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Welcome to Tony Attwood's Website

A guide for parents, professionals and people with Asperger's Syndrome or Autism Spectrum Disorder Level 1 and their partners.

About Aspergers / ASD Level 1
What is Asperger's Syndrome/ASD - Level 1? > More Info
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Professor Tony Attwood is considered
to be one of the world’s foremost experts on
Autism Spectrum Disorder.
April 29, 2024
Autism in School
May 10, 2024
Autism, ADHD & Executive Function
June 28, 2024
Understanding and Supporting Non-Speaking Autism

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Exploring Depression

Books by Tony Attwood

Tony has published many books about Asperger's Syndrome and Autism.
He has also co-authored and contributed to publications with other experts.
New Release Out Now

Autism Working:
A Seven-Stage Plan to Thriving at Work

By Tony Attwood and Michelle Garnett

Attwood & Garnett Events

FOUNDED BY PROFESSOR TONY ATTWOOD & DR MICHELLE GARNETT
Dr Michelle Garnett PhD is a clinical psychologist who has specialised in autism within her own private practice for over 27 years. She has co-authored six highly regarded books on autism, five with Prof Tony Attwood. Her 2018 book with Barb Cook is a seminal work on the female presentation, Spectrum Women: Walking to the Beat of Autism. Her most recent books Having Fun with Feelings on the Autism Spectrum and Ten Steps to Reducing Your Child’s Anxiety on the Autism Spectrum provide guidance to parents of young children on the autism spectrum.
Together Tony and Michelle have created a series of online courses that are available to download. There are also webinars consisting of a series of mater classes.

Recent Articles by Tony

Can Autism be confused with schizophrenia?
05 November 2023
Can Autism be confused with schizophrenia? The term autism was first used by the Swiss psychiatrist Eugen Bleuler in 1919 to describe a withdrawal from reality with a pathological predominance of inner...
Autism over the age of 50
05 November 2023
Autism over the age of 50 As clinicians, we have seen an increasing number of adults, and especially women, over the age of 50 seeking confirmation of autism in their developmental history and current...
Autism and Ehlers Danlos Sydrome
16 August 2023
Autism and Ehlers-Danlos Syndrome Researchers and clinicians in the autism area have known about the association between hypermobility and autism for a long time, and hypermobility is one common symptom...

Tony's Facebook Feed

1 day ago

Tony Attwood
The educational experiences of autistic children with and without extreme demand avoidance behavioursTruman et al. (2024) International Journal of Inclusive Education 28:1, 57-77doi.org/10.1080/13603116.2021.1916108Pathological Demand Avoidance (PDA), sometimes described as Extreme Demand Avoidance (EDA), is being increasingly accepted as a profile of autism and is accompanied by high levels of anxiety and often ADHD. We know little about the educational experiences of PDA children, and this study used an online survey collecting quantitative and qualitative data from parents on 57 autistic children who also had a diagnosis of PDA, a further 91 who displayed PDA characteristics and 63 autistic children with no signs of PDA.The data analysis found no significant group differences in the frequency of failed school placements and exclusions. However, qualitative results suggested overwhelmingly negative school experiences for all groups, especially the PDA children. Parents attributed such experiences to a misunderstanding of the PDA subtype of autism and, hence, a lack of targeted support. The misunderstandings arose due to differences in the PDA child’s presentation, which did not fit the ‘standard’ profile of autistic children.Most parents described a constant battle to get support at school. Support was generally described as ‘very limited’ - enough to ensure the child could make it through the school day but not enough to help with specific areas of difficulty.There was a high rate of reported exclusions in all three groups, with 49% (104) of children being informally excluded from school at least once. This was a much higher rate than the study's authors anticipated and is very concerning.Summary:The study is an important one because it highlights that autistic students, whether they have PDA characteristics or not, are being excluded from mainstream education at a high rate. Exclusion from school leads to other problems, such as a sense of failure and low self-esteem for the child, high levels of family stress, gaps in education, and gaps in the socialisation of the child. The study highlights the need for an increased understanding of autism and PDA in schools and support for teachers to create more inclusive classrooms.Where to from here?If you are new to PDA and wish to know more, we recommend attending our three-hour upcoming live webcast, PDA: An Introduction. On the same day, we will present a second three-hour course that assumes knowledge about PDA and explores a deeper understanding of the profile, strategies, and support: PDA Going Deeper. We hope you can join us.attwoodandgarnettevents.com/product/webcast-event-pda-and-autism-an-introduction-22-july-2024/attwoodandgarnettevents.com/product/webcast-event-pda-and-autism-going-deeper-monday-22-july-2024/#actuallyautistic #autism #autistic #autismawareness #autismacceptance #autismspectrum #psychologist #psychology #alliedhealthprofessionals #teachers #psychiatry #InclusiveHealthcare #InclusiveSociety #ResearchTuesday ... See MoreSee Less
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3 days ago

Tony Attwood
“So what does it feel like to have PDA? We are anxious all of the time. 24 hours a day, 7 days a week. It is relentless.” Asher Jenner, PDA-er, said when she was 17 years old, in a 'training' to staff at Ellern Mede, a highly specialised eating disorder treatment hospital in the UK. Asher Jenner is now 19 years old. She has recovered from anorexia nervosa and is studying in England. She absolutely loves dancing and singing and aims to open her own dance school one day. We are delighted to announce that Asher will present in our course, PDA: Going Deeper, on 22 July 2024. attwoodandgarnettevents.com/product/webcast-event-pda-and-autism-going-deeper-monday-22-july-2024...#actuallyautistic #autism #autistic #autismawareness #autismacceptance #autismspectrum #psychologist #psychology #alliedhealthprofessionals #teachers #psychiatry #InclusiveHealthcare #InclusiveSociety #QuoteMonday ... See MoreSee Less
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1 week ago

Tony Attwood
"For Me, the Anorexia is Just a Symptom, and the Cause is the Autism": Investigating Restrictive Eating Disorders in Autistic Women. A Paper by Brede et al 2020. Why is this paper important? Anorexia nervosa is a severe mental health condition that is difficult to treat and has the highest mortality rate of all of the psychiatric conditions. Research has consistently shown that between 20 to 35% of women with anorexia nervosa are also autistic. The study was conducted to understand how anorexia develops and continues in autistic individuals from the perspective of autistic women, parents and healthcare professionals. It was also hoped that a theoretical model of restrictive eating difficulties in Autism could be derived from the data. What did the researchers do? Since the questions were exploratory and the phenomenon not well researched, a qualitative research design was employed. Semi structured interviews were given, and Thematic Analysis applied to the verbatim transcripts. Fifteen autistic women, 13 parents and 16 healthcare professionals participated. What were the results? Six themes were discovered, and these are described below. 1.Sensory sensitivities. There were number of sub themes that were uncovered, including general sensory overload which affected autistic women’s eating behaviour, where some women used the effects of starvation to numb these sensations. Another sub theme was food specific sensory sensitivities, which limited the range of food that could be eaten. Wholefood groups could be cut out due to one negative experience. These issues had been present since early childhood, and often pre-dated the diagnosis of anorexia. The most common senses that interfered with eating were tactile, taste and smell. Another sub theme was hypersensitivity to certain internal sensations that are associated with eating, for example, feeling bloated, or the feeling of food digesting in the stomach. Internal sensations were reported to be highly distressing and led to restrictive eating practices. Conversely, some of the women had difficulty with sensing the internal state of the body. Problems with interoception led to consistent missing of meals because of not noticing hunger. Other women would overeat without realising but then feel so uncomfortable, they would restrict food later. Health professionals described that this characteristic appeared to be unique to autistic women with anorexia compared to non-autistic women. 2. Social interaction and relationships. For many in the study, the autistic woman’s social difficulties became greater with the onset of adolescence, and this coincided with the onset of the eating disorder. Some of the women described that they restricted their eating to cope with social difficulties because it created emotional numbness. Others used a fascination with food and exercise to distract themselves from their social confusion and exhaustion. Other women stopped eating because of the social aspects of mealtimes. 3. Self and identity. Central to the development of an eating disorder for many of the autistic women was a sense of feeling different, not fitting in, and lacking a sense of self. Immersion in eating disorder behaviours was a coping mechanism for the emotional distress of these feelings. For some, a focus on their appearance was used as a way to fit in with their peers. For others, the eating disorder itself provided a sense of identity. Not one of the women in the study knew that they were autistic at the time of the development of their eating disorder, but many wondered if they may have found it easier to cope if they knew they were autistic. 4. Emotional difficulties. A very common theme amongst the women was that they had long-standing difficulties identifying, regulating, and communicating their emotions. Many of them had adverse social experiences, and some of the healthcare professionals reported that the women had experienced traumatic and difficult experiences and were vulnerable to trauma as a result. All the participants’ accounts indicated that eating disorder behaviours, including restricting and over exercising, were used to numb or distract away from the overwhelming distress. Healthcare professionals described that eating disorders could be way of channelling anxiety, because there could just be a single-minded worry about food, and if that can be managed then anxiety is allayed. Almost all the participants described that they had other mental health conditions and that these were linked to the eating disorder. For example, one woman described that her obsessive compulsive disorder (OCD) became worse when she started to fight her eating disorder. Another woman described that she would misinterpret her emotions as physical symptoms and then become very anxious about her physical health. Stopping eating became a coping mechanism to calm down her health anxiety. 5. Thinking styles. Many of the participants talked about several autistic thinking styles contributing to a vulnerability in developing eating disordered thinking and behaviour. These thinking styles included literal thinking, obsessive and intense interests and rigid thinking. For example, many participants described that a rigid style of thinking that can come along with autism maintained the eating disorder. It was very difficult for these women to shift their focus away from the rigid rules they have created around food. For others, a literal interpretation of casual remarks had contributed to the development of the eating disorder. For example, public health advice and lessons at school about healthy eating, such as “fat is bad for you” was part of the initiation of following rigid rules about eating and exercise. Passionate interests in exercise, nutrition, environmental concerns, or for counting and monitoring numbers were common amongst the women. These interests provided enormous enjoyment and relaxation, which made it very difficult to recover from the eating disorder. 6. Need for control and predictability. Anxiety about perceived loss of control was exacerbated for many women during hormonal changes at the start of their adolescence. Being able to control their food intake and other eating disorder rituals provided a sense of predictability and hence assisted them to manage their overwhelming anxiety. These autistic features made recovery difficult for many of the women. What does this mean and where to from here? The findings in this paper have important implications for the treatment of autistic individuals for their eating disorder. The reasons that the eating disorder starts and continues are not the traditional causal and maintenance factors in anorexia nervosa. It was clear in this study that these factors can lead to more enduring presentations and poorer outcomes. It could well be that these results are because autism specific drivers for the eating disorder are not being addressed by standard treatments. Therefore, there is a need for eating disorder services to identify the autistic they are caring for, and to be able to adapt their treatment accordingly. attwoodandgarnettevents.com/product/online-course-eating-disorders-and-autism/Reference Brede J, Babb C, Jones C, Elliott M, Zanker C, Tchanturia K, Serpell L, Fox J, Mandy W. "For Me, the Anorexia is Just a Symptom, and the Cause is the Autism": Investigating Restrictive Eating Disorders in Autistic Women. J Autism Dev Disord. 2020 Dec;50(12):4280-4296. doi: 10.1007/s10803-020-04479-3. PMID: 32274604; PMCID: PMC7677288. #actuallyautistic #autism #autistic #autismawareness #autismacceptance #autismspectrum #psychologist #psychology #alliedhealthprofessionals #teachers #psychiatry #InclusiveHealthcare #InclusiveSociety #ResearchTuesday ... See MoreSee Less
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