Powerpoint from the ITeC training day on Autism Awareness.

1. Introduction to Autism
Lesley Johnston RGN. RMN. BN. Cert. Health Informatics

2. What we will cover today
Autism: what it is and is not
Autistic spectrum
Triad of Impairments
How people with autism see the world
Facts and figures
Communication
Introduction to:
◦ Autism and learning disability
◦ Understanding behaviour
◦ Anxiety and strategies for managing anxiety
◦ Challenging behaviour
Approaches, therapies and interventions
Asperger's and higher education

3. What is autism?
Throughout this session we will use the term autism -
although it is well known that autism occurs in differing
degrees of severity and in a variety of forms.
The terms Spectrum and/or Continuum of disorders
or conditions are commonly used to group people
together that have a shared difficulty in making sense of
the world.
Autism is a lifelong developmental disability that
affects the way a person communicates and
relates to people around them. Children and adults
with autism are unable to relate to others in a
socially meaningful way.

4. Group work: ‘spectrum’

5. continuum
Aspergers syndrome Autistic Disorder

6. What is autism cont.
Their ability to develop friendships is impaired, as is
their capacity to understand other people's feelings.
People with autism can often have accompanying
learning disabilities and/or mental health problems.
The term spectrum condition means that, while all
people with autism share certain areas of difficulty,
their condition will affect them in different ways.
Asperger's syndrome, is believed by many experts to
falls at the higher-functioning end of the autistic
spectrum.

7. Triad of Impairments
All people with autism (and Aspergers) have impairments
in social interaction, social communication and
imagination. This is referred to as the triad of
impairments – it is the degree that varies:
Social interaction (difficulty with social relationships,
for example appearing aloof and indifferent to other
people);
Social communication (difficulty with verbal and
non-verbal communication, for example not really
under-standing the meaning of gestures, facial
expressions or tone of voice); and
Flexibility in thinking and behaving (difficulty in
the development of play and imagination, for example
having a limited range of imaginative activities, possibly
copied and pursued rigidly and repetitively).

8. It can be hard to create awareness of
autism as people with the condition do
not 'look' disabled: parents of children
with autism often say that other people
simply think their child is naughty; while
adults find that they are misunderstood.
All people with autism can benefit from a
timely diagnosis and access to appropriate
services and support.

9. Autism and learning disabilities
People with Asperger syndrome and other
forms of autism at the higher functioning end
of the spectrum can have normal intellectual
capabilities, and some are of above average
intelligence.
However, many people with autism also have
significant intellectual disabilities but the two
do not necessarily go hand in hand.
Test: IQ 70

10. Communication
For people with autistic spectrum
disorders, 'body language' can appear
just as foreign as if people were speaking
ancient Greek!
What do we mean by ‘body language’?

11. As soon as we meet a person we make
judgements about them. From their facial
expression, tone of voice and body language we
can usually tell whether they are happy, angry or
sad and respond accordingly.
At one end of the spectrum People with
Asperger syndrome can find it harder to read
the signals that most of us take for granted. This
means they find it more difficult to communicate
and interact with others which can lead to high
levels of anxiety and confusion.

12. People further along the autism continuum
have difficulties with both verbal and non-
verbal language. Many have a very literal
understanding of language, and think people
always mean exactly what they say.
They can find it difficult to use or understand:
facial expressions or tone of voice
jokes and sarcasm
common phrases and sayings; an example
might be the phrase 'It's cool', which people
often say when they think that something is
good, but strictly speaking, means that it's a
bit cold.

14. Try to adapt your communication -
speak simply and directly, and say
exactly what you mean. Also, whenever
possible, include visual cues to your
meaning.

15. Dispelling the myths
Whilst autism, as a term, was only defined
50 years ago, it has probably been a part of
the human condition throughout history.
However, newly defined disorders inevitably
lead to confusion, so here are a few
pointers to what autism is and what it is
not:

16. What it is
A developmental disorder involving a biological or organic
defect in the functioning of the brain;
Occurs on average in four times as many males as females; 17
males to 1 female for high functioning/Asperger syndrome; 1
male to 1 female for profound learning disabilities.
A spectrum disorder comprising individuals with profound
learning difficulties through to people with average or above
average IQ;
Associated with known organic causes e.g. maternal rubella,
tuberous sclerosis;
Associated with epilepsy or seizure disorders in one third of
individuals at adolescence;
In many cases genetically linked (often a family member has
autism)
Associated with unusual responses to sensory stimuli;
A life-long disability with a need for correspondingly life-long
support in most cases.

17. What it is not
The result of emotional deprivation or emotional
stress;
A wilful desire to avoid social contact;
Due in any way to parental rejection or cold
parenting;
In any way class related;
A mental illness;
Misunderstood genius (although in a few
circumstances some individuals have special
abilities in narrow areas);
Curable (although improvements can be made in
all cases).

18. How common is it?
Autism is much more common than many
people think. There are over half a million
people in the UK with autism - that's
around 1 in 100.
If you include their families, autism touches
the lives of over two million people every
day.

19. More facts and figures
Over 40% of children with autism have been bullied at school.
Over 50% of children with autism are not in the kind of school
their parents believe would best support them.
One in five children with autism has been excluded from
school, many more than once.
Nearly two-thirds of adults with autism in England do not have
enough support to meet their needs.
At least one in three adults with autism are experiencing
severe mental health difficulties due to a lack of support1.
Only 15% of adults with autism in the UK are in full-time paid
employment.
51% of adults with autism in the UK have spent time with
neither a job, nor access to benefits, 10% of those having been
in this position for a decade or more.
61% of those out of work say they want to work.
79% of those on Incapacity Benefit say they want to work.

20. How does the world appear to
people with autism?

21. “If I get sensory overload
then I just shut down; you
get what's known as
fragmentation... it's weird,
like being tuned into 40
TV channels”.

22. People with autism have said that the world, to
them, is a mass of people, places and events
which they struggle to make sense of, and which
can cause them considerable anxiety.
In particular, understanding and relating to other
people, and taking part in everyday family and
social life may be harder for them.
Other people appear to know, intuitively, how
to communicate and interact with each other,
and some people with autism may wonder why
they are 'different'

23. Working with people with autism:
meet Scott and Marie
Key messages for practice
1) Autism affects people in a huge variety of ways.
2) Professionals and others need to have empathy and to understand
the perspective of the person with autism.
3) People with autism who are in employment often need some
additional support.
4) Professionals should use the expertise of the person with autism
and their family when providing support.
5) Good communication with people with autism is vital. This includes
recognising behaviour triggers, using visual prompts and speaking in
short, clear sentences.
6) Society disables people with autism, so we all need to
make adjustments to include them.

24. What adjustments can WE make?
Current Reality versus Desired
Future
________________________________________________
In groups, list the CURRENT REALITY of how you behave and act in
work in the context of working with people who suffer with autistic
spectrum disorder.
Why are you doing this job?
Being honest, what are your priorities in work?
What worries you?
Do you have enough time………?
How do you react to certain behaviours?
Are there things you feel you don’t do well enough?
__________________________________________________________________________________
We will come back to this later………

26. Understanding behaviour
People with autism or Asperger syndrome may
appear to behave unusually. There will generally be
a reason for this: it can be an attempt to
communicate, or a way of coping with a particular
situation.
Knowing what causes challenging behaviour can
help you to develop ways of dealing with it.

27. Anxiety
Anxiety is a real difficulty for many adults with
autism or Asperger syndrome. It can affect a
person psychologically and physically. There are
different ways you can manage anxiety, from
keeping a diary to learning relaxation
techniques and getting support from others in
a similar situation.
Anxiety can happen for a range of reasons and
people with autism or Asperger syndrome can
vary in their ability to cope with it.

28. To understand emotion you need an imagination. One
of the areas of difficulty for people with autism is not
being able to imagine things, so understanding emotions
can be difficult for them. People at the higher end of the
autistic spectrum may understand some emotions and
recognise the feelings that are associated with them. By
helping someone to understand anxiety, you can help
them to manage it better.
Resources such as those sold by Incentive Plus as well
as the Autism Research Centre's CD ROM, Mind
reading, can help teach someone with autism about
emotions.Anxiety can affect both the mind and the
body, and produce a range of symptoms.
The psychological and physical symptoms of anxiety are
closely linked and so can lead to a vicious cycle that can
be difficult to break. ……………..

29. Psychological Physical symptoms of
symptoms of anxiety: anxiety:
easily losing patience excessive thirst
difficulty concentrating stomach upsets
thinking constantly about loose bowel movements
the worst outcome frequent urinating (going
difficulty sleeping to the loo)
depression periods of intensely
becoming preoccupied pounding heart
with or obsessive about muscle aches
one subject. headaches
dizziness
pins and needles
tremors.
REMEMBER: it is extremely important to get medical advice to
rule out any medical conditions.

30. Strategies for managing anxiety
Try and be aware of what makes them anxious and how
best to help them manage certain behaviours.
Keeping a diary in which they write about certain
situations and how these make them feel may help them
to understand their anxiety and manage it better.
Time and How anxious?
date Situation How I felt (out of 1 to
10)

31. Create an anxiety plan when someone with autism is
feeling positive about things. This is a list of things and
situations that cause anxiety as well as solutions and
strategies they can use to help them manage their
anxiety levels. The plan can be adapted, depending upon
how well someone understands anxiety………..
Situation Symptoms of
Solution
anxiety
Going on the bus. Hearts beats fast; Have stress ball in
sweat and feel sick. pocket.
Squeeze the ball and
take deep breaths.
Listen to music.

32. Relaxation techniques –
what the National Autistic Society
says

33. Dealing with challenging behaviour
This is a session all of its own…….
Here is just one example.
You work with an adult who becomes
very aggressive when the TV schedule
for his favourite programme changes.
What can you do?

34. Approached, therapies and
interventions
While there is no 'cure' for autism, there are a
number of approaches that people use to help
with various difficulties they may experience.
Some people make adjustments to their diet, for
example, while others may benefit from speech and
language therapy.
Different approaches have been known to work for
some people with an autism spectrum disorder, but they
have not been evaluated on a long-term basis.

35. Beware!!
Before using any particular approach, find out as much
information as you can about it. Any approach should be for
the benefit of the person with autism and based on a multi
disciplinary decision. It must build on their strengths, help to
discover their potential, increase motivation and provide
opportunity.
Ask yourself:
What does the approach claim to do?
How does it work and who will it benefit?
How was it developed?
How many people have been treated and what was the
outcome?

36. Asperger's and higher education

37. SO…….What adjustments CAN
we make?
Back to Current Reality versus
Desired Future
_________________________________________
You have listed the CURRENT REALITY of how you
behave and act in work.
Why are you doing this job?
Being honest, what are your priorities in work?
What worries you?
Do you have enough time………?
How do you react to certain behaviours?
Are there things you feel you don’t do well enough?
_________________________________________________________________________
Now - list the DESIRED FUTURE against each point.

38. ….the last word goes to Dr Asperger
“Not everything that steps
out of line, and thus
'abnormal,' must necessarily
be inferior.” - Hans
Asperger (1938)
Thank you for listening