Anxiety Depression And Wellbeing In The Sample
All fourteen participants completed the HADS and GHQ-12. The mean HADS-A score was 13.5 , which lies above the recommended clinical cut-off. All but one participant scored above the cut-off score. The mean HADS-D score was 5.3 , below the clinical threshold, with three participants scoring in the clinical range. The mean GHQ-12 score was 15.4 , below the cut-off indicating mental disorder. Three participants scored in the distress range and a further two fell in the severe range, indicative of severe psychological difficulties at the time of interview.
Restrictive And Repetitive Behaviors
- You have trouble regulating your emotions and your responses to them.
- Changes in routines and expectations cause strong feelings that may include outbursts or meltdowns.
- When something unexpected happens, you respond with an emotional meltdown.
- You get upset when your things are moved or rearranged.
- You have rigid routines, schedules, and daily patterns that must be maintained no matter what.
- You have repetitive behaviors and rituals.
Strong Dislike Of Change
Many people with high-functioning ASD have strong negative reactions to changes in their environment. They might become anxious if something new happens, even if it’s positive. They might also be unable to cope with sudden changes in plans or schedules. For example, if they are forced to choose a different brand than their usual cereal provider, they might become highly activated and irritated.
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What Are The Levels Of Asd
ASD is divided into three levels:
- Level 1. People at this level may have symptoms that dont interfere too much with their work, school, or relationships. This is what most people are referring to when they use the terms high-functioning autism or Aspergers syndrome.
- Level 2. People at this level require some outside support on a daily basis. Examples of outside support include speech therapy and social skills training.
- Level 3. People at this level require substantial outside support on a daily basis. In some cases, support may include full-time aides or intensive therapy.
Why Do Some Young People Get A Late Diagnosis
It is common for a young person to get a late diagnosis if they are high functioning or academically able. This also occurs more in girls than in boys, as girls are generally more adept at copying neuro-typical behaviours, including verbal and non-verbal communication in order to mask their autism.
Late diagnosis can happen because there is some ambiguity which makes it difficult to be sure a young person has autism, or because other conditions have presented as being their primary need e.g. challenging behaviour or ADHD. Typically, children are also often able to cope in a primary school environment but find the increasing demand of secondary school very stressful, leading to their difficulties becoming more apparent.
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Do I Need An Autism Diagnosis
Some adults may question whether they need a diagnosis later in life. Some people self-identify as autistic without receiving an official diagnosis. Its a personal decision. What can be helpful in receiving the label is access to supports and services that may not be available without a diagnosis, i.e. an income support program that provides additional income if mental health issues prevent being able to work full time. Maybe you need a job coach, a support person to look in on you a couple of times a week, specialized mental health services, or supports in the workplace. A diagnosis can also provide peace of mind and validation that indeed, you do have ASD.
Self-diagnosis in the adult autism community is widely accepted. You can join a support group or get together with other ASD adults without a formal diagnosis. Pursuing a diagnosis can be expensive as most health plans wont cover the cost and it can be difficult to find a professional who is adept at providing an adult diagnosis.
Ramifications Of Missed /misdiagnose In Childhood And Adulthood On Psychological Well
All participants expressed that a missed or misdiagnosis and being diagnosed in adulthood had a significant impact on their lives. The lack of understanding of the underlying cause of their behavioural challenges led to ineffective measures, such as discipline, being used as a strategy to correct the difficulties. In addition, the lack of knowledge about their challenges caused distress and left some participants vulnerable to being bullied and ostracized. These feelings of isolation and lack of insight into their difficulties, further led to emotional and psychological distress with two participants reporting suicidal ideations.
Well, the way to address those concerns in those days would be discipline
I had difficulties making friends and as a result, I was severely bullied. Ive been cut on my back with a razor, Ive had my head pushed into a toilet, Ive been physically beaten. I experienced bullying at school, and I also experienced bullying at home from my father and all that made things even more difficult to bear And I had some suicidal tendencies, and I had some just general frustrations because I couldn’t quite understand what was happening inside. I felt isolated and anxious and felt like I couldnt take it anymore.
No parent should have to bury their child. I was going to kill myself after my parents had died
I think in my coping mechanisms, they have been a cost like alcohol, drugs, sex and women, you know, all these types of things
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How The Development Of Autism Works
If it is not possible for a teenager or an adult to develop autism, how does autism actually develop? A 2014 report in the New England Journal of Medicine suggests that brain changes that take place long before birth might be what causes the symptoms of autism spectrum disorder.
Looking at the brains of children with autism and those without, scientists discovered abnormalities in the brain regions that control language, social, and emotional control in 90% of the children with autism. And the abnormalities themselves were formed as the result of a process occurring long before birth.
In terms of timing, these changes occur in the cortex around the second trimester of pregnancy. Speaking to NPR, one of the authors of the study explained that something must have gone wrong at or before the second trimester.
Commenting on the study, the director of the National Autistic Society Centre for Autism in the United Kingdom stressed the importance of early detection. This is primarily because the earlier the intervention, the easier it will be for patients, parents, and therapists to compensate for the problematic developments in the brain.
Secondarily, it is for fear that undetected cases of autism will lead to more misconceptions that the disability develops as some people age. This misconception will affect how these people are treated.
Advice On Managing Behaviour In Autism For Adolescents
If you think that your teenager may be autistic, or you have an autistic child and want to know what to expect when they become a young adult, we have outlined the symptoms that can appear as an autistic child becomes an adolescent.
You will also find the steps to take if you believe that your teenager is autistic, and the strategies that can help you to manage particular behaviours.
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Why Many People With Autism Dislike Functioning Labels
These traits are no longer alien and inexplicable but are now entirely understandable and acceptable when viewed through a lens of autism. This echoes research that explored experiences of late-diagnosed adults, in which the majority of participants had revisited aspects of their personal history and rewritten their personal narratives, resulting in positive outcomes.9
We both self-identified as autistic long before deciding to seek formal diagnoses, so we expected that the diagnostic process would simply be seeing what we already knew to be true inscribed on paper. As firm believers in the validity of self-identification by informed and self-reflective adults, we underestimated just how transformative the formal diagnostic process would be for us. Our lives have now been split into pre- and post-diagnosis taking us from a place of confusion, frustration, and obfuscation to a place of understanding, self-acceptance, and radical authenticity.
We now have an understanding of the framework that underpins our existence: we have come to accept our strengths and know that they are not diminished by our challenges we now know how to exercise better self-care and are healthier and happier for it we no longer waste energy trying to be successful neurotypicals and, instead, focus our efforts on thriving as our autistic selves.
Autistic, not difficult
For we are not difficult we are autistic.
References
How Has Our Understanding Of Asperger Syndrome Evolved
1944: Austrian pediatrician Hans Asperger described four strikingly similar young patients. They had normal to high intelligence. But they lacked social skills and had extremely narrow interests. The children also shared a tendency to be clumsy.
1981: British psychiatrist Lorna Wing published a series of similar case studies. In it, she coined the term Asperger syndrome.
1994: Asperger syndrome listed in the Diagnostic and Statistical Manual of Mental Disorders .
2013: Asperger syndrome and other previously separate types of autism folded into one umbrella diagnosis of autism spectrum disorder in DSM-5.
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‘all My Life Suddenly Made Sense’: How It Feels To Be Diagnosed With Autism Late In Life
Jon Adams was 52 when he learned he had Asperger syndrome. As adult referrals rise, he and others explain the impact good and bad of a late diagnosis
One day during his last year at primary school, Jon Adams drew a picture of a street in Portsmouth, the city where he still lives. The scene he drew had no people in it, but its representation of everything else suggested a talent beyond his years.
The headteacher happened to see the picture, and said he wanted to put it up in the schools entrance hall. And that was an honour, Adams says, particularly for someone who didnt think they were any good, because theyd been told they werent any good, every day.
Adams was asked to write his name on the back, an instruction that threw up a choice. He had difficulties with writing, and he knew his class teacher could be cruel. If I asked for help, I knew what he would say: Oh, he cant even spell his own name, what rubbish is that? So I did it myself.
The teacher called Adams to the front of the class. I went up, gave it to him, he held it up in front of the class, and then he tore it up. He said, Hes spelled his name wrong hell never be anything.
My son received a diagnosis aged three. He had fixations with particular music or places traits I recognise in myself
While we talk, he hands me an anthology of his work, published in 2009, that begins with a poem titled Not Being Me, a perfect glimpse into the autistic experience of not fitting in:
Is There A Test For Adult Autism
There are no medical tests for ASD, no matter your age. This means that ASD cant be detected using methods like blood tests or imaging tests.
Instead, a doctor will review behaviors to make an ASD diagnosis. For adults, this usually means an in-person visit where the doctor asks questions and evaluates how you respond. They will also consider self-reported symptoms.
Many psychologists use the Autism Diagnostic Observation Schedule, Second Edition , a diagnostic assessment when assessing adults.
Self-administered ASD questionnaires for adults are available online. These tests include the Autism Spectrum Quotient and derivatives like the AQ-10, AQ-20, and AQ-S, among others. These tests are not the same as a professional evaluation and should not be viewed as definitive.
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Diagnosis In Older Children And Adolescents
ASD symptoms in older children and adolescents who attend school are often first recognized by parents and teachers and then evaluated by the schools special education team. The schools team may perform an initial evaluation and then recommend these children visit their primary health care doctor or doctors who specialize in ASD for additional testing.
Parents may talk with these specialists about their childs social difficulties including problems with subtle communication. These subtle communication issues may include problems understanding tone of voice, facial expressions, or body language. Older children and adolescents may have trouble understanding figures of speech, humor, or sarcasm. Parents may also find that their child has trouble forming friendships with peers.
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A New Understanding Of Asd
After reading and researching ASD and feeling certain this information describes yourself, you may experience an identity shift towards one that is autistic. Reflecting back on moments in your life, you may view things that happened in a different context, through the lens of autism. Retelling the story of your life may now have the ASD perspective. Remembering your stories, reflecting on them, and receiving feedback will change your narrative. This process of self-discovery helps to make sense of whats happened in your life how having ASD has shaped the way you think, react and feel. Maybe some of the confusion is gone, you understand yourself better, and in time you can share this discovery with people you trust.
This new identity may also cause feelings of loss, resentment or anger. Its OK to feel this way as this is a life changing event and it can feel overwhelming. Try to think about the positive things such as your strengths. People continue to grow, change and adapt throughout their lifespan. You can learn new skills and find new ways to do things that may make life easier and more comfortable.
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Safety Risks For Autistic Girls
Autistic girls may be bullied simply because theyre different. Also, Dr. Epstein says, because these girls miss social cues and want to be liked, their autism can leave them more naïve. This makes them easy prey for someone trying to take advantage of them, be it a bully or a sexual predator. The girls may be wanting the interaction but not understanding what its about, what the cues are, Dr. Epstein says. It can be very easy for them to follow their hormones without an understanding of what the dangers are. And sometimes even if they have been taught, they need ongoing support to be able to maintain safety.
Melissa says this has been true with Lisa. Ive had to think about female issues at a much earlier age than I expected, she says. Weve already had an incident of her being inappropriately touched by a boy, for whom the excuse was made that because hes also disabled, he didnt understand what he was doing was wrong.
One of her daughters greatest strengths is how accepting she is of others, Melissa adds. She always finds the good in people, even when they are mean to her, she says. But because she is so accepting and kind, others can easily take advantage of her, or bully her, and she wont say anything.
But first the girls need to be identified and accepted. This will require more awareness and sensitivity on the part of parents, teachers and clinicians.
Assessment For Autism Diagnosis
A formal diagnosis is done by a psychologist, psychiatrist, or neuropsychologist who does adult ASD assessments. A good place to start to find such a person is through your local autism society or by contacting the governing body for that profession. Most have a college or association and they may be able to provide you with some names of people in your area. You can also ask around, maybe through members of a support group. How did they get their diagnosis who did it? If there is a local university or medical teaching hospital, there may be a psychology department you can be referred to.
If a formal assessment is too expensive, contact the local autism society or services organization to see if they have someone on staff or a consulting psychologist. Some universities, hospitals or clinical centers offer assessments by supervised graduate students who need practical experience in diagnosing. If you are in on-going therapy for other issues, a therapist may suggest the possibility of ASD and be willing to give a diagnosis.
Keep in mind that there is no standardized screening tool tailored to adults that is universally endorsed. Some of the autism tests specifically designed for adults are: ADOS 2 Module 4, ADI-R, 3Di Adult, OCI-R, AFQ, SRS 2, RAADS-14, AdAS Spectrum.
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Failure To Diagnose Asd In Childhood Despite Signs And Symptoms
All participants in the present study reported presenting with were identified as challenging behaviours throughout their childhoods, with parents and teachers perceiving them as being no ordinary child. These challenges were often discounted as just boys being boys or were understood as being the result of other mental health conditions. The underlying cause of these challenges, being ASD, appeared to be overlooked, misdiagnosed, or misinterpreted. The difficulties reportedly experienced by participants in their early childhood development included behavioural and social challenges as well as regression in development . Although those around them perceived them as being no ordinary child, their difficulties were often not addressed, and ASD was not considered as being the core cause of their challenges.
Participants understood the oversight of their core difficulties of being on the spectrum in several different ways. One participant reported their difficulties being normalized based on gender stereotypes ascribed to boy children.
My sister works with children with autism and when I told her she said that there is no way I have autism she knows what autism looks like and I dont have it so I must stop looking for attention. All men are like that if thats the case then all men should have autism
Five others reported a tendency of those around them minimizing their difficulties as not being a significant problem.