AUTISM

The language and conceptions around autism, including in the current DSM-5 diagnostic criteria, are problematic, as they compare autism to neurotypical developmental norms, with the connotation of implying failure for autistic people. At ATTACH-Manchester we avoid the term autism spectrum disorder, as it has negative connotations likely to be detrimental to the self-perception of children and young people. We endeavour always to be neuro-affirming and have experienced success in supporting autistic young people. As well as professional experience and training, there is lived experience within our team, both as the parent of a neurodivergent young person and as a neurodivergent adult.

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The stereotype of autism often considers autistic people to have deficits in social-emotional reciprocity, perhaps because autistic communication and conversational styles may not align with neurotypical expectations. Autistic people may prefer to take part in conversations by discussing topics at a deep level and offering lots of information at once. They may dislike small talk, as it feels inauthentic.

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There may be a mutual breakdown in understanding when people with different neurotypes interact. The stereotype puts the full responsibility for this on the autistic participant, but communication is a two-way process, and research has shown that neurotypical people miss or misinterpret social cues from autistic people in the same way that autistic people miss or misinterpret neurotypical cues. This is known as the double empathy problem.

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Autistic people may stim, using repetitive motor movements, vocalisations and actions, which may be regulating and can be a source of joy. They may rely more than non-autistics on routines and patterns, predictability and structure. Doing so may be regulating. Changes, particularly when they are not in their control, may result in stress behaviours and distress.

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Autistics often have focused interests, passions and thought processes, and engage with them intensely. Autistic theorists have suggested that autistic attention is monotropic, meaning that autistic people tend to allocate their attention more intensely to one stimulus at a time. This has often been a negative stereotype of autism, but in fact it can lead to strong skill development or expertise in favoured areas, and can be fertile ground for creating access to learning, both in terms of the curriculum and in terms of routes leading to employment.

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A high percentage of autistic people process and engage with sensory input in a way which may result in negative or intolerable experiences or provide a sense of joy and regulation. They may find the environment in a typical school overwhelming and the sensory input may even cause them to feel physical pain, potentially leading to meltdowns. And continued masking may mean this is not evident while at school, but only seen by parents when the young person gets home. Although some autistic people may appear to cope in school by masking their differences and their distress, over time and as social pressures increase, their coping and masking strategies may cease to be effective. This school-based trauma can result eventually in shutdown, which may present as total social withdrawal or a mental health crisis, with potentially catastrophic consequences. Such crises may not be easily remediable, and some young people will require long-term low- or effectively no-demand environments to promote recovery.

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Many aspects of society have been designed around the sensory, cognitive, developmental and social needs of non-autistic individuals, which can place autistic individuals at a disadvantage. At ATTACH-Manchester our aim is to work with young people and their families to understand how best to support them to pursue their interests and talents and to learn.

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Autism remains incompletely understood and research is continually evolving. Look out on our home page for links to interesting new research results.