When I was evaluating those on the autistic spectrum, no matter their age, I turned myself inside out to reduce their anxiety. I did not want them to be "wounded" by the assessment process, nor did I want the results to be contaminated by anxiety. I wanted the best performance I could get out of them. I also wanted them to be happy about coming back to see me. Just a few of the accommodations I used are listed in the blog post, "This Is What It Takes to Diagnose Autism" which can be accessed by clicking on the blue font.
What's going on? Is it because of the autism or is it something else? The short answer? We've learned that the autistic brain has number of differences that contribute to anxiety including:
- Severe deficits in mirror neurons that reduce their ability to imitate others. Imitating others is a major learning source. You watch, you do!
- Their frontal lobe (behind the forehead) is greatly enlarged due to excess brain matter resulting in seriously compromised executive functioning (shifting gears, monitoring their behavior and thinking, using working memory, using social judgment and forethought, planning and organizing as well as inhibiting inappropriate behavior and comments.
- The amygdala is a small part of the brain with a really big role in daily life and it is enlarged in those with autism. It is the center of our emotions and plays a major role in reward and addiction. In the autistic brain, the "threat" system of the amygdala is activated when looking at faces. Eye contact and directing their attention toward faces is a painful experience.
- Hippocampus is a Latin word for seahorse because the organ is shaped like a seahorse. It ihas a major role in memory skills. In those with autism, it is about 10% larger than the neuro-typical brain which accounts for several dynamics: they can remember "odd" information in detail years later and they rely on memory to interpret situations that most people process elsewhere in their brains.
- The cerebrum is the largest part of the brain where the cerebral cortex (you think with this) and the basal ganglia (you operate your motor skills with this) and the limbic system (where your feelings/learning and memory are integrated). It's that big fat piece you see in the diagrams that lays over the rest of the brain. There is far too much white matter in this area and it interferes with speed of motor coordination, motor planning and anticipating events. Think about the role that these factors play in the fast-paced social exchanges of daily life. There's so much activity in the autistic that it is frequently overwhelmed and exhausted.
- The corpus callosum is the thick, flat bundle of nerve fibers that facilitates communication. It connects the two hemispheres. In the person with autism, this part is undersized resulting in poor coordination of various regions of the brain. The messages to the sympathetic nervous system (fight or flight) get jammed. It is constantly active in maintaining balance in the systems. You can actually see the "unreasonable" levels of fear and panic in the face of a person with autism when they are asked to eat a different brand of pizza.
At any moment, all or some of these brain differences can be at play in the level of intensity the person experiences. Locations, certain smells, lights and the people interacting in the events all come to play in the anxiety. Obviously controlling the anxiety is a huge step toward the person with autism benefiting from the interventions.
Bibliotherapy (yes, there is such a word) is the act of using books and stories to help people understand themselves and others. In researching books designed specifically for those with autism, I found the following to be helpful:
 | This book has activities to help train children who are on the spectrum and have anxiety. The basic visualization and relaxation exercises are easy to help you teach your child. Practice is critical. |
This is an interactive book for kids and teens with ADHD who are also on the spectrum.
The content offers an explanation of each of the most frequent emotions and how to maintain a comfortable level.
When your child's emotional level becomes uncomfortably intense, there are strategies for bringing them more in line.
The content offers an explanation of each of the most frequent emotions and how to maintain a comfortable level.
When your child's emotional level becomes uncomfortably intense, there are strategies for bringing them more in line.
This book was written by a mother with three children who have Asperger's Syndrome which is no longer a valid diagnosis. It is no longer used, in part, because it was felt that children identified with Asperger's were not given the support services they needed because their difficulties were minimized.
Now, all persons who meet the diagnosis of autism are described as being on the spectrum and those who would have been given an Asperger's diagnosis are now regarded as having "high functioning autism". They frequently do not have fundamental language processing problems. They do have, however, social pragmatic language deficits.
Not understanding the "unwritten social rules" frequently sparks anxiety. The more they know, the more they can control their feelings.
The author tackles many kinds of common situations from Facebook to going to the mall. She uses cartoons and entertaining writing to maintain attention.
Now, all persons who meet the diagnosis of autism are described as being on the spectrum and those who would have been given an Asperger's diagnosis are now regarded as having "high functioning autism". They frequently do not have fundamental language processing problems. They do have, however, social pragmatic language deficits.
Not understanding the "unwritten social rules" frequently sparks anxiety. The more they know, the more they can control their feelings.
The author tackles many kinds of common situations from Facebook to going to the mall. She uses cartoons and entertaining writing to maintain attention.
When your child's anxiety overwhelms them and impacts their lives on a daily basis (functional impairment), they may benefit from medication. If adrenaline and cortisol (stress hormones) are dumping into their bloodstream on a consistently, not only is their ability to function compromised, but their health is likely to be impacted. Consult with a board-certified child and adolescent psychiatrist who understands the neurological and developmental nature of autism to reduce the "misery index".
Do the best you can.
TTFN, Claudia
Join me on Facebook at Dr. Claudia McCulloch
Do the best you can.
TTFN, Claudia
Join me on Facebook at Dr. Claudia McCulloch
