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Autism

What is Autism?

Autism is a lifelong neurodevelopmental condition that means the person has a different way of understanding other people and the world around them. It is not an illness or a disease so there is no ‘cure’ but with the right support difficulties can be managed and reduced.

Autism is sometimes called autism spectrum disorder or condition; this is because each person is different. Here are some of the things you might see in various combinations, but each autistic person will have their own strengths and difficulties in these areas. 

This video from the National Autistic Society gives more information:

 

Difficulties with communication

  • Limited or absent speech ​​​​​
  • Taking what people say literally (thinking people mean exactly what they say)
  • Not understanding jokes or sarcasm
  • Preferring facts and logic
  • Finding it hard to understand facial expressions, tone of voice and gestures.
  • Only feeling comfortable when talking about topics they are interested in
  • Repetitive in what they say

Difficulties with socialising and interacting with other people

  • Not wanting to make eye contact
  • Feeling awkward and not knowing what to say or do in social situations
  • Difficulties making and keeping friends and romantic relationships
  • Preferring to be alone and only doing activities they feel comfortable to do
  • Finding it hard to take turns when playing games
  • Not liking to be touched or comforted by other people
  • Difficulty with seeing things from other people’s point of view
 

Difficulties with imagination

  • Autistic people can struggle with make believe play or storytelling
  • It can also be hard to imagine what other people might be thinking or feeling

Special interests

  • Having special interests that they invest their time and energy into
  • Becoming very knowledgeable about a specific topic and spending a lot of time involved in the topic

Sensory differences

  • Autistic people may be overly sensitive to sounds, smells, touch, pain or light, finding these things uncomfortable, frightening or painful. Some people do not appear sensitive to these things at all

Routines

  • Autistic people can find change and transition (going from one thing to another) hard, so they prefer familiar and strict routines
  • Often people can feel worried and stressed by everyday activities such as going to school, meeting people and trying new things
  • Difficulties with social communication and interaction and the differences in their interests, strengths and talents can make them feel left out and misunderstood by other people, which can lead to problems with low mood and low self- esteem

Some of the differences you might notice

Signs of autism in young children include:

  • not responding to their name
  • avoiding eye contact
  • not smiling when you smile at them
  • getting very upset if they do not like a certain taste, smell or sound
  • repetitive movements, such as flapping their hands, flicking their fingers or rocking their body
  • not talking as much as other children
  • repeating the same phrases

Signs of autism in older children include:

  • not seeming to understand what others are thinking or feeling
  • finding it hard to say how they feel
  • liking a strict daily routine and getting very upset if it changes
  • having a very keen interest in certain subjects or activities
  • finding it hard to make friends or preferring to be on their own
  • taking things very literally – for example, they may not understand phrases like "break a leg" ​​​​

Autism and Everyday Life

Autistic people have varying strengths and support needs. Some autistic people require significant support in their daily lives, while others need less support, and many autistic people live independently. Support needs can change over a person’s lifetime.

If you or your child have a diagnosis of autism, or are waiting for an autism assessment, or you/they identify as an autistic person, you may have to adjust the way you do things as you learn more about how autism affects you or your child. It can be helpful to use techniques and strategies known to help autistic children and adults manage the difficulties they are experiencing.

For details on techniques and strategies, visit Autism West Midlands’ information downloads page and further support information can be found on our page Neurodiversity national organisations and useful websites.

As everyday life activities can be challenging and cause stress and anxiety, some people find it helpful to learn ways of managing their anxiety. Check the help section on our website for Anxiety and Depression for helpful information, websites and apps.

Levels of anxiety experienced by some autistic people can lead to them avoiding and resisting everyday demands placed upon them, even what may be perceived by others as being low-level demands at school and at home. This anxiety generates a need for the child/young person to be in control in order to make their environment feel psychologically ‘safe’. Such behaviours may fluctuate throughout childhood and adolescence.

Where there is an overwhelming drive to resist or avoid everyday demands, professionals sometimes refer to the individual having demand avoidance or a demand avoidant profile.  This is sometimes referred to as Pathological Demand Avoidance or PDA. This is not currently recognised as a separate diagnosis but is a particular profile which comes under the umbrella of Autism Spectrum Disorder.

More information about PDA can be found on the PDA society website and the National Autistic Society has a page about Demand avoidance.

Autism  – Talia Grant

“So often at school autistic people feel left out, alone and just very isolated” - watch this video of Talia Grant from Hollyoaks talking about being autistic.

 

 

There are many sensory issues associated with sleep including:

  • Sensitivity to sound, touch, and visual stimuli which can be distracting and distressing and can affect the process of falling asleep.
  • Interoception difficulties, particularly recognising when hungry, full or thirsty or when the person is tired. 
  • Some children are more sensitive to foods like sugar, caffeine and additives which keep people awake.

Look at the bedroom environment to see what may be affecting their ability to go to sleep and stay asleep. Do their pyjamas and bedclothes feel comfortable, are they too hot or cold?  Is it too light or too dark, too noisy or too quiet? Perhaps it is too cluttered and stimulating. Think about your child’s diet. Are they eating too early or not having enough to eat? Are they eating food that can stimulate them close to bedtime. There can be added difficulties where children have restrictive diets but some simple adjustments of what is eaten and when can make a big difference. 

Click here for more information on sensory issues.
 

Sticking to the same routine helps your child to know what to expect at bedtime and helps them feel secure. It also helps to support your child’s internal body clock and keep it on track. The age related sleep advice and information on this website can help with establishing routines. Some children will benefit from using picture timetables, timers or social stories to help them understand their bed-time routine. More information about visual supports can be found on these websites

Visual Resources | Autism West Midlands 
Visual Supports | Autism Toolbox Autism Toolbox

Your child may be feeling overstimulated after a busy day and needs help to wind down, or their environment may be overstimulating with lots of toys, TVs and computers within reach. Avoiding TV and computers or hand-held devices an hour before bedtime can help your child to wind down. Activities that are good for the wind down period are jigsaws and colouring. Having a relaxing bath and milky drink can help some children, but for some children having a bath can over-excite them so they may need to have their bath earlier in the day.

Children who wake to use the toilet, wet the bed, or who wear nappies or pull-ups at night that need changing may have disturbed sleep. Eric, the children’s bowel and bladder charity are a good source of advice on this topic.

 

What might help 

Keeping a sleep diary 

A sleep diary can help you understand what may be causing difficulties with sleep. Fill it out every evening and record as much as you can. You can use it to spot patterns and make changes that may help. 

The Sleep Charity have templates you can download; one for teenagers and one for younger children. 

Seeking advice and help from sleep services 

There are organisations that can help you if you are having difficulties with your child’s sleep. There are many national organisations, including those who specialise in sleep for SEND families, and there are also community-based services in Shropshire, Telford and Wrekin. Click the link at the bottom of page to visit our support services page. 

Understanding sleep cycles 

The circadian sleep cycle is a 24-hour cycle that helps govern essential bodily functions especially the sleep-wake cycle. It plays a vital role in a person’s ability to sleep in one consolidated block of time at night and to stay awake during the day. As the sun sets in the evening, the brain begins producing melatonin, a hormone that induces sleepiness. Core body temperature also drops.

As melatonin and tryptophan (an amino acid which helps produce melatonin) are naturally produced in the body, there are things you can do to help their production.  Darkness helps to promote the production of melatonin which is why it is a good idea to put your child to sleep in a darkened room, and light emitting devices such as tablets and phones also can destroy melatonin so should not be used for at least an hour before bed. New research shows that limiting exposure to screens and increasing physical activity levels during the day has a positive effect on children's overall physical, mental health and wellbeing, including sleep.

Setting a waking time consistently even in holiday times, which is called ‘anchoring’ the wake time, can help to reset the body clock over time. This should be accompanied with exposure to lots of light on waking to support circadian rhythm. 

Melatonin and tryptophan occur naturally in some foods and drinks such as milky drinks and cereals which is why having a milky drink before bed can help settling to sleep. For more information visit Diet & Sleep - The Sleep Charity

Prescriptions of melatonin

Behavioural strategies and practical solutions are the best way to address sleep difficulties, but if they are having a significant impact on your child’s ability to function, a drug form of melatonin is sometimes prescribed for neurodivergent children. As the drug’s function is to re-set sleep and wake cycles, it works best combined with good sleep hygiene practices. It is important that is it taken under medical supervision and not purchased on-line so that it is closely monitored for dosage and side effects. It should be prescribed for the shortest period necessary as the long-term effects of the drug on children’s development are not yet known.

 In Shropshire, Telford and Wrekin the Community Paediatric Service and the CAMHS (BeeU) Service) can prescribe melatonin for children and young people who meet ALL of the following criteria.

  1. the child/young person must be open to and being treated by the service due to a neurodevelopmental/mental health need (diagnosis is not required but the child must be being seen by the service, not on a waiitng list)
  2. sleep issues are causing significant impact on the child/ young person, for example due to daytime sleeping or behavioural problems that are impacting daily functioning or educational attendance
  3. behavioural approaches have been tried and failed. These may have been offered by the service (where available) or by community sleep support services.

GPs are unable to prescribe melatonin although they sometimes issue repeat prescriptions when prescribing has been started by a specialist (such as a paediatrician or child psychiatrist). 

Further support 

Click on the link below to visit a page with information about

  • national websites and sleep organisations
  • local community services in Shropshire, Telford and Wrekin.