How Do I Get Help And Support
If you think you might be experiencing PTSD then speak to your GP. If your symptoms persist for more than four weeks the GP should then refer you to a community mental health team, who can assess what support you may need.
- trauma focused cognitive behavioural therapy
- eye movement desensitization and reprocessing – a psychological treatment that involves recalling the traumatic event in detail, while making eye movements. EMDR is a relatively new treatment – find out more on the NHS website.
There is currently no research into whether these PTSD treatments work for autistic people. Ideally, all treatments should be delivered by a professional with a good understanding of autism. Most importantly, to be accessible and effective, support should be adapted to your specific needs. Visit our Seeking help with mental health page for more advice.
NICE do not recommend the use of medication for the treatment of PTSD in children or young people. Adults might be prescribed antidepressants such as Paroxetine or Sertraline but only if:
- trauma-focused psychological treatment has not been successful or if you do not want this type of therapy
- psychological treatment would not be effective because there is an ongoing threat of more trauma .
Read more about autistic peoples experience of PTSD:
Trauma And The Autism Spectrum
Autism and post-traumatic stress disorder share many traits. New research suggests that those with autistic spectrum disorder are at a higher risk of developing post-traumatic stress disorder.
ASD is a neurodevelopmental condition characterised by difficulty in social communication, interactions, and forming and maintaining relationships. ASD is also identified through restricted and repetitive behaviours and interests, which could include a desire for routine, as well as repetitive speech and movements. Hypo or hypersensitivity to sensory stimuli such as lights, sounds, and sensations are also common. How these symptoms present, and the severity of their experience differs between individuals however, it frequently impacts a persons daily life and ability to function.
PTSD is a disorder that develops following a traumatic event or chronic adversity. Classically these events could include an accident, abuse, neglect, and witnessing violence. According to the current edition of the Diagnostic and Statistical Manual of Mental Disorders, symptoms of PTSD can include:
- Flashbacks, intrusive memories, and nightmares of the traumatic event
- Suppression of these memories and avoidance of triggers which could remind them of the trauma
- Hyperarousal
- Negative alterations in mood and cognition including aggression and anger
ASD and the Experiencing of Trauma
Trauma Treatment and ASD
Key Areas Of Negligence Identified
The writer was recently at a clinical negligence conference in the UK and the main burgeoning areas of alleged negligence areas linking autism to birth would be preeclampsia, failure to intervene in delivery, instrumental delivery and delay in undergoing c-section.
It remains be seen how the Law fully develops but the case of Finn Phillips has shown that science is being listened too and causation arguments are holding sway with regard to the interrelationship of birth injury linked to autism.
It is important for any family with an autistic child who also has concerns regarding their birth to seek answers as recent research is showing a clear correlation between the two. It really is a matter of getting expert advice from a team of medical experts to identify any breaches of duty during delivery leading to increased risk of autism.
Our understanding of Autism can only be enriched by a true inquisitorial process in every circumstance. Autistic children and their families deserve nothing less than a forensic approach based on all available science.
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How Is Autism Treated
Thereâs no cure for autism. But early treatment can make a big difference in development for a child with autism. If you think your child shows symptoms of ASD, tell your doctor as soon as possible.
What works for one person might not work for another. Your doctor should tailor treatment for you or your child. The two main types of treatments are:
- Behavioral and communication therapy to help with structure and organization. Applied behavior analysis is one of these treatments it promotes positive behavior and discourages negative behavior. Occupational therapy can help with life skills like dressing, eating, and relating to people. Sensory integration therapy might help someone who has problems with being touched or with sights or sounds. Speech therapy improves communication skills.
- Medications to help with symptoms of ASD, like attention problems, hyperactivity, or anxiety.
Complementary treatments may help boost learning and communication skills in some people with autism. Complementary therapies include music, art, or animal therapy, like horseback riding and even swimming with dolphins.
What Are The Signs Of Autism
Symptoms of autism usually appear before a child turns 3. Some people show signs from birth.
- A lack of eye contact
- A narrow range of interests or intense interest in certain topics
- Doing something over and over, like repeating words or phrases, rocking back and forth, or flipping a lever
- High sensitivity to sounds, touches, smells, or sights that seem ordinary to other people
- Not looking at or listening to other people
- Not looking at things when another person points at them
- Not wanting to be held or cuddled
- Problems understanding or using speech, gestures, facial expressions, or tone of voice
- Talking in a sing-song, flat, or robotic voice
- Trouble adapting to changes in routine
Some children with autism may also have seizures. These might not start until adolescence.
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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:
Does Autism Raise The Risk Of Ptsd
As of now, there hasnt been much research into the relationship between PTSD and autism. Theres some evidence that autistic people are at greater risk for PTSD, either because they arent as equipped to handle stress, they have higher chances of experiencing trauma, or because a wider range of events registers as trauma for themor a combination thereof.
Autistic children may be at higher risk of being abused by caregivers. A study of the Tennessee Child Abuse Hotline found that kids with ASD were reported to the hotline 2.5 times more than neurotypical children. This could be because children with ASD come into contact with more potential reporters, like therapists and educators, than neurotypical kids. But researchers suspect that challenging behavior and complex cognitive and language impairments, increased caregiver stress, lower levels of family social support, and higher rates of caregiver isolation play a major role.
A 1998 study found that rates of sexual abuse are twice as high for children with developmental disabilities compared to typically developing children. Neurodiverse kids could be vulnerable to predators because of loneliness, difficulty distinguishing between appropriate or inappropriate behavior, and/or being unable to report the abuse because of communication difficulties.
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Endogenous Opiate Precursor Theory
In 1979, Jaak Panksepp proposed a connection between autism and opiates, noting that injections of minute quantities of opiates in young laboratory animals induce symptoms similar to those observed among autistic children. The possibility of a relationship between autism and the consumption of gluten and casein was first articulated by Kalle Reichelt in 1991.
Opiate theory hypothesizes that autism is the result of a metabolic disorder in which opioid peptides gliadorphin and casomorphin, produced through metabolism of gluten and casein , pass through an abnormally permeable intestinal wall and then proceed to exert an effect on neurotransmission through binding with opioid receptors. It has been postulated that the resulting excess of opioids affects brain maturation, and causes autistic symptoms, including behavioural difficulties, attention problems, and alterations in communicative capacity and social and cognitive functioning.
What Causes Autism Spectrum Disorder
Caused by a complex interplay of genetic and environmental factors, autism spectrum disorder can be mild or severe, presenting only minor challenges or coming to interfere completely with the activities of daily life. The condition is far more common in boys than in girls. Autism spectrum disorder is diagnosed in around 1 in 37 boys, while it appears in about 1 in 151 girls, according to Autism Speaks.
Researchers now know that people with autism spectrum disorder are born with differences in the way their brains process information, but the condition is still poorly understood. What, in the first instance, causes these changes in brain function? Could birth injuries play a part in the story?
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Eating Out Of Plastic Containers
The use of plastic containers has been linked to causing autism. Some of these plastics have been found to have hormone disrupting chemicals, which can lead to neurological problems for a fetus. People who eat out a lot, especially fast food or out of to go containers, are at a 40% higher chance for their child to have autism.
Phthalates, particularly, which are a group of chemicals used to soften and increase the flexibility of plastic and vinyl are linked to autism. The dangers of phthalates are well known and used to be found in childrens toys, and teething rings. They were removed due to the toxic effects of them. Which makes one wonder why they are allowed in containers we eat out of?
The Need To Mask Your Autism May Be Caused By The Trauma You Have Experienced
Ultimately, masking or camouflage means hiding who you are in order to fit in. When you experience trauma and/or rejection for being who you truly are, its common to think you need to hide these traits to survive. After all, bad things have happened when you didnt. But, over time, this act of self-preservation leads you to doubt. It causes you to doubt your self-worth and question whether you are good enough or worthy of affection.
Being forced to hide who you are and having to figure out if it is safe to be yourself in a given setting is exhausting. Furthermore, this hypervigilance can be extremely anxiety-provoking and lead to a great deal of self-doubt. Social situations, especially new social situations, can be extremely stressful. If youre struggling with social anxiety, you may simply find it easier to avoid social situations altogether. But, this causes isolation and loneliness.
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Treat The Person Not The Dsm
When clinicians assess trauma and recognize PTSD symptoms, it is important to consider possible non-DSM-5 traumas in autistics. PTSD diagnosis and treatment should not be withheld simply due to the atypicality of the traumatic event.
In addition, it is important for clinicians to be aware of symptoms that overlap between PTSD and autism, so as not to conflate the two diagnoses. In the criteria below, all symptoms shared between PTSD and autism are italicized.
Criterion B : The traumatic event is persistently re-experienced, in the following way:
Can Birth Injury Cause Autism Heres How The Two Are Linked
Children diagnosed with autism spectrum disorder may struggle growing up in a world that was fundamentally not built for them. Though scientists are still not sure how ASD is caused , studies have uncovered links between the condition and other health matters.
For instance, the Autism and Developmental Disabilities Monitoring Network found that children with cerebral palsy may be up to 7 times more likely to have co-occurring ASD. This venture, which is funded by the Centers for Disease Control and Prevention , identified over 400 children with cerebral palsy across 4 states. They found 6.9% of them also had ASD, as compared to 1% of the general population. Though some findings, like the fact that ASD is more commonly linked with non-spastic cerebral palsy, bring more questions than answers, theres no doubt this relationship is worth investigating further.
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Research Into Causes Of Autism
Over the past decade there has been increased scientific evidence showing that perinatal and intranatal trauma are significant risk factors for developing autism. The first empirical breakthrough in that regard was a South California cohort Study published in 2017 which examined the interrelationship between birth trauma and the risk of developing autism.
The article, Association of Perinatal Risk Factors with Autism Spectrum Disorder discusses a study involving the analysis of birth records of children born at Kaiser Permanente facilities during an 18 year period, from 1991 through 2009. Of that study group, approximately 6,000 children were ultimately diagnosed with autism spectrum disorder.
After looking deeper into the birth records of those 6,000 children, researchers discovered that nearly 40 percent of these children suffered complications either shortly before or during birth. The complications researchers found to be most closely related to autism included birth asphyxia and preeclampsia. This research has in turn led to more clinical negligence case investigations.
Traumatic Events And Children
A traumatic event is a sudden, unexpected and shocking event that makes children feel scared, distressed or overwhelmed. Traumatic events include car crashes, natural disasters, unexpected deaths or diagnoses, and so on.
Some events cause some children trauma, but not other children. Childrens reactions to potentially traumatic events depend on a few things how old they are, whether theyve been through a traumatic event before, and what kind of support they get from family, friends and school. Personality and temperament play a role too.
How children experience an event also affects how much distress they feel. For example, a car accident will feel more traumatic if a child thought they were going to die.
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There Are Many Different Types Of Trauma But How It Impacts Someone With Autism Is Profound
People with autism experience trauma from a variety of situations. For example, they may experience name-calling, bullying, being taken advantage of, feeling isolated and rejected, and being invalidated by family or friends. These are just a few specific situations that are traumatic. But, the reality is that just a simple social interaction with a neurotypical can be traumatic when youre on the autism spectrum. It can trigger feelings of not being good enough, stupid, or worthless. Over time, this trauma may cause you to feel hopeless, numb, and have negative thoughts about yourself, other people, and the world.
Being autistic in a neurotypical world can feel like being an actor on a stage without a script. Everyone else knows whats going on and what to do or say, but you do not. You work hard to come up with a script for every situation. But, no matter how hard you try, sometimes you still get it wrong. Unfortunately, when you get it wrong, there can be dire consequences. You might lose your only friend, you might be bullied, or lose out on a promotion. You could be misinterpreted or judged negatively. People might assume you have bad intentions or are not very nice. This can really hurt your feelings because you are not at all the person they perceive you to be. To be chronically misunderstood and misjudged is traumatic.
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.
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How Does Knowing This Help Us
Firstly, it gives us insight and understanding into how our autistic children are experiencing the world. This is not to be under-estimated. The acute sense of being completely misunderstood is devastating to anyone and all the more so to an autistic person who experiences it acutely and constantly. And the more we understand them, the more we naturally adjust our behaviour towards them, which in itself can transform one important aspect of their social environment.
We can then more consciously make changes to their environment and work to provide them with a contained life to give them some much-needed space to heal.
Importantly from the perspective of our charity, it emphasises the importance of early intervention. The less time a post-traumatic stress reaction has to set in and entrench itself, and the less time the stress has to disrupt a childs system, the easier it can be healed and the more stark the improvements can be to that childs quality of life. This is why a key activity of our charity over the next couple of years will be to bring the Mifne Method to the UK, so that very young autistic children can have an opportunity to bring their unique gifts to the world without being fatally hindered by all the interference we have been talking about in this article.