Autistic people are affected in the following main areas: Communication, Social interaction, Rigidity of thought, Sensory issues. Autistic people can have an uneven cognitive profile. They can have very good communication skills and interaction skills but struggle with severe sensory issues and need a lot of structure in their daily routines.
Others may be completely non-verbal but have mastered other forms of communication such as using an assistive and augmentative communication device. They may still struggle with understanding the complexities of a conversation, but have very few sensory issues.
It is extremely important to consider the impact of stress on a autistic person. We all experience stress, and It can affect out ability to think clearly, it can make us become aggressive, it can cause us physical pain and it can affect out decision making skills. Stress impacts everyone, regardless of whether or not they have autism. Autistic people experience stress on a much more regular and intense level than the typically developing population, which can exacerbate the difficulties they already have as a result of their autism.
Communication is the exchange of information by speaking, writing or other methods. Autistic people can find some aspects of communication difficult. Communication doesn’t just cover the ability to speak, read and write, it also covers the subtleties of communication. Some autistic people, even if they are able to speak, may show some of the following:
This means that it takes longer to take in and process information they are given. Processing delays can range from a few seconds to many minutes. Given the time to process the information, a autistic person will be able to respond appropriately. However, if the question or statement is repeated while the person is still trying to process the information, they will need to start processing all over again. With repeated questioning, a autistic person can become increasingly stressed and find it more and more difficult to communicate.
Supporting a person with a processing delay
If you know how long to wait, always ensure you take this into account and let others know how long they should wait. If you think the person may have a processing delay, but you do not know how much of a delay they have, wait at least 10 seconds before repeating the question.
This means that a person may not understand sarcasm and figures of speech. Not all autistic people have difficulties with literal understanding. Others will be at different levels. Some may not be able to understand sayings like “It’s raining cats and dogs”. Others may wait exactly 60 seconds when being told “In a minute”. Others may not understand the sarcastic use of phrases like “Thanks a lot” when a person has been really unhelpful.
Supporting a person with literal understanding
If you know that the person you support takes things literally, use clear, precise language. If you do not know, be considerate if they misunderstand and tailor your language accordingly as you learn more about their communication style.
Difficulty understanding non-verbal communication e.g. tone of voice and body language
Some autistic people may not pick up on these aspects of communication. So, if you are unhappy about something, they may not pick up that your arms are crossed and you are tapping your toe. They may pick up if you are using sarcasm. Finally, some autistic people can find making eye contact extremely uncomfortable. This does not mean that they are not listening or engaging in conversation. In fact, they may find it more difficult to listen if they have to focus on maintaining eye contact.
Supporting a person who has difficulty understanding tone of voice and body language
Ensure that your body language and tone of voice match what you are saying. Do not rely only on body language to get a message across. Understand that some people may not want to make eye contact.
Unusual conversation style
This covers a range of characteristics. Some autistic people use unusual phrases. They may have a monotone voice. They may speak for a long time, especially when they are talking about a special interest. They may not understand the mechanics of conversation so have difficulty with turn taking and knowing when it is their turn to speak.
Supporting a person with an unusual conversation style
Some aspects of making conversation can be taught and the skills can be useful in job interviews for example. An autistic person should be allowed to spend time talking about their special interest. Some autistic people meet up and take part in “serial monologues” where they each monologue about their chosen topic in turn.
Some autistic people find generalising pieces of information very difficult. For example, if they are shown a picture of a cat and told it is a cat, they may not recognise other breeds of cat as being cats. Others may associate taxis with the traditional London black cab, and refuse to use taxis that do not look like this.
Supporting a person who has difficulty generalising
Ensure that the information you give is clear and be aware of possible misunderstandings due to generalisation. Think about any photos or images you use and whether these could be misunderstood.
Some autistic people do not speak at all (known as non-verbal). Some are minimally verbal and others are able to speak but at certain times do not. Just because a person does not speak, does not mean they are not taking it in. Personal accounts from non-verbal autistic people have clearly shown high levels of ability in some areas.
Supporting a person who is non-verbal
Ensure that they have alternate means of communication that allows them to communicate to the same level that speaking would give them. This can be using tablets, computers, pictures, sign language etc.
Why is communication important?
- You can let someone know what you want (or don’t want)
- You can ask for help
- You can understand what other people want you to do (or not do)
- You can understand why people want you to do things
- You can let people know you have something to tell them
- You can know when someone understands or is interested in what you are saying.
Social interaction is very closely linked to communication. It is the way people talk and act with each other and various structures in society. Some autistic people can find social interaction stressful if they do not know the rules for a particular situation. If you do not know the rules, it can make it difficult to know how and when to join in, you can appear too familiar, or on the other hand too formal, and you can go too far without realising. An autistic person who struggles with social interaction may not pay attention to others, may appear aloof, distant and uninterested, may lack some social skills, and may not understand relationships. This can mean that autistic people:
- Are anxious about contact with other people
- May not be motivated to communicate
- May not learn from, and about, other people
- May not see any reason to please others (so may not do what they are asked)
- May cause offence without being aware
- May find it difficult to make friends
- May not know how to react to other people’s feelings
- May appear insensitive or egocentric.
- May be vulnerable to bullying, abuse and people taking advantage of them.
Socialising can be exhausting for a person with autism. Ensuring that the person is able to take regular breaks from socialising can go a long way to helping them to feel welcome and understood in social situations.
Supporting a person with autism in their social interactions
Social stories™ are useful tools to explain what to do and what not to do in specific situations. Comic strip conversations can help a person to understand what others think of what the person has done and what the autistic person can do instead. Role play can help a person to learn how to respond in specific situations, and practice in a safe environment. Peer mentoring can allow a autistic person to learn about social interaction from a sympathetic and understanding peer. The methods you use should be tailored to the needs and abilities of the person you are supporting.
Rigidity or flexibility of thought
In autistic people, rigidity of thought is characterised by not knowing what might happen if a plan doesn’t happen and needing structure and routine to stay calm. In some cases, this need can lead to rigid behaviours, routines and rituals. Free time can be very difficult for autistic people as they may be unsure of what to do in this unplanned time. Some autistic people have excellent attention to detail, but may not be able to see the bigger picture or being able to cope with change or when things change. They may also have difficulty putting things into context.
There are four things a autistic person needs to know:
- What am I doing now?
- How long will I be doing it for?
- What will I be doing next?
- When will I be doing something I really enjoy?
Supporting a person with rigid thinking
Structure, timetables and knowing about change in advance can be excellent tools to help autistic people predict what will happen next. Flowcharts can be helpful to support a person to understand the consequences of their actions, or decide which action to take depending on the situation.
Many autistic people have a special interest. In contrast to obsessions, special interests bring intense pleasure to the autistic person. They are more than simply hobbies, they are what the autistic person thinks about most of the time. These special interests provide predictability and motivation.
Anything can be a special interest for a autistic person, ranging from football teams and television programs to pieces of string and 50 pence pieces or celebrities or famous people. The intensity of the interest is the key point which differentiates it from neurotypical interests. Some autistic people can name every actor who has played Dr Who, the years they appeared and what happened in each episode.
Autistic people may have more than one special interest, and some people have a range of different interests over their lifetimes.
There have been instances where a autistic person has got in trouble with the law due to their special interest. For example, Gary McKinnon’s interest in UFOs led him to hack into a US military computer network. If you are concerned that the special interests of the person you are supporting could get them into trouble, it is important for you to discuss this with them and put in place tools to help them to know what they can and cannot do.
Making the most of a autistic person’s special interests
Give the person you support plenty of time to spend on their special interest, as it is a source of happiness for them. Incorporate their special interests into other activities to motivate them. Do not use the withdrawal of a special interest as a punishment.
Autistic people can be over- or under-sensitive to any of their senses including: Touch, Sound, Sight, Taste, Smell, Balance (vestibular) and awareness of where your body is in space (proprioception).
An autistic person can have a number of different sensory issues, and can over-sensitive to one sense and under-sensitive to another. Sensory issues can have a huge impact on all other aspects of a person’s life. When a person is stressed, the sensory issues can become much worse.