Monthly Archives: May 2022

How does an autistic child learn?

Posted on by

How does an autistic child learn?

Autistic children have an unusual profile of learning abilities that can often be recognised in very early childhood. Some pre-school autistic children have reading and numeracy abilities above the level of their peers. Such advanced literacy and numeracy abilities may have been self-taught through watching educational television programs, computer games and YouTube videos. There are autistic children who appear to easily ‘crack the code’ of reading, spelling, or numeracy; indeed, these subjects may become their special interest at school. In contrast, some autistic children have considerable delay in academic skills and an early assessment of learning abilities suggests the characteristics of dyslexia and dyscalculia. There seem to be more autistic children than one might expect at the extremes of cognitive ability.

Teachers soon recognize that the autistic child in their class has a distinctive learning profile, often being talented in understanding the logical world, noticing details and patterns and remembering facts, and the artistic world with a talent for drawing or music. However, the child can be easily distracted or distressed by sensory and social experiences, and when problem solving, appears to have a ‘one-track mind’ and a fear of failure. As the child progresses through the school grades, teachers identify problems with organizational abilities, flexible thinking, and group projects. End of year school reports often describe a conspicuously uneven profile of academic achievement with areas of excellence and areas that require remedial assistance.

It is extremely important that teachers and parents know the learning profile of an autistic child to improve his or her academic achievement. This is especially important as children usually have two reasons to attend school – to learn and to socialize. If the autistic child is not successful socially at school, then academic success becomes more important as the primary motivation to attend school and for the development of self-esteem and self-identity.

Verbalising and visualising

Valuable information on an autistic child’s learning profile can be obtained from formal testing using a standardized test of intelligence and tests of academic achievement. Standardized tests of intelligence have at least ten sub-tests that measure a range of intellectual abilities. Some sub-tests measure specific components of verbal reasoning, while others measure components of visual reasoning.

Some autistic children have relatively advanced verbal reasoning skills and may be colloquially described as ‘verbalisers.’ If such a child has difficulty acquiring a particular academic ability in the social and sensory interactive ‘theatre’ of the classroom, then his or her knowledge and understanding may be improved by solitary and quiet reading about the concept. If the autistic child has relatively advanced visual reasoning skills, a ‘visualizer’ then learning may be facilitated by observation of the teacher’s actions rather than listening to their instructions and learning from a computer screen. Learning from a computer screen significantly reduces any difficulties with social and conversational abilities. The ‘verbalisers’ may eventually be successful in careers where verbal abilities are an advantage, for example the legal professions or being an author, and ‘visualizers’ may be successful in careers such as engineering or the visual arts.

Attention

Psychologists divide attention into four components: the ability to sustain attention, to pay attention to relevant information, to shift attention when needed, and to encode attention – that is, to remember what was attended to. Autistic children appear to have problems with all four aspects of attention. The duration of attention to schoolwork can be an obvious problem but the degree of attention can vary according to the level of motivation. If the child is attending to an activity associated with his or her special interest, the level of attention can be excessive. The child appears to be oblivious of external cues that it is time to move on to another activity or to pay attention to the comments, requests and instructions of a teacher or parent. The amount of sustained attention can also depend on whether the child wants to give the attention to what an adult wants them to do. The autistic child may have his or her own agenda for what to attend to.

Even when the autistic child appears to be attentive to the task set by the teacher, he or she may not be attending to what is relevant in the material in front of them. Typical children can more easily identify and selectively attend to what is relevant to the context or problem. Autistic children are often distracted and confused by irrelevant detail, and they don’t automatically know what the teacher wants them to look at. They may need specific instruction at to exactly what to look at on the page.

Some academic activities require the ability to shift attention during the activity and focus on new information. Unfortunately, autistic children can have difficulty ‘changing track’ while engaged in a ‘train of thought’. There can also be problems with memory processes such that the recently learned information is not stored or encoded as well as one would expect. Autistic children may not remember what to attend to when they encounter the same problem again. This characteristic can affect social situations. Autistic children process social information using intellect rather than intuition and can have problems remembering what the relevant social cues are and changing their conversation ‘track’ when interacting with more than one person.

The autistic child often has considerable problems switching thoughts to a new activity until there has been closure, i.e., the activity has been successfully completed. Other children appear to have the capacity to pause a thought or activity and to easily move to the next activity. In the classroom, autistic children can resist changing activities until they have completed the previous activity, knowing that their thinking cannot as easily cope with transitions without closure. A teacher or parent may need to provide multiple verbal indications when an activity is going to change, perhaps counting down and if possible, allowing the autistic child extra time to finish the task.

Executive functioning

Autistic children and adolescents often have problems with executive function. Perhaps the best way to understand the concept of executive function is to think of a chief executive of a large company, who can perceive the ‘big picture’, consider the potential outcomes of various decisions, is able to organize resources and knowledge, plan and prioritize within the required time frame, and modify decisions based on results. Such executive function skills may be significantly delayed in autistic children and adolescents.

In the early school years, the main signs of impaired executive function are difficulties with inhibiting a response (i.e., being impulsive), working memory and using new strategies. The autistic child can be notorious for being impulsive in schoolwork and in social situations, appearing to respond without thinking of the context, consequences, and previous experience. By the age of eight years, a typical child can ‘switch on’ and use his or her frontal lobes to inhibit a response and think before deciding what to do or say. The autistic child can become capable of thoughtful deliberation before responding, but under conditions of stress, or if feeling overwhelmed or confused, can be impulsive. It is important to encourage the child to relax and consider other options before responding and to recognize that being impulsive can be a sign of confusion and stress.

Working memory is the ability to maintain or hold information ‘online’ when solving a problem. The autistic child may have an exceptional long-term memory and is perhaps able to recite the credits or dialogue of his or her favourite film but has difficulty with the mental recall and manipulation of information relevant to an academic task. The child’s working memory capacity may be less than that of his or her peers. Other children have a ‘bucket’ capacity for remembering and using relevant information, but the autistic child has a working memory ‘cup’ which affects the amount of information he or she can retrieve from the memory ‘well’.

Another problem with working memory is a tendency to quickly forget a thought. One of the reasons autistic children are notorious for interrupting others was explained by an autistic child who said he had to say what was on his mind to his teacher because if he waited, he would forget what he was going to say.

Impaired executive function can include difficulties with flexible thinking. Typical children can quickly react to feedback and are prepared to change strategies or direction with new information. Autistic children tend to continue using incorrect strategies, even when they know their strategy isn’t working, as they have difficulty conceptualizing different thoughts and reactions.

In the high school years, problems with executive function can become more apparent as the school curriculum changes to become more complex and self-directed, and teachers and parents have age-appropriate expectations based on the maturing cognitive abilities of age peers. In the primary school years, success in subjects such as History can be measured by the ability to recall facts such as dates. By the high school years, assessment in history has changed, and requires that the child shows ability in writing essays that have a clear organizational structure, and that he or she can recognize, compare, and evaluate different perspectives and interpretations. Autistic adolescents with impaired executive function have problems with the organizing and planning aspects of class work, assignments, essays, and homework.

There can also be problems with self-reflection and self-monitoring. By the high school years, typical children have developed the capacity to have a mental ‘conversation’ to solve a problem. The internal thinking process can include a dialogue, discussing the merits of various options and solutions. This process may not be as efficient in the thinking of an autistic adolescent as it is in typical peers. Many autistic adolescents ‘think in pictures’ and are less likely to use an inner voice or conversation to facilitate problem solving. The autistic adolescent may need the teacher or parent’s voice to guide his or her thoughts.

One strategy to reduce the problems associated with impaired executive functioning is to have someone act as an ‘executive secretary’. The child’s mother may have realized that she has already become an executive secretary, providing guidance with organizing and planning, especially with regards to completing homework assignments. The executive secretary (a parent or teacher) may also need to create a time schedule, proofread draft reports and essays, colour code subject books, encourage alternative strategies and create ‘to do’ checklists, with a clear schedule of activities and the duration of each activity.

Such close monitoring and guidance may initially appear to be excessive for an adolescent or young adult with recognized intellectual ability. A parent who provides the support as an executive secretary may be labelled as overprotective by school agencies and family members, but that parent has learned that without such support, the autistic child would not achieve the grades that reflect his or her actual abilities. We encourage a parent or teacher to take on this very important role of executive secretary. We hope that this will be a temporary appointment as the autistic adolescent and young adult eventually achieves greater independence with organizational skills.

Coping with mistakes

The learning profile of autistic children can include a tendency to focus on errors, a need to fix an irregularity and a desire to be a perfectionist. This can lead to a fear of making a mistake and the child’s refusal to commence an activity unless he or she can complete it perfectly. The avoidance of errors can mean that autistic children prefer accuracy rather than speed, which can affect performance in timed tests and lead to their thinking being described as pedantic. An autistic girl complained that her teacher frequently asked her to hurry up but said that if she did hurry up, she might make a mistake.

It is important to change the autistic child’s perception of errors and mistakes. Autistic children often value intellectual abilities in themselves and others, and young children can be encouraged to recognize that the development of cognitive ‘strength’ is like that of physical strength, in that the brain needs exercise on difficult or strenuous mental activity, that includes making mistakes, to improve intellectual ability. If all mental tasks were easy, we would not improve our intellect. Intellectual effort makes the brain smarter.

Adults will need to model how to respond to a mistake and have a constructive response to the child’s errors, with comments such as, ‘This is a difficult problem designed to make you think and learn, and together we can find a solution.’ It must also be remembered that while there can be a fear of making a mistake, there can be an enormous delight in getting something right, and success and perfection may be a more important motivator than pleasing an adult or impressing peers.

Cognitive talents

There are autistic children and adults who have cognitive abilities that are significantly above average and are sometimes described as gifted and talented. This can provide both advantages and disadvantages to the child. The advantages include a greater capacity to intellectually process and learn social cues and conventions. Advanced intellectual maturity may be admired by a teacher and winning academic competitions can lead to greater status for the child and school. Academic and artistic success can raise self-esteem and contribute to social inclusion; their social naivety and eccentricity can be accepted as part of the ‘absent minded professor’ or artistic genius image. However, there are disadvantages.

Autistic children are more socially and emotionally immature than their peers, which contributes towards their being socially isolated, ridiculed, and tormented. Having considerably advanced intellectual maturity in comparison to one’s peers could further increase social isolation and alienation. The child may have no peer group socially or intellectually in his or her classroom. Having an impressive vocabulary and knowledge can lead adults to expect an equivalent maturity in social reasoning, emotion management and behaviour; they may be unjustly critical of the child who is unable to express these abilities as maturely as his or her age peers.

We have recently recognised that the learning profile associated with autism can also include alexithymia, which can affect the expression of academic talents. Alexithymia is a difficulty converting thoughts into words. The autistic child’s conceptualization or solution perhaps to a mathematics problem may be extraordinary. However, while the autistic child knows their solution is perfect, they may have genuine difficulty explaining how they achieved that solution.

Summary

Autistic children and adolescents have a different way of thinking and learning. This can lead to academic talents and difficulties. Teachers and parents need to be aware of the autistic student’s personal learning profile and to modify the classroom curriculum to accommodate their distinct learning profile. This can include identifying learning talents and to recognise that autistic people can produce a new perspective on the problems of tomorrow.

We have been training teachers in recognising and supporting autistic students for the majority of our combined 80 years of specialisation in autism.

To learn more about this increasingly important area we encourage you to attend our next teacher training in autism broadcast via live webcast:

LIVE WEBCAST And Live In Townsville: Autism In School – 17 June 2022 – Attwood and Garnett Events 

Why do autistic adults become depressed? Part 1

Posted on by

Why do autistic adults become depressed? Part 1

Autistic adults appear especially vulnerable to feeling depressed, with about one in three adolescents and two out of three autistic adults having experienced at least one episode of severe depression in their life. More adults than adolescents may experience clinical depression because the reasons for depression in autistic adults may intensify during the adult years. The following descriptions about why autistic adults can become depressed are also relevant for adolescents. This is the first in a two-part series on why autistic adolescents and adults become depressed.

The reasons autistic adults become depressed

Feelings of social isolation and loneliness

Autistic adults have the desire for friendship, connection, and social approval, but often struggle to easily achieve these outcomes. The reasons for this are twofold. Firstly, autistic people are not easily read or understood by neurotypicals (nonautistic people) which can cause a sense of disconnection and wish to avoid interaction for both parties. Secondly, because the neurology of an autistic person is not wired innately to assist them to easily understand people and how to navigate social interactions. This double bind has been called the “double-empathy problem” of autism (c.f. Mitchell, Sheppard & Cassidy, 2021). The result can be extreme feelings of social isolation and loneliness: as described by Debbie, an autistic woman, ‘the heartache of having unmet needs.’ The compensatory strategy of analysing social situations and social performance can be exhausting and significantly contribute to feeling depressed.

The long-term consequences on self-esteem of feeling rejected and not respected or valued by peers

Autistic adults may see other people as being ‘toxic’ to his or her mental health because of past experiences of bullying and rejection. These experiences have been described as giving intense physical and emotional pain. It is little wonder that many autistic adults choose solitude rather than company. However, as one of our clients with autism said, ‘I would rather be alone, but I cannot stand the loneliness.’ Most autistic adults have experienced bullying, rejection and humiliation, and without a well-defined and robust self-identity, cannot mentally counter what the bully says or cope with the social rejection and humiliation.

Many typical teenagers value specific qualities in their peers, such as the ability to make people laugh through quick wit, risk taking, being socially skilled, sporting ability and being perceived as ‘cool’. Being popular is equated to self-worth. The qualities that an autistic adult bring to a friendship usually include loyalty, compassion, knowledge and open-mindedness, which may not be valued by typical teenagers. It is easy for the autistic adult to believe that their friendship qualities are inferior to their peers, and that perhaps, therefore, they are not as valuable as other people. This may result in feelings of low self-esteem which contributes to feeling depressed.

The mental exhaustion from trying to succeed socially

Despite the lack of the innate hardwiring for easily socializing, many autistic adults utilize their intellect to achieve social inclusion. Unfortunately, the psychological cost is high. The mental effort of intellectually analyzing every interaction to know what to do and say is exhausting. As a Buddhist monk with Autistic adults said, ‘For every hour I spend socializing, I need an hour of solitude to recharge my energy levels.’ Energy depletion is a major cause of depression.

Internalizing and believing the peer criticisms and torments

Frequent bullying and humiliation by peers can lead an autistic adult to believe that they really are defective in the ways described by the predators of the school and workplace. As Faye, an autistic woman and public speaker said, ‘If you are told each and every day by your peers, your teachers and your family that you are stupid, you learn pretty quickly that you are stupid.’ This can lead to beliefs about the self that are judgmental and critical, such as ‘I must be stupid,’ ‘I am defective,’ ‘There is something undeniably wrong with me,’ which can both make the person depressed, and keep them depressed. In contrast, typical adolescents, when criticized by peers, will have several close friends who can quickly and easily repair their emotions and provide reassurance and evidence that the negative suggestions are not true.

A thinking style that focuses on errors and what could go wrong

Autistic adults are very good at recognizing patterns and spotting errors, which is ideal when designing a bridge or analysing an MRI scan but not so great when thinking about oneself or the future. Being able to focus on errors or anomalies is a very important employment skill; however, when the person always uses this style of thinking when contemplating themselves or their future, depression may be the outcome. An example of this style of thinking is: ‘I never get things right, I am hopeless, and I always will be.’ There can be a relative lack of optimism; as the autistic adult achieves greater intellectual maturity, there may be increased insight into being different, with the resulting self-perception of being irreparably defective and socially stupid.

There can also be high expectations of social competence and an aversion for social errors and self-criticism. As Caroline stated, ‘The worst thing about disappointing yourself is that you never forgive yourself fully,’ or Ruth’s comment that, ‘When something happens, such as not having your homework done, your inner voice blames and shames you for failing.’

Belief that change is aversive and unattainable

Autistic adults often have great difficulty adjusting to change or the unanticipated, and usually actively seek and enjoy and feel relaxed when there is consistency and predictability in their daily lives. This can lead to a mindset that change is unpleasant and to be avoided. Another characteristic of autistic adults is cognitive inflexibility, which is not being able to conceptualize an alternative: in other words, a ‘one track mind’. Thus, as described by Joshua, ‘I may not want to change, know how to change, or believe that change is even possible.’ This can lead to the belief that feeling depressed will continue and be consistent throughout my life.

Not being able to cope with specific sensory experiences

An extremely difficult part of autism for many people can be the way they experience their sensory world, for example smells, sounds, textures and light intensity. Specific sensory experiences that are perceived by others as not particularly intense or aversive can be perceived by autistic adult as being unbearably intense and painful. If the person does not have coping or escape strategies for avoiding or tolerating these intense sensory experiences, he or she may begin to feel very hopeless and depressed about how they are ever going to cope with this aspect of their life. The anxiety they feel while both anticipating and being overwhelmed by aversive sensory experiences can be paralysing, and paradoxically, can increase their sensory sensitivity.

Being diagnosed with autism

Autism has historically been perceived in our society as being a disability, which it can be, or a mental illness, which it is not. However, when we confirm the diagnosis of autism in our diagnostic clinic the most common reaction from an adult who has sought the diagnosis is tears of relief. Finally, there is an explanation for the differences that the person has been observing and analysing for a lifetime. Now the explanation can be that ‘My brain is wired differently’ instead of, ‘I have a defective personality,’

Unfortunately, for some adolescents and young adults there is a rejection of the diagnosis due to genuine concern as to how it might be interpreted by society and especially by peers. There is understandably a sensitivity to the potential for being labelled in a pejorative way, which could then be perceived as official confirmation of being defective. Adolescents can also be acutely aware that peer ignorance of the nature of autism may lead to subsequent rejection. The diagnosis and diagnostic label can become ammunition for verbal and physical abuse.

Family history of depression

We have known for some time that there is a higher-than-expected incidence of mood disorders, including depression, in the family members of an autistic person. Recent research has suggested that 44 per cent of mothers and 28 per cent of fathers of an autistic child have reported having had a clinically diagnosed depression. In more than 50 per cent of cases, the diagnosis occurred before the birth of the child. If a parent has episodic depression, then their son or daughter may have a higher genetic risk of experiencing depression themselves.

A ‘sixth sense’ emotional sensitivity

One of the diagnostic characteristics of autistic adults is a difficulty with nonverbal communication: that is, the ability to read facial expressions, body language and tone of voice. However, clinical experience and autobiographies describe a ‘sixth sense’ ability to perceive and absorb negative emotions in others; the person is over-sensitive to another person’s distress, despair, anxiety or anger, and this can occur without their actually seeing or hearing the other person. An example is a teenager in bed one morning, facing the bedroom wall with eyes closed. His mother tapped the door and silently walked into the room to open the curtains. He immediately said, “What’s wrong Mum?” which was an accurate appraisal of her emotional state of high anxiety, but without engaging conventional nonverbal cues to provide that information.

The following quotes describe the experience:

There’s a kind of instant subconscious reaction to the emotional states of other people that I have understood better in myself over the years. If someone approaches me for a conversation and they are full of worry, fear or anger, I find myself suddenly in the same state of emotion.

I am able to distinguish very subtle cues that others would not see, or it might be a feeling I pick up from them.

This sensitivity to ‘negative vibes’ can feel like being an emotional ‘sponge’. There is a difficulty creating a sense of detachment from the negative feelings of others which seem to be contageous. Another person’s feelings of sadness can become ‘infectious’ to the autistic person, who is not able to determine ownership of the original depressive thoughts. It is interesting that one of the reasons for self-imposed social isolation for an autistic adult can be to provide protection against negative feelings in others that are detrimental to one’s own mental health.

How do I find out more?

We have written a self-help book for depressed autistic adolescents and adults with the intention of saving lives. The above information is taken directly from one of the book chapters. Subsequent chapters outline a 10-Step Programme for recovery from depression. The programme is best undertaken with a Mentor who could be a health professional such as a counsellor or clinical psychologist, or a parent, partner or family friend.

Exploring Depression, and Beating the Blues: A CBT Self-Help Guide to Understanding and Coping with Depression in Asperger’s Syndrome [ASD-Level 1] by Tony Attwood and Michelle Garnett, published by Jessica Kingsley Publishers, Web: www.jkp.com

If you are a Professional who works with adults, we highly recommend attending our upcoming event which may be attended live in Sydney or via webcast:

If you are an autistic adult or supporting an autistic adult, we can highly recommend our one-day course:

References

Mitchell, P., Sheppard, E. & Cassidy, S. (2021). Autism and the double-empathy problem: Implications for development and mental health. British Journal of Developmental Psychology, 39, 1-18. DOI: 10.1111/bjdp.12350

10 Challenges your autistic teenager likely faces every day

Posted on by

10 Challenges your autistic teenager likely faces every day

Introduction

If you live with, teach or work with an autistic teenager, it is very likely that you have noticed that many days seem to be characterised by struggle. They often experience very strong emotions, including anxiety, stress, depression, and anger. On some days even the smallest trigger, for example, looking at the person, can trigger a meltdown. They come home from school catastrophically tired, seeming to need hours in the bedroom lying on the bed to recover, or disappearing into a computer monitor, only to emerge in a worse mood than they went in with. What is going on? Why are our autistic teenagers struggling so much with life? In this blog we cover 10 likely challenges your autistic teenager faces every day, with a hope to increase your understanding of why your teenager is struggling so much. We find that when we can understand the reasons for the struggle, that understanding can provide a roadmap of how to better assist our teenagers.

1. Being different

An autistic person often experiences that they are different from other people from an early age, but commonly does not understand why they are different. Within this gap of understanding they can insert many self-derogatory labels, like “weird,” “psycho,” or “stupid.” It is very difficult to be different at school, especially socially. You will remember from your own experiences of high school just how critical, rejecting and punishing teenagers can be to each other. One of the developmental milestones of adolescence is to individuate, that is to become an individual separate from your parents, to gain a sense of self. The individuation process is often characterised by trying to fit in with peers. It is very difficult to fit in with peers when you are socially different. The other kids know you are different, you know it, but you have no idea what to do about it. The result can be very low self-esteem, a poor sense of self and a sense of hopelessness, leading to depression and suicidality. Some teenagers react by denying that there is a problem, and overcompensate with an inflated self-esteem, or arrogance, and blame others. They often have anger problems.

2. Self-regulation

Autism is a frontal lobe condition, which means that it affects the frontal lobes of the brain, which are responsible for executive functioning. In fact 3/4 of people with autism also have attention deficit hyperactivity disorder (ADHD), a condition characterised by poor executive functioning. Executive functioning abilities include the capacity to focus on the right thing at the right time, transition between events, organise ourselves and our time, plan and prioritise, hold a problem in our mind while we are solving it, and to inhibit first responses. An autistic teenager is often struggling with each of these abilities, which truly impairs their ability to regulate their emotions and behaviour. They often ricochet between emotions, acting impulsively, becoming defensive, and avoiding situations that make them anxious. This pattern allows no space to sense themselves, to process what is happening, to learn, or to problem solve. Without self-regulation, your teenagers feels out of control, and increasingly anxious. When someone cannot control themselves, they usually start to try to control other people.

3. Sensory challenges

One of the defining features of being autistic is that there are sensory challenges. Often noises are too loud, light is too bright, and the person can be very distressed by certain aromas, textures and tastes. Having a different sensory system can also affect the person’s ability to register pain and temperature. The consequences of a different sensory system include persistent hypervigilance, exhaustion and sleep problems. There can be difficulty with concentration and focus during the day because of the background stress of trying to process sensory experiences.

4. People

If you ask an autistic teenager what is the biggest problem of their life, they often will tell you that it is people. What they mean is that people are confusing, it is difficult to read them and to know what they expect, and they can also be punishing and rejecting. Research tells us that over 90% of autistic teenagers will have received cruel bullying, including peer rejection, by the time they reach 14 years old. Often our autistic teenagers decide quite early that people are “toxic,” and they prefer to avoid them to stay safe. The problem with this is that they have overlearned the lesson. Not all people are toxic, and your autistic teenager needs people in their life, including friends, mentors, parents, siblings, professionals and teachers. As one autistic teenager said, “I would choose to be alone but I can’t stand the loneliness.” We know from research and clinical practice that having just one friend can protect an autistic teenager from poor mental health outcomes.

5. Double empathy problem

Autistic people struggle to read other people, to infer their expectations and intentions. This problem is called “theory of mind,” or cognitive empathy. It is important to point out that autistic people do not lack empathy, they usually have an abundance of affective empathy, as discussed below. However, they do struggle to “read” people, to have cognitive empathy. We now understand that the problem goes both ways. As much as autistic people struggle to read neurotypical people, neurotypical people struggle to read autistic people. The unique social communication style of an autistic person, which may include less eye contact, facial expressions and body gesture, can lead that person to be misinterpreted and even perceived unfavourably. Similarly, an autistic person can misperceive certain facial expressions, gestures and tones of voice as being negative, and thus perceive the person unfavourably. On each side, whenever an unfavourable impression is made, the person perceiving the unfavourable impression is less welcoming, leading to the autistic person to both reject other people and perceive that they themselves are not welcome (Mitchell, Sheppard & Cassidy, 2021).

6. Overthinking

Due to problems with both social confusion and executive functioning, the person tends to overthink many situations as a coping mechanism. Autistic people often highly value intellect and can utilise their intellect to overcome their problems. This is a very valuable skill, but when overused we call it overthinking. Overthinking one’s problems can lead to both exhaustion and “analysis paralysis,” where the person becomes overwhelmed and avoids the problem. You know your teenager is avoiding the problem when they spend a lot of time in bed or in front of a screen. This avoidance is called thought blocking and leads to much greater levels of distress. Overthinking is also associated with being disconnected from the body and hence from processing one’s emotions. We need to feel to heal.

7. Empathy overarousal

We have talked about cognitive empathy and we mentioned affective empathy. Affective empathy is when the person feels other’s emotional distress as if it were their own. They may not be able to understand how to describe that distress, or why the distress is occurring, but they feel it as if it were their own. Research has shown that many autistic people experience other peoples’ pain more intensively than neurotypical people do. This has been called the “empathy over arousal hypothesis.” Autistic teenagers and adults describe that they often feel overwhelmed by other peoples’ emotional pain, and have no idea how to deal with it, either how to help themselves, or how to help the other person.

8. Alexithymia

Up to 80% of autistic people also have alexithymia. Alexithymia literally interprets to “a” – a lack of, “lexi” – words for “thymia” – emotions. It also includes difficulty sensing bodily sensations associated with emotions, or problems with interoception. When someone cannot detect the early signs of an emotion, or find and words for that emotion, they are severely under equipped for managing the emotion. Alexithymia is one of the reasons many autistic teenagers rise from 0 to 100 in half a second on their Anger Thermometer. Unfortunately, having alexithymia is a risk factor for developing clinical levels of anxiety and depression.

9. A different learning profile

When an autistic person completes an Intelligence Quotient (IQ) test it is very common for them to show a great deal of variability between the various subtests that make up the IQ test. This means that they often have great strengths in their cognitive learning ability, but also areas of great difficulty. Because of their uneven learning profile they can really struggle with new learning tasks, even if they are very intelligent or even gifted. We call this the different learning profile of autism. Being a different learner can be very challenging in all contexts, including school, but also in social situations and within the family and community. Despite good intellect, your autistic teenager may feel that they are stupid, and can feel very depressed and hopeless about that.

10. Trauma or the effects of past trauma

It is unfortunately the case that autistic people are both more likely to experience a traumatic event and are more likely to have a traumatic stress reaction, for example, to develop PTSD, after trauma. It may be that your autistic teenager is suffering current trauma, for example, being bullied or abused, or has developed PTSD, but the condition is undiagnosed. A person with PTSD will experience high levels of hypervigilance throughout the day, distrust of people, flashbacks to the traumatic event, and nightmares that interrupt good quality sleep. If you suspect that your autistic teenager has developed PTSD or is suffering a current trauma, we highly recommend seeking professional assistance for them immediately. Fortunately, PTSD is treatable, and if we know about ongoing traumatic experiences, we can keep our autistic teenagers safe by stopping them.
Summary

The teenage years are challenging for typical teenagers, however our autistic teenagers face unique challenges that can amplify the typical challenges of the teenage years. Over the many years we have specialised in autism, we have discovered that understanding specific challenges that our autistic teenagers face is the most important first step in knowing how to support and assist our teenagers. The 10 challenges we list in this blog are ones that we commonly discover in our clinical practice, and have further understood with research and clinical practice. Hopefully your autistic teenager is not experiencing all of these challenges, but we encourage you to continue to explore and understand the challenges they face. It can be painful to tune in and listen, or to lean in and observe closely. We ourselves may have faced similar issues and have not yet healed. However, one of the most consistent findings across research on what helps to maximise the best outcomes in autism is support. When we provide ongoing support and understanding for our autistic teenagers, we give them the best opportunity to succeed.
What Next?

If your autistic teenager, student or client is experiencing any of these challenges and you are uncertain about next steps, we encourage you to come to our next Succeeding with Autism in The Teens Live Webcast on Friday 22nd July, 2022.

More information is available on our website:

https://attwoodandgarnettevents.com/product/succeeding-with-autism-in-the-teens/

References

Mitchell, P., Sheppard, E. & Cassidy, S. (2021). Autism and the double-empathy problem: Implications for development and mental health. British Journal of Developmental Psychology, 39, 1-18. DOI: 10.1111/bjdp.12350

Nonverbal autism and visual intelligence

Posted on by

Nonverbal autism and visual intelligence

The term nonverbal autism is used to describe an autistic child or adult who has little or no spoken language. However, does that imply the person is also intellectually disabled? When the cognitive abilities of nonverbal autistic children are assessed on standardised assessment scales such as the Wechsler Intelligence Scale for Children (WISC-IV) there can be great difficulty ensuring the child understands the instructions and has the attention span and motivation to complete the test items. This can result in an assumption the child’s cognitive abilities are untestable, or they are clearly severely intellectually disabled. This contrasts with the experience of parents and teachers who have sometimes been astounded by the nonverbal autistic child’s ability to complete complex puzzles.

A recent research study explored the cognitive abilities of six- to twelve-year-old nonverbal autistic using the WISC-IV and three standardised assessments of visual intelligence (Courchesne et al. 2015). The 30 nonverbal autistic children who participated in the study attended two special schools in Montreal, Canada and their intellectual abilities were assessed using the five WISC-IV subtests that do not require a verbal response. The subtests were block design, matrix reasoning, picture concepts, coding, and symbol search. None of the 30 autistic children could complete all five subtests with only six completing any of the five subtests of the WISC-IV. All the autistic participants would be considered as intellectually disabled according to their response to the WISC-IV.

The children were also assessed using the Raven’s Colored Progressive Matrices (RCPM), the Children’s Embedded Figures Test (CEFT) and a visual search task (a predetermined target to be found within a field of distractors). An age matched control group of 27 typical children were also assessed on the same instruments.

The RCPM is a test of general and fluid intelligence. The researchers chose the board or ‘puzzle’ form given the age of the children in the study. The board form is a one-format 36 item test divided into three sets of 12 items which increases in difficulty and complexity within and across sets. Each item is composed of a pattern or two-by-two matrix with the last piece missing, leaving an empty hole or space in the board. There are six movable pieces underneath, among which the one that best completes the matrix must be chosen to fill the empty space. All three cognitive assessments minimize or eliminate the need for spoken instructions and for pointing and are better suited to measure autistic cognition that can include a talent for identifying patterns.

The administration of the three assessments were observed by each child’s teacher who anticipated that the child’s attention and performance would be dependent on reinforcers as used in their education programmes. However, the nonverbal autistic children often ignored or refused reinforcers while being tested. There was an intrinsic motivation to solve the puzzle.

Although none of the 30 nonverbal autistic children could complete the five WISC-IV subtests, 26 (87%) could complete the RCPM. Their scores ranged from the 2nd percentile to the 90th. Seventeen (65%) of the 26 children with RCPM scores performed in the normal range of intellectual ability, as measured by the RCPM, and eight autistic children performed at or above the 50th percentile and three (10%) were at the 90th percentile.

27 autistic children also completed the visual search task, while 26 completed the CEFT on which the autistic children were faster than the RCPM-matched typical children. Autistic performance on the RCPM, CEFT and visual search were correlated.

The conclusion of the study was that nonverbal school aged autistic children are at risk of their cognitive abilities being underestimated with important implications for intellectual assessment and attitude. For nonverbal autistic children, an absence of speech does not automatically imply an absence of intelligence.

Summary

There can be an automatic assumption that lack of speech in an autistic child means that they are also intellectually impaired. The result is that the child or adolescent can be under stimulated, leading to anger, frustration and/or depression. As the above study shows, and certainly in our clinical experience, many children with nonverbal autism have at least average intellectual abilities.

What Next?

If you are interested in further exploring the intelligence of your nonverbal autistic child, student, or client, for the purpose of better supporting them, consider using the Raven’s Colored Progressive Matrices. A psychologist with knowledge of autism can administer the test. Understanding their intellect will assist in goal setting and programme planning.

If you are interested in learning more about nonverbal autism to better understand and support your you nonverbal autistic child, student, or client, we are presenting a full day workshop live. The recording will be available to you for 60 days after the event. Click here to find out more.

References

Courchesne et al (2015) Autistic children at risk of being underestimated Molecular Autism 6:12