It is called a spectrum as there is such diversity with autism, which is displayed in a multitude of ways. You should always be working in a person-centred way, with any service users you support. You need to learn to value what is important to them, although it could be strange or different compared to what we think is important. You need to make an effort to take the time to listen and share or even take part in their interests, providing respect for the individual and will help to build rapport with them.
Autism can be considered as a spectrum as it reinforces the fact that although those with autism may find similarities with their difficulties and needs, it will affect each individual in a different way. The autism spectrum extends from those considered to be affected severely to those who are considered to be very high functioning and the range will include social support needs, physical needs, cognitive difficulties and communication issues. As well as the autism spectrum you have other variations of autism which run alongside including; Asperger Syndrome, Atypical Autism and Pathological Demand Avoidance (PDA). Other disorders and conditions that may be associated with and autistic condition include; Attention deficit hyperactivity disorder (ADHD) Hearing impairments Downs syndrome Dyslexia Dyspraxia Epilepsy – between 20% and 40% of people with autism have epilepsy. Foetal anti- convulsant syndrome (FACS) Fragile X syndrome Hyperlexia Learning disabilities Social communication disorder Visual impairments. Those on the autistic spectrum may have difficulty processing different aspects of day to day life that neurotypical may not even consider.
These can affect some or all of their senses, they can either be over or under sensitive or both. For example, for someone without autism you wouldn’t think twice about walking into your local supermarket, this can be a struggle for those on the spectrum, because they may struggle to process all the sensory information, in a supermarket there are lots of different sensory inputs; smells from a multitude of different foods, someone may walk past them with a strong perfume on. At the same time, they will be able to hear the trollies wheels spinning and hitting the cracks in the tiles, the announcements made by the supermarket staff, a baby crying. They may find it the very difficult to concentrate on the task at hand or understand due to all the sensory input at once. Although these can have an effect on an individual’s everyday life, there are therapies and equipment that can help them to process all sensory information. Those on the autistic spectrum present a triad of impairments. These are considered the three areas of difficulty that those affected with autism share. One area of the triad of impairments is language and communication, the types of difficulties that they have in this area varies for each individual.
Some individuals with autism may struggle to start a conversation or some kind of interaction, or struggle with how to respond or reply to what’s been said, some may be very intellectual on one subject; you will find they will always try to bring the conversation back to that subject as it is where they are most comfortable. Some individuals on the spectrum may repeat things many times, this could be due to processing information. Many individuals take longer to process what is happening or what has been said to them, which can cause delayed reactions or behaviours. Most individuals with autism struggle to understand sarcasm or irony, therefore will take what you say literally. Another area of difficulty for someone with an autism spectrum condition is in social interaction and relationships, this is because they may struggle to understand or know how to respond to non-verbal parts of communication. An individual on the autistic spectrum may not be able to tell the difference between someone being excited and someone being angry. This is because they often cannot read facial expressions and physical gestures, and also struggle with eye contact. Your tone of voice may not be clear to them. More often that not this will cause the individual to be more withdrawn as this impairs their ability to share interest and activities with others. The last area of difficulty in the triad of impairments is; restricted and repetitive patterns of behaviours, activities or interests.
This can affect individuals on the spectrum very differently. Many people with autism like to follow a set routine and may struggle with change. For example, they may wake up, have a shower, brush their teeth, then eat 3 Weetabix. But when the individual goes to the cupboard, there are only two bits of Weetabix left. For a neurotypical person, they may either just have two bits or they would have something else for breakfast. For someone with autism they may struggle to process the change, which could disrupt their whole day or even result in the individual displaying risk behaviour. A lot of people with autism find an interest which they are highly focussed on. They tend to pick up these interests from a young age. These interests may change over time, or their intensity over their interest may decrease. These interests could be a very big part of the individual’s life.
You may find those on the spectrum have an unusually intense or focused interests, this is usually focused on one subject, you may find it difficult to get their concentration off this subject. They may also display stereotyped and repetitive body movements such as hand flapping and spinning, standing on tip toes and clapping hands. They may also repeat what they are saying a number of times and display repetitive use of objects such as repeatedly switching lights on and off or lining up toys. They may insistent on sticking to routines such as travelling the same route home each day and doing things in exactly the same order every time. You may find that someone on the spectrum has unusual sensory interests such as sniffing objects or staring intently at moving objects.
They may display sensory sensitivities including avoidance of everyday sounds and textures such as hair dryers, vacuum cleaners and sand or water. Those on the spectrum may display these behaviours as it may help them to process situations and cope with what is going on in that environment. Their behaviour is usually an attempt to communicate how they are feeling and possibly to let you know that they may be struggling. The reason most people with autism like to follow routines and repetitive behaviours is because it is a way to reduce any uncertainty and it helps to maintain the predictability of their environment.
Anxiety can be difficult for most people to manage, especially those on the spectrum. But for those of us who support individuals with autism need to be able to tell how our service users usually display signs of anxiety or stress. There are many ways to work this out and to help support those individuals at this difficult time. To start you should think about keeping a diary and recording the time and date, what was happening before, then what kind of behaviours were displayed, how that person seemed and what help to lower this heightened level of anxiety. Once you can work out situations that tend to increase the levels of stress or anxiety you can then come up with a prevention plan, for example they may become more stressed during transitioning, you may have found they start flapping their arms as their level of anxiety rises, but you know singing with them helps them to relax; therefore, at the first sign of them flapping you encourage them to sing a song.
You may find that there are other relaxation techniques that can help your service user to cope, you may also need to find further guidance from a specialist whom can guide you in more specific ways. It is important to have structures and routines in place which should be clearly written in the care plan, which should be written with that person in mind, including their likes and dislikes. This will help us to follow their routines in detail which will help the individual to feel at ease and less anxious. The care given to someone with autism is based around their care plan which will match their wishes and needs of that individual. Those on the spectrum will all have different needs to each other and therefore how you care for them will be different, structures and routines make things clearer for them.
Having clear routines helps them get through their day, will help them interact with other people and help then to accept when they are expected to go into other environments. By having these structures and routines in place a person with autism will feel more secure and be able to cope with people and environments and they are more likely to feel included in what is going on around them. Person Centred planning is a way of helping to plan how to support an individual and help plan their life, making sure you focus on what is important to the individual. To do this you need to make sure you include their loved ones and carers in the process. This is important as these are the people who will make a big impact on the individuals life, supporting them from day to day and will also help to bring some understanding of what we need to do, and how we do certain things. It is also important for that individual as it means less change between home and care life, offering the individual more stability, helping them to control their stresses and anxiety.
Individuals with autistic spectrum conditions and their families what the best for the individual and need to work consistently, this will help the individual feel safe. We must work together with the family to agree a person-centred plan that reflects the family’s ambitions for the individual from the early years to adulthood, this will then be reviewed regularly to reflect if there are any changes to their needs. We need to make sure that there is regular communication between service providers and families, and if there are any changes to existing routines and structures. We need to make sure that ambitions are achievable and realistic, while still encouraging and pushing them to their full potential. We need to recognised challenges and behaviours which may present over time and address them as soon as possible, and everyone involved needs to be made aware of any new behaviours or coping mechanisms.
Working with individuals with autism should be pushing them to their full potential and should have the skills to help them to learn. We need to notice what prevents them from learning or taking in the information, we then would look at the best way to provide them with new information and how to keep their concentration on new tasks. The individual may need many small breaks, so that their mind doesn’t wonder away from the subject. It is also useful to teach them while basing the information around their interests. It is important to be aware of the impact of my own verbal and non-verbal communication on an individual with an autistic spectrum condition because they may respond anxiously or may become stressed to certain things such as; loud voices, too much eye contact, standing too close or physical contact.
Therefor it is important to be observant to what is happening, whether it be verbal or non-verbal. It is important to try and gain the individual’s attention first so they are positive that you are talking to them. You also need to remember to slow down and speak calmly with short clear sentences so that the individual can process what is being said with more ease. 5.2 Being on the spectrum can make an individual struggle to concentrate on one thing.
If I was talking to an individual and they seemed distracted, there are a lot of environmental factors that need to be taken into consideration. These could be things like other loud noises or very strong smells, which could possibly affect someone not on the spectrum to not be distracted. There are also other environmental factors that we may not even think about, for example: if you were the wear a bright patterned top, they may not be able to concentrate on what you are saying as the colours and patterns are distracting to them the lighting in the room may be florescent or quite bright, someone on the spectrum may be more sensitive to these kinds of lights. Even curtains and blinds can be distracting, especially slatted blinds which distort the lighting and picture. To reduce barriers to effectively communicate with an individual with autism you first need to have a person-centred approach and communicate at their level, the individual may use objects of reference or pictures of reference. If communicating verbally you need to remember to speak calmly and not too quick, use short sentences with key words, so that they can process the conversation easily. Your body language needs to show you are approachable and that you are wanting to communicate at their level, for example, if they are sat down, you should also sit down. Also, for non-verbal communication, imitating what they are doing can help in individual to bond and find confidence in you.
Visual communication systems for individuals with autism include: objects of reference photographs short videos miniatures of real objects coloured pictures plain squares of coloured card line drawings symbols written words. To make visual communication systems as effective as possible they should be portable, so that they can be used anywhere at any time. They should also be durable, this may be the only way someone communicates, so make sure you have copies and if they are on paper, that you laminate them so they can have more use. They need to be easy to find and easy to get to, make sure they are kept in the same place so that the individual will remember where they are. If they are used to be attached to a board, the board should be kept at eye level, making it easily visible.
