And yet when they arrive home, to their safe zone, they explode.

People just can't seem to fathom that my seemingly calm and confident 9 year old daughter can turn into a Dr Jekyll/Mr Hyde character the minute she leaves the school ground. L has also recently started withholding his anxiety and frustration throughout the school day and exploding at home.

At times we have resorted to recording O, and L, when they have been in this state of completely-out-of-control at home to show the school what occurs on a semi-regular basis. Until we show O's teachers a video of her melting down at home, they simply cannot believe that the mild mannered, courteous child that they see day in day out, is capable of such an action.

It is simply heartbreaking to have to watch your child in this state knowing that there is absolutely nothing that we can do to help them.`

I've spoken to O about this post and asked her permission to talk about her when she is in a meltdown. She told me that I could share a very short video of her whilst in a meltdown so that, in her words, "people can begin to understand what it feels like." But her body language while we were talking screamed a big fat NO!

So what I have done instead is take screen shots from two points in the video to show what Autism masking can look like.

Before you read on, please no judgement. Until you have walked in our shoes, walked in my nine year old daughter's shoes, please do not judge.

We don't record this behaviour to humiliate her. We record this behaviour to show what an autism meltdown looks like. Please keep an open mind.

This shows a child who at this point in time could not find the words to verbally express how she felt.

This shows a child who knows that we are her safe place. We won't judge, we will still love her unconditionally and we won't try to stop her. We will simply stand back and allow her to vent her pent up frustration and anxiety. We have no choice but to let her vent and get it all out.

This shows a child who has successfully held her anxiety at bay all day whilst at school.

This is a child who has successfully fooled her teachers at school into thinking that she is okay.

This shows a child who is expending so much energy during the meltdown that she will collapse once her body has rid itself of the anxiety that has been eating at her all day.

This shows a child whose strength increases ten fold during a meltdown with the adrenalin that is pulsing through her body.

This shows a child who knows that if she was to exhibit this behaviour at school, she would be frowned upon by her teachers, the school officials and her peers.

This shows a child who knows that to stand out from the crowd is generally not a good thing - she will be singled out, she will be bullied.

This shows a child who is in so much distress that all she can do is writhe around on her bed screaming nonsensical sounds and thrashing her body in all directions, lashing out at whoever comes near her. And yet if we walk away, that makes the situation so much worse.

This shows that the mask of autism is very real. And unfortunately for many individuals who have been diagnosed with autism, this is a much too regular occurrence for them.

There is so much pressure for individuals to suppress their autism so that they fit into the world around them. And the end result of suppressing and holding in their anxiety, is this. A meltdown.

For individuals who have been diagnosed with autism, meltdowns do not stop when they turn the magical age of eighteen. I know many adults on the spectrum who find themselves in a state of meltdown well after they turn eighteen.

The one thing that you can do is be supportive. Please be supportive of parents who may describe this behaviour in their children. Please don't be dismissive of them. Please be supportive of adults who tell you that they themselves feel that they are struggling with the environment around them.

So the next time you see a child, or an adult, who is struggling, what will you see? What will you do?

Why is support for Autism lacking?

I have often been asked the questions - "why is support for individuals with autism lacking?" and "why do you have to fight so hard for support services?"

There is no hard and fast answer to both of these questions but before I can attempt to answer them, there is a little background information about my little superheroes that you need to know, so bare with me ...........

On the mornings when we are having a rough time at home, I will rarely call the little superheroes school after I have completed the school drop off. I will write in the little superheroes communication books to their teachers prior to school drop off, but I will rarely call.

And the reason is that at school I know that both of my little superheroes will settle, they will conform to what is expected of them and they will both appear to be happy despite the turmoil at home prior to going to school. They both get on with their day despite what had occurred prior to arriving at school. They may need extra sensory breaks or brain breaks as L has taken to calling them, but they do get on with their day.

Prior to gaining L and O's autism diagnosis, we were often accused of providing a lack of discipline and a lack of structure at home. We were often told that L's behaviour was a result of our parenting style. We were regularly asked "are you sure that is how they are behaving?" We were accused of lying or of over exaggerating the behaviours. All of the behaviour was put back onto us as parents - it was all our fault.

I have had to resort to recording videos of my little superheroes when they are at their most vulnerable at home to PROVE what I am describing to professionals. I should not have had to do this and yet, at least once or twice a year, I have to.

And then when we received the final diagnostic reports for both L and O, we had to start proving that the behaviour was occurring all over again. This time to funding bodies.

According to the medical and education professionals that we spoke to, the common denominator for L's poor behaviour was us, his parents. When it comes to a child's poor behaviour it appears to be quite easy for professionals to jump to conclusions and place the blame directly on "poor parenting decisions."

Unfortunately for us, the poor behaviour was rarely seen outside of our home.  

The act of behaving one way at home and another outside the home has a name. It is known as Autism Masking or autism camouflaging and it is more common than you'd think among individuals with autism.

When a child acts differently at school, when they put on the mask, this makes it incredibly difficult to access the support that they desperately need. They are denied access to inclusion services due to their presentation outside of the family home.

Autism is a very complex and confusing (at times) disorder, and yet many individuals learn when they can and can't explode. O is a master of this! O knows that standing out in the crowd is not a great thing to do and L is slowly picking this habit up. They both know that they can show their vulnerable sides at home as there is no judgement from us. They will both internalise their anxieties and frustrations throughout the school day and explode when they walk through the door at home in the afternoon.

Many medical and education professionals have the mistaken assumptions that if a child truly had challenges, the challenges would manifest in all settings in exactly the same way. 

And as a result the consequence of these assumptions is that children are left with little support as they are unable to access the support services that they need and families are left to struggle.

So what needs to change so that our children can access the support services that they need? What needs to change so that the support is more readily available?

In my mind there are two areas in which changes need to be made and the changes more have to do with the thought processes of medical and education professionals than anything else.

The first change that needs to be made is that medical and education professionals need to be more understanding and be willing to listen to a parent when they are describing the way in which a child behaves at home. 

Just because you don't see the behaviour on a daily basis, does not mean that the behaviour doesn't occur.

I am yet to meet an adult who doesn't go home and moan to others to let off steam after a rough day at work. While adults generally don't arrive home and immediately enter into meltdown mode, there are days at work where I am sure that we all put on a mask and pretend that life is great. When we are put into a different environment than what we are used to, we will all change to suit the environment. When we are all put under stress, our coping mechanisms come into play.

Children are no different.

There are many stresses in the classroom that teachers, at times, are not aware of. There are sensory issues that will affect some students more than others. There are the stresses of needing or wanting to conform to the expected norm so that they blend in with the crowd. Then there are the academic pressures that are placed upon students throughout the school year.

All of these stresses alone are enough to cause anxiety to bubble to the surface in any child. If all of these stresses are combined, then you have a recipe for internalising anxiety and a behavioural explosion at home.

The second change that needs to occur is that medical and education professionals need to be much more aware of the many different ways in which autism can present. The saying "so you've met one person with autism" can not be more appropriate when it comes to support for individuals with autism.

When a child does not present autism traits in the manner in which professionals are familiar with, this causes confusion. It can't possibly be autism, can it?

Traits can be seen just as "quirky features" of a child and a parents concerns are dismissed.

A child who makes eye contact, they can't possibly have autism, can they?

Children with autism aren't social, are they?

Every individual with autism presents differently - no two individuals are alike. There are traits that are similar between all individuals and then there are traits that can present as though they are on opposite ends of the spectrum.

Girls will often present autism traits quite differently to that of their male counterparts and this in itself causes difficulty for students to access services and funding.

Girls are fantastic at copying or mimicking their peers and as such girls, generally speaking, are not diagnosed until after the age of 6 or 7 or until they hit their teenage years. Obtaining an autism diagnosis for a girl can be a very challenging process due to their innate ability to copy the behaviour of others.

All professionals need to remember that the autism is a spectrum - a very wide spectrum.

I have two children and both present completely differently to each other. They are alike in some ways but completely different in others.

If these two changes alone occurred then parents would begin to feel less alone and not belittled by the professionals who are meant to be there to support them.

If these changes occurred, then perhaps the support for individuals with autism would increase or be easier to access.

The Autism that You DON'T see.........

"Oh, L is fine at school!"

"We don't see any of that, O is the model student!"

"Really, O/L is like that at home?"

These questions, these statements, can make interactions with teachers, educators and medical professionals quite uncomfortable. In a blink of an eye, questions and statements like these can turn a conversation from a pleasant one into, well ........... hackles become raised, voices become emotional ......... you get the picture.

Questions and statements like these can make the child's behaviour seem as though the parent is at fault and this in turn can cause us to question every little decision that we make and have made on our child's behalf.

Questions and statements like these cause a parent to shut down and not want to bring up issues with those who should be supporting them, instead of questioning them, for fear of the underlying judgement from others.

Questions and statements like these really highlight the autism that you don't see unless you are in the immediate family unit.

It really is a case of the autism that you DON'T see.

You see a child who is so rigid and seemingly unwilling to compromise on anything that their behaviour becomes annoying to you. The child who is acting like a spoilt brat.

I see a child who wants his world to stay the way that it is because then his world is predictable. I see a child who doesn't want to stray from her predictable world because the minute that her world becomes unpredictable, her anxiety is provoked into action and she becomes glued to one spot unwilling and unable to make any moves. I see child whose anxiety is like a tightly knotted rope and until that knot is loosened, she is physically unable to move or speak or participate in her much loved activities, including school work. A child who is not yet sure how to loosen the knot of anxiety. I see a child who is desperately trying their hardest NOT to enter into meltdown mode. 

I see a child who has strict and often very complicated routines and rituals for simple every day activities. And these routines and rituals have to be done the same way. Every. Single. Time. The tiniest deviation from these routines and rituals can result in an explosion of a huge magnitude.

You see a child is happy, who is chatty and gets along well with others but who can be very shy at times.

I see a child who knows that to stand out is a bad thing so she is compliant all day. I see a child who badly wants to fit in with others around her and yet she is unable to because she just does not understand the social interactions of others. I see a child who then struggles to keep it together all day that the minute she arrives home and walks through the front door, her pent up frustration and anger explodes. I see a child who knows that we are understanding and will remain calm so she feels safe to show this other side to us. I see a child who breaks down in tears because he knows that he is different and doesn't yet understand that different is good.

You see a child who is unable to focus on their work and is becoming disruptive as they move around the classroom or as they start to vibrate in their chair. You see a child is unwilling to do their school work unless they are removed from their classroom.

I see a child who is in sensory overload by their surroundings and is physically and mentally unable to focus until they have had a sensory break. I see a child who needs regular sensory breaks to assist them to focus. I see a child who is beginning to understand they need to have a sensory break but is not yet able to find the words to communicate his needs. I see a child who views being removed from their classroom as a punishment not as an opportunity to complete their school work.

You see a child who is rude or ignorant because they are refusing to speak or interact with those around them.

I see a child who is in sensory overload by all that is going on around them and the only way for them to cope is to shutdown and to retreat into their inner self.

You see a child who is a fussy eater and who you believe should be made to eat the food that is put in front of them.

I see a child with sensory processing difficulties. A child who has to wear the same clothes day in day out. Not for style, purely for comfort. I see a child whose skin feels as though it is literally crawling when particular textures are felt or eaten. A child who needs a lot of time and effort put in my others to try to increase the foods on their list of acceptable foods. I see a child who knows when we change a brand of food, they don't have to see the change in food label, they just know.

You see a child who is obsessed with a particular toy or subject and who you believe is spoilt as they seem to always have the latest toy, gadget or clothing item or costume.

I see a child who is in his comfort zone. A child who while wearing a superhero outfit is willing to venture out from his shell to interact with others. A child who is trying desperately to establish some common ground with others. A child who is willing to verbally communicate as he joins in on a conversation about his obsession.

You see a child having a tantrum.

I see a child who is in meltdown mode. A child who entered into sensory overload as a result of their surroundings. A child whose anxiety has become so crippling that the only way that they know how to cope is to let loose with screaming and yelling and throwing random objects. A child who desperately wants to escape their surroundings but they physically cannot find the words to voice their needs. I see a child who needs space and a parent who is calm with a seemingly unending patience level. I see a child who at that point in time is only able to communicate their needs through an angry outburst. I see a child who is not aware of their actions or words while they are in meltdown mode and yet is remorseful in the aftermath even though they have no recollection of the event.

What you are seeing is a mask, a front. 

Remember looks can be deceiving, not everything is as it seems to be.

The mask is the autism that you DON'T see.

How much do I really understand?

As each new dawns, I have a much deeper understanding of just how little I really know and understand about my little superheroes autism.

I have had many people say to me that I know a lot about autism and the related issues that individuals with autism can present with. But this is completely untrue.

I know a lot, but not everything, about my little superheroes autism. I don't know everything about autism. There is a difference.

L's key therapist and the team at the early intervention centre that he attends know the complete ins and outs of autism. I know the ins and out of my children's autism. I know about the "symptoms" of autism and the different therapies that are available.

But in saying this, there is also a lot that I don't know, and will probably never know, about my little superheroes autism.

For example I cannot hear sounds the way that O and L hear them. There are times when particular sounds really grate on my nerves and I can feel my brain recoiling at what I am hearing. But not to the extent of how O and L are effected by different sounds and noise in general.

I also do not see colour and light the way that O and L see them. O and L can pick out the minutest amount of colour in the greyest of grey skies. O can tell the difference between magenta and violet just by glancing at it and she is always correct! How???

When I visit a hair salon, I do not have the same terrifying feeling that L usually gets with something as completely ordinary as getting a haircut. To L a hair cut can feel like torture and can be an absolutely terrifying experience.

Nor do I sense touch the way that O and L sense it. O is over responsive to touch, L is under responsive. And both can be variable in their responses from day to day!

There are days when all I can do is sit back and watch my little superheroes as they experience levels of pain and fear that I cannot, do not and probably will never feel. I know that they are in pain or are fearful as I can see the emotions written all over their little faces.

And all I can do is be there for them to reassure them, to keep them safe from themselves. There is nothing else I can do but be there for them and offer them sensory breaks in the form of block ear protectors, squishy cuddles or simply helping them to physically escape from the sensory overload.

I will never know how it feels for my little superheroes to go through life with autism. There are particular facets of autism that I understand, as I see those little snippets in myself as a child. I see O struggling with her anxiety and I know exactly how she is feeling. I also know what I need to do as her Mum to assist her.

The social communication and unwritten social rules that we all take for granted, are a completely foreign language to both O and L. The social rules do not make any sense whatsoever to O and L but they must both learn the rules. And I must teach them.

I can explain the social rules to my little superheroes until I go blue in my face, and they still won't understand them. However O and L will follow the rules simply because a rule is a rule. That they understand, you have to follow the rules. But just because they follow the rules, does not mean that they understand them.

O and L live inside their own little worlds, inside our world. And that feat alone is anything but simple.

Every time we leave our house, they both leave their safe place where they understand the rules. Their safe place is where there is consistency, schedules and routines that never change. Every time they step out of the house, anything could change at the snap of a finger and they have no control over it whatsoever.

There are days when I close my eyes and I try to imagine their world. A world in which they feel safe, where everything has a place and a purpose. A world which they leave each and every day as they desperately try to understand others around them as they try to fit in. Oh how I long to completely be immersed in how they experience life as I will have a greater understanding of the emotions and thoughts that run through them.

How O and L experience life is different to how I experience life and I will never know the full extent of how they experience the world around them. I can take guesses as to what goes on inside their heads but there are days when even these guesses cause my little superheroes pain and fear.

But through tyring to understand my own children, I am able to see the bigger picture of just how wide the autism spectrum really can be. Then I begin to understand that I have so much more to learn. We are all on this very steep learning journey together.

Where to next?

Sooooo ...... last week we received the phone call from O's psychologist that we have been eagerly awaiting since mid-February - the psychologist's report from O's Autism assessment was finally ready to be collected.

We'd also been able to collect the report from O's speech assessment so we're now headed back to the paediatrician this coming Tuesday for the final diagnosis. Both reports strongly indicate that a diagnosis of Autism Spectrum Disorder is on the cards for O.

We had an inkling as to what the two reports would say but still it is never easy to read about your child's deficits. It is incredibly disheartening to read all the areas in which O is struggling.

There were phrases such as "level of severity - 3" mentioned numerous times throughout the reports, level 4 is the most severe on the scale that was being referred to. Other phrases that leapt off the page were -

• "Indicating the presence of an autistic spectrum disorder within the severe range."
• "The adaptive functioning level is in the moderately low range."
• "Rated as clinically significant."
• "Shows impairment in social emotional reciprocity and deficits in non-verbal communication."
• "Current severity on the DSM-5 is level 2, requiring substantial support.
• "O meets part A, meets part B, meets part C...."

And then there phrases such as "visual spatial is high average" and "working memory and processing speed is high average."

All of these phrases confirmed what we had already suspected, that O is in fact on the spectrum.

Both reports also confirmed what an amazing job O has been doing at masking her Autism traits and the huge effort that she has been putting in to successfully mimic the actions of her peers. The reports confirmed that only trained medical professionals who know what to look for were able to see through O's mask and see her actions and behaviour for what they are, Autism traits.

While it was so very disheartening to read through the reports, there was also a huge sense of relief as now we can move forward.

We already know that O is capable of achieving great things and these reports are just the next step in obtaining the assistance that O needs to navigate this world of ours.

We don't view these reports in a negative way, they are written that way for a reason. We view the reports as the next step in O's autism journey.

The reports are the next step in O writing her own story.

How can Autism present in girls?

After we'd been through the ASD diagnosis process with L and had received his official diagnosis, we began to notice that O was presenting with quite a few ASD traits. We weren't sure if we were noticing O's traits because we were more aware of them due to L's diagnosis or if she had in fact been presenting with the traits the entire time.

O has always been an anxious child, she has always found something to worry about. In the past we have tried numerous techniques to try and assist O with her anxiety but all to no avail. In the second half of last year we came to the point that we needed to seek the assistance of a child psychologist. During O's second session, the psychologist took me aside and suggested that we should look at getting O assessed as she strongly believed that O was on the spectrum.

And wouldn't you know it, O now has a provisional diagnosis of High Functioning ASD, not that medical professionals diagnose children with High or Low Functioning ASD anymore. However the scale of 1 to 3 that a child receives reflects High to Low Functioning.

During O's diagnosis process I began to ask questions of the medical professionals that we were visiting frequently and also began to do some research of my own.

How on earth had I missed O's ASD traits? They were there the entire time and I had missed them. Why? How?

Well.......

For a start, girls are generally brilliant at masking their traits by either copying or mimicking their peers. It is only when the social and emotional side comes more into play as girls grow older, that girls with ASD begin to struggle. It becomes more difficult to understand and mimic others emotions and social interactions as these become more complicated.

O has always been a little copy cat. I used to regularly comment when she was a baby and toddler that it was as though she was watching the other children around her before she practiced a new skill. And when she did "practice" a new skill, she often succeeded on the first try.

Last year O really struggled to understand the girls in her class and others that were older than her. She would often tell us that she didn't understand the way that they talked or acted. It was becoming harder for her to blend in.

Girls, ASD or not, often know that standing out in the crowd is generally not a great thing to do. They will have enough skills to be able to blend in with their peers. They watch and observe and then use their intelligence to join in on social situations. Girls will learn socially appropriate and acceptable behaviours such as maintaining eye contact, memorising phrases that are commonly used and imitating the facial expressions of others.

O is variable when it comes to maintain eye contact. She usually finds eye contact difficult however occasionally she will maintain eye contact but the catch is that she is in fact staring at you. It can become very uncomfortable.

It's often known as Autism camouflaging and as a consequence of being able to camouflage their traits, girls generally stay off the radar and are diagnosed at an older age, compared to boys with ASD. Girls are usually diagnosed after the age of 6 or 7 or even older as a teenager.

There are numerous females that have gone through their life undiagnosed until they begin the diagnosis process with their own children. It is during that process that they begin to relate to the criteria being used to assess their children. I am one such adult - I can see a lot of myself as a child in O. I have also been able to relate my teenage years and how I was feeling to the diagnostic criteria.

This is not to say that girls are not diagnosed before the age of 6 or 7, numerous girls are diagnosed younger than that and it is most likely due to the fact that their ASD traits were obvious. Children present ASD traits in many different ways, there is no typical way of presenting. But what Autism researchers are finding is that more and more girls and women are coming forward to be diagnosed.

The original DSM criteria was very much male biased. In fact ASD used to be thought of as a male disorder as females were rarely diagnosed. In the past girls may been misdiagnosed or missed altogether simply because at times they do present differently to what the criteria is suggesting. Or the traits simply didn't stand out to those adults around them.

When Dr Hans Asperger originally reported about Autism in 1944, he initially only found it in boys and he stated that "in the autistic individual the male pattern is exaggerated to the extreme.....it could be that the autistic traits in the female only become evident after puberty. We just don't know." (Firth, 1991, pg 85.)

In fact for every four boys who are diagnosed with ASD, only one girl will be diagnosed. Obtaining a diagnosis for a female can be a very challenging process. The idea that girls can present ASD traits differently to that of boys is a relatively new concept and as such not all medical professionals are in agreeance.

Neurotypical boys and girls differ in terms of how they socialize, how they communicate and in their behaviour. It is safe to stay that ASD children are no different.

In saying that, I do need to add that boys and girls with ASD are also similar in many ways - they all have difficulty relating to and communicating with other people, they may have repetitive behaviours, they may be fixated on a special topic or interest and so on.

But those similar characteristics which both girls and boys both experience difficulties with may present differently between the sexes.

Boys will generally act out their frustration behaviourally when they are unable to understand social situations. Girls however tend to internalize their frustration and are less disruptive at school. At school they are well behaved and generally fly under the radar. They are quiet, helpful and kind and may appear to be shy or sensitive. This in itself makes it very difficult to convince educational and medical professionals that something is not right.

O worked out very early on in her schooling that acting out at school was not a good thing, she did not want to get into trouble so she would internalize all her frustration and then release it all when she arrived home. Her teachers have never seen this other side of her.

This is the downside of camouflaging - it takes a considerable amount of mental effort to be constantly on the ball when in social situations. This leads to mental exhaustion and it does take an emotional toll on the individual and their family.

Constantly camouflaging leads to high anxiety which, for girls, rarely presents at school or in social situations. Boys may become disruptive when in an anxious state, girls tend to internalize their anxiety and let their emotions explode when they arrive home to their safe place. This is O to a tee......

Other ASD traits that girls may present with include:

At times girls with ASD will possess the ability to read above their developmental level, however their comprehension does not always match their reading skills. They may have an average or slightly above average IQ, will receive good grades and not appear to struggle academically which leads to confusion among educational and medical professionals during the diagnosis process.

Girls may be book worms or love to write creative stories and they often have the most amazing imaginations. The stories and poems that O composes are simply amazing. We have been told recently that girls with ASD do not have an imagination, however I beg to differ.

Girls with ASD will often prefer the company of much older or much younger children. They generally like to play the same game and play the same role every time! O played a game when she was younger called Mummies and Darlings. She was the Mummy and I was the darling. She would fall into the Mummy role and would not break character. This game could go on for days, we'd go to sleep at night and when we awoke the following morning, the game would continue. And if I broke character, hooley dooley, O would completely lose it!

Girls with ASD may go to a speech therapist for their speech when they are quite young but this initial speech issue is initially unrelated to Autism. As a baby and toddler, O suffered from numerous ENT issues to the point that between the ages of 2 and 2 and a half she could not hear. Missing 6 months of hearing affected how she learnt new sounds and as such when she entered Kindy she was unable to pronounce certain sounds. O attended speech therapy for approximately 18 months to correct her speech pattern.

Girls with ASD may have repetitive behaviours and special interests like their male counterparts however these can look different as well. L has an obsession with anything and everything to do with superheros - clothing, toys, books, bedding, facts, comic books, TV shows ...... O has special interests, Monster High Dolls and Shopkins are some of her interests, but these are very similar to those interests of typically developing girls. O has collections of objects, one being tiny bits of paper. This type of collection is generally not common amongst neurotypical children!

At school and in other social situations, girls with ASD may spend a considerable amount of time either alone or looking for opportunities to help out other children or their teachers. We're constantly told that O is always helping other children at school and that she likes to help the teachers during recess and lunch. Mmmmm....

Having now completed the diagnosis process with O and having to look closer at her traits, I can see that her traits were there all along but other than her anxiety, none of her other ASD traits stood out like L's did. O's stimming didn't stand out as being odd, her collections and obsessions were similar to those of other children her age, being first time parents we put her favouring of certain foods down to being slightly fussy. O has a variable pain tolerance. I could go on but hopefully you get the picture.

What I can tell you is that we have had several years of feeling like we were banging our heads against a brick wall when trying to explain her emotional outbursts and we now know why. O was simply presenting her ASD traits differently to other children.

One important lesson that I have taken from O's diagnosis process is that it is paramount that parents are listened to by educational and medical professionals when they are desperately seeking answers for their children's behaviour.

I'm not in any way dismissing how other children present with ASD, there is no typical way. As the saying goes, if you've met one person with autism, you've met one person with autism. Some children present with autism traits at a younger age than others.

What does need to happen is more awareness of the difference in autism traits. The more awareness that there is in the educational and medical system, the easier it will become to get our children the help that they desperately need.

Reference:

Firth, U. (Ed). (1991) Autism and Asperger Syndrome. London: Jessica Kingsley Publisher.

10 Things that I wish Teachers knew about Children with Anxiety

As an individual who has suffered from anxiety for as long as I can remember and as a parent of a child with severe anxiety issues, there are certain things that I wish teachers and other educators knew about anxiety.

In regards to special needs education, anxiety is a relatively new concept and many people truly do not understand how difficult it can be for a child to live with anxiety. Every child deserves an equitable educational environment and for that to happen, school staff need to be aware of just how anxiety can affect children while they are in their care.

Anxiety is one of those hidden illnesses and at times, as an adult, it is difficult to explain how anxiety affects me. Imagine how much more difficult it must be for a child to articulate how anxiety is making them feel.

O, for most of the time, is able to “hold it together” while she is at school. But in saying that, her anxiety levels would be rising throughout the school day and there would be tell-tale signs that she needs assistance to calm herself down. Helping O to learn how to manage her anxiety has, in turn, helped me to manage mine.

So in the scheme of paying it forward, here is a list of things that I hope will help educators to understand how anxiety may affect their students. I will add that I am not claiming to be an expert on anxiety disorders, these are just observations that I have made over the years!

1.     Anxiety is more than just being worried, stressed, nervous or being a sensitive child.

Anxiety is a biochemical reaction that occurs in the body as a result of environmental factors or to put it in simpler terms, anxiety is simply the body’s reaction to brain stress. Anxiety is more than just feeling stressed or worried. Stress and anxious feelings are a very common response when we feel under pressure and these feelings will usually pass once the stressful situation is removed. You might feel stressed leading up to a job interview or an exam but once the job interview or exam is over, the stressful feeling passes.

The term anxiety is used when these anxious feelings that an individual may have, simply don’t go away. The anxious feelings are more frequent and ongoing and often will present without any particular rhyme or reason. Anxiety doesn't discriminate and it does not care when it chooses to raise its ugly head.

O has become anxious over leaving a pencil at school in her school desk. She has worried about forgetting where she left her school hat. O has worried about forgetting to take her library book to school. O has become anxious because we forgot a step in her bedtime ritual. For some people, these worries may seem insignificant, to a child with an anxiety disorder, these are major worries.

At times, O has not been able to tell us what she is worried about, only that she has an immense feeling of worry and fear. At one point last year, O was in tears at school and when she was asked by her teacher why she was crying, O replied "I don't know."

And yes O can be a sensitive child, but she is sensitive because of her anxiety. Her anxiety causes her to overthink situations, experiences and conversations. Please do not dismiss a child simply because you think that they are being a sooky la la.

It is important not to dismiss a child’s anxious feelings as this will only make the situation worse. Their feelings need to be acknowledged. Let them know that their anxiety is real and that with your help, they can get through it. Acknowledge that they may need help from time to time and that this is perfectly okay. We all need a helping hand, it isn’t a sign of weakness, it is a sign of strength.

Being understood and not judged can make all the difference to a child.

2.     Parents need to be heard and listened to.

I have lost count of the number of times that we have been told “but O can’t suffer from anxiety, I’ve never seen that in her."

Parents who express concern over their child, whether it be to teachers, medical professionals, friends, they need to be heard and listened to. Many children, O included, are able to hold it together all day, only to crumble the minute they step inside their home, their safe haven.

Teachers and educators may never see this side of the child but that's not to say it doesn't happen. Yes, students are in your care for 6 hours, or there about, 5 days a week but you do not see the child when they are at their most vulnerable. You don't see them when they are shaking and in tears because they didn't understand their friends. You don't see them when they have no energy left to hold it together. You don't see the emotional and mental destruction that anxiety can cause.

Speaking from experience, anxiety can be a crippling experience. Anxiety can make it incredibly difficult to cope with day to day functioning. Anxiety can impact on an individuals quality of life. If not watched and managed, anxiety can manifest into larger mental health problems.

3.     Anxiety requires understanding, it is not something that can be turned on and off like a running tap.

Everyone feels anxious from time to time and when we feel anxious we may be able to reason with our thoughts to assist us to cope in stressful situations. This is not the case for a child suffering from anxiety issues. Their anxious feelings are not easily controlled and they may not be able to reason with their thoughts.

Telling a child who suffers from anxiety to stop worrying is not going to help. The only thing that the statement “stop worrying” will do is make the situation worse, ten-fold.

A child suffering from anxiety is most likely going to a huge massive ball of turmoil on the inside and even the simple act of breathing can pose a challenge to them. Any individual suffering from an anxiety disorder doesn’t want to be in that situation. They don’t want to be feeling the way that they are and in all honesty they probably wish that they could just snap their fingers and calm down.

But it isn’t that simple. Telling a child to calm down or stop worrying may make them feel shame, anger and frustration, which then adds extra anxiety as they try to deal with those emotions on top of the anxiety.

Please understand that an anxious child needs you to be patient, they may need your help to get them to calm down. They may need to escape from the stressful situation to assist themselves to come back to a calm state.

4.     Anxiety doesn’t look like one thing.

Everyone is different and it can often be a combination of factors that contribute to developing an anxiety disorder. At times, the symptoms of anxiety is not all that obvious. Anxiety may be a sudden onset in some and a gradual process in others.

Every individual that suffers from anxiety would have different triggers. Anxiety can present as different levels of intensity. Some individuals may be able to cope with high levels of anxiety, others may not.

One child may have completely different coping mechanisms to another.

And as with ASD, anxiety generally presents differently in girls and boys. Boys reactions to anxiety may tend to be more behavioural driven. Girls on the other hand may tend to internalise their reactions to anxiety. Both reactions require different strategies to manage the anxiety and also to teach effective coping strategies to the child.

As the ASD saying goes, so you've met one child with anxiety! No two are alike.

5.     Build a relationship with an anxious child.

If you get to know an anxious child, if you develop a good rapport with them it may mean the difference between being able to pick up on their triggers or not being able to.

Building a rapport with your students means that they are going to trust you enough to come to you for help.

You are then going to be able to pick up on their tell-tale signs throughout the day and perhaps assist in preventing them from getting to the edge of the anxiety precipice. This will make a huge different to a child.

6.     Odd behaviours often come about as a result of stress.

As a result of her anxiety O has developed some self-calming rituals. O will start chewing on things - clothes, pencils, books, anything really. O will start to rock on her chair. O will start to fidget with pencils, clothes, toys, again anything really. These are all her little cues that her anxiety is starting to become too much for her.

Telling a child to stop chewing on their shirt or to stop bouncing on their chair, is not going to help. The child has developed those self-calming rituals for a reason. Let them use them.

If the self-calming ritual is distracting for the rest of the students in your class, sit down with the child and their parents and discuss what other self-calming rituals can be employed instead.

7.     Develop strategies

Once you become aware of a child's anxiety issues perhaps you could meet with the child and their parents and draft a plan of strategies that the child can use when they feel their anxiety levels rising.

You could pre-plan and come up with your own strategies to help students in your class. Have a list of jokes to distract your students. Even a funny thought is sometimes enough of a distraction for children.

I have been using breathing exercises with my kindy children at work when they need a brain break and we're at the point now that the children are able to recognise when they need time out. They will walk away from the situation, take some deep breaths and walk back in a lot calmer.

There are a number of wonderful books available that can assist children to deal with anxiety and worry. We love the book "I have a Worry" and "The Angry Octopus.'

Keep in mind that older children may not want to be singled out in front of the peers. Perhaps you and the student come up with a secret signal so that they can discretely communicate with you when they need a brain break.

8.      Remain calm

Have you ever noticed that a calm teacher somehow magically ends up with a classroom of calm students?

An anxious child craves quiet and calm. If you speak with an anxious child in a quiet and calm voice, they are more than likely going to respond to you and listen to what you are saying. It is much easier to come back down to a calm state when the person who you are talking to is also calm.

O responds so much better when we remain calm. She is obviously still very much in an anxious state, but she is able to come down much easier.

9. Anxiety can be difficult.

Please remember that anxiety can be difficult not only for the child, but also for their family members who are in the firing line once the child gets home school.

Anxiety can make it incredibly difficult to focus and pay attention in the classroom. Imagine being overly worried about leaving the oven on a home and then having to go to work and put all your efforts into doing your job for the day. All the while with the thought "did I turn the oven off" running through your mind. That is what it is like with anxiety.

Anxiety may cause an A-grade student to fidget and want to move around. They're not doing this deliberately.

I remind myself regularly that behaviour is not done on purpose, it is done for a purpose. Why is your normally well behaved well mannered student misbehaving?

10. Anxiety is a part of the child, not the whole child.

Lastly the anxiety is part of the child, but it is not the whole child. I read somewhere, and at the moment I simply can’t recall where, that at times anxiety is part of a child like freckles are a part of another child.

Anxiety should never be looked at as a flaw. A child with anxiety has enough self-confidence issues, pointing out anxiety as a flaw is not going to help their self-esteem.

Focus on the positive aspects of the child. O is smart, she is kind and caring. Acknowledging those aspects are important as those are what make her the loving intelligent girl that she is.

O's anxiety does not define her, it is simply part of her being.