Finding A Low Rate Of Ptsd In Abused Youth With Autism
Researchers do not know why relatively few of the abused youth developed PTSD. “While it is well documented that not every individual who experiences a traumatic event goes on to develop PTSD, the interplay between vulnerability and resilience is not well researched in individuals with ASD,” said Dr. Brenner, who worked at Children’s Hospital Colorado, one of the six hospitals in the AIC study.
“For individuals in our study, the difference between reported trauma and PTSD diagnosis seems large. We can only theorize as to why this might be,” she said. It’s possible that the youth had more trouble communicating their symptoms, that they might be more resilient than others, or that doctors may have had trouble separating the symptoms of autism from signs of PTSD, she explained.
Researchers said they could not tell if children with autism are more or less likely to develop PTSD after a trauma, because they were not able to compare them to typically-developing children who also experienced abuse.
Explaining Traumatic Events To Autistic Children
Its important for your child to have information about the traumatic event that they can understand but that doesnt scare them. Here are some ideas for explaining traumatic events to autistic children:
- Use a calm, reassuring tone of voice.
- Think about what your child needs to know. Use concrete descriptions and language that your child will understand. For example, There has been a car crash. Billy is hurt. He has to go to hospital so that doctors can help him to feel better.
- Ask your child what theyve heard or read. Correct any misinformation, talk through anything thats upsetting your child, and answer questions. Your child might find it easier to share their thoughts and experiences using puppets or toys, drawing, or sensory activities like playdough or sand.
- If your autistic child gets focused on one aspect of the event, work on a plan to get the information they need. For example, if your child wants to know where their cat is, plan who to ask or where to look.
- Use a social story or a visual support like a book or a picture to explain whats happening. This can be especially helpful if the traumatic event goes on for several days, like a bushfire or a flood.
Its important to monitor how much media coverage of disaster news and distressing news events both you and your child are seeing. Its not helpful for anyone to watch distressing images over and over again.
What Does Ptsd Look Like In A Child With Autism
PTSD is hard to diagnose in children with ASD because traits may overlap. In both conditions, you might find repetitive play, social withdrawal, intense anxiety, sleep issues, etc.
This is especially true in very young children, because PTSD is diagnosed based on changes in behavior after experiencing traumatic events. Some children may have suffered trauma at such a young age that its hard for parents to tell whether their behavior changed. Signs of autism also typically appear early in life, making the diagnosis process more complicated.
Theres still more to learn about how PTSD may manifest in people with autism specifically. But, along with the symptoms from the DSM, here are some hints your kid may show:
Also Check: The Good Doctor Autism Consultant
Possible Environmental Causes Of Autism
The search for environmental triggers has been mostly focused on trying to find a cause for a alleged rapid increase in the reported prevalence of autism in recent decades. The prevalence increase would appear to implicate recent changes in human lifestyle, but there is serious doubt as to whether the the incidence of Autism Spectrum Disorders is actually increasing. See the Is there an autism Epidemic? fact sheet.
A recent finding of an anomaly in the apparent lower rates of autism among the Amish community would seem to support the notion that modern lifestyle has to do with the prevalence increase. The Amish, however, are a very isolated community, genetically as well, so this finding does not necessarily shed any light on heritability without further study. It should be stressed that the Amish finding is very preliminary. Many of the environmental trigger theories are based on anecdotal accounts of regressive autism observed after a particular occurrence, vaccination being the most popular one among parents.
At The Intersection Of Autism And Trauma
Autism and post-traumatic stress disorder share many traits, but the connection between them was largely overlooked until now.
Having autism can sometimes mean enduring a litany of traumatic events, starting from a young age. And for many, those events may add up to severe and persistent post-traumatic stress disorder .
Before Gabriel could even talk, his fathers girlfriend at the time told him his mother had abandoned him. At age 3, he was sexually abused by a cousin. He was mercilessly bullied once he started school, showed signs of depression by age 7 and by 11 began telling his mother he did not want to live. About three years ago, while at summer camp, he almost drowned. Shortly after that, he experienced life-threatening heatstroke when he went to get his Legos from the car trunk and accidentally locked himself in. Six months ago, just after his grandmother died, he attempted suicide.
Hes been hurt and had so much disruption in his life that hes having problems realizing that he has stability now, says his mother, Kristina. The world is chaotic and crazy for typically developed people. For him, its overwhelming and confusing. Gabriel, now 13, started seeing a therapist about five years ago and last year was diagnosed with PTSD.
Given these differences, and the communication challenges autistic people often have, their PTSD can be particularly difficult to recognize and resolve.
Also Check: High Functioning Autism Adhd
When The Trauma Is Eased And When There Is Some Sense Of Safety And Security Many Of What Are Commonly Perceived To Be The Attributes Of Autism Change Considerably
We do not fully understand how traumatic. Recent data, both preclinical and clinical, show that pediatric tbi and asd share not only similar symptoms but also some of the same biologic mechanisms that cause these symptoms. He was excited to learn that we had more. I crouched down to his level and gently expressed interest in the toy. Thus, if you know an adult or older child who has suddenly, out of the blue, developed behavioral or social communication issues, you are not seeing someone who has acquired autism after a period of normal development. In both cases, the children had experienced trauma at a very young age , which made differential diagnosis difficult.
In fact, birth injuries increased the risk for autism by an extraordinary amount. In fact, birth injuries increased the risk for autism by an extraordinary amount. Individuals with autism spectrum disorder may be at increased risk of experiencing victimization or significant stressors and may have limited coping skills to respond to these experiences. He then just needs to experience a second emotional shock during his early childhood that triggers the emotional feeling specific to the autistic constellation for the behavior to manifest. Birth trauma and developmental delays.
Birth Injuries That Lead To Developmental Delays
There are numerous birth injuries that can lead to developmental delays. Most common are birth injuries involving asphyxia or lack of oxygen during birth. Other injuries and risk factors that can be a cause of developmental delays include:
- Forceps and vacuum extraction injuries
- Injuries due to improper epidural administration
- Uterine inertia
- Shoulder dystocia
Another study performed by the University of Miamis Miller School of Medicine concluded that oxygen deprivation during and shortly after delivery may also be a cause of Autism.
Reduced oxygen supply during labor, during delivery, during the prenatal period, during early infancy, could influence autism risk. We cant say that definitely from our study, but that certainly is one possibility.
Also Check: Freddie Highmore Autism
Examples Of Developmental Delays
As you continue to monitor your childs development, be mindful of the following five areas where developmental delays are most common:
These are your childs thinking skills. How they think, learn, and learn to solve problems. Every child is different in terms of their level of attention and awareness. However, by a certain age, your child should be capable of understanding their environment and objects in it. Talk to your childs doctor if your child shows signs of a cognitive developmental delay. Some red flags are if your child does not use gestures, does not point to objects or pictures, does not know the function of everyday items, and does not follow instructions when given.
These are skills that your child develops for socialization, getting along with others, and expressing needs. Social or emotional delays are usually apparent before your child reaches school age. Some of the red flags that may indicate a delay include not smiling, not responding with others, lack of facial expressions, lack of interest in games or play, lack of interest in engaging with others and difficulty being comforted.
Daily Living Activities
What Counts As Trauma
Theres been a lot of debate among psychologists about whether the DSMs definition of trauma is broad enough.
Although bullying doesnt meet the DSM-5 criteria, some research shows thatit can produce traits of PTSD in the general population as well as the autistic population. Harassment and bullying are big problems for children with ASD. A 2012 study of 1,200 kids on the spectrum revealed that 63% of them had been bullied by peers.
Individuals with autism often have higher stress responses to situations that dont bother neurotypical people. For that reason, some professionals have considered whether things that are less extreme than death, serious injury, or sexual violence are enough to trigger PTSD symptoms in autistic people.
Rumball, Happé, and Grey surveyed 59 adults with autism, asking whether they had experienced trauma and whether they showed signs of PTSD afterward. A total of 35 participants said they had gone through a situation they considered traumatic, but wasnt classified as such under the DSMs standards. Some of the non-DSM traumas included:
- Parents divorce
- Abandonment by a family member
- Mental health issues
- Autism diagnostic process
A total of 22 of the 35 participants said theyd experienced PTSD symptoms, and 15 of those 22 said they currently experienced symptoms.
Read Also: Puzzle Piece Symbol
Understanding What Ocd Is
Obsessive-compulsive disorder, also known as OCD, is defined by obsessive, negative thoughts that lead to distress and anxiety. In order to minimize the stress created by their negative emotions or stop their obsessive thoughts, people conduct repetitive, time-consuming actions.
Some common symptoms are:
- Interruptive or unwanted thoughts, mental images, and urges
- Feeling like you have to check something, often multiple times
- Fear of germs, contamination, or illness
- Fear that something bad will happen if you dont act on compulsions
- Hoarding, and anxiety at the thought of throwing items away
OCD can manifest in many different ways. Some people are obsessed with ordering objects in a certain way, while others are overwhelmed by fears of harming someone they love. You might be so used to living with it that you have accepted its effects, but there are many ways that you can address its causes and take control of it. While it is believed to be caused by a combination of various genetic and environmental factors, one potential cause that has been the focus of recent research is childhood trauma.
Psychometric Properties Of Co
While it appears that children with ASD have relatively high rates of co-morbid behavioral and emotional symptoms , appropriately validated assessment instruments are lacking . A few instruments have been developed for co-morbid diagnosis in ASD, which have shown acceptable psychometric qualities, but none of these directly assess trauma symptoms .
One solution is to evaluate the application of symptom measures developed for non-ASD groups. Mazefsky et al. assessed the validity of several commonly used self-report rating scales including the Revised Child Manifest Anxiety Scale , the Childrenâs Depression InventoryâShort Scale , and the Conners-Wells Adolescent Self-Report ScaleâShort Edition . All of these measures have been found to have significant clinical utility with typically developing children. However, when administered to children with ASD, high false negative and false positive rates resulted. The authors recommend caution in using these self-report measures for children with ASD.
Another well-validated and widely used measure, the Behavioral Assessment System for Childrenâ2nd Edition has been shown to produce characteristically different pattern types when applied to children on the autism spectrum . These differences likely reflect and are sensitive to the unique behavioral tendencies of the population but must be interpreted with these differences in mind.
Recommended Reading: Is The Good Doctor Offensive
Crossroads Of Adverse Childhood Experiences Ptsd And Autism Symptoms
Without a specific, objective diagnostic test for autism spectrum disorder , clinicians can struggle to distinguish behavioral symptoms of ASD from depression, anxiety, post-traumatic stress disorder , or other behaviorally-based disorders. Should the 7 year-old boy who is shy, engages in repetitive play, and prone to violent bursts when overwhelmed receive a diagnosis of ASD? Could he be struggling with PTSD? Could it be both?
Research has shown that up to 70% of people who are diagnosed with autism also have a co-occurring mental health disorder. Depression, anxiety and obsessive-compulsive disorder are most common among autistic* individuals, and approximately 3% are affected by PTSD, according to recent research.
While PTSD and ASD are separate conditions, they are not mutually exclusive, and little is known about what experiences autistic individuals find traumatizing and how they process and cope with these traumatic experiences. Recent research has shown that autistic children are more likely to experience adverse childhood experiences than typically developing children.
Symptoms Of Psychological Trauma
We all react to trauma in different ways, experiencing a wide range of physical and emotional reactions. There is no right or wrong way to think, feel, or respond, so dont judge your own reactions or those of other people. Your responses are NORMAL reactions to ABNORMAL events.
Emotional & psychological symptoms:
- Muscle tension
You May Like: Does Autism Cause Early Death
When To Seek Professional Therapy For Trauma
Recovering from trauma takes time, and everyone heals at their own pace. But if months have passed and your symptoms arent letting up, you may need professional help from a trauma expert.
Seek help for trauma if youre:
- Having trouble functioning at home or work
- Suffering from severe fear, anxiety, or depression
- Unable to form close, satisfying relationships
- Experiencing terrifying memories, nightmares, or flashbacks
- Avoiding more and more anything that reminds you of the trauma
- Emotionally numb and disconnected from others
- Using alcohol or drugs to feel better
Working through trauma can be scary, painful, and potentially re-traumatizing, so this healing work is best undertaken with the help of an experienced trauma specialist. Finding the right therapist may take some time. Its very important that the therapist you choose has experience treating trauma. But the quality of the relationship with your therapist is equally important. Choose a trauma specialist you feel comfortable with. If you dont feel safe, respected, or understood, find another therapist.
- Did you feel comfortable discussing your problems with the therapist?
- Did you feel like the therapist understood what you were talking about?
- Were your concerns taken seriously or were they minimized or dismissed?
- Were you treated with compassion and respect?
- Do you believe that you could grow to trust the therapist?
Understanding The Relationship Between Autism And Post
Autism and Post-Traumatic Stress. My past wasnt that bad, but I will never get over it.
Like many people on the autism spectrum, I seem to be incapable of letting go. I perseverate on my interests, which is enjoyable. I worry about my future, which is frightening. And I ruminate about my past . . . which is exhausting.
While I can ruminate about anything, I ruminate most about my bipolar disorder, a devastating condition that I developed as a teenager already living with the stresses of autism. I know mental illness is often triggered by stress. If I had responded differently somehow, reached out sooner, established different patterns of thinking, could I have avoided getting bipolar? I have lost years of my life asking this unanswerable question.
What is it about autism that makes the mind so sticky?
The AutismPTSD Connection
Autism is a genetic neurodevelopmental disorder that is not caused by childhood trauma or abuse. Again: child abuse is not the cause of autism. However, children who are severely abusedmost disturbingly the 170,000 warehoused in Romanian orphanages in the 1960s through 80soften develop behaviors, such as social withdrawal and repetitive movements, that resemble autism.
Repetitive behaviors are central to autism. Repeatedly re-experiencing the past is central to PTSD. Perhaps it is not surprising that the two should overlap.
Ways of Thinking
So, Whats the Answer?
About the author
Recommended Reading: Autism Level 2 Symptoms
Signs Of Nervous System Damage
If the nervous system is damaged, infants typically exhibit common signs within 24-48 hours afterwards. Some of the common signs of an injury include:
- Feeding difficulties, such as spitting up or vomiting after being fed
- Excessive crying marked with the failure to console the baby
- Arched back marked when the infant is held on placed on his/her side
- Abnormal movements in the legs and/or arms
- Weak or absent cry
- Seizure activity
- Partial or complete paralysis
Physical developmental delays will occur when the child fails to meet milestones, including rolling, crawling, sitting up, pulling up and holding onto furniture, and walking. As the child enters school, parents may notice for the first time that behavioral and cognitive problems exist. Although, in some cases these problems may have been detected earlier.
What Situations Could Lead To Autism Caused By Birth Trauma
Research indicates a number of missteps may result in autism caused by birth trauma. Mistakes during labor and delivery can have catastrophic consequences for an infant.
Science Daily reported a study that found children exposed to complications just before, or during birth, such as preeclampsia and birth asphyxia, were more likely to develop ASD. Birth asphyxia plays a role in birth injuries since a lack of oxygen during labor could easily cause infant brain damage and other complications.
The study looked at the health records of more than 590,000 children in California hospitals between 1991 and 2009. The data showed complications before or during birth increased the risk of ASD by as much as 10 percent.
Parents of children with autism caused by birth trauma may not have realized there could be a connection between their childs medical issues and problems during labor and delivery.
Reduced oxygen supply during labor and delivery, the prenatal period, or during early infancy could influence autism risk, University of Miami epidemiologist Hannah Gardner told WebMD in 2011.
Don’t Miss: What Is High Functioning Aspergers