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By Munaza Rafiq & Nikki Fox

Ambiguous interview questions and application forms are keeping autistic people out of work, a report has found.

While 53.6% of all disabled people are in work, only 30% of autistic people are, the latest official figures show.

One autistic person told BBC News having more tick-boxes in applications might help him to land an interview.

The government has urged employers to "get behind" all recommendations set out in Sir Robert Buckland's report on autism in the workplace.

Autism is a developmental disability that affects how people perceive the world and interact with others. The Buckland review says there are around a million people with an autism diagnosis in the UK.

Adam Murphy, from Cheltenham, says he is ready for a job after more than 20 years as a full-time carer for his son Ryan, who is autistic and has learning disabilities.

'Frustrating' lack of support

But Mr Murphy, who is also autistic, has applied for six jobs since October with no success so far.

He has difficulty filling out forms so usually asks to talk through application questions with an employer over the phone instead - but says some workplaces refuse his request.

"Somebody gave me feedback and said: 'Well, we can't help everybody because all autistic people are different, and we can't put reasonable adjustments in place for everybody'," Mr Murphy said.

Mr Murphy says having tick-boxes in applications instead of free-form text-boxes, and getting interview questions in advance, are among the other adjustments that would help him.

He describes the rejected requests for support as "really frustrating", adding: "If we're not putting the basics into place to begin with to allow those autistic people to apply, then that's failing them."

The Buckland review said that for certain jobs, there was evidence that autistic staff could be more productive than neurotypical staff.

The report sets out how businesses and government can work together over the next five years. It lists 19 recommendations for both, including:

signing up for the an employers' index for neurodiversity, to access guidance on designing inclusive processes

offering career-progression training focused on autistic staff

ensuring careers advisers can give appropriate advice to autistic jobseekers

The Equality Act 2010 made it harder for employers to unfairly screen out disabled people and ensured there was a duty to make reasonable adjustments for people at a substantial disadvantage because of their disability - and some businesses are already championing autistic people in the workplace.

Since opening in 2019, Cafe Track in Northampton has supported more than 120 autistic people into paid employment and work placements.

Ex-teacher Thomas Cliffe set up the social enterprise after feeling "angered" by the lack of employment prospects for autistic people.

He trains and supports businesses to help make their workplaces more accessible.

"It's not a nice thing to do to employ an autistic person - it's a good business choice," he says.

'Adjustments help me feel safe at work'

Almost all of the staff at CubeLynx in Central London - one of hundreds of firms that fed into the Buckland review - are autistic.

One of those is Darcey Isaacs, who has been given various reasonable adjustments to help her work: she works part-time on a very flexible schedule, has access to quiet rooms during the day and uses noise-cancelling headphones.

"Having reasonable adjustments can help me feel safe and valued, and contribute to the company," she says.

"I am more than just a woman with a disability."

Ms Isaacs says autistic people's unique needs, skills, strengths and weaknesses vary - "just like neurotypical people".

Dr James Cusack, chief executive of research charity, Autistica, said: "To be their best and to ensure they can get the best out of their whole workforce, including autistic people, employers need to change the way that they recruit and support staff.

"This is not about reasonable adjustments for a small number of people - it's about changes that benefit everyone, because we all think and work differently."

The review was commissioned by Work and Pensions Secretary Mel Stride, who said it provided "practical and inexpensive steps to open up workplaces to autistic people", backed by the extra employment support available in the government's £2.5bn Back to Work Plan.

Businesses and government "must come together if we are to create the cultural change needed", he said.

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Autistic people held back by job interview questions - report

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Unfair hiring practices and outdated attitudes are among barriers autistic people face, a review says.

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By Munaza Rafiq & Nikki Fox

Ambiguous interview questions and application forms are keeping autistic people out of work, a report has found.

While 53.6% of all disabled people are in work, only 30% of autistic people are, the latest official figures show.

One autistic person told BBC News having more tick-boxes in applications might help him to land an interview.

The government has urged employers to "get behind" all recommendations set out in Sir Robert Buckland's report on autism in the workplace.

Autism is a developmental disability that affects how people perceive the world and interact with others. The Buckland review says there are around a million people with an autism diagnosis in the UK.

Adam Murphy, from Cheltenham, says he is ready for a job after more than 20 years as a full-time carer for his son Ryan, who is autistic and has learning disabilities.

'Frustrating' lack of support

But Mr Murphy, who is also autistic, has applied for six jobs since October with no success so far.

He has difficulty filling out forms so usually asks to talk through application questions with an employer over the phone instead - but says some workplaces refuse his request.

"Somebody gave me feedback and said: 'Well, we can't help everybody because all autistic people are different, and we can't put reasonable adjustments in place for everybody'," Mr Murphy said.

Mr Murphy says having tick-boxes in applications instead of free-form text-boxes, and getting interview questions in advance, are among the other adjustments that would help him.

He describes the rejected requests for support as "really frustrating", adding: "If we're not putting the basics into place to begin with to allow those autistic people to apply, then that's failing them."

The Buckland review said that for certain jobs, there was evidence that autistic staff could be more productive than neurotypical staff.

The report sets out how businesses and government can work together over the next five years. It lists 19 recommendations for both, including:

signing up for the an employers' index for neurodiversity, to access guidance on designing inclusive processes

offering career-progression training focused on autistic staff

ensuring careers advisers can give appropriate advice to autistic jobseekers

The Equality Act 2010 made it harder for employers to unfairly screen out disabled people and ensured there was a duty to make reasonable adjustments for people at a substantial disadvantage because of their disability - and some businesses are already championing autistic people in the workplace.

Since opening in 2019, Cafe Track in Northampton has supported more than 120 autistic people into paid employment and work placements.

Ex-teacher Thomas Cliffe set up the social enterprise after feeling "angered" by the lack of employment prospects for autistic people.

He trains and supports businesses to help make their workplaces more accessible.

"It's not a nice thing to do to employ an autistic person - it's a good business choice," he says.

'Adjustments help me feel safe at work'

Almost all of the staff at CubeLynx in Central London - one of hundreds of firms that fed into the Buckland review - are autistic.

One of those is Darcey Isaacs, who has been given various reasonable adjustments to help her work: she works part-time on a very flexible schedule, has access to quiet rooms during the day and uses noise-cancelling headphones.

"Having reasonable adjustments can help me feel safe and valued, and contribute to the company," she says.

"I am more than just a woman with a disability."

Ms Isaacs says autistic people's unique needs, skills, strengths and weaknesses vary - "just like neurotypical people".

Dr James Cusack, chief executive of research charity, Autistica, said: "To be their best and to ensure they can get the best out of their whole workforce, including autistic people, employers need to change the way that they recruit and support staff.

"This is not about reasonable adjustments for a small number of people - it's about changes that benefit everyone, because we all think and work differently."

The review was commissioned by Work and Pensions Secretary Mel Stride, who said it provided "practical and inexpensive steps to open up workplaces to autistic people", backed by the extra employment support available in the government's £2.5bn Back to Work Plan.

Businesses and government "must come together if we are to create the cultural change needed", he said.

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Autistic people held back by job interview questions - report

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Unfair hiring practices and outdated attitudes are among barriers autistic people face, a review says.

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This Padlet has recently been updated with many resources to help extend your learning. All links are relevant to each section, and you can find the majority within the course material.

The feedback form has now been updated.
The Distance Learning Team

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Please note if you are a provider registered with CQC, and with premises located in England, CQC is the relevant regulatory body for patient safety matters

People who work in health and social care constitute a large and diverse workforce looking after a predominantly vulnerable population. Employees have the right to work in a healthy and safe workplace, and the people using services are entitled to care and support that is safe and takes their needs, freedom and dignity into account.

Managing these different needs can sometimes present unique and complex situations which can, if not effectively managed, result in serious harm to employees, people using care services and others. The typical hazards include:

Whilst specific hazards to people using care services may also include:

The risk assessment process is not about creating huge amounts of paperwork; it is about identifying and taking sensible and proportionate measures to control the risks. You may already be taking steps to control the risks, but the assessment process will help you decide whether you should be doing more. You may need to consider different elements of risk when producing your assessment, including:

the common risks to everyone on the premises, for example, risks from legionella, asbestos, electrical equipment and transport

the common risks to people using services, for example, from falls from height or scalding. Whilst you may have some individuals who are not at risk you must implement measures to prevent harm to the most vulnerable

the individual risks to particular staff, for example expectant mothers and young workers

the individual risks to particular people using services, for example the risk of an individual falling out of bed, or needing help to safely mobilise

When considering the individual risks for particular people using a service, you must also bear in mind that health and social care is regulated by other organisations who may expect some form of care assessment. Usually the health and safety risks identified for the individual will be recorded as part of this 'care assessment' or 'support plan'.

Making sensible risk assessment decisions

The provision of care and support should be tailored to meet the needs of the individual and should encourage them to do what they can for themselves. This is particularly important in the provision of social care but also applies to people receiving longer-term healthcare.

Often when assessing the care and support needs of an individual, everyday activities are identified that will benefit their lives, but also put them at some level of risk. This requires a balanced decision to be made between the needs, freedom and dignity of the individual and their safety.

Care assessments should enable people to live fulfilled lives safely, rather than be a mechanism for restricting their reasonable freedoms. Many care providers find it hard not to slip towards a risk adverse approach for a multitude of reasons, for example, resources, bad experiences and a fear of the consequences if things go wrong.

HSE will support decisions to allow everyday activities to be undertaken provided a suitable and sufficient risk assessment has been carried out, documented and reviewed as necessary. This should identify and implement any sensible precautions to reduce the risk of significant harm to the individual concerned (see examples below).

Key points to consider when balancing risk include:

Concentrating on real risks where there is a realistic risk of harm

Close liaison with the individual, carer and family when carrying out risk assessments which is essential to achieve outcomes that matter to them

How the risks flowing from an individual's choice can best be reduced, so far as is reasonably practicable, by putting in place sensible controls

When organising group activities, think how the most vulnerable can be protected without unnecessarily restricting the freedoms of the most capable.

Examples of sensible and proportionate management of risk

Individual risks for making a cup of tea

A young person with learning disabilities is vulnerable to the risk of scalding but will benefit from being able to make their own cup of tea. Assessment identifies that the size, weight and volume of water in a standard kettle puts them at risk of serious harm. A single cup hot water dispenser is a reasonably practicable solution. Owing to the resident's physical condition and tendency to shake, a cup with a limited opening (spill resistant) is provided.

Individual risks for walking to the local shop

A resident who has walked to the local shop on a daily basis to collect their newspaper develops Alzheimer's. They become confused and start to forget how to get back to their care home. Having considered different possibilities, the shop owner agrees to give a gentle reminder of the route home every time the resident purchases their paper. This, coupled with checks by the home, allows the resident to continue with their daily routine - subject to regular review. Other control measures may be appropriate, dependent on the individual.

Individual risks for a person with dementia walking away from the care setting

A person with dementia develops a tendency to walk away from the care setting. They were formerly employed in a job where they walked long distances on a daily basis. Assessment indicates the main risk is from getting lost. The professional team, family and person agree to the use of a tracking and personal alarm system, which will alert the care setting if they become lost.

Individual risks for helping to cook in a care home

A person wishes to help in the kitchen at a home. The individual has dementia and is able to carry out certain activities without much support and helping in the kitchen will provide great benefits to the individual and will reduce boredom. An assessment of the kitchen identifies that some of the equipment presents a significant risk. However, it is decided that the individual can undertake a number of tasks under supervision.

Individual risks for outdoor activities

A person with Down's syndrome wishing to ride horses may be vulnerable to the risk of falling and may not have the capacity to appreciate the potential danger. The benefits and enjoyment gained from carrying out the activity are felt to outweigh the risks. An assessment identifies suitable measures to reduce the risk, including the selection of a reputable leisure provider, use of protective clothing, safe supportive seating, the selection of a suitable horse, and close supervision.

Further information

Further information on sensible and proportionate approach to the management of risk and carrying out risk assessments can be found on the HSE website.

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Sensible risk assessment in care settings

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The risk assessment process is not about creating huge amounts of paperwork but identifying and taking sensible and proportionate measures to control the risks.

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Self-injurious behaviour is where a person physically harms themselves. It's sometimes called self-harm. This might be head banging on floors, walls or other surfaces, hand or arm biting, hair pulling, eye gouging, face or head slapping, skin picking, scratching or pinching, forceful head shaking.
About half of autistic people engage in self-injurious behaviour at some point in their life, and it can affect people of all ages. This guide includes the possible causes, things you can do when it happens, and ways you can try to prevent it happening. In extreme circumstances or emergencies, call 999.

Causes of self-injurious behaviour

There might be a number of factors causing someone to self-injure. People with learning disabilities told Self-Injury Support they self-injure when:

they feel they are not listened to

they have been told off

they have little or no choice about things

they have been bullied

they are involved in arguments, or hear other people arguing

they are feeling unwell

they have memories of a bereavement

they have memories of abuse.

Communicating

The person might have no other way of telling you their needs, wants and feelings. Head slapping, or banging the head on a hard surface, may be a way of telling you they are frustrated, a way of getting an object or activity they like, or a way of getting you to stop asking them to do something. Hand biting might help them cope with anxiety or excitement. They might pick their skin because they are bored. Ear slapping or head banging might be their way of coping with discomfort or saying that something hurts.

Mental health issues

Some self-injurious behaviour might indicate mental health issues such as depression or anxiety.

Repetitive behaviour

Some forms of self-injury might be part of a repetitive behaviour, an obsession or a routine.

Developmental stages

The person might still do some things that most people stop doing as young children, such as hand mouthing - putting their fingers or hand into their mouth - causing injury.

Learned behaviour

The person might learn that self-injurious behaviour can be a very powerful way of controlling the environment. A behaviour, eg head slapping, which they did at first because of physical pain, could eventually become a way of avoiding or ending a situation they don't like, eg turning the television off, or interrupting an argument taking place nearby.

What to do when self-injurious behaviour happens

Here are some pointers on things you could do when the behaviour is happening. In extreme circumstances or emergencies, call 999. You should also try to find ways to prevent the behaviour happening.

Respond quickly

Respond quickly and consistently when the person self-injures. Even if you think what the person is doing is to get attention, it's never appropriate to ignore severe self-injurious behaviour.

Keep responses low key

Limit verbal comments, facial expressions and other displays of emotion. Try to speak calmly and clearly, in a neutral and steady tone of voice.

Reduce demands

The person might be finding a task too difficult or overwhelming. If it's a task that needs doing, come back to it later when the person is feeling calmer.

Remove physical and sensory discomforts

Smells, sounds or tastes might be causing the person distress. If there's a smell that's bothering them, take the smelly thing away, or take the person to another room. If their clothes are uncomfortable, prompt them to change. If it's noisy outside, close the window or offer ear defenders. Provide relief for physical discomfort (eg pain killers) if a medical professional has advised this after seeing the person.

Redirect

Tell them what they need to do instead of the self-injurious behaviour, eg "David, hands down". Use visual cues such as picture symbols to back up instructions. Redirect to another activity that can't be done at the same time as the self-injurious behaviour, eg an activity that needs both hands. Give praise when they switch to the activity, eg "David, that's excellent playing with your toys".

Provide light physical guidance

If the person is having difficulty stopping the behaviour, provide light physical guidance, eg gently guide their hand away from their head, using as little force as possible. Immediately try to redirect their attention to another activity and be prepared to provide physical guidance again. This approach must be used with extreme caution as it may escalate the behaviour or cause the person to target others.

Use barriers

Place a barrier between the person and the object that is causing harm. For head slapping, place a pillow or cushion between the head and hand. For hand or arm biting, provide another object to bite down on. For head banging on a hard surface, place a cushion or pillow between the surface and the head. You can get removable padding that is placed temporarily on the floors or walls to minimise injury.

Consider physical restraints

If there is risk of serious harm, a specialist might suggest using physical restraints such as arm restraints, gloves or helmets. These may also reduce the sensory experience and frequency of the behaviour. Physical restraints are very restrictive and should always be used under the guidance of a specialist to ensure they are used safely and appropriately, and with a plan to fade out their use over time.

Physical restraints do not address the cause of the behaviour, so they must never be used in isolation without teaching the person new skills which address the reason for the behaviour.

Preventing self-injurious behaviour

Ask a health professional for help with any self-injurious behaviour which is difficult to manage or which places the person at risk of harm.

Rule out medical and dental causes

Visit the GP or dentist. Bring along notes about the behaviour - what time of day it happens, in which situations, how often it happens, when it first started and how long it lasts.

Think about the function of the behaviour

Complete a behaviour diary, which records what is occurring before, during and after the behaviour. This could to help you to understand the purpose of the behaviour. Make notes on the environment, including who was there, any change in the environment and how you think the person was feeling.

Increase structure and routine

Create a clear daily routine. This will make things more predictable and could reduce anxiety. Put a range of activities into the routine. This will reduce boredom and leave fewer opportunities for the person to engage in self-injurious behaviour. Make plans for difficult times of the day, providing more supervision and support at these times. People with a demand avoidant profile might need a more flexible approach than other autistic people.. More about routine and transition times.

Provide sensory alternatives

Build alternative sensory experiences into the daily routine. Jumping on a trampoline or swinging on a swing might provide a similar sensory experience to head shaking or slapping. Providing the person with a bag of safe objects to chew on - gum, carrots, raw pasta or sultanas - might reduce the need for hand or arm biting.

Use communication tools

Support the person to use other ways of communicating their wants, needs and physical pain or discomfort. You could try visual supports, pictures of body parts or symbols for symptoms.

Reward appropriate behaviours

Give encouragement to the person for appropriate behaviour and for periods when they didn't engage in self-injurious behaviour. This will help them learn that other behaviours bring positive outcomes. Rewards can be verbal praise and attention, a favourite activity, toys, tokens or sometimes small amounts of favourite foods or drinks. Say clearly what it is that you are rewarding, and give the reward straight away.

Note that some autistic people don't enjoy social attention. Verbal praise could cause distress and have the opposite effect to the one you wanted.

Medication

Medication is sometimes used where the behaviour is very severe or lasts a long time. Medication should only be used under the direction of a suitable medical practitioner.

More information

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This guide looks at the causes of self-injurious behaviour and things you can do when it happens, and ways you can try to prevent it happening.

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Pew Research Center: Internet, Science & Tech

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About half of the people responding in this study were in substantial agreement that the positives of digital life will continue to outweigh the negatives. However, as in all great technological revolutions, digital life has and will continue to have a dark side.

Roughly a third of respondents predicted that harms to well-being will outweigh the positives overall in the next decade. In addition, even among those who said they are hopeful that digital life will be more helpful than harmful and among those who said there will not be much change, there were many who also expressed deep concerns about people's well-being in the future. All of these voices are represented in this section of the report.

The technologies that 50 years ago we could only dream of in science fiction novels, which we then actually created with so much faith and hope in their power to unite us and make us freer, have been co-opted into tools of surveillance, behavioral manipulation, radicalization and addiction.
Anonymous research scientist
and professor

Rob Reich, professor of political science at Stanford University, said, "If the baseline for making a projection about the next today is the current level of benefit/harm of digital life, then I am willing to express a confident judgment that the next decade will bring a net harm to people's well-being. The massive and undeniable benefits of digital life - access to knowledge and culture - have been mostly realized. The harms have begun to come into view just over the past few years, and the trend line is moving consistently in a negative direction. I am mainly worried about corporate and governmental power to surveil users (attendant loss of privacy and security), about the degraded public sphere and its new corporate owners that care not much for sustaining democratic governance. And then there are the worries about AI [artificial intelligence] and the technological displacement of labor. And finally, the addictive technologies that have captured the attention and mindspace of the youngest generation. All in all, digital life is now threatening our psychological, economic and political well-being."

Rich Salz, principal engineer at Akamai Technologies, commented, "We have already seen some negative effects, including more isolation, less ability to focus, more ability to be deceived by bad actors (fake news) and so on. I do not see those lessening. Sadly."

Leora Lawton, lecturer in demography and sociology and executive director of the Berkeley Population Center at the University of California, Berkeley, shared these reasons digital life is likely to be mostly harmful: "The long-term effects of children growing up with screen time are not well understood but early signs are not encouraging: poor attention spans, anxiety, depression and lack of in-person social connections are some of the correlations already seen, as well as the small number of teens who become addicts and non-functioning adults."

David Ellis, Ph.D., course director of the department of communication studies at York University in Toronto, said, "Much like a mutating virus, digital services and devices keep churning out new threats along with the new benefits - making mitigation efforts a daunting and open-ended challenge for everyone. Over the next decade, the majority of North Americans will experience harms of many different kinds thanks to the widespread adoption and use of digital technologies. The last year alone has seen an outpouring of commentary, including some 20 trade books, arguing that our digital habits are harming individual welfare and tearing up the social fabric. In marketing its services, Silicon Valley is committed to the relentless promotion of convenience and connectedness. Its success in doing so has wreaked havoc on personal privacy, online security, social skills and the ability to focus attention, not least in college classrooms. While they may be victims of a kind, most consumers are simply in denial about their compulsive use of smartphones and social media, as well as other services designed by their developers to be addictive - a problem that persists even when legal sanctions are in play, as with texting while driving. There's growing evidence these digital addictions are promoting depression, loneliness, video-gaming abuse and even suicidal behavior, especially among teens and young adults. Instead of feeling obliged to moderate their level of connectivity, however, consumers have come to feel a sense of entitlement about their habits, unconstrained by social mores that previously framed these habits as inappropriate. Indeed, heavy use of digital devices is widely encouraged because of the misguided idea that so-called multitasking makes us more productive."

An anonymous research scientist and professor said, "The grand internet experiment is slowly derailing. The technologies that 50 years ago we could only dream of in science fiction novels, which we then actually created with so much faith and hope in their power to unite us and make us freer, have been co-opted into tools of surveillance, behavioral manipulation, radicalization and addiction."

The next few sections share primary concerns expressed by respondents, grouped under commonly expressed themes: digital deficits; digital addiction; digital distrust/divisiveness; digital duress; and digital dangers.

Digital deficits: People's cognitive capabilities will be challenged in multiple ways, including their capacity for analytical thinking, memory, focus, creativity, reflection and mental resilience

A number of respondents said people's cognitive capabilities seem to be undergoing changes detrimental to human performance. Because these deficits are found most commonly among those who live a highly digital life, they are being attributed to near-constant connectivity online.

Steven Polunsky, a research scientist at Texas A&M University, wrote, "One way to describe how we behave is the OODA cycle - when something happens, we Observe it, Orient it to our personal context, Decide what to do and Act on that decision. The internet is easily weaponized to short-circuit that process, so we receive minimal information and are urged to act immediately on it. Unless behavior changes and adapts, this tendency will lead to greater dissatisfaction among internet users and those affected by their actions, which may be a wide audience."

Nikki Graves, an associate professor at Emory University's Goizueta Business School, said, "We currently live in a culture that fosters attention-deficit disorder because of hyperconnectivity. I have been teaching at the college level since 1993, and I can see a definitive decline in students' ability to focus on details and in general. Additionally, I believe that the research on the relationship between hyperconnectivity and this has merit."

We currently live in a culture that fosters attention-deficit disorder because of hyperconnectivity.
Nikki Graves

Meg Mott, a professor of politics at Marlboro College, said, "The internet is harming well-being. My answer has to do with the disturbing trend amongst college students, who operate as if all questions should be answered online. The devices make it so easy to find answers elsewhere that students forget to ask deep questions of themselves. This lack of uninterrupted introspection creates a very human problem: the anxiety of not knowing oneself. The more the culture equates knowledge with data and social life with social media, the less time is spent on the path of wisdom, a path that always requires a good quotient of self-awareness. This becomes evident in classes where a portion of the grade is derived by open-ended writing assignments. In order to write a compelling essay, the author needs to know that the process of crafting a question is more interesting than the retrieval of any answer. Instead, the anxiety is attached to getting the 'right' piece of data. I am of the mind that a lot of the anxiety we see in college students is the agony of not having a clue about who they are. This hypothesis is now supported by Jean Twenge's research on the impact of smartphones on the Millennial and post-Millennial generations."

An anonymous director of one of the world's foremost digital rights organization said, "I'm concerned that the pace of technology creation is faster than the pace of our understanding, or our development of critical thinking. Consider, for a moment, the latest buzzword: blockchain. Yesterday, I heard about a blockchain app designed for consent in sexual interactions - designed, of course, by men in Silicon Valley. If it sounds ridiculous, that's because it is. We've reached a phase in which men (always men) believe that technology can solve all of our social problems. Nevermind the fact that a blockchain is a permanent ledger (and thus incontestable, even though sexual abuse can occur after consent is given) or that blockchain applications aren't designed for privacy (imagine the outing of a sexual partner that could occur in this instance). This is merely one example, but I worry that we're headed toward a world in which techno-solutionism reigns, 'value' has lost all its meaning, and we're no longer taught critical-thinking skills."

An anonymous president of a U.S.-based nonprofit commented, "Increasingly social media is continuing to reduce people's real communication skills and working knowledge. Major industries - energy, religion, environment, etc., are rotting from lack of new leadership. The level of those with aliteracy - people who can read but choose not to do so - is increasing in percentage. The issues we face are complex and intertwined, obfuscated further by lazy bloated media and readers and huge established industry desperate to remain in power as cheaply, easily, safely and profitably as possible - of course! Those of us who still read actual books that require thinking rather than mere entertainment, must redouble our efforts to explain the complex phenomena we are in the midst of addressing in simple terms that can encourage, stimulate, motivate."

Some respondents also more indirectly noted that individuals' anxiety over online political divisiveness, security and privacy issues, bullying/trolling, their loss of independent agency due to lack of control over what they are served by platform providers, and other psychosocial stress are contributing factors in this cognitive change.

An anonymous professor wrote, "As life becomes more and more monitored, what was previously private space will become public, causing more stress in people's lives. Furthermore, some of these technologies will operate without a person's knowledge or consent. People cannot opt out, advocate for themselves, or fix errors about themselves in proprietary algorithms."

A sampling of additional comments about "digital deficits" from anonymous respondents:

"We have less focus - too much multitasking - and not enough real connection."

"The downside is too much information and the lack of ability to manage it."

"Attention spans have certainly been decreasing recently because people are inundated with information today."

"There is increasing isolation from human interaction and increased Balkanization of knowledge and understanding."

"Over 50% of U.S. children over 10 now have some sort of social network-based application, whether it be Instagram, Snapchat or Minecraft. These children are always looking for what they may be missing online. They are increasingly finding it hard to be present and focused."

"The writing skills of students have been in constant decline, as they opt for abbreviations and symbols rather than appropriately structured sentences."

"Digital users who have not lived without technology will not know how to cope with utilizing resources outside of solely tech. With users relying on devices for companionship, we will no longer see people's faces, only the blue or white screens reflecting from this effervescent gaze."

Digital addiction: Internet businesses are organized around dopamine-dosing tools designed to hook the public

Some of the most-concerned respondents pointed to the monetization of attention - the foundation of the internet economy - as the driving force behind many wellness issues.

Douglas Rushkoff, writer, documentarian, and professor of media at City University of New York, said, "The real reason why digital technology will continue to compromise human cognition and well-being is that the companies dominating the space (Facebook, Google, Amazon) are run by people with no knowledge of human society or history. By leaving college at an early age, or running companies immediately after graduating, they fell under the spell of venture capitalists who push growth of capital over all other values. So the platforms will necessarily compromise humanity, democracy and other essential values. The larger the companies grow, the more desperate and extractive they will have to become to grow still further."

Unfortunately, major social media corporations have discovered that anger and insecurity keep people glued to their screens. As long as profit is more important than people, digital life will only grow more destructive.
Kate Thomas

Michael Kleeman, senior fellow at the University of California, San Diego and board member at the Institute for the Future, wrote, "The early promise of the Net has been realized, but the financial incentives to use it for harmful purposes, including legal and illegal ones, have proven too attractive. 'Digital Life' will continue to erode personal interactions, reduce the diversity of ideas and conversation and contribute to negative health impacts. Other than the use of data analytics we have virtually no proof that wearables, etc., alter health trajectories. We do have evidence of a radical reduction in privacy, increase in criminal activity (as digital means reduce the cost of major financial and personal crimes), reduction of engagement with and caring for the environment as a result of increased interaction with online and digital devices."

Kate Thomas, a writer/editor based in North America, wrote, "Unfortunately, major social media corporations have discovered that anger and insecurity keep people glued to their screens. As long as profit is more important than people, digital life will only grow more destructive."

An anonymous professor at one of the world's leading technological universities who is well-known for several decades of research into human-computer interaction wrote, "Deterioration in privacy; slicing and dicing of identity for sale; identification of individuals as targets for political messaging. I don't see the institutions growing that will bring this under control. I don't see corporations taking sufficient responsibility for these issues."

Sam Punnett, president of FAD Research Inc., said, "Distraction is our most prevalent commodity, paid for with attention span. The society-wide effects of 'continuous partial attention' and the tracking, analysis and corruption of the use of data trails are only beginning to be realized."

Many respondents to this canvassing wrote about their concern that online products are designed to tap into people's pleasure centers and create a dependence leading to addiction.

Richard Bennett, a creator of the WiFi MAC protocol and modern Ethernet, commented, "Highly-connected nations such as South Korea have had to develop treatment programs for internet addiction. Gamers in particular are subject to this malady, and Korea's broadband networks make gaming very attractive to socially isolated teens."

Vicki Davis, an IT director, teacher and podcaster based in North America, said, "Un-savvy consumers don't realize the addictive nature of the dopamine hits they are getting through the social media sites they use. In an attempt to keep a Snapchat streak going or to perform for the illusion of a growing audience, this generation could easily live a life one inch deep and a mile wide instead of a deeper life with deeper relationships and deeper productivity. The future of society depends upon our ability to educate people who are willing to get out of the zone on their phone and live life in the real world. ... Many students I work with seem to show some sort of withdrawal symptoms after just a few hours away from Snapchat or Instagram. The greatest innovations often happen with uninterrupted thought. This interruption generation must learn how to turn off their notifications and find satisfaction in solving problems that aren't solved in a snap but take years of dedication. Without tenacity, self-control and some modicum of intelligence about the agenda of social media, the interruption generation will miss out on the greatness that could be theirs."

Robert Stratton, cybersecurity entrepreneur, coach and investor, wrote, "While there may be beneficial uses for this technology ... we cannot ignore the question of what happens when addictive technologies are coupled with very plausible but erroneous content, particularly when generated by skilled actors with specific goals. Additionally, there are decentralized, distributed-actor groups with information operations capabilities that I will assert now rival those of nation-states. Things are not what they seem. We now live in an environment where digital audio and video can be generated with modest skill to produce video that is functionally indistinguishable from photography while being essentially wholly specious. Most internet users and virtually all of the news media seem to operating on two errant assumptions: 1) People mean what they write on the internet. 2) People are witting of their roles in events that occur due to their actions. I would respectfully assert that anyone with a basic knowledge of intelligence tradecraft would agree that these are naïve in the modern environment. Additionally, there are now generalized programming APIs that provide the ability to make essentially ANY application or website habituating for its users."

An anonymous respondent predicted this scenario as a continuation of today's trends into the next decade: "More and more will seem possible in all aspects of life. People may perceive that their lives are better, but it will be the experience of the lobster in the slowly boiling pot. Digital life will take people's privacy and influence their opinions. People will be fed news and targeted information that they will believe since they will not access the information needed to make up their own minds. Out of convenience, people will accept limitations of privacy and narrowed information resources. Countries or political entities will be the influencers of certain groups of people. People will be become more divided, more paranoid as they eventually understand that they have no privacy and need to be careful of what they say, even in their own homes. Some people will break free but at the loss of everything they had worked for. The digital divide will become worse, and many will be unable to pay for all the conveniences. To ensure simpler access and control, some political entities may try to make it available to everyone but at a cost of even more privacy. Convenience will be chosen over freedom. Perhaps."

The massive change in people's news-finding habits instigated by the rapid adoptions of the smartphone and social media was cited by some as the reason for the destruction of accurate, objective journalism, a foundation of democracy. An anonymous respondent commented, "The addictive nature of social media means the dis-benefits could be profound. Watch a young mother utterly engrossed in her phone and ignoring her small children and you will know what I mean. Humans need real-time, real-life interaction not just social interaction, yet the pull of the phone is overwhelming. More broadly, the platform companies are already destroying the business models of legacy media, and as that continues civic journalism will become thinner, poorer and possibly obsolete. Journalism won't disappear. It will simply drift back to propaganda."

A sampling of additional comments related to "digital addiction" from anonymous respondents:

"Engaging apps and digital experiences are much like addictive substances such as alcohol, tobacco and even sweet foods and sex and there has been little progress in creating a 'healthy' consumption model for digital experiences."

"Kids and adults alike are prone to go for the quick fix, the easy high or pleasant feeling, but not well armed to understand its impact on their health."

"People's well-being will continue to be affected by the internet because the software, hardware and structures that are already in place are built to do exactly this."

"As social networking becomes 'professional grooming' as well as providing family/friend updates, the need for multiple platforms (such as LinkedIn and Facebook/Instagram) becomes an assumed need. The amount of time it takes for workers to manage tedious online interactions will lead to an increasing lack of work/life balance."

"Behavioral and psychological impacts of digital life will continue to be discovered and will confirm negative trends."

"Digital communications and the time they take away from personal interactions are contributing to growing social isolation and eroding interpersonal relationships. This affects individuals' mental well-being. People everywhere - walking, in their cars, in meetings, etc. - are glued to their cell phones."

"Unless we are more aware/careful/media literate, there are a lot of 'analogue' behaviours we will jettison that are actually more efficient, positive and valuable."

"When human beings are constantly reminding themselves about a selfish bubble they've lost touch with the truth."

"I fear ... social media having us surround ourselves with people who think like we do, entrenching divisions among people."

"Engagement in social media takes a lot of time for the individual and gives back small and decreasing jolts of satisfaction for a substantial cost in time."

"There is a reason the iPhone was initially called a 'crack-phone.' Spending time on websites and apps is a very seductive way to avoid and/or ignore painful and difficult situations. I've seen very young children ignored while their caregiver texts, plays games, or surf the Net and can't help but wonder how this neglect is affecting them. Will these children learn to parent their children in a better way or will they do the same thing?"

Digital distrust/divisiveness: Personal agency will be reduced and emotions such as shock, fear, indignation and outrage will be further weaponized online, driving divisions and doubts

Among the most-expressed fears for well-being in the next decade were those having to do with issues of social isolation, societal distrust and identity and human agency.

Fay Niker, postdoctoral fellow at Stanford University's Center for Ethics in Society, wrote, "Understanding well-being in terms of human flourishing - which includes among other things the exercise of autonomous agency and the quality of human relationships - it seems to clear to me that the ongoing structuring of our lives by digital technologies will only continue to harm human well-being. This is a psychological claim, as well as a moral one. Unless we are able to regulate our digital environments politically and personally, it is likely that our mental and moral health will be harmed by the agency-undermining, disempowering, individuality-threatening and exploitative effects of the late-capitalistic system marked by the attention-extracting global digital communication firms."

People spend too much time online, often devouring fake and biased items. They grow hateful of each other rather than closer in understanding.
Anonymous respondent

Evan Selinger, a professor of philosophy at Rochester Institute of Technology, wrote, "The repeal of the Obama administration's 2015 rules for Net neutrality is a devastating blow. ... Net neutrality is fundamentally about social control. Thanks to the [Ajit] Pai regime at the FCC, Internet Service Providers have more power than they deserve to micromanage how we conduct our online social, political, educational and economic lives. While Net neutrality advocates have identified several disheartening outcomes to be on our guard for, the projected parade-of-horribles only scratches the surface. If we can't get the information superhighway right, it's a bad omen for the future where we'll need to govern a mature Internet of Things. Second, although analysis of the last U.S. presidential election is shining a spotlight on the problem of botified communication, the focus on internet propaganda obscures the more basic, habit-forming ways that we're being techno-socially engineered to outsource more and more of our communication - and thus ourselves - to software. Third, despite increased awareness of the value of being able to spend time offline, practical constraints continue make the freedom to unplug ever-harder to achieve."

Adam Popescu, a freelance journalist who has written for The New York Times, Bloomberg and other publications wrote, "You see it everywhere. People with their heads down, more comfortable engaging with a miniature world-in-a-box than with the people around them. And you see it while they're behind the wheel driving, while working and performing dangerous and focus-intensive tasks. Forget emotional happiness and the loss of focus and deep thought and the fact that we're now more comfortable to choose who we sleep with based on an algorithm than we are based on serendipity, intuition, chance, and the potential for rejection by walking up to someone and saying 'Hi, my name is ...' The biggest issue with our addiction to smartphones, one none of us talk about openly yet all engage in, is the threat to health and safety. Sure, no one says 'hi' anymore when they're passing by, no one takes a moment to be friendly or reach out, even with just our eyes, because our eyes are no longer at eye-level, they're down, hiding in our screens. Social media over the past year has been revealed for the ugly wolf-in-sheep's clothing it is, a monster once draped in the skin of liberty. We see it for what it is. When will we see that it's not just the programs and toys and apps and sites on our screens that are the problem - but our screens themselves?"

Judith Donath, author of "The Social Machine, Designs for Living Online," also predicted, "We will see a big increase in the ability of technologies to affect our sense of well-being. The ability to both monitor and manipulate individuals is rapidly increasing. Over the past decade, technologies to track our online behavior were perfected; the next decade will see massively increased surveillance of our off-line behavior. It's already commonplace for our physical location, heart rate, etc., to be tracked; voice input provides data not only about what we're saying, but also the affective component of our speech; virtual assistants learn our household habits. The combination of these technologies makes it possible for observers (Amazon, government, Facebook, etc.) to know what we are doing, what is happening around us, and how we react to it all. At the same time, increasingly sophisticated technology for emotion and response manipulation is being developed. This includes devices such as Alexa and other virtual assistants designed to be seen as friends and confidants. Alexa is an Amazon interface - owned and controlled by a giant retailer: she's designed, ultimately, to encourage you to shop, not to enhance your sense of well-being."

A number of these experts wrote about their concerns that technology's evolution would make people suffer a "loss of agency" and control over their world.

Dewayne Hendricks, CEO of Tetherless Access, said, "It is important to consider just how much of digital life is provided/controlled by cyber monopolies. Those entities will have an ever-increasing ability to control/shape the factors that make up that digital life. I see individuals for the most part having less control as time passes."

John Klensin, Internet Hall of Fame member, longtime Internet Engineering Task Force and Internet Society leader, and an innovator of the Domain Name System administration, said, "I am impressed by the increasing anecdotal and research evidence of people not only using the internet to isolate themselves from others but to select the information they are exposed to in a way that confirms and strengthens their existing, predetermined views. While that behavior is certainly not new, the rapid turnaround and instant responsiveness of the internet and social media appear to be reinforcing it in ways that are ultimately undesirable, a situation that is further reinforced by the substitute of labeling and denunciations for examination and reasoning about facts."

Rosanna Guadagno, a social psychologist with expertise in social influence, persuasion, and digital communication and researcher at the Peace Innovation Lab at Stanford University, wrote, "In my professional opinion, the current trends in digital communication are alarming and may have a negative long-term impact on human social interaction. It was naive of social media companies fail to consider and prepare for the prospect that their platforms could be misused for large-scale information warfare (e.g., Russian interference in the 2016 U.S. presidential election). Furthermore, these companies have shirked their responsibility to their users by failing to protect their customers from cyberwarfare. This has not only interfered with people's perception of reality and their ability to tell fact from fiction (I've actually conducted research demonstrating that information presented on a computer screen is perceived as more persuasive than comparable printed material). This has caused a lot of disinformation to spread online and has fueled myriad divisive online interactions. In addition to these issues, there is quite a bit of evidence mounting that people are spending more and more time alone using digital communication as a proxy for face-to-face interactions and this is increasing loneliness and depression among people, particularly our young adults. These technologies should be designed to promote healthy interactions. One way to accomplish this would be to switch to more interactive options for conversation (e.g., video chat instead of text-based conversation would reduce miscommunications and remind people that there are other people with real thoughts, feelings, and emotions behind the computer screen). It remains to be seen whether any of the promises made by digital technology companies to address these issue will be implemented. As a faculty member, one issue I've also commonly noticed is how little time is spent on ethics and psychology as part of the typical software engineering course curriculum. The ethics of software development and the idea that technology should be designed to enhance people's well-being are both principles that should be stressed as part of any education in software design."

A sampling of quote excerpts tied to "digital distrust/divisiveness" from anonymous respondents:

"The dominance of algorithmic decision-making and speed and reach of digital realms have proliferated cultures of misinformation and hatred. We have not yet adjusted to this. It may take a while for the political realm to fully engage with it, and for people to demand tech companies regulate better. I am more optimistic in the long run than I am in the short term."

"People spend too much time online, often devouring fake and biased items. They grow hateful of each other rather than closer in understanding. Negative and harmful ideologies now have platforms that can reach much farther."

"There will be an increase in isolation, further dependence on technology and an increase in unearned narcissism."

Digital duress: Information overload + declines in trust and face-to-face skills + poor interface design = rises in stress, anxiety, depression, inactivity and sleeplessness

A swath of respondents argued that as digital life advances it will damage some individuals' sense of self, their understanding of others and their faith in institutions. They project that as these technologies spread, they will suck up people's time and attention and some will be overwhelmed to the point that they often operate under duress, in a near-constant state of alert.

Device use will lead to more social alienation, increased depression and less-fit people. Because it's still relatively new, its dangers are not well understood yet.
Anonymous digital strategy director

Larry Rosen, a professor emeritus of psychology at California State University, Dominguez Hills known as an international expert on technology and its impacts on well-being, wrote, "1) We continue to spend more time connecting electronically rather than face-to-face, which lacks essential cues for understanding. 2) We also continue to attempt to multitask even though it harms performance. 3) We insist on using LED-based devices close to our eyes right up to bedtime even though it negatively impacts sleep and our brain's nightly needs for synaptic rejuvenation harming our ability to retain information."

Susan Price, lead experience strategist at USAA, commented, "Mental health problems are rising and workplace productivity is falling. The tendency to engage with digital content and people not present instead of people in our immediate presence is growing, and small-screen trance has become an accepted interpersonal norm in the workplace. Culturally-induced attention-deficit behavior has already reached staggering proportions, and is still rising. The mini-serotonin payoffs we get when 'connecting' in this way are mildly, insidiously addictive and are squeezing out the more uneven, effortful, problematic real social connections we need for true productivity and intimacy."

Stowe Boyd, futurist, publisher and editor-in-chief of Work Futures, said, "Well-being and digital life seem so intertangled because of the breakdown between personal and public life ... that digital tools have amplified. One significant aspect of public life is our relationship to work. ... We need to wake up to the proximate cause of the drive for well-being, which is the trap of overwork and the forced march away from living private lives."

K.G. Schneider, dean of the university library at Sonoma State University, wrote, "Anonymized discourse, it turns out, is not a civilizing influence, nor is having one's every thought broadcast in real time the best way for us to interact as humans."

Marcus Foth, professor of urban informatics at Queensland University of Technology, wrote, "Advancement and innovation of digital technology is still predominantly driven by the goal to increase and optimise productivity rather than people's quality of life or well-being. While proponents of an elusive work-life balance may argue that you can always switch off digital technology, the reality is that [it] is not being switched off - not because it cannot, but there is now a socio-cultural expectation to be always available and responding in real-time."

Jan Schaffer, executive director at J-Lab, wrote, "Overall, people will be more harmed than helped by the way the internet is evolving. People's trust in basic institutions has been hurt, perhaps irreparably, by conflicting accounts of what is true or not, online. People's productivity at work has been hampered by the distractions of social media. People's social and emotional intelligence have been impaired by the displacement of personal interactions with online interactions. "

An anonymous digital strategy director for a major U.S. professional association wrote, "Device use will lead to more social alienation, increased depression and less-fit people. Because it's still relatively new, its dangers are not well understood yet."

An anonymous professor wrote, "While there are many positive aspects to a more digitally connected life, I find that it is very difficult to keep up with the volume of spaces where one must go. I spend too much time answering emails, communicating in digital spaces and just trying to keep up. This causes a significant amount of stress and a lack of deliberate, thoughtful approach to information sharing. One cannot keep up with personal and professional email accounts, LinkedIn, Twitter, Facebook, Instagram and all the rest. Truly, it is just too much."

A sampling of comments about "digital duress" from anonymous respondents:

"There is too much connecting to other people's anxieties and expectations."

"We already know there are negative effects for everyone waiting for a 'like' or other similar kind of gratification."

"I worry about mental illness and increasing social isolation as a result of more time spent with technology."

"Increased digitalization is leading to more sedentary lifestyles in a society already plagued with obesity challenges. Social media use has also led to poor communication skills, even in face-to-face settings, people opt to burying their faces into the smartphone screens."

"Some people are creating and then trying to live up to fake worlds they build with their phones."

"Constant connections to electronic-information feeds causes anxiety and damage to our eyes, brains."

Digital dangers: The structure of the internet and pace of digital change invite ever-evolving threats to human interaction, security, democracy, jobs, privacy and more

A number of respondents pointed out that digital life opens the door to societal dangers that can affect individuals' well-being. They say the digital world's systems - the internet, the web, the smartphone, all networked digital hardware and software - have evolved so rapidly due to their incredible appeal and the economic and social forces driving them forward that there has been little recognition of nor a real reckoning with the wider negatives emerging with the positives.

What we are seeing now becoming reality are the risks and uncertainties that we have allowed to emerge at the fringes of innovation.
Anonymous respondent

Anthony Rutkowski, internet pioneer and business leader, said, "Clearly - as DARPA's director noted in his seminal 2000 millennium article on this topic - the past 17 years have demonstrated how the DARPA internet, which was never designed for public infrastructure use, has resulted in all kinds of adverse impacts to people's lives and even the security of society. It has amplified the most outrageous behavior and alt[ernate]-truth as the new normal. See details of my position at http://www.circleid.com/posts/20170312_the_internet_as_weapon/ (Excerpt: 'The existence of 'an open platform that enables anyone, everywhere, to share information, access opportunities and collaborate across geographic and cultural boundaries' globally is fundamentally a weapon. ... Such an infrastructure has inherent economic, operational, and political self-destructive properties that are playing out exponentially every day.')"

An anonymous longtime leader of research at one of the top five global technology companies said, "I chose my career believing that technology would improve our lives. Seeing what has happened, I've grown pessimistic. Our species has lived for millions of years in small communities - bands, tribes, extended families. We are wired to feel valued and good about ourselves through direct, repeated interactions in such groups. These tight-knit associations are disappearing as our activity moves online. Relationships are replaced by transactions. If we avoid catastrophe, in the long run natural selection will produce a new kind of human being that is adapted for the world we are creating. That individual will not be like most of us. Living through the transition will be painful."

Aram Sinnreich, an associate professor at American University's School of Communication, said, "In general, people's lives will change for the worse over the next decade because of the internet. There are several factors I am taking into account here: 1) The increasing prevalence and power of internet-based surveillance of citizenry by state and commercial actors. 2) The catalyzing power of digital technology in exacerbating the gaps between haves and have-nots. 3) The as-yet-undertheorized and unchecked role of digital disinformation in polluting the democratic process and news dissemination channels. 4) The increasingly savvy and widespread use of the internet by crime syndicates. 5) The increasing vulnerability of our social infrastructure to internet disruption and hacking. 6) The environmental consequences of the internet, recently exemplified by studies analyzing the electrical power consumption that goes into Bitcoin transaction processing. This isn't to say there aren't many benefits to the internet, or that its impact won't net positively over the longer term. But I don't see any likely benefits outweighing the threats I outlined above over the next decade."

An anonymous professor based in North America said there is a public perception of well-being - crafted by platform builders and policy (or lack of policy) - while well-being is actually being damaged. This respondent wrote, "People may very well experience an increase in subjective well-being. The techno-social world we're building is increasingly geared toward engineering happy humans. While a life of cheap bliss, of satiated will, may yield more net well-being measured in terms of subjective happiness, it would at the same time be a rather pitiful life, devoid of many of the meaningful blessings of humanity. Brett Frischmann and Evan Selinger address the questions you're asking in a 500-page book, ' Re-Engineering Humanity,' due out in April 2018. One chapter, 'To What End?' directly considers the normative values at stake and the issue of what well-being means. Other chapters explain in detail the technological path we're on and how to evaluate techno-social engineering of humans."

Bob Frankston, a technologist based in North America, said, "The internet is not a thing but rather a product of the ability to use software to program around limits. It enables the creation of systems of technologies that work in concert. But the benefits will be limited to point solutions as long as we are limited to solutions that are profitable in isolation, until we invest in common infrastructure and have open interfaces."

Jeremy Blackburn, a computing sciences professor who specializes in the study of the impacts of digital life, wrote, "1) People will continue to be manipulated via targeted (mis/dis)information (sic) from a variety of sources. 2) There will be an increase in online harassment attacks that will be mostly ignored due to their statistical weight (Google/Facebook/Twitter/etc. do not care if 0.1% of their users are attacked, even though the raw numbers are substantial). 3) There will be an increase in extremists and their ability to recruit and radicalize vulnerable individuals. 4) There will be an increase in information silos, eventually resulting in extreme polarization of information acceptance. 5) There will be decreased concern about individual impact in the face of big data and large-scale machine learning (e.g., a 1% increase in revenue due to scale is worth it, even if it means a few people here and there will suffer). This will eventually cascade to large-scale suffering due to network effects. 6) There will be an increase in the acceptance of opinion as fact due to the democratization of information. No one knows if you are a dog on the Internet, and no one cares if you are an expert."

An anonymous respondent commented, "What we are seeing now becoming reality are the risks and uncertainties that we have allowed to emerge at the fringes of innovation. One is the systemic loss of privacy, which is a precondition for deliberation and a sense of self-determination. Further, we already see how our critical infrastructures - ranging from energy supply to health systems and the internet itself - increasingly are at risk of failing us due to their openness for malicious attacks, but also due to the complexity of interrelated, networked processes. Due to the lack of traceability on the internet, there is no expectation that we will achieve accountability in such situations."

An anonymous Ph.D. in biostatistics commented, "The culture of anonymity on the Web is scary and seems to allow people to behave in ways they wouldn't otherwise (see recent news about 'swatting' in the online gaming community). Then there is the social media 'hive' that allows internet uproar to dictate what happens. There is no room for discourse, grey areas or mistakes. Lives can be ruined by the publicity of a simple mistake (and combined with people sharing home addresses this can also be dangerous)."

An anonymous professor in the United States commented, "My belief is that unless extensive regulation and user education occurs, we will see an increase in negative consequences of online activity such as violations of privacy, dissemination of misinformation, crime and displacement of jobs."

An anonymous research scientist and internet pioneer commented, "We have reaped great benefit from digital life over the past decades. My answer compares the next decade to the current situation, not to the time prior to the digital life. The negative aspects of the digital life are becoming more pronounced, and I think the next decade will be one of retrenchment and adjustment, while society sorts out how to deal with our perhaps over-optimistic construction of the digital experience."

A sampling of additional comments about "digital dangers" from anonymous respondents:

"Election results will remain unverifiable and subject to digital manipulation by political criminals. ... Terrorists will recognize more ways to destabilize economic, social, political and environmental systems."

"Security/hacking and manipulation online may cause more harm; e.g., the latest Intel bug."

"People's well-being will be hurt unless we figure out the cultural and social and political solutions - and religious and economic ones - to life online. Every medium needs to be tamed. It will take a while for digits to be domesticated."

"I fear government and private-sector security measures in 'protecting' individuals, and I fear the advancement of AI."

"The loss of privacy as data sharing and integration continues will be highly problematic. Government, industry and hackers will all benefit."

"We don't know the effects of electromagnetic fields (EMF) and radiation. It's not a mainstream idea to protect people from the negative health impacts of radiation."

"Technology's beneficial effects (improved efficiency, access to information) are increasingly being overwhelmed by its negatives - distraction, disconnection from real in favor of virtual interactions, and how anonymity unleashes ugly behaviors such as misogyny, racism and overall nastiness."

"Increasing surveillance and social control by corporations and their political representatives will reduce the standard of living and freedom for the majority of the citizens in a world of rapidly changing climate."

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3. Concerns about the future of people's well-being

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About half of the people responding in this study were in substantial agreement that the positives of digital life will continue to outweigh the

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Prevent legislation, guidance and resources - The Education and Training Foundation

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Access a wealth of Prevent duty and British values resources, tools, guidance and articles from the last five years to support teaching.

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Understand best practice in protecting autistic individuals

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Supporting autistic people with eating difficulties

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Dr Elizabeth Shea discusses autism and eating difficulties and how best to support autistic people

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Our guidance aims to help you address common eating difficulties for autistic people.

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What is a dietitian?

Dietitians are health experts specialising in food, nutrition and diet. They provide guidance about diets and nutrition for people who may be affected by a range of health conditions, such as obesity, cancer or heart disease, and certain disabilities or disorders.

Why are dietitians recommended for people with autism?

As some people on the autism spectrum can have difficulty with eating, or can be fastidious eaters, there are a number of professional registered dietitians who have a particular interest in the nutritional needs of children and adults with autism.

Behavioural challenges as well as sensitivities to certain foods, particularly among some children with autism, can make it difficult for parents and carers to ensure they are providing them with a nutritious diet.

For example, people with autism may refuse to eat unless they sit in the same place at the table, eat on the same dishes, use the same tablecloth, and eat the same foods every single day. Just a small change in routine can cause an enormous amount of anxiety or fear in a child or person with autism, and can often result in the refusal to eat.

Researchers at Marcus Autism Center at Emory University School of Medicine found that children on the autism spectrum are five times more likely to have mealtime outbursts, be more selective about their food, or have ritualistic eating behaviours.

The study also found lower intakes of calcium and protein in children with autism. Calcium is crucial for building strong bones, while adequate protein is important for growth, mental development and health.

This can be why people with autism, or with a child who has autism, find it useful to seek advice from a dietitian, as they can provide solutions for evading some of these common issues.

Autism and diets

Given the well-established relationship between diet, health and wellbeing, it's natural for people with autism and parents of autistic children to seek out food-based solutions that may improve their child's health or wellbeing.

One of the most common beliefs amongst parents of children on the autism spectrum is that removing gluten (the protein in wheat, rye and barley) and casein (the protein in milk) from the diet will improve adaptive behaviours. However, medical practitioners warn that these diets can be low in fibre, B vitamins and calcium, which can affect overall health.

There is general agreement, that as many as 50% of children on the autism spectrum have digestive problems , but the reasons for this are not established.

Just like the nature of the autism spectrum, there is no one size fits all approach to autism and diet, so if you have any concerns around your child's nutrition, it's best to contact a dietitian and seek professional advice.

Food additives

The increasing concern about food additives in our general diet are believed by some to influence behaviours. However, at this stage there is insufficient evidence to support these claims.

A dietitian can clarify concerns about food additives such as food dyes and colours, artificial flavourings, preservatives and artificial sweeteners and their role in behavioural symptoms.

Dietitians can also help you to develop natural, wholefood diets that are generally better for your health.

How can a dietitian help?

Generally, a dietitian will initially undertake a consultation with you, or your child or dependant, to understand diet and eating behaviours.

The consultation will identify food aversions that may be promoted by texture, appearance, smell or temperature.

They will also want to learn more about health and lifestyle problems such as constipation and diarrhoea, sleep issues, body weight, and skin conditions such as eczema.

They may then recommend biomedical testing to identify food allergies and sensitivities, gastro-intestinal parasites and viruses or micro-nutrient deficiencies.

After a comprehensive review of a person's current diet they will often then recommend an individualised diet that provides the right nutritional balance for that person. They can also clarify current research relating to diets such as the Gluten-free casein-free (GFCF) diet, and will provide an objective opinion about the benefits and potential problems that may arise as a result of such diets.

A dietitian will sometimes collaborate with an Occupational Therapist or Speech Pathologist to develop a program which can support a healthy diet and assist with mealtimes. This might include developing a specific mealtime environment that is practical for your family and routines, such as optimal seating positions, table height, or the removal or adjustment of distracting noises, lighting and smells.

Depending on age, children may like to get involved in their own menu planning in conjunction with their dietitian.

How do dietitians provide their services?

After an initial assessment, dietitians will often recommend a personalised course of action that suits you or your child's needs. This may include keeping a food diary, coming in for one-on-one sessions with the dietitian, or group sessions with you, your family or carers.

Where can I find a dietitian?

Dietitians work across a range of health settings including private dietetic practices, larger multidisciplinary health practices, community health centres, and public and private hospitals. Dietitians also often work in disability facilities or for disability service providers.

What training do dietitians undertake?

Accredited Dietitians have to complete a recognised Bachelor or Masters Level dietetic qualification. This includes completing a minimum of 30 hours per year of continuing professional development

Accredited Dietitians must adhere to the DAA Code of Professional Conduct and Statement of Ethical Practice, and comply with audit requirements.

Dietitians are accredited by the Dietitians Association of Australia and may be eligible for Medicare and other government funding, including the National Disability Insurance Scheme (NDIS).

What does a dietitian cost?

Costs can vary greatly, but as a guide an initial hour and a half consultation with an accredited dietitian in Australia can cost between $290- $440. Subsequent consultations are charged between $64 and $200.

Dietitian consultations are an approved service under the NDIS. For more information about the NDIS and to find out if you are eligible for funding visit our funding page.

Further information

For more information visit the Dietitians Association of Australia.

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Dietitians are health experts specialising in food, nutrition and diet. They provide guidance about diets and nutrition for people who may be affected by a range of health conditions, such as obesity, cancer or heart disease, and certain disabilities or disorders.

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If you are autistic, you may have difficulty with communication and social interactions with others. This Fact Sheet looks at the most common dietary problems affecting autistic people and how dietitians can help.

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Support for skills and activities for people with autism

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Support for skills and activities for people with autism

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Social Care Institute for Excellence (SCIE)

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Social interaction is difficult for people with autism.[ 82] The National Autistic Society reports that the main services requested by autistic adults in its 'I exist' study [ 37] were social skills training, social groups and befriending.[ 48] For many people with autism, therefore, training in social skills, and the opportunity to engage in social situations in which they feel comfortable, can be important in preventing them from feeling isolated and unable to cope. Such training often works better in a specific context such as part of the transition from school [ 62] or in the workplace; in isolation it can be less effective.

Our research showed people were fairly consistent in wanting support in order to engage with social activities, but more varied in exactly how they socialised currently, and what else they wanted by way of social activities.[ 13]

People with autism most commonly socialised with family members and friends, but we found that the next most common arena for socialising was online.[ 13] As a medium in which people can exert more control over the timing, pace and flow of both giving and receiving information, as well as a space to find people with similar interests, interacting online may have real benefits for many people with autism.[ 62] A common misconception is that autistic people do not seek friendships. Studies have shown that this is not the case and that many people would welcome support in this area.[ 13, 82]

Difficulties with public transport and low incomes can make socialising problematic.[ 33, 82] Other barriers included a lack of suitable activities, not feeling accepted and being worried about other people's perceptions.[ 13] For some, this can lead to a preference for autism-specific social spaces, perhaps structured around certain themes or interests.[ 45, 62] Others, however, express disquiet about groups targeted at people with autism, and stress the value of ordinary activities, asserting their right to be accepted within them.[ 13] Still others found buddy schemes very helpful. Here, an identified person or 'buddy' supports them as they negotiate new situations. Some people with autism have benefited from mentoring and life coaching.

In all support for social activity scenarios, however, it is worth noting the following.

People may need to build up to social support. There often needs to be an extended period of time receiving support in the home before the person is confident to go out with support staff.

People need to have a choice in who supports them so that they feel comfortable socialising with them, and need to be able to state their preferences over common interests.

Schemes need to have confident, consistent staff with training in a range of issues, such as additional mental health problems.

Poor social support can lead to increased feelings of rejection or replicate previous failed relationships.

Carers' concerns need to be listened to, as they may be able to anticipate difficulties and may be anxious to start with.

Guardian article: " An opportunity not a drawback"

View more: News

A new two-day open access course. Providing participants with an introduction to understanding the Autism Spectrum and strategies which can help ensure appropriate methods of communication and support.

View more: Training courses

Get SCIELine ebulletin & access all resources. Free MySCIE account

View more: Case studies

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Support for skills and activities for people with autism - SCIE

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Social interaction is difficult for people with autism.[ 82] The National Autistic Society reports that the main services requested by autistic adults in its 'I exist' study [ 37] were social skills training, social groups and befriending.[ 48] For many people with autism, therefore, training in social skills, and the opportunity to engage in social situations in which they feel comfortable, can be important in preventing them from feeling isolated and unable to cope.

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Advice, guidance and useful resources about autism and anxiety.

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Understand best practice in supporting autistic individuals to manage their own behaviour

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Some autistic people can display distressed behaviour. It includes what would normally be considered physically aggressive behaviour, such as slapping, biting, spitting or hair pulling, but can also include other behaviours if they are having a negative impact on the person or their family. Below we give some strategies to try and information on getting support.

What causes distressed behaviour?

Behaviour has a function, and there could be a number of reasons for it. These may include difficulty in processing information, unstructured time, sensory differences, a change in routine, transition between activities, or physical reasons like feeling unwell, tired or hungry. Not being able to communicate these difficulties can lead to anxiety, anger and frustration, and then to an outburst of distressed behaviour.

Strategies to try

Keep a behaviour diary

Completing a behaviour diary, which records what is occurring before, during and after the behaviour, could help you to understand its purpose. It is important to make notes on the environment, including who was there, any change in the environment and how the person was feeling. A diary may be completed over a couple of weeks or longer if needed.

Rule out medical and dental causes

Distressed behaviour such as biting may be due to pain in the mouth, teeth or jaw. Spitting may be related to a difficulty with swallowing or to producing too much saliva. Visit your GP or dentist to rule out medical causes.

Your response

Respond quickly and consistently, eg for spitting, wipe away saliva immediately. Limit verbal comments, facial expressions and other displays of emotion, as these may inadvertently reinforce the behaviour. Try to speak calmly and clearly, in a neutral and steady tone of voice.

Be consistent in your approach to the behaviour, and ask others around the person to use the same approach.

Communication

Speak clearly and precisely using short sentences. By limiting your communication, the person is less likely to feel overloaded by information and more likely to be able to process what you say.

You can use social stories to explain why it's not appropriate to bite/spit/hit, and describe alternatives.

Support the person to communicate their wants, needs and physical pain or discomfort by using visual supports. Some people use communication boards to indicate how they are feeling. This could be a blackboard or a Velcro board with key emotional words or emotional faces. Every time the person engages in distressed behaviour, encourage them to use this form of communication instead.

Use rewards

Using rewards and motivators can help to encourage a particular behaviour. Even if the behaviour or task is very short, if it is followed by lots of praise and a reward, the person can learn that the behaviour is acceptable.

Rewards can take the form of verbal praise and attention, preferred activities, toys, tokens or sometimes small amounts of favourite foods or drinks. Ensure that you clearly name the behaviour that you are rewarding, eg "Jane, that's good waiting!" and ensure that rewards are provided immediately after the behaviour that you wish to encourage eg "You can spend 10 minutes on the computer now".

Some autistic people do not enjoy social attention. In these circumstances, verbal praise can cause distress and actually stop the person engaging in the desired behaviour in the future.

Redirect to other behaviour

Tell the person what they need to do instead of the behaviour, eg "David, hands down". Use visual cues such as picture symbols to back up instructions. Redirect to another activity that is incompatible with the behaviour (eg an activity that requires both hands, or that occupies the mouth, such as sucking a sweet) and provide praise and reinforcement for the first occurrence of appropriate behaviour, eg "David, that's excellent playing with your train".

Remove physical and sensory discomforts

Provide relief for physical discomfort, eg painkillers. Remove unpleasant sensory input, eg use ear defenders to block out noise, use sunglasses to reduce light, and reduce strong smells, replacing them with smells that the person prefers.

Prepare for change

Prepare the person for any changes in routine or for meeting new people. You could use visual supports, showing photos of new people and places, introducing them in small stages.

Read our tips on dealing with change and transitioning between activities. - link to new page in behaviour section - transitions and dealing with change.

Provide sensory opportunities

Find alternative activities, or provide a bag of alternative objects, that provide a similar sensory experience to that provided by the behaviour, and build these into the daily routine. For a person who bites, you could provide chewy tubes, gum, carrots, raw pasta or sultanas. For a person who pinches, you could provide play-dough. For a person who hits, you could do a clapping song/rhyme. For a person who pulls hair, tie long hair back and find something to replicate the pulling sensation, eg 'row your boat' game, tug of war, climbing up a rope.

Opportunities for relaxation

Create opportunities for relaxation. You can do this by, for example, encouraging the person to look at bubble lamps, smell essential oils, listen to music, or use a swing.

Distressed behaviour can often be diffused by an activity that releases energy or pent-up anger or anxiety. This might be punching a punch bag, bouncing on a trampoline or running around the garden. Read more about anger management

When a particular person is targeted

If a particular family member or support worker seems to be the target for challenging behaviour, think about what might be triggering it. It might be that a perfume scent is overwhelming, or that the other person is associated with a distressing activity.

Maybe the person is upset when the support worker or family member spends time with other people. If so, you could try scheduling some time specifically for them to spend together and showing this on a visual timetable. Very strict boundaries need to be kept as to when this will happen and for how long. It may be useful to have a sand timer so that the person knows that the time is up when the sand runs out.

There may simply a personality clash between the person and a staff member. If this may be the case, consider whether this staff member could work with other people instead?

Getting specialist help

If the distressed behaviour is presenting significant risks to the person or those around them, try to get specialist help to deal with the behaviour. Arrange an appointment with the GP to discuss the issue and to request referral to a behavioural specialist if appropriate.

Support for you as a parent/carer

There are a number of ways in which you could get some support.

Meet up with other carers, or get support from a local National Autistic Society branch or group, community service or family support service in your area. Other local support groups and services are listed in our Autism Services Directory.

Get ideas from other families, and share your tips with them in our Online Community.

Request a social care needs assessment for your family member and for yourself as a carer. You may be able to get respite care or the help of an outreach team who can support you with behaviour strategies.

Get support from a counsellor who understands autism and can support you and your family.

Further information

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This guide offers some strategies for helping autistic people who are showing signs of distressed behaviour.

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The implementation of proactive strategies will lead to improvements in the person's quality of life and their need to engage in challenging behaviour.

It is important to be realistic about the changes you can make and remember that while some proactive strategies may have immediate effects, some will take longer.

What are proactive strategies?

A range of changes we can make in the person's environment, in the ways that we communicate, in staff attitudes and in risky situations to reduce the need for the behaviour. These might include:

Making the day more understandable for the person

Teaching the person alternative ways to get what they need

Increasing the range of activities and interactions available to the person

Changing the way we invite the person to be involved in activities

Rethinking our interpretations of behaviour as intentional

Getting better at picking up signs of anxiety

To find out more how we support people with challenging behaviour using proactive strategies, see our Positive Behaviour Support resource.

Get support

To find out more about being supported by United Response, please use our online form to make a support enquiry.

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The implementation of proactive strategies will lead to improvements in the person's quality of life and their need to engage in challenging behaviour. It is important to be realistic about the changes you can make and remember that while some proactive strategies may have immediate effects, some will take longer.

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1.1.4 Health and social care provider organisations should ensure that teams carrying out assessments and delivering interventions recommended in this guideline have the training and supervision needed to ensure that they have the necessary skills and competencies.

1.1.5 If initial assessment (see section 1.5) and management have not been effective, or the person has more complex needs, health and social care provider organisations should ensure that teams providing care have prompt and coordinated access to specialist assessment, support and intervention services. These services should provide advice, supervision and training from a range of staff to support the implementation of any care or intervention, including psychologists, psychiatrists, behavioural analysts, nurses, social care staff, speech and language therapists, educational staff, occupational therapists, physiotherapists, physicians, paediatricians and pharmacists.

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Challenging behaviour and learning disabilities: prevention and interventions for people with learning disabilities whose behaviour challenges

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1.1.4 Health and social care provider organisations should ensure that teams carrying out assessments and delivering interventions recommended in this guideline have the training and supervision needed to ensure that they have the necessary skills and competencies.

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Understand best practice in managing behaviours of autistic individuals

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Online Sensory Story training available now

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Creating your own sensory story is very easy and doesn't have to cost anything.

You just need to follow these simple steps:

1. Choose a story: Choose a book, story or theme that you and your child will enjoy - remember you don't need a book to tell a story!

2. Summarise it: Summarise the story into short sentences - about 10 for the whole story is ideal. Keep it short and simple!

3. Pick 10 keywords: Think about roughly 10 keywords in the story - these should be the most important for the story to be told and will usually include the who/what/where/doing words.

4. Find props: Look around your home for props to bring your sensory story to life - and especially find props to represent your keywords. Props can be anything from using the space behind a sofa as a dark cave, or using coffee grains from the kitchen as mucky dirt. Pound shops and charity shops can be great places to find cheap props too! (Please bear in mind that not all props are allergy-free/safe for children to use without your supervision).

5. Make some noise! You can use sounds, songs, clapping and actions to create a truly sensory story experience. Encourage your child to join in or make their own sounds and movements.

6. Use your imagination: Don't feel that everything has to be literal. Rain could be the noise of your fingers pattering on the table, a water spray, waggling your fingertips to indicate raindrops falling to the ground or a combination of these things. The more clues you give your child to help them understand a word the better.

7. Repeat, repeat, repeat! Be ready to tell the same story several times. Repetition is very important in helping young children to learn.

We've created a sensory story guide for you, which you can download below and read with your child.

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Create your own sensory story in 7 steps

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Creating your own sensory story is very easy and doesn't have to cost anything. You just need to follow these simple steps: Choose a story: Choose a book, story or theme that you and your child will enjoy - remember you don't need a book to tell a story!

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Have you ever felt like your head was going to explode from loud noises and bright lights piercing through your brain? Do big crowds and parties with music blaring overwhelm you?

When your brain receives more input from your five senses than it can process and organize, you may experience sensory overload. Maybe you can't focus on what's happening around you and you become restless and wound up. You could also feel the need to close your eyes, cover your ears and escape the situation. What's more, it can take a lot of energy to process all those sensory stimuli, leaving you tired and brain fogged.

So what is sensory overload?

Sensory overload can happen to anyone, but some of us are more sensitive to sensory input than others. Children and adults with autism, ADHD and mental health disorders like PTSD are more likely to experience sensory overload than the general population. Sensory overload is also a common problem in people with chronic illnesses like chronic fatigue syndrome, fibromyalgia, multiple sclerosis (MS) and stroke survivors.

In these cases, the brain's filter which identifies and then ignores irrelevant sensory information doesn't work properly. Your mind becomes unable to tune out less important things like background noises, strong perfumes and busy decorations. As a result, your brain experiences 'mental flooding' and sends warning signals to your body to escape the sensory input.

What are the symptoms of sensory overload?

The symptoms of sensory overload vary from person to person. Some people are more sensitive to sounds, while children with autism, for example, often struggle with different textures and tastes.

Common symptoms include:

inability to ignore sounds, smells and visuals

having difficulties to focus due to competing sensory input

sensitivity to textures, fabrics and clothing tags

irritability or restlessness

feeling wound up, stressed or anxious

feeling the urge to cover your eyes or ears

avoiding or running away from specific places and situations.

How do you deal with sensory overload?

At this time, there are no diagnostic guidelines nor medical treatments available for sensory overload. The best thing you can do is to learn how to prevent mental flooding and how you can deal with sensory overload when it does occur.
This blog post contains some affiliate links to resources you may find helpful, at no extra costs to you. All opinions are my own.
How to Prevent and Cope with Sensory Overload

1. Identify triggers and recognize early symptoms

Often, not all sensory stimuli cause mental overwhelm. Maybe you're sensitive to invasive smells from spicy foods and fragrant body lotions. Or perhaps your brain goes into overdrive when you're in motion, especially unfamiliar movements like boats and amusement park rides. Sometimes it's the accumulation of sensory input, like lively parties with loud chatter, background music and flashing lights. Once you know your triggers, you can try to avoid them or 'dose' your sensory input to reach comfortable levels of stimulation.

Next, try to recognize early warning signs. What do you feel when you're starting to experience sensory overload? In trigger situations, pay attention to the sensations in your body and mind. These early symptoms could be your cue to take action to prevent sensory overload from getting worse.

2. Understand how sensory overload works

Learning how sensory overload works for your specific condition can help you prevent and manage sensory overload. But remember that everyone is unique. What triggers or helps others, might not work for you.

Also be aware that every situation is slightly different . Sometimes it may feel like there's no logic at all. Why are you able to handle a concert well, but the background noise in restaurants drives you crazy? Try to look closer: maybe it's because you have to multitask and juggle conversations with your dinner companions in the midst of many distractions, whereas you can fully focus on the music at a concert. Details like the acoustics, comfortable seating and time of day could also play a part.

3. Develop coping strategies that work for you

No matter how hard you try, you can't always prevent sensory overload from happening. There are birthday parties you want attend, shopping that has to be done, the artist you really want to see, not to mention the stimulation in your workplace. Here are some general and situation-specific ideas on how to deal with sensory overload when it does occur.

General coping strategies:

Prepare yourself for (over)stimulating activities. Take pre-emptive rest before attending a birthday party or theatre show. Even more important: give yourself permission to (temporarily) remove yourself from busy situations at the first signs of sensory overload.

Schedule alone time. If you're easily overloaded, you probably need some quiet time each day to wind down and recharge.

Don't over-schedule and plan plenty of rest in between appointments and activities. Having regular routines may also help you to be in the 'best shape' to prevent sensory overload.

Practice meditation and mindfulness. It's very helpful to fall back on these calming techniques when your senses get overwhelmed. You can learn how to do relaxing breathing techniques and take mindful micro-breaks throughout the day.

Reduce your overall stress levels. Make time to wind down with soothing activities like nature walks, a warm bath or adult coloring books.

Optimize your surroundings. At home, look into the best lighting for you and decorate with neutral colors. Reducing clutter could also help you avoid sensory overload. Kids sensitive to sensory overload may enjoy sitting on bean bag chairs that take the shape of their body.

Make sure rest is a priority. Being well-rested may not stop sensory overload from happening, but it does help you to better deal with it. If you struggle to get enough sleep, you could try weighted blankets. Weighted blankets simulate a comforting hug, and this sensory tool is often recommended for anxiety and autism.

Social get-togethers:

Don't handle large groups of people very well? Meet up one-on-one with your friends and choose a quiet venue. You could also ask someone over to your house to avoid unnecessary sensory input.

Listening to someone talk non-stop can be tiring, especially in a room filled with people. Try to avoid making conversation while doing something else, because multitasking requires even more brainpower. And don't feel bad about (politely) excusing yourself after a while, and quietly grabbing yourself a drink before talking to someone else.

Attending a wedding or another special occasion? If possible, take frequent 'sensory breaks'. Stretch your legs, get some fresh air or hide out in the bathroom for a few minutes at a time.

Make sure you're well-rested and well-fed before going out. Being tired, stressed and hungry can all make you more susceptible to sensory overload.

Replace FOMO with JOMO - the joy of missing out. You don't have to sign up for every activity and say yes to every invitation. Instead, prioritize: which activities do you really want to do?

Shops, restaurants and other public places:

Avoid crowded places. Don't join the Black Friday craziness or go to a busy beach on a sunny holiday. When planning an activity, pick a time and day when it's likely to be quiet. Less noise, less distractions and less lines!

Come prepared. Make a list of what you want to buy and go 'speed shopping'. Instead of aimlessly wandering through the high streets, take a more goal-orientated approach to save mental energy. And if you're highly sensitive to sensory overload while shopping, the Internet is your best friend.

Wear 'protection'. Putting on your sun glasses outdoors or wearing reusable ear plugs at the movie theatre could reduce the amount of sensory input coming at you.

Remove yourself from the situation when you start to get overloaded. Find a quiet spot or retreat to your car if you need to wind down and recharge.

Work:

If you work in an office, there are a few ways you can minimize sensory overload. Set up your desk in a quiet corner, with your boss's permission of course. If you have control over your work hours, consider coming in early, when it's still quiet. You could also put on noise-cancelling headphones when you have to do focused work. Finally, you can discuss working from home one day a week to prevent sensor overload.

Don't keep too many tabs open - neither on your screen, nor in your brain. Multitasking requires a lot of brainpower, leaving you with less capacity to process sensory input.

Take brain-recharging breaks. Not all employers acknowledge this, but you can't crank out high-quality work for 8 hours straight. To be actually productive, your mind and body need time to recharge. Alternate your mentally-stimulating work with more physical breaks, like a short walk or desk stretches.

You don't have complete control over your sensory input, but hopefully these 19 coping strategies give you the tools to stop sensory overload in its tracks.
I'd love to know, what are your best tricks to prevent and manage sensory overload in all kinds of social situations? Get more tried-and-tested tips for living a good life with chronic illness in your inbox, by signing up for your weekly health sessions today.

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How to Deal with Sensory Overload: 19 Coping Strategies | The Health Sessions

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Have you ever felt like your head was going to explode from loud noises and bright lights piercing through your brain? Do big crowds and parties with music blaring overwhelm you? When your brain receives more input from your five senses than it can process and organize, you may experience sensory overload.

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Today is world mental health day and one of Wiltshire's hospitals has challenged its staff to a very modern way of learning and understanding the affects of mental illness.

The Great Western Hospital is using virtual reality to show its staff how someone suffering from Autism could experience sensory overload so they can understand and support patients better.

Those on the autistic spectrum have a higher probability of experiencing mental health issues although 1 in 4 adults will experience mental health issues of some kind in their life.

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What's it like to experience sensory overload?

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Today is world mental health day and one of Wiltshire's hospitals has challenged its staff to a very modern way of learning and understanding the affects of mental illness. The Great Western Hospital is using virtual reality to show its staff how someone suffering from Autism could experience sensory overload so they can understand and support patients better.

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Sensory activities for kids with autism are important to help regulate the sensory system. Sensory activities for autism include fine motor and gross motor activities.They are also fun and can promote increase learning, communication and interaction. Read about the 21 benefits of sensory play for autism in this post. For the best autism activities for parents, teachers and therapists, get my autism activities workbook bundle.

Best Sensory Activities for Autism

You may notice that your child has multiple food sensitivites, refuses to wear certain types of clothing, avoids getting his or her hands dirty or general hyperactivity and irritability. All of these symptoms can be caused by sensory dysfunction.

If you are looking for a comprehensive overview of sensory processing disorder, as well as specific and effective strategies to help you deal with it in your home or classroom, I highly recommend you take a look at Sensory 101 the most complete resource I know of to help you deal with these challenges.

At my center, I include a lot of sensory activities in the children's programs because they tend to be very motivational for the kids and give us the opportunity to work on so many skills : communication, interaction, following steps, independent activities and more, depending on the organization of the activity.

These are 30 of my favorite sensory activities for kids with autism :

(We have included affiliate links for your convenience. You can read our disclosures here.)

1. Spring Chicks Sensory Box.

2. Gardening with Kids with Autism.

3. Fish Bowl Playdough Mat.

4. DIY Light Table & Light Table Projects.

5. 3 Fun Water Activities.

6. Seashell Crafts and Activities.

7. Teaching Scents Game.

8. Dried Beans and Other Everyday Therapy Tools.

9. Silly Playdough Monsters.

10. Creative and Fun Play with Straws.

11. Sensory Box Ideas.

12. Building a Nest Playdough Play.

13. Playdough Stamping.

14. Bow Tie Pasta Crafts.

15. Flower Power Springtime Crafts for Kids.

16. DIY Plantable Felt Gardens.

17. Food Stamping Paint Play.

18. Dinosaur Sensory Boxes.

19. Frozen Legos.

20. Water Table Sensory Play Ideas.

21. Fake Snow Sensory Play.

22. Zoo Playdough Mats.

23. Printable Sensory Communication Workbook.

24. Colorful Tulips Playdough Mat.

25. DIY Fidgets.

26. Colorful Socks Playdough Mat.

27. Train Sponge Painting Activity for Kids with Autism.

28. DIY Gluten-Free Playdough.

29. Bow Tie Pasta Crafts.

30. Monet Inspired Sensory Play.

Enjoy these sensory activities for kids with autism!

If you are looking for a comprehensive sensory resource to better understand your child's sensory-seeking behaviors and how to help your child, I highly recommend the Sensory 101 Guide.

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30 Sensory Activities for Kids with Autism - Special Learning House

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Sensory activities for kids with autism are important to help regulate the sensory system. Sensory activities for autism include fine motor and gross motor activities.They are also fun and can promote increase learning, communication and interaction. Read about the 21 benefits of sensory play for autism in this post.

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Understand best practice in managing sensory needs of autistic individuals

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May 7, 2008 Alternately tethered to a potty seat or tied up in a sleeping bag in a mesh-sided crib under a metal cover, Genie had contact only with her abusive father during nearly 12 years of confinement.

After her emergence from that torture in 1970, the waiflike child became a cause celebre among researchers and do-gooders who wanted both to learn from her and save her. For doctors, her case is like that of the three children recently released from years of isolation in an Austrian cellar.

The world read with revulsion last week the details of Austrian Josef Fritzl's 24-year imprisonment and abuse of his daughter and three of the seven children he fathered with her.

The twists of Genie's life since her release -- a succession of breakthroughs, setbacks and manipulations at the hands of caregivers, researchers and foster homes -- offer some perspective on the path ahead for the severely stunted Austrian children, who communicate mostly in simple grunts and gestures, much like Genie did after her rescue.

During the four years she was under the intense care of specialists at Children's Hospital at UCLA, Genie progressed, but only briefly.

Though she eventually learned to speak, the team of credentialed doctors with millions of dollars in federal funding could not rescue Genie from a fate of abuse and exploitation.

Doctors argued over her care and affections. Finger-pointing, hateful allegations and a lawsuit followed. Even storytellers and filmmakers took sides, and ultimately, Genie regressed.

Today Genie is 51. She is again in psychological confinement as a ward of the state -- her sixth foster home. And again, she is speechless.

"We fumbled the ball," James Kent, a consulting psychologist for the Victims of Crime program in California and Genie's psychologist told ABCNEWS.com. "We had the opportunity to allow more of her potential. It was as much out of ignorance as disagreements."

Brutal Conditions, Stunted

Genie's story began 20 months after her birth in 1957. Believing she was mentally retarded, Clark Wiley locked his daughter away, separating her from her nearly blind mother and 6-year-old brother, under the guise of protecting her.

Wiley spoon-fed her only Pablum and milk, and spoke to her mostly in barks and growls. He beat her with a wooden paddle every time she uttered a sound.

In 1970, Genie's 50-year-old mother, Irene, escaped with Genie, then 13. Her brother, John, then 18, was left behind, and told ABCNEWS.com that he, too, had been abused at the hands of his father -- a man who was raised by a "bar girl" in a bordello and didn't "pamper or baby."

Mother and child turned up at welfare offices in Los Angeles, seeking financial support. Caseworkers noticed the odd child, who spat and clawed and moved in a jerky "bunny walk," with her hands held out front.

The Wileys were charged with child abuse, but the day they were to appear in court, Clark Wiley shot himself to death after reportedly leaving a note that read: "The world will never understand."

John Wiley, now 56 and a housepainter in Ohio, admitted he had often been in the room where Genie was tortured. "Whether I liked what I seen or not, it wasn't like I was in a position to tell my mom. I was a captive audience and could do nothing about it."

Ward of the State

When she entered Children's Hospital at the age of 14 -- still in diapers -- Genie was the size of an 8-year-old with the language and motor skills of a baby, speaking only a few words -- including "stopit" and "nomore."

Her discovery coincided with the premiere of Francois Truffaut's film "The Wild Child," about an 18th century French "wolf boy" and the doctor who adopted and tried to civilize him.

Riveted during a private showing of the film, the staff assigned to Genie's care applied for a grant from the National Institute of Mental Health to study Genie's rehabilitation.

The hottest academic issue of the day was the 1967 Lenneberg theory that maintained that children cannot learn language after puberty. In some ways, Genie disproved this, but she had passed the "critical period" and was never able to master grammatical structure.

From 1971 to 1975, a multidisciplinary team used Genie as a case study -- "Developmental Consequence of Extreme Social Isolation" -- under the direction of Dr. David Rigler.

The team was mesmerized by her charisma and curiosity. Susie Curtiss, just out of graduate school in theoretical linguistics, was a member of the team and worked with Genie on language acquisition.

"I was a very young woman given the chance of a lifetime," Curtiss, now a professor of linguistics at UCLA, told ABCNEWS.com.

"She wasn't socialized, and her behavior was distasteful, but she just captivated us with her beauty," said Curtiss, who took the child on daily outings.

Because of the Genie study, doctors now know that grammatical development needs linguistic stimulation. When children are isolated from language, a window closes and they lose the ability to speak in sentences.

'We Fell in Love With Each Other'

"I spent most of my time being a human being, relating to her and we fell in love with each other," Curtiss said. "I wasn't old enough to be her mother, so I was able to be somewhere between a sibling and a parent. Genie was just amazing."

Curtiss described Genie as "highly communicative," despite the fact that she spoke fewer than 20 words at the onset. She often made her needs known by gesturing or other means, and she loved being stroked and hugged, and learned to hug back, according to Curtiss. When she was upset, at first she had a "tearless cry," but eventually she "showed emotion very clearly."

In her textbook, "Genie: A Psycholinguistic Study of a Modern-Day Child," Curtiss described how Genie eventually could use limited language to describe her father's cruelty: "Father Hit Arm. Big Wood. Genie Cry."

Believing that a loving home would help Genie's development, some of the specialists became her foster parents. At first psychologist James Kent became a father figure. He had argued unsuccessfully that Genie should not be separated from her mother, the one emotional attachment in the child's life.

Soon, Jean Butler, Genie's nursery school teacher while in the UCLA study, took the child under her wing. But Butler, who has since died, became obsessed with making a name for herself, Curtiss said in a 1994 documentary called "The Secret of the Wild Child."

According to Curtiss, Butler told colleagues she wanted to be the next Annie Sullivan -- the so-called "miracle worker" who taught language to the blind and deaf Helen Keller.

Soon, team members were divided into combative camps, accusing one another of exploitation. Butler criticized the team members for overtesting the child and other infractions. Rigler eventually asked Butler to leave, according to Kent. "She was an odd person," he said.

Research Head Became Foster Parent

In 1971, Rigler and his wife, Marilyn, became Genie's legal foster parents. She learned sign language and continued to progress. But by 1975, NIMH officials -- citing poor organization and lack of results -- refused to renew the study grant. The Riglers, who had received compensation as foster parents, then ended their care.

ABC News was unable to find current contact information for Rigler, who is now 87 and reportedly in failing health. But in a 1994 NOVA documentary, the Riglers said they assumed the foster care arrangement was "temporary."

Genie was sent to foster care homes for special needs children, including one that was particularly religious. She immediately regressed.

She was readmitted to Children's Hospital in 1977 for two weeks and was able to describe in sign language how her foster parents had punished her for vomiting. After that incident, Genie never regained her speech.

Again, she was thrown into foster care, some of it abusive, according to Curtiss and UCLA's archival data on her case.

When Genie turned 18 in 1975, just after the study ended, Irene Wiley convinced the court to drop the abuse charges against her, claiming she had also been a victim, and Wiley took custody of Genie for a very short time. According to reports in the Los Angeles Times, Wiley worked as a "domestic servant" and quickly found she could not tend to Genie's needs.

In 1978, after cataract surgery, Wiley again petitioned for custody and obtained legal guardianship of her daughter, but by then Genie had been placed in an adult care home. No one has released the name of the facility, and the private foundation that supports her care would not give out the information.

Mother Sues Team

In 1979, Wiley filed a lawsuit against the hospital and her daughter's individual caregivers, alleging they used Genie for "prestige and profit."

The suit was settled in 1984, but the rancor deepened. Curtiss, who had continued to work with Genie on a volunteer basis, was banned from visiting her. Meanwhile, the Riglers reconnected with Irene Wiley.

"I was banned from seeing her and was prevented from explaining to her why," said Curtiss. "Genie had so many losses, and here she was losing the one person who had remained in her life ever since I met her."

Authors, Filmmakers Contradict

Those who tried to tell Genie's story were also divided. Russ Rymer, author of the 1993 book "Genie: An Abused Child's Flight From Silence," worked closely with Genie's mother and Rigler for his book. He was later lambasted by Curtiss and Kent after a review of his book appeared in The New York Times.

"I am still scarred by the tragedy," Rymer told ABCNEWS.com.

Harry Bromley-Davenport's 2001 film, "Mockingbird Don't Sing," told a self-described "sentimental" story from Curtiss' point of view. He told ABCNEWS.com that Rymer's work was "highly inaccurate" and "self-serving."

"The tremendous rift complicated my reporting," Rymer said. "That was also part of the breakdown that turned her treatment into such a tragedy."

Bromley-Davenport said he spent two years researching the case, including 40 hours of interviews with Curtiss.

"Susie is the only absolute angel in this whole horrifying saga," Bromley-Davenport said. "She is an extraordinary person.

"The greatest tragedy was Genie being abandoned after all the attention," he said. "She disappointed the scientists, and they all folded their tent and left when the money went away -- all except Susie."

What Has Become of Genie Today, none of the people who spoke openly to ABCNEWS.com know what happened to Genie.

"I have spent the last 20 years looking for her," said Curtiss. "I can get as far as the social worker in charge of her case, but I can't get any farther."

But one person who has researched Genie's life told ABCNEWS.com that he had located her through a private detective about eight years ago. That person, who wishes to remain anonymous, said that at that time, around the year 2000, Genie was living in a privately run facility for six to eight mentally underdeveloped adults.

"I got ahold of the accounts of her expenditures -- things like a bathing suit, a towel, a hula hoop or a Walkman," he said. "It was a little pathetic. But she was happy."

Kelly Weedon, a 23-year-old student at the University of Greenwich in Britain, has spent eight months researching the case for her English dissertation. She is flying to Los Angeles in June to view the special collections at UCLA, where Genie's story is encased in 37 feet of boxes that hold medical records, videotapes and legal files, as well as Genie's artwork.

Weedon is studying to be a special education teacher and has forged relationships with most of the players in Genie's drama.

"I truly believe that all the doctors who worked with Genie did the best they possibly could," Weedon told ABCNEWS.com. "But it was charged with emotion. In the end, they were crucified for it. But they would have been crucified, whatever they did."

In her meticulous research, Weedon learned Genie's real name and, "without too much more investigation" could find her -- but has decided against it.

"It wouldn't be fair," she said. "It would be too invasive, and she isn't the same little girl when the stories were written about her. I wouldn't do it -- for her sake and her memory."

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Wild child 'genie': A tortured life | 6abc Philadelphia | 6abc.com

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May 7, 2008 Alternately tethered to a potty seat or tied up in a sleeping bag in a mesh-sided crib under a metal cover, Genie had contact only with her abusive father during nearly 12 years of confinement.

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Understand best practice when interacting with autistic individuals

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Technology to support social communication and interaction

Technology can be particularly helpful for autistic people who have difficulties with their social communication and interaction. Used for this purpose, it is referred to as Augmentative and Alternative Communication (AAC).

AAC covers a wide range of strategies, some do not involve technology such as gesture and signing, but many do including symbols, word boards, communication boards and books, as well as communication aids. The purpose in using them is to enhance communication, not to replace or inhibit existing skills. There is no evidence that using AAC negatively impacts speech and language development.

Using visuals to support understanding

Many AAC strategies are visual and relatively static. Spoken language, on the other hand is auditory and always transitory by nature. Some people process information better when they are looking at pictures or written words to help them visualise spoken information (for more about this see below - Technology to support visual thinking).

Visual supports for communication often take the form of picture symbol sets used through pointing by those in the environment to supplement their speech. As well as supporting understanding, this also provides a model to the individual on how they can use symbols to get a message across. This teaching technique is often referred to as Aided Language Stimulation.

Autistic learners can benefit from the use of symbols in their environment and within their AAC system, whether printed (low tech) or electronic (high tech).

There is a range of picture symbol sets and software for printing visuals, including:

Boardmaker using Picture Communication Symbols (PCS)

Matrix Maker Plus which uses Widgit symbols, SymbolStix and Inclusive Technology symbols

Low Tech AAC systems

It is important to consider the use of Low Tech AAC systems, these include:

Pen and paper to write messages or draw

Alphabet and word boards

Communication charts or books with pictures, photos and symbols.

Some low-tech systems have been designed primarily for use by autistic learners, these include:

Picture Exchange Communication System (PECS) - designed to teach autistic learners the basic concept of communication. At its core, is the shaping and developing of communication activity, encouraging the individual to give a symbol to another person. That person giving the desired object in return

Pragmatic Organisation Dynamic Display (PODD) - an approach which involves giving individuals access to a large vocabulary of words in a symbol communication book, based on the way that we use language socially and taught through modelling. It is also available in some communication devices and apps.

Assessment for using AAC

Assessment of skills for using AAC is essential when matching a person's communication needs to the technology available. A speech and language therapist can usually carry this out, which would include information on the individual's:

Language skills - understanding of the meaning of words, and how they can be combined into phrases to form meaning and understanding how symbols or written words in their AAC system can be used to expressive language themselves

Autistic learners may not pay attention, take spoken language literally and have limited/no speech. Technology can support them to develop their understanding and use of language and provide them with a for speech output system

Operational skills - this is the development of the technical skills needed to operate the technology, such as switching on, navigating pages, using different access options and involves sensory/perceptual and cognitive demands. For autistic learners this may be are area of strength, as many are particularly interested in and have the sensory and physical skills to use the technology

Social skills - this is the understanding of the social roles in communicating and how we connect with other people, such as when to speak and use language for different social functions, including making requests, relaying information, giving opinions.

Strategic skills - this is about making the best use of what communication skills you have, in different situation and with different people. It involves knowing when to use different communication strategies (in combination) such as gestures, signs, vocalisations, aids to communicate effectively.

Some autistic learners have limited social skills. They may want to interact with others, but lack the skills and means to do so, or they may be inherently uninterested in communicating. They can learn how to interact with others if they are taught the skills and a communication method(s).
Learn about making communication goals and monitoring outcomes through the CODES Framework.

Supporting Autistic Learners with their AAC System

Essential Environmental Factors

For autistic learners to develop effective communication, they require appropriate support from others in their environment. In order for the individual to practice and develop their AAC system they must have communication opportunities, such as making choices, expressing opinions and shared reading and good communication partners to facilitate interactions.

Free communication symbols

To access free symbol resources which have been created and organised around Curriculum for Excellence and to explore further information on symbols which support inclusive education and communication go to CALL Scotland's website.

Examples of High Tech AAC Systems

These are devices that speak and/or produce text, ranging from simple buttons or basic pages that speak when touched, to full communication systems. Some are based on mainstream equipment such as mobile devices, tablets and laptops, others use specially designed equipment. Most require selection and download of AAC apps or software.

There are many communication apps for learners with complex communication support needs. CALL Scotland have a collection of tried and tested apps on their website AAC App Wheels. These include picture exchange apps for people with ASC:

Grace (iPad/Android)

SPEAKall! (iPad/Android)

So Much 2 Say (iPad) - SymbolStix symbols

Pictures Can Talk (iPad) - Mulberry symbols

PECS IV+ (iPad) - PECS images

CALL Scotland have created 2 posters which highlight a range of communication apps - some of which are freely available.

Click here to download the CALL Scotland AAC Android APP Wheel poster

Click here to download the CALL Scotland AAC IPad APP Wheel poster

Further professional learning information on AAC is available in the Professional Development section of this Toolkit.

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Technology can be particularly helpful for autistic people who have difficulties with their social communication and interaction. Used for this purpose, it is referred to as Augmentative and Alternative Communication (AAC). AAC covers a wide range of strategies, some do not involve technology such as gesture and signing, but many do including symbols, word boards, communication boards and books, as well as communication aids.

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The quirks in Ramsey Brewer's conversation are subtle. The 17-year-old repeats himself from time to time and makes small mistakes in the words he uses. For instance, he says he and his best friend look scaringly, not scarily, similar. He also pauses at odd spots, and for a beat or two longer than most people do. When he's talking, he makes eye contact briefly but then slides his eyes sideways - or closes them. And his comments swerve in unexpected directions: Asked where he goes to school, he says Boston Latin Academy, but then suddenly adds, "I'm not actually from this state," even though he and his family have lived in Massachusetts for years.

Ramsey knows he regularly misreads other people, but he leaves it to his mother, Kathryn Brewer, to explain how. Once, she says, when she had just climbed some stairs and was short of breath, he thought she had been about to cry. During a visit to the dentist, when Ramsey put on the safety sunglasses, the dental hygienist joked with him: "Hey, you can really pull those off." Taking her comment literally, he pulled the glasses off his face.

These slight miscues mean that it only takes a few minutes of being in Ramsey's company to guess that he has autism. Yet he falls within normal ranges on standardized tests of language and cognition and gets high grades at his prestigious mainstream school. It's that combination of challenges and capabilities that brought him to Ruth Grossman's Facial Affective and Communicative Expressions (FACE) lab at Emerson College in downtown Boston. There, Ramsey is participating in a series of studies investigating how social communication goes wrong for adolescents like him.

And go wrong it does. Many of the teenagers with autism whom Grossman works with experience what she calls "conversational breakdowns." In 2014, Grossman showed 87 people videotapes of 9 children with a mild form of autism and 10 without, each speaking a few sentences. The observers didn't know anything about the children, but it only took one second of tape - video or audio alone, or together - for them to realize there was something different about the children on the spectrum. The results, which have since been validated several times over, inspired Grossman's subsequent work and her passion for this line of inquiry. "Clearly there is something going on, something very salient and very subtle at the same time," she says, with an intense energy appropriate for someone who is studying expressiveness. "It happens all the time, and it leads to a reduced willingness of people to engage with people with autism."

The big question is just what, exactly, those communication quirks are. Ever since Leo Kanner and Hans Asperger first identified autism, language problems have been part of the diagnostic criteria in some form. But historically, those criteria bifurcated people on the spectrum into those with or without severe language deficits, and didn't consider less obvious problems. The current iteration of the "Diagnostic and Statistical Manual of Mental Disorders," the DSM-5, dropped language problems as a diagnostic requirement, subsuming them under difficulties with social interaction. That change recognized the reality that anything social involves communication, but scientists are just beginning to explore the fine-grained aspects of how people with autism communicate.

Part of the delay in the field has been due to the condition's heterogeneity. "We've always known that individuals with autism have a different manner of speaking, but it's been very hard to characterize it because there's so much variability," says Joshua Diehl, chief strategy officer for autism services at the Logan Center, a nonprofit service provider in South Bend, Indiana.

To cut through that variability, researchers such as Grossman are turning to acoustic analyses of minute changes in the pitch and duration of utterances from people with autism, as well as motion-capture technology to measure detailed facial movements. These techniques enable them to assess the relevance of different components of communication, from someone's facial expressions to their tone of voice or the actual words they use. The focus is on how people with autism express themselves, not just what they perceive when listening to or watching others. The shift brings a new level of scientific rigor to this branch of research, with the goal of raising awareness and finding targets for therapies. "I'm trying to quantify awkward," says Grossman, who started her career as a speech pathologist. "This is about small aspects of language use that are falling apart even though everything else is looking good."

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Where communication breaks down for people with autism

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The quirks in Ramsey Brewer's conversation are subtle. The 17-year-old repeats himself from time to time and makes small mistakes in the words he uses. For instance, he says he and his best friend look scaringly, not scarily, similar. He also pauses at odd spots, and for a beat or two longer than most people do.

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Your Internet Explorer 11 browser is not supported by this site. Please upgrade to a recent browser for the best experience.

Advice, quick tips, and visual tools to support autistic people with communication.

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Advice, quick tips, and visual tools to support autistic people with communication.

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Although the effects of autism and Asperger's syndrome on a child's communication vary greatly, there are basic communication strategies parents can use to help their child.

Keep language simple, specific and concrete

We are usually unaware of the complexity of the language we use. While children can normally make enough sense out of complex sentences, a child with autism may have little understanding of "Come on, Tom. We don't live in a tent! You have to always close doors behind you, okay?" Tom would have a much better chance of understanding "Tom, shut the door".

While this style of communication appears to lack politeness, your child will have a greater chance of understanding and your respect can be indicated by your body language and tone of voice.

Language also needs to be specific. "Tom, you shouldn't be so rude to people" will be harder to understand than "Tom, don't tell people they are fat". Another common problem is giving instructions in the form of questions. "When are you going to tidy up your room?" can be very ambiguous compared to "Clean up your room" although the former may sound more polite.

Concrete language refers to making the meaning of a sentence very plain - the words simply mean what they say. Much of our language involves sub meanings such as sarcasm, irony or 'reading between the lines' and children with autism or Asperger's consistently have trouble with anything other than a literal meaning of the words spoken. Examples of difficult phrases to understand would be:

* Great work, I'm sure that girl really enjoyed you pushing her into the mud!"

* "I wonder if people might think it's unusual if you wear just your underpants in public".

allow time for your child to respond

It may appear as though a child has not understood a question or statement, but often it just takes time to process the incoming information, up to 45 seconds in some cases. It can be frustrating and feel very abnormal, but giving your child time to respond will help them learn communication skills faster.

Repeating the question every few seconds to force a response, or constant talking, can lead to challenging behaviors as the child becomes frustrated by being overwhelmed with verbal information.

establish eye contact

A common feature of autism and Asperger's is a lack of eye contact. It is important to encourage proper eye contact. Other people are more likely to interact with your child, and it is the first step to your child learning to 'read' the facial expressions of others or follow your line of sight if you are indicating an object by looking at it.

This may involve a simple statement: "Tom, look at me", or it may also involve stepping into the child's line of vision or a gesture with the hands to indicate the child should be looking at you during conversation. An important point here is to be at your child's level. While it is often tempting to stand when talking to your child, getting down to their level increases the chance of eye contact and bonding.

keep the volume and tone of your speech moderate

While a loud angry tone of voice can be a useful part of discipline with challenging behaviors, it usually only worsens the situation for a child with Autism or Asperger's. There is frequently a heightened sensitivity to loud sounds and high pitched noises, so angry voices will often lead to challenging behaviors. There are many alternative ways to manage behaviors that don't involve raised voices. See the Behavior & life skills page for more information on behavior management.

use your child's interests to build motivation

Autism and Asperger's syndrome often result in a restricted range of interests, whether it be telephones, leaves or running water. Although a parent will not want to encourage an obsessive interest, these do provide a basis for building communication skills. Ask questions and encourage your child to talk about the things they like. As communication skills develop, you can encourage your child to talk about other things and widen their range of interests.

avoid negative words that act as triggers

Words such as 'not now', 'no' and 'stop' can act as triggers for challenging behavior in autistic children. When this happens, it is necessary to find positive statements that redirect the child's behavior. An example is a child who is playing with her toys instead of getting ready for school. Instead of saying 'No, Sarah. Stop playing with your toys', a redirection focuses on 'Let's put your clothes on for school'.

While redirection sounds very easy, it can be very difficult to focus on a positive statement when getting frustrated with your child's lack of attention or inappropriate behavior.

break instructions or long sentences into steps

A key to helping a child learn complex skills is to break them into understandable pieces. The same principle works with communication. Take the following sentence:

"Today we'll have a swim at the beach after seeing grandad for morning tea and getting some fruit at the supermarket".

A children with Asperger's syndrome or autism will have trouble understanding this mass of information, and in what order it will happen. This would be better explained in order, one-by-one, and giving the child time to digest the information in each case .Techniques such as social stories or visual cues (photos or story boards) can also be a great help.

See the Communication skills page for more information.
Click here to read the fact sheet on helping your child to make friends.

Click here for the full range of autism and Asperger's fact sheets at www.autism-help.org
This autism fact sheet is licensed under the GNU Free Documentation.

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Autism, PDD-NOS & Asperger's fact sheets | Basic strategies for better communication in children with Autism or Asperger's

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Although the effects of autism and Asperger's syndrome on a child's communication vary greatly, there are basic communication strategies parents can use to help their child. We are usually unaware of the complexity of the language we use. While children can normally make enough sense out of complex sentences, a child with autism may have little understanding of "Come on, Tom.

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How can an IMCA help me?

An IMCA should help you:

When an NHS body wants to provide serious medical treatment to you.

When there are plans to give you long-term accommodation in hospital (more than 28 days) or in a care home (more than 8 weeks). However, if the arrangements are urgent, the NHS body does not have to appoint an IMCA.

In some cases, if the professionals apply for a standard or urgent authorisation to deprive you of your liberty under the deprivation of liberty safeguards. You have the right to help from an independent mental capacity advocate with challenging an authorisation even if you have a relevant person's representative helping and supporting you to do this. Both you and your relevant person's representative would be entitled to get help and support from an independent mental capacity advocate.

Your IMCA can:

Visit you in a care home, hospital or other place. If they have been appointed to help you, they should be able to speak to you in private, unless you want someone else there to support you.
Help collect relevant information about the decision that needs to be made about you - for example your health records.

Consult with health professionals providing your care and treatment, if you agree. If appropriate, they can consult other people who may be able to comment on your wishes, feelings, beliefs and values, if you are unable to comment yourself at the time.

Support you so that you can make decisions for yourself. This includes support like:

identifying your wishes, feelings, beliefs and values, or what these would be if you had the capacity to make the decision

telling you what your options are

if your decision is about medical treatment, they can suggest whether it would be useful to get another medical opinion about the treatment

making sure that the best interests checklist has been followed, the least restrictive options for your care and treatment have been considered, and that the Mental Capacity Act Code of Practice has been followed

writing a short report with their findings, giving their opinion on how the decision should be made in your best interests.

Help you complain. If the independent mental capacity advocate believes that their opinion has not been taken into account by the health professionals, or if there is a disagreement between the professionals about what is in your best interests, they can:

make a complaint to the NHS body (the hospital or trust) or the local authority, or

take the matter to the Court of Protection for a decision.

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An IMCA should help you: When an NHS body wants to provide serious medical treatment to you. When there are plans to give you long-term accommodation in hospital (more than 28 days) or in a care home (more than 8 weeks). However, if the arrangements are urgent, the NHS body does not have to appoint an IMCA.

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Social Care Institute for Excellence (SCIE)

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Running through recent government publications about autism, and mirrored in our research, is the view that social care staff, among others, do not know enough about autism to identify when someone may have it, or to properly support someone who does. The 'Think autism' guidance sets out to ensure that better understanding and awareness is put in place for social care services.[ 20]

As long as they realise that in a way it's like teaching someone who's blind to see, or someone who's deaf to hear. There has to be real understanding that our brains are differently designed so we really can't spot body language fast enough, etc.
(Autistic adult)[33]

If there is one thing people with ASD want and need, it is greater awareness. We want people to understand us and to accept us as we are. We do not want cures or medical interventions, just understanding.
(Autistic adult)[13]

Training content

Many people need to understand autism better: employers, benefits workers, people in the criminal justice system, housing officers and health professionals. People with autism also need social care to work better for them, so it is vital that staff become more knowledgeable about what autism is, and the needs of people who have it.

Training should:

cover how to recognise autism and its diversity, and how to make reasonable adjustments to accommodate people with autism

be delivered efficiently - e.g. sharing training between organisations, or including autism in general equalities training

be delivered in detail for those conducting assessments, those working directly with people with autism, and the managers of these people [16, 19, 20]

alter behaviour and practice among key professionals - it isn't enough to attend training but then carry on as before

be ongoing, as thinking about autism continue to develop

include input from people with autism and their families [4, 21]

cover awareness-raising about Asperger syndrome and high-functioning autism - the lack of support offered to people with autism of these types means that staff may have less awareness and experience.[11, 13]

Training delivery

Local areas should set out plans for how key staff will be trained. Training must be available to personal assistants and others working in micro-commissioned support services. Commissioners should insist that good autism training is built into the services they purchase, and regularly updated. One aspect of awareness-raising is that of 'mutual misunderstanding'. [ 13] People without autism can lack understanding of the condition which can make communication hard, but people with autism can find the language and customs of the neurotypical world perplexing and anxiety-provoking, to the extent that they give up trying to access services. While some people with autism have called for training in how to understand the neurotypical world,[ 34] for there to be a meeting of minds, it is up to those who do not have impaired social communication to make more adjustments.[ 11]

Making these adjustments, and spreading awareness about autism, is vital in ensuring that people are directed to the right sources of support.

Guides for families and professionals supporting adults with autsim and adults with learning disabilities during the coronavirus (COVID-19) crisis.

A new two-day open access course. Providing participants with an introduction to understanding the Autism Spectrum and strategies which can help ensure appropriate methods of communication and support.

View more: Training courses

Get SCIELine ebulletin & access all resources. Free MySCIE account

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Running through recent government publications about autism, and mirrored in our research, is the view that social care staff, among others, do not know enough about autism to identify when someone may have it, or to properly support someone who does.

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03 March 2016

In the first of three posts about person-centred thinking and autism, Vicky reflects on how person-centred approaches can support young people with an autistic spectrum condition (ASC) to make important decisions that reflect what really matters to them.

Over the last few months, I've been working with Ambitious About Autism as a partner on their ' Succeeding at College ' programme. In particular, we have been working together to explore how person-centred approaches can support positive transitions from college education to adulthood.

Work to support this transition is crucial. Research by the National Autistic Society showed that only 15 per cent of adults with ASC were in full-time paid employment ( Reid, 2007, p.6). However, the NAS' own employment service, Prospects, which provided work preparation, job finding and employment support for individuals with ASC, and assistance with recruitment, training and the retention of staff with ASC for employers, was able to secure employment for 67 per cent of its clients. The numbers speak for themselves, and at Helen Sanderson Associates we're sure that more can be done to support the transition from college into adulthood for young people with an autistic spectrum condition.

When planning for this transition, a one-size-fits-all approach for young people with autism simply doesn't work. This is mirrored by the move from the term 'having autism' to 'being on the autistic spectrum'. People exist at all points along that spectrum, and as a result, their needs are different. In addition to that, every individual will have their own personality, interests, likes, and dislikes. Given this infinite combination of needs and personalities, there are an equally large range of life choices to navigate through.

To take all this into account, we need to build a way of understanding what really matters to the person into their post-college transition. Only through doing this can we support them to make decisions that truly reflect who they are and what is best for them.

Of course, the same is true for all young people in education, which is why we think person-centred thinking can benefit everyone. That said, young people with autism will often need more support to make decisions at this important junction in their lives, because of the points of difference that they are likely to experience as a result of the condition. These are:

Communication and interaction: differences in understanding and using communication and language, with skills ranging from individuals who are highly articulate to others who may be non-verbal.

Social understanding: differences in understanding social behaviour and the feelings of others, which informs the development of friendships and relationships.

Interests and information processing: differences in how information is processed can lead to a strict adherence to routines and rules and/or difficulties in planning and personal memory.

Sensory processing: differences in the way sensory information is processed, often resulting in over and/or under sensitivities, can lead to extreme levels of stress and anxiety, particularly in unfamiliar or over stimulating environments.

The degree that these factors impact on a person's life varies for each individual, but they need to be fully understood so that we can help the person plan for a future that works for them. They can impact on everything from the way a person learns, to the type of job that might suit them or where, how and what their home life might look like.

Person-centred thinking works in such a way that it doesn't look at a person as a set of symptoms or a clinical condition to be treated. Instead it's simply a way of structuring conversations so that people can explore the best way forward, using a solid understanding of who they are as the foundation for any decisions.

I'm hopeful for a future where the use of person-centred thinking tools will be embedded into the further education process for all young people, so we can make sure that we're taking an individual's points of difference into account when helping them to plan for their future. Only by doing so can we make sure that we're really helping them to live the life they want.
As part of the 'Succeeding at College' programme, HSA and Ambitious About Autism have developed an e-learning package to support professionals in colleges to help young people with ASCs to plan for the future. Visit hsalonlinelearning.org for more information or to buy.

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Why we need person-centred thinking when supporting young people with autism to transition to adulthood - Helen Sanderson Associates

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03 March 2016 In the first of three posts about person-centred thinking and autism, Vicky reflects on how person-centred approaches can support young people with an autistic spectrum condition (ASC) to make important decisions that reflect what really matters to them.

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Understand best practice in providing support to autistic individuals

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The quirks in Ramsey Brewer's conversation are subtle. The 17-year-old repeats himself from time to time and makes small mistakes in the words he uses. For instance, he says he and his best friend look scaringly, not scarily, similar. He also pauses at odd spots, and for a beat or two longer than most people do. When he's talking, he makes eye contact briefly but then slides his eyes sideways - or closes them. And his comments swerve in unexpected directions: Asked where he goes to school, he says Boston Latin Academy, but then suddenly adds, "I'm not actually from this state," even though he and his family have lived in Massachusetts for years.

Ramsey knows he regularly misreads other people, but he leaves it to his mother, Kathryn Brewer, to explain how. Once, she says, when she had just climbed some stairs and was short of breath, he thought she had been about to cry. During a visit to the dentist, when Ramsey put on the safety sunglasses, the dental hygienist joked with him: "Hey, you can really pull those off." Taking her comment literally, he pulled the glasses off his face.

These slight miscues mean that it only takes a few minutes of being in Ramsey's company to guess that he has autism. Yet he falls within normal ranges on standardized tests of language and cognition and gets high grades at his prestigious mainstream school. It's that combination of challenges and capabilities that brought him to Ruth Grossman's Facial Affective and Communicative Expressions (FACE) lab at Emerson College in downtown Boston. There, Ramsey is participating in a series of studies investigating how social communication goes wrong for adolescents like him.

And go wrong it does. Many of the teenagers with autism whom Grossman works with experience what she calls "conversational breakdowns." In 2014, Grossman showed 87 people videotapes of 9 children with a mild form of autism and 10 without, each speaking a few sentences. The observers didn't know anything about the children, but it only took one second of tape - video or audio alone, or together - for them to realize there was something different about the children on the spectrum. The results, which have since been validated several times over, inspired Grossman's subsequent work and her passion for this line of inquiry. "Clearly there is something going on, something very salient and very subtle at the same time," she says, with an intense energy appropriate for someone who is studying expressiveness. "It happens all the time, and it leads to a reduced willingness of people to engage with people with autism."

The big question is just what, exactly, those communication quirks are. Ever since Leo Kanner and Hans Asperger first identified autism, language problems have been part of the diagnostic criteria in some form. But historically, those criteria bifurcated people on the spectrum into those with or without severe language deficits, and didn't consider less obvious problems. The current iteration of the "Diagnostic and Statistical Manual of Mental Disorders," the DSM-5, dropped language problems as a diagnostic requirement, subsuming them under difficulties with social interaction. That change recognized the reality that anything social involves communication, but scientists are just beginning to explore the fine-grained aspects of how people with autism communicate.

Part of the delay in the field has been due to the condition's heterogeneity. "We've always known that individuals with autism have a different manner of speaking, but it's been very hard to characterize it because there's so much variability," says Joshua Diehl, chief strategy officer for autism services at the Logan Center, a nonprofit service provider in South Bend, Indiana.

To cut through that variability, researchers such as Grossman are turning to acoustic analyses of minute changes in the pitch and duration of utterances from people with autism, as well as motion-capture technology to measure detailed facial movements. These techniques enable them to assess the relevance of different components of communication, from someone's facial expressions to their tone of voice or the actual words they use. The focus is on how people with autism express themselves, not just what they perceive when listening to or watching others. The shift brings a new level of scientific rigor to this branch of research, with the goal of raising awareness and finding targets for therapies. "I'm trying to quantify awkward," says Grossman, who started her career as a speech pathologist. "This is about small aspects of language use that are falling apart even though everything else is looking good."

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Where communication breaks down for people with autism

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The quirks in Ramsey Brewer's conversation are subtle. The 17-year-old repeats himself from time to time and makes small mistakes in the words he uses. For instance, he says he and his best friend look scaringly, not scarily, similar. He also pauses at odd spots, and for a beat or two longer than most people do.

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Every place is becoming louder, busier, crowded and visually stimulating. Even adults like us, we may feel overwhelmed with all the noises, too bright lights, we may feel suffocated being in a crowded place. So, children with sensory processing issues can't keep up with our society. No wonder children experience sensory overload more than usual. What causes sensory overload varies with each child so observing is important.

What Causes Sensory Overload?

Look out for signs of sensory overload in your child. If you caught early the possible cause of a sensory meltdown then you can prevent it from happening.

Some of the things that can trigger sensory overload
Visual (sight): Auditory (sound):

Many people talking at once

Music

Background noise such as fans, air conditioners, birds chirping, or traffic sounds

Loud noises such as alarms, sirens, screaming

Sound of the vacuum cleaner and lawn mower

Olfactory (smell):

Strong food smells

New smells

Cleaning agents

Candles, air fresheners

Scents such as perfume, cologne, scented lotions, or scented hair products

Gustatory (taste):

New Flavors

Strong tastes like spices

Flavors disliked

Tactile (touch):

New textures

Clothing (new material or seams or tags)

Being touched

Taking bath

Touching an unusual or new object, person, or animal

Rain or snow or wind

Vestibular and Proprioception:

Movement such as the motion of a vehicle, rocking of a boat, swinging

Being bumped in a crowd

Spinning

Having a heavy coat on or being confined in a car seat

Change in air pressure

Jumping

Interoception:

Hunger or being too full

Thirst

Change in temperature such as rainy, sunny, humid, hot and cold

Needing to go to the bathroom

Tips to Prevent Sensory Overload

1. If your child is prone to sensory overload, schedule your outings during the days that you know that there will be a lesser crowd. Avoid being in a place with a lot of people. Also, you might want not to go with your child to get groceries if they are overly sensitive.

2. We, as parents want to expose our child to various things such as swimming lessons, karate class. art class and other sports that will benefit our child. But for a sensory child, too many activities can lead to anxiety. They need a lot of breaks so you might want to schedule wisely to avoid a sensory meltdown.

3. Be aware of the environment and what causes sensory overload so you can avoid it in the future. If your child is sensitive to sounds then have your child wear noise-canceling headphones in places that are loud.

4. Talk to your child's school to remove unnecessary visual, auditory, and other distractions from classrooms and hallways. Since there are already lots of overwhelming things in school and minimizing it would be best.

5. A lot of children and adults are sensitive to strong scents. Therefore, don't wear perfume, lotions or hair products if your child is sensitive to them.

6. Explain to your child the schedule for the day. Have a predictable schedule when going outside. Also, ensure your child is hydrated, have a good amount of sleep, and well-fed.

7. Avoid rushing your child it will stress them and it can lead to a meltdown. So you need to be flexible with your schedule if you are going out with your child.

8. Provide sensory breaks throughout the day.

9. Teach your child calming breathing techniques and have them practice them daily.

10. Go to a place with less simulation when they are feeling overwhelmed with their surroundings.

Tips to Prevent Sensory overload

As awareness grows about the struggle our children face with outings more and more attractions and museums are becoming sensory-friendly. Look for Sensory Days in your local community and let me know what you find.

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Hi, I'm Maggie and I wanted to welcome you to the family! I work daily towards improving the lives of children who are going through their sensory journey by creating a positive community of families who support each other. I'm a homeschooling mom of three amazing children, two of whom are twice-exceptional: gifted and on the autism spectrum. I currently serve as Chairman of the Center for Autism and Related Disabilities Constituency Board at USF. My volunteer work also includes serving the Hispanic community as one of the hosts of the weekly, "La Hora de Cafecito", or The Coffee Hour, which is a spanish language program that serves Hispanic families looking for autism support and resources. I have a passion for spreading the love of learning to children and advocating for their needs. I obtained my M.A. and taught elementary school for a number of years moving from kindergarten teacher to elementary gifted specialist with a love for working with students who are uniquely abled.

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Every place is becoming louder, busier, crowded and visually stimulating. Even adults like us, we may feel overwhelmed with all the noises, too bright lights, we may feel suffocated being in a crowded place. So, children with sensory processing issues can't keep up with our society.

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Autism/Apergers has an affect on all of our senses. For most of us we are hyper (over) sensitive to information received by our senses, although some of us with autism/Aspergers are hypo-sensitive. I am very hypersensitive to light and bright colours. This type of sensory overload has the greatest impact on my life.
Sight Overload
With my high functioning autism (Asperger's) sight overload causes tiredness, fatigue, headaches and confusion. All of which trigger feelings such as unhappiness, pain or being irritable.

Tiredness and fatigue occur the most often with sight overload. It can be caused by things such as:

Too much sunlight

Artificial lights (such as lamps and ceiling lights) that shine too brightly, or directly into my eyes.

Bright colours like red and yellow (especially big blocks of colours such as a painted wall).

Reflected sunlight or artificial light

Computer monitors

Mobile phone screens (especially when using in the dark so the bright light is contrasted with the dark background)

The television

Reading in the wrong type of light (either too bright so the light reflects off the page into my eyes, or too dark so my eyes strain to read the words).

Even though I was diagnosed with high functioning autism as recently as a few years ago, I have know about my sensitivity to light my whole adulthood.

As an adolescent I had headaches most days. I used to have really painful eye strain (that I could only stop if I put a patch over the affected eye, when I was indoors, to prevent light entering it) and by taking painkillers such as ibuprofen and paracetamol. Sight overload really affected my everyday life. As it affected me so much I spent many hours researching how to reduce it. From this, and life experience, I found many ways of reducing sight overload so I have far fewer headaches. But even today there are still times when I cannot prevent or reduce it, and I have the headaches and eye strain as a consequence.

There are a number of measures that I found for reduces visual overload. Some of these are very obvious but I will list them anyway.
Stopping bright light entering my eyes
Probably in relation to my autism/Aspergers I constantly check weather forecasts. If it is sunny outside, or sun has been forecast, I will always wear a cap or sunglasses. This greatly reduces the amount of strong light from the sun entering my eyes.

If the sun is low, such as a morning or evening, I will always choose to wear sunglasses, but most of the time I will wear a cap outdoors. I have, in the past, worn a cap and sunglasses together but it looks too odd so I don't do this anymore.

When I am driving I wear sunglasses nearly all the time (except on the dullest of days or night times of course). I have had the odd negative comment in the past, but I brush this aside.

In the house I always use side lights or lamps where possible. In addition to this I use low wattage (lower brightness) bulbs in all the light fittings. If my wife turns on a ceiling light I will instantly shield my eyes as I know it could give me an instant headache. I have also worn caps indoors occasionally if I need a bright light on (for tasks such as ironing or writing).

If I am using a computer, phone, TV or reading a book I always make sure a side light is on. This ensures there is no darkness around the light source. As TV images constantly change from dark to light, our eye and pupils keep adjusting which is a big cause of eyestrain.

I also make sure no light is reflecting off the screen, such as my laptop. If it is I will either close the curtains or move into another location. If light is reflected from another source, such as on a glass table or a window I will either move or cover the reflected light (The last time this happened I was visiting my dad and the sun was reflecting off his glass table into my eyes. I put a cap on the table to stop this).

The key is, to always try your best to stop too much light entering your eyes. There are times when I cannot help light entering my eyes. The last time I remember this happening was when I was in a classroom. I was sat in the only available space where sunlight was coming through the window that kept catching my eye. I would normally close or lower a blind (at the expense of making other people slightly uncomfortable in the darker lighting) but on this occasion the window did not have a blind. I could not leave the room or the place as I was supporting a student that needed me so I had to just wait it out. I had a three day headache after, but it could not be helped.
Avoiding bright colours
It is strange that these bright colours do not really exist in nature unless it is to warn you of danger. For example fire, the sun, poisonous plants or snakes. When I go for a walk through the countryside or woodland I only see calm colours such as greens, browns and blues. Unfortunately (of fortunately depending on your view) we live in a world full of these bright unnatural colours. If you walk into a supermarket, for example, almost everything is red, yellow, pink, fluorescent green, fluorescent yellow or bright orange. Probably to alert the shopper to a product. It is the same in toy shops where nearly every product is a brightly coloured plastic toy. Going to this kind of place is torture for me but sometimes necessary.

When I know I am going on a shopping trip like this, sunglasses look a little strange so I now wear a baseball cap. This really helps to reduce the bright lights from above entering my eye and some of the bright colours from the side if I face forwards. I will also avoid the brighter aisles such as where the toys are located if I don't need to go down them. There are still some occasions when the lights are very bright, and the displays are all white, so I decide to leave the shop. I often think to myself just how autistic unfriendly many of the shops are.

The one place that I can avoid bright blocks of colours is in my home. Luckily I can decorate in neutral colours that are dull like greys such as egyption cotton and neutral greens. My eldest did want to decorate his own room in red but we agreed to a warm orange which is not too bright for me but colourful enough for him. My place of comfort is my bedroom where I do not have any bright colours.

With all this in mind there are some ways in which visual overload can be reduced, but even with all these measures there are times when I get caught out. The place where I have the least control is work. I cannot control the lighting, wear sunglasses to reduce light entering my eyes, avoid bright colours (although most of it is neutral) and stop too much sunlight entering my eyes. I also have to use computers and watch projected videos with incorrect lighting. All of these things cause me to be tired and fatigued and sometimes cause me to have headaches. Its just one of the many things that makes work more difficult for me, than normal people, but I am still much happier that I am in a job that I can manage rather than being out of work.

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Autistic Sensory Overload - How Bright Lights and Bright Colours Affect Us

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Autism/Apergers has an affect on all of our senses. For most of us we are hyper (over) sensitive to information received by our senses, although some of us with autism/Aspergers are hypo-sensitive. I am very hypersensitive to light and bright colours. This type of sensory overload has the greatest impact on my life.

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The hustle and bustle of modern life can be too much to cope with at times and can cause what is known as sensory overload. Sensory overload can have a huge impact on a person's day to day life, it occurs as a response to too much sensory stimuli at one time, the triggers themselves vary for different people but could be any kind of sensory input, for example; bright lights, strong smells or loud noises. The stimuli may be something that others do not even notice or have no reaction to, but people with sensory overload are unable to process all of the information at one time making the situation intolerable. In this article, we are going to take a look at the signs of sensory overload, common triggers and how to help the situation.

What is Sensory Overload?

When there is more sensory input than your brain and nervous system can process at one time it causes sensory overload. When someone is experiencing this it means they cannot cope with the amount of sensory stimulation at that moment and will often remove themselves from the situation if possible or try to stop the input by covering their eyes/ ears etc. This can happen when there is a lot going on to the point where it is intolerable, confusing and causes anxiety. Sensory overload is something that can affect everyone, the triggers vary from person to person and some people are more sensitive to it than others.

There are associations between sensory overload and a variety of conditions including autism, ADHD, PTSD and sensory processing disorder. This is something we will take a closer look at later.

Sensory Overload in Children

Sensory Overload is often associated with children but adults can suffer from it too. It is more commonly seen in young people as they are still developing and learning how to process different sensory input. A child who is experiencing sensory overload may display very strong reactions and at times, it can be difficult to recognise the reasons for the outbursts. Recognising the signs of sensory overload in your child will help in managing and preventing it from occuring. Discussing ways for your child to explain and deal with the feelings of sensory overload will help them to recognise and cope with the situation too. Some children benefit from working with an occupational therapist, an occupational therapist can help a child (or adult) identify and manage their triggers.

If the sensory overload is occuring frequently it may be a symptom of another condition. If you are concerned or unsure, speak to a doctor who will be able to help with diagnosis, advice and treatment.

Signs of Sensory Overload

Although symptoms vary for different people, these are some of the most common signs of sensory overload:

Irritability

Discomfort

Inability to focus

Urge to shield eyes/ ears/ face from sensory input

Over-excitement

Anxiety, nervousness, stress, or fear

Sudden mood change

Crying

Glazed over look/ falling asleep unexpectedly

High sensitivity to fabrics/ tags/ textures

Conditions Associated with Sensory Overload

As we mentioned, anyone can experience sensory overload. There are also links between it and certain health conditions. The most commonly associated conditions are listed below:

Autism - people with autism experience sensory information differently, this is often linked with hypersensitivity and as a result, sensory overload is more likely to occur.

Attention Deficit Hyperactivity Disorder (ADHD) - as someone with ADHD may not be as aware of the sensory input around them, they may not realise that they are being overwhelmed until it is too late and they are experiencing symptoms of an overload. Sensory information will be battling for the brain's attention which can contribute to sensory overload.

Anxiety and Post Traumatic Stress Disorder - both of these conditions may also increase the likelihood of sensory overload as stress and anticipation can make the sensory input feel more intense and contribute to sensory overload. As people with sensory overload can become anxious about everyday activities it can be mistaken for an anxiety disorder, and vice versa. It is important to find out what the root cause of the issue is as this will help you to more effectively treat the problem.

There are reports of sensory overload being more common for people with conditions relating to sensory processing and nerve impulses too. People with Fibromyalgia, Multiple Sclerosis, Chronic Fatigue Syndrome and Sensory Processing Disorder may also experience sensory overload as a symptom.

Potential Causes & Common Triggers

The triggers will vary from person to person as each individual has different sensory overload experiences. Due to this, there are countless possible triggers and scenarios. However, we have listed some of the more common triggers people experience. This may help you to identify what is causing you or your child's sensory overload, an important step to avoiding or preventing it in the future.

Touch

Scratchy, uncomfortable clothing material

Greasy or strong fragranced skin products

Physical touch - being patted, hugged, poked

People accidentally touching you

Touching unusual things

Sound

Loud work environment

Sound of footsteps when people walk around

Loud music

Several people talking at once

Sound from multiple sources

Hand dryers in public bathrooms

Sirens/ traffic

Smells

Deodorants, skin care products, cleaning products with strong fragrance

Spices

Strong aromas

Candles

Perfumes

Sight

Bright lights

Visual clutter

Crowded places

Strobe lights

Busy/ multicoloured displays

Unfamiliar surroundings

Taste

Textures of certain foods

Feeling of a toothbrush

Spices

Strong/ unpleasant tastes

How to Help

Sensory overload is becoming increasingly common in our fast-paced society but not only that, the causes are also getting harder to avoid. Fortunately, there are things you can do to prevent sensory overload. The quickest way to ease the symptoms is to remove yourself from the situation and give yourself a break from the sensory input, but we know that is not always an option so let's take a look at a few other ways to lessen the symptoms.

Learn the triggers

By identifying the sense triggers you will be able to find ways to lessen their effects or even avoid them. Learning what it is that triggers sensory overload may take time but recognising the similarities in situations can help you to understand the cause. Once you know the triggers you can avoid them, understand your limits and take time out to rest before an event or situation you feel may cause sensory overload.

Prepare for situations that could cause sensory overload

When you know the cause of the overload, you will be able to take steps to prepare and reduce the likelihood of being triggered. Asking to close doors to reduce noise pollution, turning the music or lights down or keeping separate from crowds may help avoid too much sensory input at one time. You may choose to wear dark glasses or noise cancelling headphones to help combat too much sensory information. Having some prepared coping strategies can help reduce anxiety and put you back in control of the situation.

It's not unusual for a combination of factors to trigger symptoms so when you are in a situation that is overwhelming, it may be most effective to remove yourself from the situation altogether in order to reduce the sensory input and give yourself (and your brain) a break.

Keep Well Rested

To help your brain function at its best, try to keep well rested and hydrated. It is also important to give yourself time to recover after experiencing sensory overload. You will probably feel very tired and resting or at least having some time alone will help you to recover.

Treatment of Associated Conditions

If sensory overload is occurring as a symptom of another condition, you may see an improvement by treating the associated condition.

Living With Sensory Overload Summary

There are many things that may trigger sensory overload, particularly in the modern world. For example, a public bathroom with fluorescent lights, automatic hand dryers and cleaning chemicals can be a nightmare for someone who experiences sensory overload. It is important to recognise what it is that triggers the symptoms as this is the best way of moving forward. Once you know what the triggers are it gives control of the situation back to you. You can then find ways that lessen the chances of sensory overload and take steps to prepare for certain situations.

Remember that sensory overload can happen to anyone. Understanding the challenges will help you to deal with them more effectively. If you think your child is experiencing sensory overload, remove them from the situation. Once they are calm, take the time to sit with them and discuss how they are feeling. A doctor or occupational therapist will be able to provide advice and support too.

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Living with Sensory Overload | HomeGuides.co.uk

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The hustle and bustle of modern life can be too much to cope with at times and can cause what is known as sensory overload. Sensory overload can have a huge impact on a person's day to day life, it occurs as a response to too much sensory stimuli at one time, the triggers themselves [...]

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Understand how the physical environment impacts upon an autistic person

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In this section we look at why autistic students are more likely to be bullied, how you can help, and at cyberbullying.

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School should be a place to make new friends, try new things and grow in confidence. But sadly, we know that many autistic children and young people experience bullying during their time in education.

According to a recent survey by Ambitious about Autism's Youth Council, 75% of autistic young people have experienced bullying and only half of young people said they felt safe at school.

What is bullying?

The Anti-Bullying Alliance defines bullying as the repetitive, intentional hurting of one person or group by another person or group, where the relationship involves an imbalance of power. This can either happen face-to-face or online.

Autistic children and young people can often be more vulnerable to bullying because they find it harder to 'read' social situations or demonstrate different behaviours, such as stimming.

They may also find it hard to communicate what's happening to them - all of this can lead to increased anxiety and isolation, or to school refusal.

How to help prevent bullying

Increasing understanding and acceptance of autism within schools and wider society will help to tackle the targeting of autistic young people.

Ambitious about Autism's Youth Patrons have created some top tips for supporting young people in education. These simple changes will make learning environments more accessible and supportive for all.

Our training and consultancy team also offers autism awareness training for teaching professionals.

By law, all state schools must have a behaviour policy in place that sets out the measures they will take to tackle bullying. Parents can request this from the school or it might be available on the school's website.

Further information about anti-bullying support

The Anti-Bullying Alliance has lots of information and support for young people, parents and teaching professionals.

You can listen to a podcast about autism and bullying presented by Ambitious about Autism Youth Patrons.

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School should be a place to make new friends, try new things and grow in confidence. But sadly, we know that many autistic children and young people experience bullying during their time in education. According to a recent survey by Ambitious about Autism's Youth Council, 75% of autistic young people have experienced bullying and only half of young people said they felt safe at school.

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Autism: People face 'daily discrimination' in work

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Tattoo artist Charl Davies says she would not survive in work if she was not her own boss.

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Autism, PDD-NOS & Asperger’s fact sheets | Handling discrimination as parents of children on the autism spectrum

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Information and practical tips for parents on managing discrimination against their autistic child

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If you're a fan of either of two new television shows that debuted in the United States this September "Atypical" on the streaming service Netflix or "The Good Doctor" on ABC - I've got news for you. You're watching an overly positive depiction of autism that doesn't reflect reality for the majority of people on the spectrum.

To the TV-watching public, autism has come to mean the verbal, higher-skilled, savant end of the spectrum, because individuals at that end make for interesting characters.

In "Atypical," the protagonist Sam's autism complicates the typical struggles high school students face, from finding a girlfriend to fitting in with the popular teens. But Sam never seems to spend any time in a special-education classroom, much less at a special school.

In "The Good Doctor," Shaun, the eponymous doctor, struggles with the stress of being a brilliant surgeon; he's a compelling character but a far cry from most nonverbal, intellectually disabled adults with autism who struggle to find any job at all.

And in "The Big Bang Theory," a wildly popular comedy that has been on the air for 10 years, one of the leading characters, Sheldon, is a scientific genius with Asperger syndrome-like tendencies. But unlike many adults with autism, Sheldon lives with his friends and is engaged to be married. His habit of knocking three times on his neighbor Penny's door is seen as cute and endearing; in real life, the stereotypies many adults with autism have are self-injurious and downright dangerous.

These enormous disparities reflect a broader challenge: The word 'autism' is applied so broadly as to be practically meaningless. In the previous version of the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-IV), 'autistic disorder' was defined as a specific cluster of characteristics, including abnormal social interaction and communication, and a restricted repertoire of activity and interests.

The manual included separate diagnoses for Asperger syndrome and pervasive developmental disorder-not otherwise specified - which were typically given to people on the milder end of the spectrum.

But in the current version of the diagnostic manual, the DSM-5, those diagnoses have disappeared. Since 2013, when this version debuted, individuals with a wide range of autism features have all received the diagnosis of 'autism spectrum disorder.'

Lumped together:

These days, someone with autism can have a genius-level intelligence quotient or have intellectual disability and a score far below average. It can include someone who has no language, minimal language or intact language. It can apply to an individual who has self-injurious, aggressive behavior, or someone who has trouble navigating the social scene in the school cafeteria. It can describe a person who graduated from Harvard Law School or an individual who exited high school with a certificate of attendance.

Thanks to years of research, we know that autism encompasses core features that are present in each person who is diagnosed. Every individual with autism has to have impaired social communication skills and restricted or repetitive behaviors to merit a diagnosis. But beyond that, these individuals' abilities are vastly different. Saying someone has autism provides almost no information about the type of treatment they need; this is the opposite of personalized medicine.

The autism community must find new terms to apply to subtypes of the condition so that the diagnosis is meaningful and leads to a specific set of appropriate treatments. Developing more specific language around autism will allow clinicians and others to personalize their approach to care and provide benefits to all people on the spectrum.

The DSM-5 was supposed to do this; it was supposed to provide greater specificity so that an autism diagnosis would point toward potential services. But hardly any clinicians apply the criteria in the way they were intended. For instance, clinicians are supposed to use a table to indicate the level of severity. But almost none do. Instead, everyone is lumped together as having diagnosis 299.0: autism spectrum disorder.

Left behind:

The use of this term is a disservice to individuals on both ends of the spectrum, and to those in the middle. It may, unintentionally, be depriving many people of the attention and supports they need, because on TV, autism doesn't look that bad. On the other end of the spectrum, several self-advocates who have discussed this issue with me recounted how hard it was to access services because they didn't fit the mold of severe autism and "didn't look disabled."

Research has revealed how incredibly heterogeneous autism is; to use a single term to describe it is a contradiction to the knowledge we have gained and a setback for the people we love.

We need to start seeing characters on TV and in movies who reflect the breadth of experiences of people with autism - not just the brilliant surgeon, but the child who bangs his head on the floor so hard and so often that his retina detaches; and not just the high school student who struggles to date, but the one who is so fascinated by the color yellow that he sits home alone watching "SpongeBob SquarePants" all day. Otherwise, people who are highly challenged and struggle every day are at risk of becoming invisible.

Hollywood's blind spot - or maybe it's a blind eye - speaks to our society's aversion to confronting the realities of autism. But in the end, it's not Hollywood's fault that autism is presented unrealistically.

The reality of severe autism can be disturbing. What we see on TV and in movies reflects our own reluctance to deal with the enormous burdens severe autism places on individuals and their families. Still, shining the Hollywood spotlight on the Sams, Shauns and Sheldons leaves our most vulnerable individuals in the shadows.
Alison Singer is president of the Autism Science Foundation.

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Portrayals of autism on television don't showcase full spectrum

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If you're a fan of either of two new television shows that debuted in the United States this September "Atypical" on the streaming service Netflix or "The Good Doctor" on ABC - I've got news for you. You're watching an overly positive depiction of autism that doesn't reflect reality for the majority of people on the spectrum.

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My girlfriend and I love watching Girl Meets World together. It's a bit of nostalgia for us, since we were both avid fans of Boy Meets World when we were younger. I didn't go into the show expecting any discussion of autism, but in the episode "Girl Meets Farkle," I was surprised to find the characters dealing with the possibility that Farkle might be autistic.

Soon after the characters embrace Farkle as he is, autism and all, we're dealt a plot twist: Farkle isn't actually autistic, but Isadora Smackle, his nemesis-turned-love-interest, is. Immediately, I was both pleased and a little disappointed. The point they were trying to make, I think, was that Farkle would be exactly the same person if he were diagnosed with autism, and so is Isadora. I was also thrilled, because growing up, I never saw any female characters with autism on screen outside of the movie Temple Grandin.

Isadora fits the textbook definition of autism perfectly: she detests physical affection, struggles with empathy and emotion, and centers her life around science. And even though I'm not Girl Meets World's primary audience, I was a little disappointed by the depiction of this autistic character. When I was in middle school, like Isadora is, most people didn't believe me if I talked about being autistic, because I'm so emotional and I'm much more interested in fashion than I am in science.

When most people think about autistic women - or autistic characters in general - they typically envision someone exactly like Isadora Smackle. Which makes sense, as there simply aren't enough portrayals of autistic women in the mainstream media. As a result, the few characters that are autistic represent all of us.

I'm thrilled that shows have autistic women on screen, but, even so, I'd love to see a little more diversity in how these autistic women are portrayed. Autistic women aren't always adverse to physical and emotional affection, and many of us focus our autistic special interests (the intense and focused interested in a particular topic, which for most on-screen examples is science or math related) on subjects like literature, fashion, and the arts. I'm an autistic woman, and I've never seen an autistic character like me in the media: Someone who spends most of her time engaged with literature and the arts, who loves emotional conversations, and who is as adept with sarcasm as she is with fashion.

Because while I'm happy that people have a character they can relate to on screen, I'm also disappointed that it's always via the same traits, namely trouble understanding sarcasm coupled with an intense, bordering on obsessive, love of science. The best autistic characters would mirror real people, not a set of diagnostic criteria. They would be as diverse and different as the real life autistic community is.

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I Have Autism, And This Is What You DON'T See on TV

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My girlfriend and I love watching Girl Meets World together. It's a bit of nostalgia for us, since we were both avid fans of Boy Meets World when we were younger. I didn't go into the show expecting any discussion of autism, but in the episode "Girl Meets Farkle," I was surprised to find the characters dealing with the possibility that Farkle might be autistic.

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Understand how society impacts upon an autistic person

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Families with autistic children: support from family and friends

If you have an autistic child or children, your extended family and friends can be key parts of your informal support network.

The best way to build this support network is to help family and friends learn about your child's autism. This is especially important in the early days after diagnosis. Just like you, people in your support network need to understand what autism means for your child and your family.

You can:

acknowledge the feelings of family and friends - they might be having trouble understanding the diagnosis and what it means

give them basic information about autism

let them know how autism affects your child and your child's behaviour - for example, your child sometimes gets overwhelmed and needs quiet time on their own

tell them how best to connect with your child - talk to them about your child's likes and dislikes and the best ways to communicate with your child

organise extended family get-togethers and activities that suit your child's needs and abilities.

Handling the responses of extended family and friends

Extended family and friends will probably respond in various ways to your child's autism diagnosis and behaviour. Some might be ready to support you and your child straight away. Others might take a bit longer to understand how they can help.

Some family and friends might find it hard to support you. Or they might respond in ways that aren't very helpful. If you find yourself in this situation, there are a few things you can do:

Make sure you're ready with some basic information about autism and how it affects your child. Unhelpful reactions usually happen because people aren't sure how to respond, don't understand or feel uncomfortable.

Let your family and friends know which comments and reactions are helpful and supportive and which ones aren't.

Focus more on your relationships with supportive people. This means you'll get the emotional support you need.

Help family and friends see your child's strengths and what your child brings to your life.

Give it time. Generally, things will get better as people understand more about your situation.

To help extended family and friends help you, don't be afraid to let people know what you need. This might be cooking you a meal every now and then, taking you out for coffee, babysitting or just listening when you need to talk.

Grandparents and autistic children: a special relationship

When a child in the family is diagnosed with autism, the effects on grandparents are likely to be similar to those on parents.

Initially some grandparents might be shocked and sad. They might also feel worried for the whole family. For example, they might worry about their grandchild's future, the demands on the child's parents, or the wellbeing of other children in the family. Many grandparents also show great resilience, unconditional love and support for their families.

How grandparents can help
When they're possible, strong relationships with grandparents are good for children's development, just like strong relationships with parents. They give children a sense of belonging and help children build their self-identity.

And when grandparents live close by, they might also be able to help with:

providing social and emotional support - for example, by spending special time with their grandchild

caring for their grandchild sometimes

looking after siblings or household tasks

advocating in the community or being a source of information about autistic children.

Some families might not have the support of grandparents, but they might choose to 'adopt' a special friend, or have people in their lives who take on the role of grandparents.

When grandparents have concerns
Grandparents of an autistic child can sometimes have concerns about their grandchild's autism diagnosis or how they can help.

If your child's grandparents talk to one of your child's health professionals, it could help them understand your child's diagnosis. And going to a therapy session with you could help them learn how to use the same strategies when your child is with them.

If your child's grandparents have worries and concerns, it's great if you can talk them through together. An open, constructive approach can help your whole family have happier, healthier and stronger relationships.

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Extended family and friends: supporting families with autistic children

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If you have an autistic child or children, your extended family and friends can be key parts of your informal support network. The best way to build this support network is to help family and friends learn about your child's autism. This is especially important in the early days after diagnosis.

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Being diagnosed as autistic can be difficult to come to terms with. You may be coping with a condition that you know very little about, and wondering how to get appropriate support.
Alternatively, you may have known that you are autistic for a while and find the diagnosis a relief. Although looking for support with adult life, many autistic people celebrate their neurodiversity and unique strengths and qualities.

Here, we talk about how you can find support after diagnosis.

If you have been diagnosed as having a demand avoidant profile, the  PDA Society have information on  life with PDA.

Getting support

There are various different types of support you might want to explore after getting a diagnosis. You may need to approach professionals and local services for this support.

Autism awareness and understanding is growing but you may still need to explain to others, including professionals, how being autistic affects you and what support you might need.

Community support and housing

You may be able to live independently or need occasional or full-time support to help you with household tasks and to get out and about in your local community.

This support can be accessed through your local social services. You have a right to an assessment of your support requirements if you have an apparent need.

You should contact your local social services (in England and Wales), social work department (in Scotland) or Health and Social Care Trust (in Northern Ireland) to ask for an assessment of your needs.

Benefits

There are different benefits that autistic people can claim.

To find out more read our information about benefits for autistic adults or contact the  citizens advice bureau.

Education

Every university or college has a team dedicated to supporting autistic students. Talk to them about anything you think might help you. This could be things like extra time in an exam, or being able to avoid busy rooms and libraries.

Read more about starting college or university in our transitions information.

Employment

As an autistic person, you have a lot to offer potential employers. However, it can be a struggle to find the right job.

It's unlawful for an employer to discriminate against you because you are autistic.

Read our advice about work, including disclosing your autism diagnosis and tips for interacting and coping at work.

Advocacy

Having an advocate can help you to say what you want, ensure that your rights and interests are understood and that you get the services that you need.

Socialising and making friends

Our organised  group outings and activities are a way of meeting and socialising with other autistic people.

If you find that there is not a National Autistic Society group local to you then you can search our Autism Services Directory for groups arranged by other organisations, charities and autistic people.

You could also post in our community  to ask if anyone attends a group that may be suitable for you or contact.

General information and advice

Here are some ways that you can find general support, information and make contact with other autistic people.

Use our  Autism Services Directory  to look for services in your area, including counsellors

Find out more about what help and support is available

Read  the Spectrum, our magazine written by and for autistic adults. You can also subscribe to it.

Become a member  of our charity to receive our quarterly Your Autism magazine and exclusive discounts on our events and products.

Find out more about:

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Being diagnosed as autistic can be difficult to come to terms with. You may be coping with a condition that you know very little about, and wondering how to get appropriate support. Alternatively, you may have known that you are autistic for a while and find the diagnosis a relief.

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Diagnosing, supporting and caring for adults with autism

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Diagnosing, supporting and caring for adults with autism

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Many autistic children and young people find the change of starting or moving to a new school difficult. If you're the parent or carer of an autistic child, it can be tough to know how to help.

In this guide, we look at how to prepare your child for this change and suggest what you can do to support them. We also look at what their school can do to help support you.

Preparing for change

Here are some strategies that you, the local or education authority and school could use to help your child to prepare for the change.

Plan visits and phased entry

Visit the school at least once with your child before they start. If possible, meet and take photos of any key people who will be involved in their transition. Create a book of photos and information they can refer to, as this can help to relieve anxiety. You might be able to arrange a phased entry into the new school where your child goes for a few hours a day or a few days a week to start.

Use visual supports

Visual supports can help your child to understand what will be happening and reinforce verbal communication. These will need to be used more than once, particularly if the change is going to take place over a prolonged period of time.

When using visual supports it's important to:

use clear language and give your child time to process what is said

make sure that you show outcomes as well as the stages of a process. For example, if you are using a visual support to explain a bus journey to school, make sure you use pictures of the whole process, including arriving at school.

Mark the day of the change on a calendar and encourage your child to count down to that day.

Use social stories

Social stories are short descriptions of a particular situation, event or activity, which includes specific information about what to expect in that situation and why. You could create a social story to help your child know what to expect in their new school.

Prepare in the current setting

Your child's current school could organise individual or group work on preparing for the transition. This could include activities in the curriculum that will help your child with transition.

Communicate with staff

Share information with staff at the new school about your child's needs, likes, dislikes, capabilities, difficulties, and what causes them anxiety. Effective communication between you, your child, the authority, school and any support services, will make a positive difference.

Having a key worker or transition coordinator can help with this and with preparing a transition plan, or including targets and support strategies in an existing statement or education plan.

Managing your child's anxiety

If you are concerned about your child's anxiety regarding the change, make sure you give them the opportunity to ask questions about their concerns and explain why the change will benefit them. You could provide them with a worry toy, book or box where they can write or draw any concerns they have.

Try to set aside some time to try and teach some relaxation techniques. You could also create an anxiety plan or a social story to explain what your child should do if they are anxious.

Find out more about supporting autistic people to prepare for change.

Support during change

When the change is taking place:

keep familiar things close to your child and make sure you communicate clearly with them.

give specific instructions, without using gestures or specific facial expressions. This will help them to process what is being said to them.

Using visual supports create a visual timetable can help your child to understand what's happening. Give them lots of praise for coping with the change and adapting to a new routine.

If your child has already attended an early education setting, such as nursery, their needs may have already been identified early. Ask your child's nursery or other setting to pass information to your child's new school so they can prepare for their admission.

If your child or young person is starting secondary school or changing school, ask the previous school to pass any information about their educational needs to their new school.

Keep in regular contact with staff working with your child to see how they are progressing. If you notice that the school is not dealing with specific behaviours appropriately, or using the means of communication that your child is familiar with, bring this to the attention of the relevant staff and arrange a meeting.

What your child's new school should do

When your child starts school, the school is likely to assess your child's levels of attainment, even though they may already have received information from a previous setting.

If additional support or special educational needs have been identified, staff should:

use information to develop an appropriate curriculum

assess, identify and focus on your child's skills and areas where support will be needed in class

ensure there is ongoing observation and assessment

involve you in developing and implementing a joint learning approach at home and in school.

You can also give staff information on how to deal with any specific behaviours or obsessions. If visual supports such as PECS (Picture Exchange Communication System) have previously been used, then it's important that these are made available to your child.

Some autistic children and young people find it difficult to transfer certain skills into different situations, so putting means of communication in place is important.

They may also have complex sensory issues and become anxious due to different smells, noises and lights in the school environment. To help them cope with this, you can ask school if they are able to take in reassuring and familiar smells. Some people are sensitive to bright lights or noise so sunglasses or earplugs may help them.

Schools are responsible for making reasonable adjustments to help an autistic pupil feel more comfortable.

Read more about reasonable adjustments and disability discrimination in England.

Involving you as the parents or carers

You should always be consulted and kept informed of actions taken to help your child and the outcomes of these actions. The school must tell you when they first start giving extra or different help for your child because they have additional support or special educational needs.

The extra or different help could be:

a changed way of teaching

some help from an extra adult, perhaps in a small group

use of particular equipment, like a computer or a desk with a sloping top.

Remember, you know your child better than anyone, so talk to their school if you have concerns about their education.

Transition support

Schools across England have a legal duty to take positive steps to make sure that pupils with disabilities can participate in all aspects of school life. During transition phases, you may find that you need to advocate for your child.

However, your child or young person's school should never refuse strategies or supports that may help them.

If your child or young person has an education, health and care plan or statement of special educational needs, your local authority has a legal duty to amend the plan or statement by 15 February in the year of transition to include the name of their next school.

Further links and resources

Find out about our free Transition Support Service that offers young autistic people aged 14 years plus and their parents or carers, looking for information and advice on the transition to adulthood. This includes young people preparing to leave school as well as further and higher education.

Read our information on communication, including information about social stories and visual supports.

Read about dealing with change.

Read about anxiety and how to support your child.

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Many autistic children and young people find the change of starting or moving to a new school difficult. If you're the parent or carer of an autistic child, it can be tough to know how to help. In this guide, we look at how to prepare your child for this change and suggest what you can do to support them.

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How autism can affect you and your family

Having an autistic child can put a lot of strain on you and your family.

You might need to spend a lot of time helping your child get the support they need. This can be very stressful and exhausting.

It may be hard to make time for the rest of your family and can affect your relationships with each other.

If you feel you need help, you can get support from lots of places.

Things that can help you and your family

Do

ask friends and family if they can help with day-to-day things or just be there to talk to

get advice from other parents of autistic children or autistic adults - find out where to get support

listen to other parents' stories - the charity healthtalk.org has stories of parents of autistic children, or you can search online for blogs, videos and books

ask your local council for a carer's assessment - you might be able to get extra support and financial benefits

think about doing a course for parents of autistic children - such as the EarlyBird course from the National Autistic Society

Don't

do not feel guilty for taking time for yourself when you can - even just going for a walk on your own can help give you a break

If you have questions about your child or family, you can call the National Autistic Society helpline on 0808 800 4104.

Talking to your child about autism

It's your choice when you want to tell your child about their autism.

Some parents do it straight away, while others wait until their child's a bit older. There's no right or wrong time.

When you tell your child, it may help to:

do it when they're feeling calm or relaxed

talk to them in a place where they feel comfortable, with no distractions

explain they do not have an illness, but they might need extra support to help them with some things

explain they might find some things harder than other people, and some things easier

bring them to a support group to meet other autistic children

The Autism Easyread guide from the National Autistic Society might help you explain autism in a way your child will understand.

Supporting your other children

Some children can find it hard if their brother or sister is autistic.

If you have other children, there are things you can do to help them.

Do

make time for them whenever you can - try to do some activities with just them

talk to them about what's going on and ask if they have any questions or worries

let them have time on their own or with their friends - for example, sleepovers at friends' houses

check the advice from Sibs, a charity for siblings of disabled children

Don't

do not be afraid to involve them in things like meetings with health professionals - it can help them understand what's going on

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Help for parents and families of autistic children

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Having an autistic child can put a lot of strain on you and your family. You might need to spend a lot of time helping your child get the support they need. This can be very stressful and exhausting. It may be hard to make time for the rest of your family and can affect your relationships with each other.

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Understand the impacts of autism on the family of an autistic person

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Sometimes, autistic children and young people demonstrate behaviours of distress at home. Our education experts have shared their strategies to help children overcome these behaviours and support the wellbeing of the whole family.

Give clear expectations

We know that many autistic children and young people thrive off and enjoy routine.

Therefore letting them know what to expect of them next, gives them a sense of certainty. Speaking calmly, give them a particular scenario to help them understand what to expect. For example: "If you complete all of your work sheet, then you can have five minutes on the iPad". Make sure you follow through with a gesture or reward, like playing a game, after the expectation is completed, this shows consistency in what you say and builds trust.

Communicate the expectation to your child in the way that is easiest for them to understand it. For example, using visual examples. It may be helpful to use Makaton or visual stories like our 'now and next' resource.

If your child or young person doesn't want to do as they have been asked, gently remind them that what they expect to happen next will need to wait until they have completed the request. This might be the excitement of moving onto the next activity or contribute to some form of reward. If they complete the request, show gratitude, say thank you and give lots of praise.

Praise positive behaviours

When times are tough, sometimes it can be easy to lose sight of the positive things. Try to identify at least five positive behaviours each day that your child is doing and make sure to recognise them with praise, a smile, a hug, or whatever your young person enjoys.

The more good behaviours are seen and praised, the more it will be encouraged that they happen again.

Think of times that are normally a challenge, for example getting dressed in the morning, going to sleep or dinner time. Rather than focusing on the negatives of these challenges, try to identify at least one positive behaviour your child does, (for example sitting at the dinner table). Give specific praise about this behaviour, for example: "I love how you're sitting." The next day, try to increase this to two positive behaviours, and so on.

Give choices

Giving plenty of choice to children and young people increases their willingness to complete an activity and builds up independence. We know parents juggle a lot, but try to provide lots of opportunities that are enriching and enjoyable for your child.

Asking them to choose the type of activity they want to do and the reward they would like for completing it can decrease behaviours of distress related to task demands.

Give a choice between two activities, for example: "Would you rather do an English work sheet, or help me clean the kitchen first?" When they make an independent choice give them praise, for example: "Nice choice."

Use countdown timers

The concept of time can be very difficult for any child to understand. Using countdown timers can help avoid a child's frustration at having to finish an activity. Timers also promote positive routines and can help your child's self-regulation skills.

Try to avoid your child or young person getting frustrated by having to finish an activity by using countdown timers. They can be used to pre-warn them of when an activity will be finished. This can be helpful in supporting your child to transition from one activity to the next. Using a timer also promotes positive routines and can help your child's self-regulation skills.

Here's an example of using a timer.

Set a pre-determined amount of time, place it in front of the young person and let them know how long they have. For example, 10 minutes for a computer game.

Give them warning about time left on the clock, for example, "you have 10 minutes, five more minutes," and so on.

When the timer goes off, tell them that the time is up. If they do not want to give up the activity right away, prompt them to ask for 'one more minute' and reset the timer for one minute.

Once the timer sounds, it is time for the activity to end and let them know it is time for the next activity.

Give regular brain breaks and movement breaks

Make sure to incorporate plenty of breaks throughout the day for rest or exercise where possible. For example, a break mid-morning, after lunch and mid-afternoon. Research suggests that regular breaks during a day will decrease the likelihood of children and young people trying to escape or ignore task demands.

Organise relaxing activities such as listening to music, doing some colouring, going out to the garden, nature walks or reading a favourite book or something else your child enjoys.

Stop and redirect negative behaviours

Try to stop and redirect negative behaviours that cannot be ignored. Here are some tips if your child is escalating or is starting to increase behaviours of distress.

Calmly reassure them that you can see they are upset, validate how they feel but also that it is not okay to act out, by saying: "Sorry that you are feeling upset or angry, but it is not okay to act that way."

Redirect the behaviour by identifying a calming strategy to help them calm down, for example offer a walk outside, offer space alone, offer to chill out on the sofa.

Once the situation has been diffused and they are calmer, you may try to talk to them. It can be hard to get a point across when they are already upset or angry. Let them know: "I am here for you when you are calm."

Try to get them to take deep breaths.

Although it can it difficult, it is important to try and stay calm. By showing you are calm, you are modelling the behaviour you want to see.

You can also read our condensed list of top tips for families supporting children or young people with anxiety who may show behaviours of distress.

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Ambitious about Autism is the national charity for children and young people with autism. We provide services, raise awareness and understanding, and campaign for change. Through TreeHouse School, The Rise School and Ambitious College we offer specialist education and support.

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"I don't know what we're supposed to look like, but it means women aren't getting the support they need because they don't appear to be as autistic as someone expects them to look."

The words of Mahlia Amatina, who is an autistic abstract artist.

Her pieces celebrate neurodiversity, differences in the human brain, and she runs workshops using shape, line and form to describe how people feel.

The multi-award winning artist is far from the 'Rain Man' stereotype, as she's warm, chatty, and often chuckles, causing her whole face to light up.

'LIFE ON A SPECTRUM': Mahlia became an artist after being diagnosed six years ago.
Credit: www.creativecommercialphotography.co.uk (Catherine Hadler)

Her newest interactive exhibition, 'Life on a Spectrum', incorporates visual art, writing, videography and performance art, all influenced by how people across the world experience 'sensory overload', anxiety and emotional breakdowns.

When Mahlia was diagnosed five years ago, aged 31, she knew little about autism, except from what she'd read in books or seen in films and the media.

She said: "It really isn't a very accurate representation, it's always a guy, someone nerdy who's into trains."

MISDIAGNOSIS: The Read-based artist was diagnosed with Borderline Personality Disorder before realising she was autistic.
Credit: www.creativecommercialphotography.co.uk (Catherine Hadler)

Five years on, she has come to understand why holding down a corporate job was impossible, why it took nine attempts to pass her driving test, and why after attending Indian weddings as a child, it took her days to recover from the social and sensory overload.

She said: "I think back to issues that I may have had as a child, that could have been picked up on.

"Autistic women are often not diagnosed or misdiagnosed, and I feel like there's much more to be understood about ethnic minorities as well."

Whilst early research suggested there was a ratio of up to 16:1 autistic males to females, new studies indicate the numbers could be far more equal.

Dr Sarah Lister Brook, Clinical Director at the National Autistic Society, said: "It's important to point out that every autistic person is different.

"But girls are often better at developing ways to 'mask' what we traditionally think of as the signs of autism, which mean that it's harder to get a diagnosis of autism."

Masking, she explained, means actively learning to behave like non-autistic people, so girls might copy the behaviour of their peers.

But this can be exhausting and lead to incredible levels of stress, meaning many women develop secondary problems such as anxiety, eating disorders or depression.

For 23-year-old Yangdzom Lama, years of 'camouflaging' her behaviours to adapt to social environments suddenly made sense after being diagnosed four years ago.

HAPPY FACE SAD FACE: The picture is an exploration of mental illness and how people have the capacity to hide their feelings and deny their blueness in front of others. Credit: Yangdzom Lama

The west London artist explained: "I feel like I could put a name to my weirdness.

"Through understanding, it's helped me change certain things that I don't like, and work out how I might react to a difficult situation, which would then lead me to have a meltdown."

Yangdzom is pensive and eloquent, a shock of blonde hair against a backdrop of intricate hanging tapestries.

Her abstract work largely features animal-headed humans and deities, influenced both by her close relationship with animals, and by her thangka painter father, who created traditional Tibetin buddhist art.

The Norwich graduate continued: "I definitely feel like it's helped me grow up since the diagnosis, and understand more about my identity and who I am."

Jess Hendrickx, owner of Autism Spectrum Conditions specialists Hendrickx Associates, agreed that her diagnosis helped her own self-identity.

By the time she was diagnosed at 30, Jess had ten-year-old twin sons, her mother Sarah having been diagnosed aged 40.

She said: "Looking back and reflecting is something I've done a lot since I was diagnosed.

"My mother was fantastic, and I don't think my autism has hindered me in any way at being a good parent.

"But I think autistic women and girls are getting missed because the profile for autism is still very male, and these prejudices need to be shaken off."

Clinical psychologist Trevor Powell, an abstract art enthusiast himself, said progress over the past 10 years means female presentations of autism are now starting to be recognised.

He explained: "Many women are relieved because it gives them an explanation for why their life has been difficult.

"There's nothing wrong with them, their brains are just wired in a different way."

Dr Lister Brook added: "A diagnosis can help explain that feeling of difference, which in itself can take away some of that stress, as well as allowing people to find the right support."
Featured image credit: www.CreativeCommerciaPhotography.co.uk (Catherine Hadler)

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The art of masking: autistic women and their experiences of diagnosis

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"I don't know what we're supposed to look like, but it means women aren't getting the support they need because they don't appear to be as autistic as someone expects them to look." The words of Mahlia Amatina, who is an autistic abstract artist.

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Advice on what stimming is, why some autistic people do it and intervening if stimming is unsafe.

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Children who 'mask' or 'camouflage' their Autism

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Children who 'mask' or 'camouflage' their Autism

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Those who haven't experienced the frustration of being misunderstood as the parent of a child with Autism can find it hard to believe that the perfectly behaved little girl (and it is usually little girls) who keeps her head down at school and tries really hard to comply and 'fit in' with the other children can suddenly change when she comes out of school. Many parents report that they have barely got out of the school gates before the 'meltdowns' start. Sometimes there is no apparent reason, at other times she may be able to verbalise that the teacher has been mean or that someone has refused to play with her. For others it may be the realisation that very soon it will be homework time again and once again, they are not sure what they are supposed to do or how to go about it.

I walk into the room and feel like people are looking at me.

Girls in particular can be very good at 'masking' their worries and anxieties. They will smile, laugh and joke with the other children, appear to be getting on with their school work and have lots of friends. However, the strain of trying to keep this up all day can be huge. Grown women who are Autistic have explained to me what it feels like. 'I walk into the room and feel like people are looking at me'. 'I have no idea what to say to people or what they expect from me'. 'Everyone else seems to know what to do'. These are adult women, who have had years to learn how to cope and appear 'normal' (whatever normal is!). Imagine how much harder it must be for an eight, nine or ten year old. Girls' friendships become much more complex at this age. What is said is not always what is meant, girls talk behind each other's backs and make nasty and sarcastic remarks. For a girl on the Autistic spectrum, this is unbelievably difficult to negotiate.

So many parents report not being believed or being accused of poor parenting when in fact they are trying their best for their children. It can be difficult to even get an assessment. Many diagnostic teams are hugely over-stretched and may be forced to rely heavily on reports from schools when reaching a decision to assess a child. So what happens if the child masks and behaves perfectly at school? How can parents persuade professionals that there is a genuine difficulty? Some resort to videoing or recording their children on Smartphones. I can see why this might be tempting and why parents might feel the need in some way to 'prove' that their child has difficulties. However, imagine how it would feel to be this child? She is already trying her best to fit in and probably already knows in her heart of hearts that she is 'different' to the other children. Also whilst a parent is busy recording a 'meltdown', they are not emotionally or physically able to help their child.

The majority are good, caring, exhausted parents who are trying their best ...

What is actually needed is a far better understanding by teachers and health professionals about how Autism presents in girls and the issues of 'masking'. If this was more widespread and professionals were able to move away from the male (or more typical) presentation, parents would not feel this need to prove themselves. On so many occasions it is suggested that rather than the child having difficulties, the problems lie with the parents or the term 'attachment disorder' is put into the mix. Some of the parents I have worked with have even been accused of fabricating their child's problems. In all the years I have been working with children on the Spectrum, I can honestly say I have not come in contact with any parent who has deliberately 'made up' behavioural symptoms. The majority are good, caring, exhausted parents who are trying their best to come up with strategies to help their children. That is not to say that there are not sometimes other explanations for a child's difficulties. Family life is hard, things happen within families, people are stressed, modern-day parenting is not easy. Going right back to the original work which was carried out by Mary Ainsworth looking at attachment, it was noted that only 70% of children have what is referred to as a 'secure attachment'. This means that 30% do not. However, 30% of the population do not have the anxiety and behavioural challenges reported by parents of children on the Spectrum.

Both education and health professionals may need to look again at the research into girls with autism and listen to their stories. They may need to look beyond a superficial sociability and (apparently) good friendships. There is certainly a need to look again at how and whether 'gold standard' assessment tools such as the ADOS (Autism Diagnostic Observation Schedule) work with girls (and boys) who have learned to 'mask' their difficulties. The ADOS was never intended to be a one-off definitive assessment - it should be used in conjunction with other evidence gathered from a variety of sources. The long term risks of not helping these children and young people are significant and real - many will go on to have relationship difficulties, problems holding down a job and significant mental health problems in adulthood. PDA and less obvious forms of Autism are not a new phenomenon - we just need to get better at identifying them early.

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Children who 'mask' or 'camouflage' their Autism

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Those who haven't experienced the frustration of being misunderstood as the parent of a child with Autism can find it hard to believe that the perfectly behaved little girl (and it is usually little girls) who keeps her head down at school and tries really hard to comply and 'fit in' with the other children can suddenly change when she comes out of school.

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Sensory differences - a guide for all audiences

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A general guide to some of the sensory differences autistic people may experience, and strategies to help with this.

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Some of the most common problems autistic individuals experience are their hyper- or hypo-sensitivities to sensory stimuli. Their senses seem to be too acute (hypersensitivity) or not working at all (hyposensitivity).

Hypersensitivity

Hypervision means that their vision is too acute. For example, they notice the tiniest pieces of fluff on the carpet, complain about 'moths (air particles) flying', dislike bright lights, look down most of the time and may be frightened by sharp flashes of light. Under fluorescent lights such children can see a 60-cycle flickering: the whole room pulsates on and off.

Individuals with hyperhearing are generally very light sleepers, are frightened by sudden unpredictable sounds (for instance, telephone ringing, baby crying); they dislike thunderstorm, crowds and are terrified by haircut. They often cover their ears when the noise is painful for them, though others in the same room may be unaware of any disturbing sounds at all. Sometimes hyperauditory children make repetitive noises to block out other disturbing sounds.

Children with olfactory hypersensitivities cannot tolerate how people or objects smell, though their carers can be unaware of any smell at all. They run from smells, move away from people and insist on wearing the same clothes all the time. For some, the smell or taste of any food is too strong, and they reject it no matter how hungry they are. They are usually poor eaters, gag/vomit easily and eat only certain foods.

Some individuals with ASDs are hypertactile. They pull away when people try to hug them, because they fear being touched. Because of their hypertactility, even the slightest touch can send them into a panic attack. Parents often report that washing their child's hair or cutting nails turns into an ordeal demanding several people to complete it. Many individuals refuse to wear certain clothes, as they cannot tolerate the texture on their skin. Some children with hypertactility overreact to heat/cold, avoid wearing shoes, avoid getting 'messy' and dislike food of certain texture.

Children with vestibular hypersensitivity experience difficulty changing directions and walking or crawling on uneven or unstable surfaces. They are poor at sports. They feel disoriented after spinning, jumping or running and often express fear and anxiety of having their feet leave the ground.

Individuals with proprioceptive hypersensitivity hold their bodies in odd positions, and might have difficulty manipulating small objects.

Hyposensitivity

Sometimes the senses of autistic children are in 'hypo', so that they do not really see, hear or feel anything. To stimulate their senses they might wave their hands around or rock forth and back or make strange noises.

Children with hypovision may experience trouble figuring out where objects are, as they see just outlines, then they may walk around objects running their hand around the edges so they can recognise what it is. These individuals are attracted to lights, they may stare at the sun or a bright light bulb. They are fascinated with reflections and bright coloured objects. Having entered an unfamiliar room they have to walk around it touching everything before they settle down. Often they sit for hours moving fingers or objects in front of the eyes.

Children with hypohearing may 'seek sounds' (leaning their ear against electric equipment or enjoying crowds, sirens and so on). They like kitchens and bathrooms - the 'noisiest' places in the house. They often create sounds themselves to stimulate their hearing - banging doors, tapping things, tearing or crumpling paper in the hand, making loud rhythmic sounds.

Individuals with hypotaste/hyposmell chew and smell everything they can get (e.g. grass, play dough). They mouth and licks objects, play with faeces, eat mixed food (for instance, sweet and sour) and regurgitate.

Those with hypotactility seem not to feel pain or temperature. They may not notice a wound caused by a sharp object or they seem unaware of a broken bone. They are prone to self-injuries and may bite their hand or bang their head against the wall, just to feel they are alive. They like pressure, tight clothes, often crawl under heavy objects. They hug tightly and enjoy rough and tumble play.

Children with vestibular hyposensitivity enjoy and seek all sorts of movement and can spin or swing for a long time without being dizzy or nauseated. People with vestibular hyposensitivity often rock forth and back or move in circles while rocking their body.

Those with proprioceptive hyposensitivity have difficulty knowing where their bodies are in space and are often unaware of their own body sensations, for example, they do not feel hunger. Children with hypoproprioceptive system appear floppy, often lean against people, furniture and walls. They bump into objects and people, stumble frequently and have tendency to fall. They have a weak grasp and drop things.

Autistic children are often engaged in stereotyped activities. Very often these self-stimulatory behaviours - such as

Rocking

Spinning

Flapping their hands

Tapping things

Watching things spin

(which are often defined by non-autistic people as 'bizarre/abnormal behaviours'), - can be viewed as involuntary strategies the child has acquired to cope with 'unwelcome (and often painful) stimulation' (in the case of hypersensitivity) or to arouse the nervous system and get sensory stimulation from the outside (in the case of hyposensitivity), and sometimes to provide themselves with internal pleasure. That is why, no matter how irritating and meaningless these behaviours may seem to us, it is unwise to stop them without learning the function they serve and introducing experiences with the same function.

Each of the senses should be assessed, and depending on the sensitivity, we can desensitize the child's capability to tolerate the stimuli and/or to provide the aids to help him/her cope with 'offensive' stimuli (for example, tinted glasses, earplugs). Desensitization is aimed to increase sensory tolerance very gradually through pleasurable activities.

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Sensory Hyper- and Hyposensitivity in Autism - Integrated Treatment Services

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Hypersensitivity Hypervision means that their vision is too acute. For example, they notice the tiniest pieces of fluff on the carpet, complain about 'moths (air particles) flying', dislike bright lights, look down most of the time and may be frightened by sharp flashes of light.

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Understand how autism may affect an individual's behaviour

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Developmental co-ordination disorder (DCD), also known as dyspraxia, is a condition affecting physical co-ordination. It causes a child to perform less well than expected in daily activities for their age, and appear to move clumsily.
This topic is about DCD in children, although the condition often causes continued problems into adulthood.

Find out more about DCD in adults.

Symptoms of DCD

Early developmental milestones of crawling, walking, self-feeding and dressing may be delayed in young children with DCD. Drawing, writing and performance in sports are also usually behind what is expected for their age.

Although signs of the condition are present from an early age, children vary widely in their rate of development. This means a definite diagnosis of DCD does not usually happen until a child with the condition is 5 years old or more.

Find out more about symptoms of DCD in children.

When to seek medical advice

If you're concerned about your child's health or development, talk to a GP or health visitor, or speak to a nurse, doctor or special educational needs co-ordinator (SENCO) at your child's school.

They may refer your child to an occupational therapist, paediatrician, or another health professional who can assess them and try to identify any developmental problems.

Find out more about diagnosing DCD in children.

Causes of DCD

Doing co-ordinated movements is a complex process that involves many different nerves and parts of the brain.

Any problem in this process could potentially lead to difficulties with movement and co-ordination.

It's not usually clear why co-ordination doesn't develop as well as other abilities in children with DCD.

However, a number of risk factors that can increase a child's likelihood of developing DCD have been identified.

These include:

being born prematurely, before the 37th week of pregnancy

being born with a low birth weight

having a family history of DCD, although it is not clear exactly which genes may be involved in the condition

the mother drinking alcohol or taking illegal drugs while pregnant

Treating DCD

There's no cure for DCD, but a number of therapies can help children to manage their problems.

These include:

being taught ways of do activities they find difficult, such as breaking down difficult movements into smaller parts and practicing them regularly

adapting tasks to make them easier, such as using special grips on pens and pencils so they are easier to hold

Although DCD does not affect how intelligent a child is, it can make it more difficult for them to learn and they may need extra help to keep up at school.

Treatment for DCD will be tailored to your child and usually involves a number of different healthcare professionals working together.

Although the physical co-ordination of a child with DCD will remain below average, this may be less of a problem as they get older and develop coping strategies. Some children may continue to have problems.

However, difficulties in school - particularly producing written work - can become much more prominent and require extra help from parents and teachers.

Find out more about treating DCD in children.

Dyspraxia or DCD?

While many people in the UK use the term dyspraxia to refer to the difficulties with movement and co-ordination that first develop in young children, this term is used less often by healthcare professionals.

Instead, most healthcare professionals use the term developmental co-ordination disorder (DCD) to describe the condition.

This term is generally preferred by healthcare professionals because dyspraxia can have several meanings.

For example, dyspraxia can be used to describe movement difficulties that happen later in life because of damage to the brain, such as from a stroke or head injury.

Some healthcare professionals may also use the term specific developmental disorder of motor function (SDDMF) to refer to DCD.

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Developmental co-ordination disorder (dyspraxia) in children

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Read about developmental co-ordination disorder (DCD), also known as dyspraxia, a condition that affects physical co-ordination.

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Proprioceptive Exercise - Physiotherapy - Treatments - Physio.co.uk

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Physio.co.uk’s experienced physiotherapists can prescribe proprioceptive exercises to help stabiise joints, helping to prevent future injuries.

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The proprioceptive system is located in our muscles and joints. It provides us with a sense of body awareness and detects/controls force and pressure. The proprioceptive system also has an important regulatory role in sensory processing as proprioceptive input can assist in controlling responses to sensory stimuli.

Proprioceptive input can be very calming for those who are easily overwhelmed by sensory stimulation.

Proprioceptive input can be alerting for those who need increased sensory stimulation to facilitate attention and learning.

Many students with autism seek proprioceptive input in order to regulate their emotional and behavioural responses to sensory stimulation.

It should be noted, however, that some students may be overresponsive to proprioceptive input and will therefore avoid the activities listed below. It is important to find alternative calming strategies for these students as listed in other sections.

Indicators that a student is seeking proprioceptive input

Bites/chews on objects e.g. sleeve of jumper, pen/pencil

Hyperextends joints e.g. bending back fingers, locking knee joints

Bangs body parts e.g. bangs hands together, bangs jaw with hand

Holds objects with excessive pressure e.g. pencil; writes heavily on page

Enjoys rough and tumble play but can be excessively rough with others

Throws self heavily onto floor

Prefers to run, jump or stamp heavily when he/she should be walking

Likes to sit with knees tucked under himself/herself

Engages in weightbearing activities e.g. swinging on desks, climbing

Walks on tiptoes (NB there are other possible factors for this gait pattern; seeking proprioceptive input is just one factor)

Providing proprioceptive activities can enhance a student's learning in the classroom. These activities will help a student to achieve a calm and alert state which then improves emotional wellbeing and the ability to engage and learn.

Ideas for Proprioceptive Activities

Proprioceptive activities involve providing intensive input to the muscles and joints. Some ideas are provided here but you may wish to develop your own ideas which will suit your students and your classroom routine. Think of activities which will work the muscles and joints:

Weightbearing activities e.g. crawling, push-ups

Resistance activities e.g. pushing/pulling

Heavy lifting e.g. carrying books

Cardiovascular activities e.g.running, jumping on a trampoline

Oral activities e.g. chewing, blowing bubbles

Deep pressure e.g. tight hugs

Consider the following factors when introducing proprioceptive activities:

WHAT is the purpose of the activity?

Are you using the activity to calm an overresponsive child?

Are you using the activity to increase input to an underresponsive or sensory seeking child?

WHEN will the activity take place?

If using the activity to calm an anxious student, try to introduce the activity before he/she becomes anxious and distressed. Identify trigger points for anxiety (e.g. the playground, Music, Assembly) and implement the proprioceptive input before these times. This will then keep him/her calm during these times. Incorporate the activities into the student's timetable or visual schedule.

Some students may be able to recognise when they are becoming stressed and request permission to participate in a calming activity. Use a visual support so the student can request the break without the need for verbal communication.

The activities can also be used to calm a student who becomes suddenly and unexpectedly distressed by sensory input. The teacher should use a visual support to direct the student to an appropriate activity. The activity should be very familiar to the student so that he can perform it easily and independently.

If using the activity to provide increased input in order to alert an underresponsive or sensory seeking student, identify the times when he/she tends to be disengaged or seeking input, and incorporate proprioceptive activities at these times. This will often be before and after sitting to do quiet/independent work.

Some students may be able to recognise when they are losing attention or becoming restless, and can then request a break for proprioceptive activities to re-engage attention.

If the teacher notices students becoming lethargic or restless, direct them to carry out a proprioceptive activity, or carry out activities with the whole class.

HOW OFTEN will the activities take place?

Identify when the overresponsive student is becoming distressed or when the underresponsive/sensory seeking student needs more input, and provide the activities at these times.

The frequency of the activities will depend on the individual sensory needs of the student.

Activities do not need to be lengthy. Short frequent activities are often more beneficial. Some activities can be completed in 30 seconds, while others may last several minutes.

Observe the student and monitor when he/she reaches the calm alert state. This will then guide how long and how often activities need to take place.

WHERE will the activities take place?

Some activities can be completed by students without leaving their seats e.g. hand pushes, chair push ups, squeeze objects

Some activities can be completed in the classroom e.g. wall pushes, star jumps, wiping benches

Some activities may have to take place outside the classroom e.g. stacking chairs, jumping on a trampoline, climbing wallbars

WHAT activities will be used?

CHAIR BASED EXERCISES

CLASSROOM BASED EXERCISES

OTHER EXERCISES

FUNCTIONAL ACTIVITIES

Wiping benches and tables

Brushing/mopping floors

Holding doors open

Carrying piles of books

Carrying a backpack with a heavy item in it

Stacking chairs

Moving furniture

Putting out and tidying away PE equipment

ORAL ACTIVITIES

Blowing bubbles

Blow football i.e. blowing cotton wool along a table to score goals

Drinking through a straw of bottle with a sports cap

Chewing food or appropriate object e.g. chewy tube

Playing a wind instrument

Blowing up a balloon

Drinking a thick liquid through a straw e.g. milkshake, yoghurt, custard

PASSIVE ACTIVITIES

'Hot dog': student is rolled in a blanket and another student or adult pretends to spread on tomato ketchup, mustard etc.

'Sandwich game': student lies on a mat, and another mat is placed on top of him/her

Steamroller: student lies on stomach and an exercise ball is rolled over his/her back

Applying deep pressure to shoulders/arms

Tight hugs

WEIGHTED RESOURCES
Consult with an occupational therapist before using weighted items.

Weighted jacket/vest

Weighted blanket

Weighted lap pad

Weighted belt

Back pack with heavy book (or equivalent)

Beanbags in coat pocket

Weighted animals

Weighted cap

↑ Back to top

Strategies According to Sense

Activities

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The proprioceptive system is located in our muscles and joints. It provides us with a sense of body awareness and detects/controls force and pressure. The proprioceptive system also has an important regulatory role in sensory processing as proprioceptive input can assist in controlling responses to sensory stimuli.

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Have you ever heard someone say that we have 7 senses? You obviously know about sight, sound, smell, taste, and touch. How about proprioception and vestibular senses? These terms were new to me when I first got into this field, but after having worked with kids with autism I can see why they can be considered the 6th and 7th sense. Today's post is all about proprioceptive and vestibular movement activities for the classroom.

A lot of my prior students I worked with tended to have difficulties with sensory processing. One of the first things I noticed with my kids was their issues with body awareness and spatial orientation. It wasn't until I learned about proprioceptive and vestibular senses that I could fully help kids with sensory processing issues. It also helped me give them the sensory input tools they needed to be regulated.

In this post I will tell you all about the proprioceptive and vestibular senses and why they are important in the autism world and ideas for you to help your kids work through proprioceptive and vestibular related issues.

What Does Proprioception and Vestibular Mean?

Proprioception is the sense of body awareness. More specifically, it's the ability to know how your body moves. Without thinking about it you probably know how to move from a standing to a sitting position. Your brain knows how to move your feet up and downstairs. The receptors in our muscles automatically know where our body parts are and how to use them.

Vestibular is a sense of balance and spatial awareness. That is the sense of how your body moves through space. The inner ear and brain work together and controls balance, eye movement, and spatial orientation. With the vestibular sense, I can gauge where I need to put a button through a buttonhole or how wide I need to open the door to get through.

How Does Proprioception and Vestibular Affect Kids With Autism?

As discussed in another post, Sensory Needs In The Classroom-5 Senses CheckList, I talked about how a lot of my students had difficulty with sensory processing. They often had a particular sense that is challenging to regulate.

Integrating proprioceptive and vestibular input is no different. In particular, the difficulties often come out in gross-motor and fine-motor planning.

Kids that have a hard time with proprioception may display behavior such as:

Walking on tip-toes

Bumping or crashing into objects and clumsiness

Movements are quick, sudden or rigid

Weak muscles or poor posture

Unaware of strength or space needed for tasks

Kids that have difficulty with vestibular functions may act in ways such as:

Poor eye-hand or eye-foot coordination

Difficulty following directions

Seem unregulated

Difficulty with balance to walk, sit, or going downstairs

Dislikes swinging, or going upside down

Seeks out stabilizing tools like walls or railings

Unaware of surroundings

Why Proprioceptive and Vestibular Input Is Important

When kids have difficulty with sensory processing proprioceptive and vestibular needs are often overlooked. Many times professionals think a child has a general sensory issue, tries many sensory activities but ends up with poor results. I once had a student that was unresponsive to the sensory activities offered him.

Throughout the day he would spin in circles. I let him sit in a swing but he didn't like it. He often crashed into walls or bumped into desks. I thought he wanted to crash into pillows, but no amount of pillows helped him regulate. He had difficulty focusing on writing activities and following directions. I assumed he needed to burn off energy but a sensory break on the trampoline didn't help him focus or pay attention.

It wasn't until an Occupational Therapist told me about proprioception and vestibular senses that I could see why my efforts weren't working. What I thought was generalized sensory issues turned out to be poor proprioceptive and vestibular planning.

Upon further assessment of my student, I saw he had difficulty with spatial awareness and that's why he spun in circles and didn't like swinging. He had a hard time balancing, that was why he bumped into things. He wasn't looking to crash into objects. My student had low eye-hand coordination and trying to figure out how to hold a pencil distracted him from focusing and following directions.

I took a different approach and focused on activities that helped develop his proprioceptive and vestibular senses and overtime saw much better results in his performance at school.

Proprioceptive and Vestibular Movement Activity Ideas

I have a FREE printable for you summarizing the activity ideas listed below in this post. Simply print and post this in your classroom to ensure you and your staff are all consistent! Grab this freebie in my FREE RESOURCE LIBRARY!

If you have a student that is displaying proprioceptive or vestibular delays here are are some activities you can use in your classroom.

Proprioceptive Movement Activities

Heavy work carrying weighted objects like books, backpack, milk jugs, baskets with objects.

Resistant activities like pushing blocks, pulling a wagon, pressing a pillow or climbing

Deep pressure like weighted blankets, sitting in bungee chair or big pillow

Strength building activities for hands like play-dough or stress balls, wheelbarrow walking or pushups.

All of these activities target the proprioceptive system because they increase awareness of bodies moving through space. Pressure and weight-bearing activities help build awareness. Strength building exercises also help develop fine-motor skills.

Vestibular Movement Activities

Swinging on playground, hammock, in a blanket

Jumping on a trampoline, to music, in an obstacle course on a fitness ball

Rocking in a rocking chair or horse

Picking up objects during a scavenger hunt, playing catch

These activities target the vestibular system because these types of movements engage the inner ear and vestibular system which in turn helps children develop a sense of spatial awareness and increases balance.

You can easily integrate these activities into your classroom as your students need them. As always don't force a child to do something he or she may not be comfortable doing. Try something else if it's not working.

For more tips on how to work these ideas or other sensory activities into the classroom be sure to check out these posts:

Like what you read? Don't forget it, PIN IT!

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Proprioceptive and Vestibular Movement Activities " Autism Adventures

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Have you ever heard someone say that we have 7 senses? You obviously know about sight, sound, smell, taste, and touch. How about proprioception and vestibular senses? These terms were new to me when I first got into this field, but after having worked with kids with autism I can see why they can be considered the 6th and 7th sense.

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Proprioception (body awareness) Proprioception is a sense tells us where our bodies are in relation to other objects and in open spaces, and

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Understand how autism may affect an individual's physical experiences

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Our Community of Change supports Local Authority Children's and Adult Services, Provider Services from both independent and voluntary sectors, Clinical Commissioning Groups, user led organisations, and Housing Providers.

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We are a national charity working for an inclusive society where everyone has the support they need to live a good life and make a valued contribution.

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Parents always face the issue of balancing the degree of risk and independence they allow their child. The presence of an Autism Spectrum Disorder such as autism or Aspergers syndrome complicates this process. One of the important things parents do is to help young people learn to manage and judge risk. As parents, you need to judge what risks are acceptable and make sure your young person has the necessary skills to avoid danger. Parents who encourage independence and allow a manageable element of risk are showing optimism and confidence in their child.

Decisions about risk crop up all the time - your child, maybe, wants to go to the milk bar alone, go to a party where you don't know the parents, cook something on the stove. Ask yourself:

* Does your child have necessary skills?
* Can you trust your child to follow the rules?
* What are the likely risks, including risks to others?
* Are there dangers outside his or her control?
* What would make it safe?

It may be tempting to put physical safety above all else, but saying 'no' too often can have a cost. Kids lose confidence, or rebel, or simply miss out.

Autism Spectrum Disorders and risk

The pitfalls and dilemmas faced by all parents can be magnified when the young person has autism or Aspergers syndrome. The young person may be less capable of anticipating danger, judging risk, or showing self-control. It may be harder to learn the skills needed to be safely independent. These might be physical skills, and/or skills related to behavior, judgment, memory and perception.

Inappropriate behavior can place the young person at risk, or a lack of social skills may lead to bullying at school. At the same time, if you try to protect your young person by restricting them more than others of their age, this can also affect their self-esteem and relationships with other young people.

What protects autistic children from risk?

Research has shown that some of the most important factors that protect young people from getting involved in some of the riskier activities of adolescence are a strong and caring family and school, and a sense of connection to family and school, coupled with personal skills that enable the young person to develop self-esteem and confidence. Other things that help are a stable family structure, open lines of communication, a pro-active approach to solving problems, and having a good relationship with an adult outside the family - someone who believes in the young person.

Managing risk in the context of autism & asperger's

It is always important to equip young people with the skills, knowledge and confidence to say 'no' to things they do not want to do. At the same time, risky activities are a normal part of growing up, and it is imperative to try to minimize any harm that may result.

Where autism or Aspergers syndrome are involved, there are further considerations. For example:
* Can the young person understand and remember instructions?

* Can the young person understand rules or laws and apply general rules to specific situations?
* Are impulsiveness and poor judgment issues?
* What sort of training or instruction does the young person need?

The following strategies may help:
* Set sensible and firm limits based on your family's values and respect for laws and regulations
* Be a good example and role model
* Try to keep the communication lines open within the family

* Listen to what your children have to say

* Respect their point of view (even if you don't agree with it).
Provide a 'safety net' of appropriate supervision

* Be aware of your child's friendships, know where they are at night, be awake when they get home.

Everyday risks with autism & Asperger's syndrome

For young people with Autism or Aspergers, the small steps toward independence that their peers manage easily may require extra training or supervision. If they lack foresight or are impulsive, some activities possibly should be avoided, controlled or prohibited.

Getting around outside the house

Very young children are generally under adult supervision when they walk to shops or cross the road. Sometime during primary school, many children begin to do these things without assistance. Throughout secondary school, young people are generally expected to get themselves to school and other places. With increasing independence, children and young people might, for example, want to walk to local shops alone, ride a bike around the local neighborhood or take public transport to social events as well as to school.

A young person will usually want to do what others their age are allowed to do. However, parents need to decide whether their child with an Autism Spectrum Disorder has, for example:
* The necessary skills for traffic safety
* The ability to remember rules

* The know-how to get where they are going and home again

* Knowledge of what to do if they have problems
* The necessary physical skills and reflexes for a bicycle or roller blades
* The ability to organize what they need to do ie. transport timetables and buying tickets.

If your child does not have the skills needed, then a structured learning program - combined with an appropriate 'safety net' - may help.

Stranger danger and trusting other

Some children and young people on the autism spectrum may be worryingly ready to trust and be friends with anyone and everyone. Rules need to be very specific and structured, about how to behave in particular situations. They need to be practiced over and over, in social situations. A useful strategy here can be the use of Social Circles where social stories can be used to teach children about personal safety.

Other everyday risks for Autistic children

Using household equipment like stoves and knives can by risky unless the sequence of steps is taught appropriately. Again, set very specific rules and practice and rehearse them repeatedly. Where necessary, you may need to put some activities off limits, or install protective devices around, for example, stoves. Talk to an occupational therapist about managing risks of this nature.

Some kids always seem to be looking for something ambitious - and possibly forbidden - to do. Try to step back and ask yourself what you would do for a child who didn't have an Autism Spectrum Disorder. Make sure lines of communication remain open, boost the young person's self-esteem, encourage more positive friendships and provide appropriate supervision - for example, have friends visit your house, rather than letting your child go out with them.

Young people on the autism spectrum and driving

Obtaining a driving licence will not be possible for some young people with autism or Aspergers, but it will be an option for many others. Problems that may affect a young person's ability to drive include:
* Physical weakness and/or poor coordination
* Difficulties in perception
* Difficulty concentrating on multiple things
* Difficulty in understanding maps and directions.

It is crucial that you find out the requirements to be met if someone is applying for a driver's license and has an Autism Spectrum Disorder. It is important to get this done, as it provides you, your child and others with legal protection should an accident occur. Failure to disclose a disability that affects driving may be an offence, and any license or permit obtained by false statement could be rendered null and void. An assessment by an occupational therapist and/or a neuropsychologist is recommended.

See the Family and Carer issues section of the website for more information.

Click here to read about sexual issues and Autism Spectrum Disorders.

Click here for the full range of Asperger's and autism fact sheets at www.autism-help.org
This autism fact sheet is under copyright www.autism-help.org

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Autism, PDD-NOS & Asperger's fact sheets | Balancing risk and independence for a child with Autism or Aspergers syndrome

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Parents always face the issue of balancing the degree of risk and independence they allow their child. The presence of an Autism Spectrum Disorder such as autism or Aspergers syndrome complicates this process. One of the important things parents do is to help young people learn to manage and judge risk.

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By Kate Kelly

At a glance

A sensory diet is a treatment that can help kids with sensory processing issues.

It includes a series of physical activities that are tailored to sensory needs.

An occupational therapist can create a sensory diet.

A sensory diet is a tailored plan of physical activities and accommodations designed to meet a child's sensory needs. This type of treatment has nothing to do with food. The goal is to get kids in a "just right" state.

What does that mean? For kids who tend to get overstimulated, a sensory diet will include activities that help them come down from an overloaded state and feel calm. Kids who feel or seem sluggish will do activities to help them feel more alert.

Having the right sensory input helps kids pay attention in school, learn new skills, and socialize with other kids. But not all kids are able to recognize when they're not in a "just right" state. Using a sensory diet regularly can help kids build that self-awareness.

Usually, an occupational therapist designs a child's sensory diet and uses it during therapy sessions. The more kids practice, the better. So parents and caregivers should use the diet at home, too. Teachers can also do some of the activities in school.

Adults with sensory processing issues may benefit from the types of activities in a sensory diet, too. But typically a sensory diet is a plan used to help kids who are struggling.

Dive deeper

About the author

Reviewed by

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A sensory diet is a treatment that can help kids with sensory processing issues. It includes a series of physical activities that are tailored to sensory needs. An occupational therapist can create a sensory diet. A sensory diet is a tailored plan of physical activities and accommodations designed to meet a child's sensory needs.

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Fussy/Picky Eating: Why Sensory Processing Disorder May be the Reason | Dr Jennifer Cohen

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Kids can be fussy eaters for many reasons. The first step in helping your fussy eater is to understand the reason for their fussy eating.

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Ann & Robert H. Lurie Children's Hospital of Chicago

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These questions matter because children who are chronically flooded with sensations, or are distant from the world around them, need help - whether they have autism or not.

Many of the day-to-day struggles of people with autism have to do with perceptions gone haywire, such as being overcome by sounds, or feeling a revulsion toward certain foods. This home truth may often go unnoticed and unaddressed by clinicians, but it has a powerful impact on family life.

Some parents of children with autism are big fans of sensory integration and similar therapies. They say the interventions help soothe the most disruptive problems of everyday life. Jennifer, the mother of a teenage boy with autism and fragile X syndrome, a related condition, says the occupational therapy her son began around age 3 was transformative. He was nonverbal at the time, and thanks to this therapy, she finally understood that her son's senses were wired in a way to make some things soothing and others bothersome to him. "We realized that's why he likes his hands rubbed so much, and his arms squeezed," says Jennifer. (She asked that her last name be withheld to protect her son's privacy.) It helped her grasp why her son demanded tight pajamas, and would only wear one particular pair of shoes. "It started making sense to us," she says - and made it easier for her to meet his needs.

Until a few years ago, the evidence supporting sensory integration therapy for children with autism or other conditions was relatively thin. And some practices of therapies that focus on sensation, such as working with playdough, hanging upside-down, or brushing a child's skin to desensitize him to touch, can seem unscientific or even downright bizarre. The approach is also difficult to study because it tends to be ad-hoc. Clinicians "come up with treatment plans that are highly individualized, and that's another challenge for really rigorous scientific study," says Cascio. "It becomes really difficult figuring out what the relevant outcomes are, how are you going to measure them, how you measure improvement." And in the past, the field was generally more focused on therapeutic practice than on creating standardized interventions.

Some families of children who lack an official diagnostic label struggle to get any help at all. "There are a lot of people who suffer from this kind of difficulty, and they're not able to access services or get the kinds of accommodations they need in schools, or early intervention, without the diagnostic label," says Baranek.

Lori Craven is homeschooling her son Jack because she says it was too difficult to get the public school system to accommodate him. Because Jack doesn't have hearing loss, he wasn't eligible for an assistive technology that amplifies his teacher's voice to help him focus. Because he doesn't have vision impairments, the school balked at providing enlarged, simple-looking versions of worksheets, or even allowing Lori to prepare them. "I just realized I was spending so much time fighting the school - I was trying to do it for them, and it was too much to ask," Lori says.

Savvy parents of children with SPD often seek out an additional diagnosis such as anxiety or ADHD - or embrace one when it is offered. Linda says that in the end, it was her daughter's anxiety label that helped the family arrange an individualized education plan for her daughter. The anxiety diagnosis "seemed to be the language that the school understood best," she says.

This fancy footwork around labels and diagnoses may become a thing of the past as researchers pursue the ultimate goal: figuring out which treatments for sensory problems are effective. They hypothesize that the right treatments will work whether a child has autism, anxiety, ADHD or no diagnosis at all, as long as the underlying problem, such as being too sensitive to touch, is the same. "You're trying to establish what the commonalities are," Baranek says. "And looking to see if those interventions actually help in similar ways despite the different diagnoses."

That means tailoring the treatment to the child rather than to the diagnosis. "I think [occupational] therapists do this on the fly," says Alison Lane, associate professor of occupational therapy at the University of Newcastle in Australia. "But we don't have a systematic way of saying, 'This child with this particular pattern of behavior and sensory features will respond best to this type of approach.'"

Lane and others have begun defining sensory subtypes within the autism spectrum, in an effort to more systematically match symptoms to treatment. She plans to use this framework to guide therapy in a pilot study later this year.

A precisely defined procedure for choosing sensory therapies in autism will also help make studies in this area more rigorous, says Schaaf, the Philadelphia-based occupational therapist and neuroscientist who led the development of such an approach. She is using it to test whether sensory therapy or a more standard autism treatment is better at boosting the ability of people with autism to integrate auditory and visual information.

A small pilot study of this approach found that sensory therapy in children with autism improves not only their perceptual difficulties but also their social skills. "That was unexpected," says Schaaf. "We didn't hypothesize that at all." In their follow-up, the researchers are collaborating with Molholm's team to track the children's sensory integration abilities through electroencephalography to observe brain activity, as well as monitoring how they are doing in daily life. The study, slated to run for five years and involve 200 children, began enrolling participants in February.

Researchers are also applying neurobiology findings to treatment studies of SPD. Marco is collaborating with the SPD Foundation on a pilot study to scan the brains of children with SPD before and after occupational therapy, in order to determine whether the intervention improves brain connectivity.

In the meantime, Ari Young has come up with his own way of managing his highly attuned brain, on top of the therapies he gets for autism. He often wears headphones at school to block out distracting or distressing noises, but he has noticed that most other kids don't wear them. "I used to feel like wearing headphones would just kind of pin me out of the rest of the group, make me look like I was not paying attention," he says. They also make it more difficult for him to hear what his teacher is saying.

So Ari has been conducting a sort of informal sensory therapy, challenging himself to briefly take his headphones off during events such as school assemblies and performances. "Sometimes there are quiet moments at loud concerts, when ... I decide to peek open the headphones a little bit," he says. "And then when the next loud part comes, I snap them back on as fast as I can."

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Talking sense: What sensory processing disorder says about autism

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These questions matter because children who are chronically flooded with sensations, or are distant from the world around them, need help - whether they have autism or not. Many of the day-to-day struggles of people with autism have to do with perceptions gone haywire, such as being overcome by sounds, or feeling a revulsion toward certain foods.

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Time perception problems may explain autism symptoms

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Time perception problems may explain autism symptoms

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Individuals with autism have trouble perceiving the passage of time, and pairing sights and sounds that happen simultaneously, according to two new studies.

These timing deficits could underlie some of the cognitive impairments that characterize the disorder, the researchers say.For example, communication problems could stem from tiny delays in the perception of speech, or from imprecise pairing of spoken words and gestures.

"If a baby's sense of time [and order of events] and how long to wait before responding is disrupted in any way, that's going to interfere with the smooth dialogue that goes on between babies and their caregivers," notes lead investigator Dermot Bowler, professor of psychology at City University London in the U.K. "This is certainly what you see in children with autism."

Anecdotal reports suggest that individuals with autism have trouble gauging how much time has passed, and parsing the order of events. Timing relies on working memory, multitasking and planning, all of which are impaired in individuals with autism.

Only a handful of empirical studies have investigated these timing errors in a rigorous manner, however. Some have found no evidence for timing impairments in people with autism, whereas others have found significant deficits,.

In the May issue of the Journal of Autism and Developmental Disorders,Bowler and colleagues report that adults with autism fail to accurately gauge the duration of sounds.

The researchers tested 20 high-functioning adults with autism and 20 healthy controls. Participants first heard one of seven tones, varying in length from 0.5 seconds to 4.1 seconds. They then heard a second tone and were asked to click a button when they thought it matched the length of the first.

Compared with controls, individuals with autism are less accurate at assessing the length of the tone, the study found. They also tend to overestimate short tones and underestimate long tones, and their responses vary across a broader range compared with those of the control group.

One possible interpretation of these results is that individuals with autism construct a rolling average of all the time intervals they've experienced across trials. A bias toward the average time interval could indicate impairments in memory, says lead investigator Jonathan Martin, clinical psychologist at the University of Birmingham in the U.K.

The researchers plan to repeat the experiments using tones that last up to 14 seconds. Increasingly poor performance with longer time durations would suggest a memory-based problem, whereas difficulties that are consistent with shorter-interval trials would indicate that the problems are timing-based, he says.

Flashes and beeps:

In addition to problems in judging the passage of time, children with autism tend to show abnormal responses to sight and sound synchrony.

For instance, a study published last year in Nature found that children with autism are drawn to movements and sounds that are perfectly synchronized, such as a pat-a-cake game.

In June, researchers reported that children with autism are more likely than those without the disorder to perceive asynchronous events - such as the sight of a bouncing ball followed by the sound of it - as if they are happening simultaneously.

In the study, Mark Wallace and colleagues at Vanderbilt University in Nashville investigated the 'binding window,' the period in which visual and auditory events occur closely enough that the brain attributes them to the same event.

The researchers gave 29 children with autism and 17 healthy controls a test called the 'flash-beep illusion.' Participants saw a flash accompanied by two beeps and were asked to report the number of flashes they perceived. Typically, this pairing results in the illusion of two flashes.

Both groups reported seeing two flashes. But healthy controls lose the illusion when the beeps are separated by 300 milliseconds, whereas children with autism see it until the delay reaches approximately 600 milliseconds. This suggests that children with autism have a wider window of time in which they bind sights and sounds.

An enlarged binding window is analogous to the effect of a poorly dubbed movie in which a person's lip movements are not in sync with speech sounds.

"You can imagine why the world would be so over-stimulating and confusing if you didn't integrate things as precisely as other people do," says Lorraine Bahrick, professor of psychology at Florida International University, who was not involved with the study. This could help explain why some people with autism are overly sensitive to sensory stimuli, such as loud sounds or being touched, which could in turn lead to abnormal social interactions, she says.

A large binding window could also contribute to some of the repetitive behaviors that are characteristic of autism, Bahrick says. By creating predictable cycles of sensory feedback, repetitive behaviors may allow an individual to compensate for overstimulation, she says.

Brain windows:

Wallace's work suggests that training exercises can narrow the binding window in people with autism.

His team has trained healthy participants to bind sights and sounds 40 percent more precisely by presenting them with sounds and flashes separated by various intervals and providing feedback on their accuracy. "We may be able to ameliorate some of the problems associated with autism, at least those attributable to sensory processing issues," says Wallace, professor of psychiatry and hearing and speech sciences at Vanderbilt University.

The new research does not identify mechanisms underlying the timing problems in autism, however. "I think these [studies] are exciting and provocative, but they lend themselves to trying to tease apart the stages of those processes," notes Timothy Roberts, professor of radiology at Children's Hospital of Philadelphia, who was not involved in either study.

Brain imaging could enable researchers to tease apart the various roles of memory, cognition and attention during timing tasks, Roberts says.

Using magnetoencephalography (MEG) - an imaging technique that is especially sensitive to split-second changes in brain activity - his team has found that children with autism have a slight delay in processing sounds compared with typical individuals.

Roberts has preliminary evidence that the delays could be caused by inadequate insulation of white matter - the nerve fibers that transmit signals between cells. "If the highway isn't conducting signals fast, then you could have some problems with encoding and the time it takes to process things," Roberts says.

References:

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Time perception problems may explain autism symptoms | Spectrum | Autism Research News

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Individuals with autism have trouble perceiving the passage of time, and pairing sights and sounds that happen simultaneously, according to two new studies. These timing deficits could underlie some of the cognitive impairments that characterize the disorder, the researchers say.For example, communication problems could stem from tiny delays in the perception of speech, or from imprecise pairing of spoken words and gestures.

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Experiences

These are real life experiences that other parents or families have gone through. They discuss what is was like experiencing puberty. Some gave more detailed experiences than others. But, please remember that these are all different experiences from different parents. All of these are not experienced by one parent;

They may not understand what they should/shouldn't discuss with others.

Aggression - aggression appeared from nowhere. Or some found that the aggression was already there but it became a lot worse when going through puberty.

They query relationships - what are they? Who has them? Who should they like? How do they meet someone? Lots of questions and we urge you to answer them as honest as you feel you can be.

Body odour - you may need to encourage your child to wash more, use deodorants etc.

Masturbation - yep, it happens. Many children can become more aggressive if you try to stop them during masturbation. You can try to use social stories. Or, you can discuss appropriateness with them - doing it in private, in certain areas etc.

Mood swings

Start of stimming - the individual out of nowhere started to stim all the time. Not being able to rest without doing their stimming. This could well have been a comfort to them while going through so many changes.

Regression in some areas, sometimes academically, sometimes socially etc.

The start of medication - this is when many children with autism first start medication. Either at the start of puberty or during it.

Seizures - there have been some studies carried out which you should be able to find online. They are trying to link autism, puberty and seizures together.

Onset of anxiety. This could also be due to the changes that they are going through and experiencing within their body.

The start of menstruation is one of most difficult challenges. Understanding how to deal with it. The use of feminine products and disposing of them/replacing them. Cleaning themselves etc. Many families also mentioned their children with PICA had a very difficult time starting menstruation.

Emotional - with emotions all over the place.

Everything is amplified.

It came much earlier than expected. While some families stated that it came much later than expected in their children.

Some state that there was very little change in their child when going through puberty.

Self harm. A lot of people stated that many females struggled with the growth of breasts. Understanding why they were growing and coping with them. Especially with the need to start wearing bras. Many found sports bras more comfortable.

Sensory overload.

Take-away

Many families stated that they felt their children didn't understand what was happening to them. They stated that when puberty changed their body and they didn't know how to deal with it. This led to knock on effects and repercussions.

Many of our children also can't communicate with us their feelings. And those who didn't know what was happening, struggled to communicate this. This made them become even more frustrated. Especially if they needed our help but couldn't ask for it.

All that I can offer you advise wise is - do your best. Like you do every day. Be there for your child and support them as best as you can. Look for clues for how they are feeling. Or if there's anything you can help with. There's no right or wrong answer for dealing with this. Mainly because every child is different. What works for one child - may not work for yours. And some of these reactions to puberty may not happen to your child either!

Discussion

A lot of families ask whether they should discuss puberty with their child - and if they should, when? There's not really a right or wrong question here. Every child is going to be different so I would say go with your gut and what feels best for your child. You can speak to your child's school about this as well. Many schools now offer classes to discuss puberty, relationships, sex and so much more.

Puberty is nothing to be embarrassed about and it's ok to discuss it with your child. It's also best to discuss it if you can. That way your child doesn't feel embarrassed about it too and will come to you when they need you. If you feel you need support you can ask family members, classroom staff or your GP.

Support

There's lots of ways available now that you can get support for your child. You can also get support for your family during this time too. Some ways of support are;

Social stories - there are so many available now so you should be able to find the ones you are after. You can find many on my website here or on my TpT.

School - talk to your child's school. Don't be afraid to ask them for help. They've more than likely been through this many times with other children. They can be a wealth of knowledge and may be able to recommend some classes, resources or tips for you.

Family - use your family support network if you have it available. Encourage them to be open with your child. They may feel more comfortable talking to a close aunt/uncle rather than you - and that's ok!

GP - talk to your doctor, they may have access to a variety of different resources that can help you

Research - there are lots of amazing books out there now for you to read. They are about going through puberty with autism and how you can help your child.

Training - there are lots of great training courses available now. Many of which are run by Autism groups and charities to provide specific training and help.

Autism groups - local support groups are a great way to get hold of valuable resources. You will also be able to talk with other families/professionals. They can also help you to find out about courses or training that you can access to help your child.

Support groups - lots of parents now form local support groups. They may meet up either in person or facebook groups. It's great to be able to discuss any issues or concerns with other families. We usually feel it's a bit less intimidating this way. And it's also a bit of a comfort to talk to someone who's going through the same/similar thing to you.

Have you experienced your child going through puberty yet? Or are you going through it now? How are you finding it? Don't forget to reach out to our community if you need any support.

You can also check out another of our posts where we discuss autism and girls. Why is the diagnosis less? And how does it differ in boys and girls? Read it here.

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Experiences These are real life experiences that other parents or families have gone through. They discuss what is was like experiencing puberty. Some gave more detailed experiences than others. But, please remember that these are all different experiences from different parents.

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Social Care Institute for Excellence (SCIE)

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The transition from children's to adults' social care can be particularly difficult for people with autism. In 2010 it was reported that 70 per cent of children with autism identified in the special educational needs (SEN) system were entitled to transition planning due to statements of special educational need.[ 21] Since then there has been a year-on-year increase in the number of children and young people with autism receiving help at school, and autism is the most common reason for a child to receive a statement of special educational needs.[ 61] The Children and Families Act 2014 introduced education, health and care (EHC) plans for children and young people from 0-25 years, replacing statements of special educational need. Such plans are intended to be more person-centred and to prepare young people for adulthood, with the focus on transition remaining from year 9 (age 14).[ 19]

A recent study found that support for young people leaving school remained variable,[ 62] with some places providing transition support to all students identified as autistic, while others provided support only to young people with greater support needs. Post-education support was less accessible, particularly for autistic young people who were not entitled to adult social care. Guidance for 'Think autism' suggests that even where young people with autism are not entitled to adult social care services, under the Care Act 2014 they should be signposted to other sources of guidance and support in the community.[ 20]

Young autistic people face the same problems as other groups during transition,[ 13] namely:

difficulties maintaining consistent staffing over the transition period

lack of communication between professionals in different services

different services switching to adult services at different ages

fewer, less well-resourced services in adulthood

paying for services that were free as a child

carers feeling excluded from consultations about their now-adult family member.

Autism-specific barriers

Some aspects of autism can make transition particularly difficult:

School provides a structure that many people with autism like, and feel the lack of when they leave.

Coping with change can be problematic.

Conceiving of a range of new options can be hard.

There is a chance of falling through the gaps in adult services for people with high-functioning autism and Asperger syndrome. [63]

Adult life and expectations, including the world of personal relationships, can carry new challenges. [10, 64]

There is limited provision of further education options, especially for those who display challenging behaviour. [13, 62]

Furthermore, if transition goes badly, people with autism can be stuck in poor-quality services, and have lives that are not as independent as they ought to be.[ 23]

Improving transition

During transition, services should aim for:[ 62]

full involvement of young people with autism and their families in multi-agency transition planning

respect given to the preferences of young people with autism. Research has found that adaptations to the person-centred approach to consultation were particularly helpful in transition [65]

better information given to families as young people approach transition

better communication between adults' and children's services. Under the Care Act 2014, local authorities have a duty to assess young people who are likely to need adult services regardless of whether they have been receiving services prior to transition [19]

an opportunity for people placed out of area to return home, should they wish

autism training for transition staff, including staff working in child and adolescent mental health services

attention paid to the needs of young people with autism who display challenging behaviour [62]

autism training for workers in employment and training services such as Connexions and the National Careers Service

differentiation in assessments between support needs and education needs, so that people are not put on academically limited courses due to their communication difficulties

awareness that, for those who go on to college or university, support needs may need consideration alongside educational needs [66]

an underlying assumption that young people with autism can lead full lives of their own choosing.

Approaches to transition

In England, transition planning is addressed within a young person's education, health and care plan [ 67] covering social care, education, health and support into employment, which runs until a person is 25 (for those in education or training - excepting university study). There is also a strong emphasis on professionals having much higher aspirations for children with disabilities, building on the messages of the previous government's 'Aiming high for disabled children'.[ 68]

In Northern Ireland, transition planning is guided by the Education (Northern Ireland) Order 1996 as amended by the Special Educational Needs and Disability (Northern Ireland) Order 2005. Further guidance is contained in the 'Code of practice' [ 69] and a supplement to this issued in 2005.[ 70] A priority for action within the autism strategy 2013-2020 and action plan 2013-2016 is the development of multi-disciplinary, multi-agency approaches to transition.[ 28]

A government interdepartmental group was set up to take forward strategic developments in the transition process for young people with special educational needs, which includes the needs of young people with autism. The group's report highlights deficits in transition planning and provides a wide range of actions to make improvements in moving across the spectrum of service provision.[ 71]

Further reading

Guardian article: " An opportunity not a drawback"

View more: News

Guides for families and professionals supporting adults with autsim and adults with learning disabilities during the coronavirus (COVID-19) crisis.

A new two-day open access course. Providing participants with an introduction to understanding the Autism Spectrum and strategies which can help ensure appropriate methods of communication and support.

View more: Training courses

Get SCIELine ebulletin & access all resources. Free MySCIE account

View more: Case studies

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Transition to adult services and autism - SCIE

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The transition from children's to adults' social care can be particularly difficult for people with autism.

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Your Internet Explorer 11 browser is not supported by this site. Please upgrade to a recent browser for the best experience.

Moving between different stages of life, such as school, college and work, is especially hard if you find change difficult, as many autistic people do. This section provides advice about strategies and support that can help.

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Your Internet Explorer 11 browser is not supported by this site. Please upgrade to a recent browser for the best experience. Moving between different stages of life, such as school, college and work, is especially hard if you find change difficult, as many autistic people do.

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The ability to organise and prioritise helps us to plan daily activities and manage our time effectively. However, some autistic people may find organising and prioritising difficult. Here, we explain why this can be the case, and list some ways to help.
An autistic person may have difficulties with:

processing information

predicting the consequences of an action (if I do this, what will happen next?)

understanding the concept of time

'executive function' (coping with daily tasks like tidying up or cooking).

One or all of these can affect a person's ability to organise, prioritise and sequence. For example, if you struggle to understand the concept of time, how do you plan what you will do over the course of a week?

Strategies to help

Here are some ways in which people on the autism spectrum can organise and prioritise daily activities and tasks. At first, other people may need to have a lot of involvement introducing the strategies. You may use the strategies in more than one place, for example at home and at school, so it is important that everyone who is using them - be it family members, employers, teachers or friends - uses them consistently.

Over time, some autistic people will be able to use the strategies independently. Others may always need support.

Visual supports

Pictures, written lists, calendars and real objects can all be good ways of helping autistic people to understand what is going to happen and when. For example, a person might have a daily timetable with pictures of a shower, clothes, breakfast, their school, dinner, a toothbrush, pyjamas, and a bed to indicate what they will be doing, and in what order, that day. Find out more about visual supports.

Colour coding

Colours can be used to indicate the importance or significance of tasks (and therefore help to prioritise tasks and work through them in a logical sequence).

For example, work in a red tray or file could be urgent, work in a green tray or file could be pending, while work in a blue tray or file is not important or has no timescale attached to it.

Colours can also help people to distinguish between paperwork, for example different household bills.

Voice recording

Recorded messages, on a dictaphone or smartphone, can be a useful auditory reminder of tasks, work, events or deadlines.

Lists

Lists can remind us of the tasks we need to do, and to help us prioritise. Lists can also be a good way of registering achievements (by crossing something off when you've done it), and of reassuring yourself that you're getting things done. Lists can be visual, written, or in the form of a task list app.

Alarms and alerts

Computer calendars can have important dates stored on them, or reminders about when to pay bills. Instructions can be sent to the person's mobile phone by text - text messages lend themselves to this especially well as you are forced to keep instructions brief and simple. A text message is also an unobtrusive and discreet way of contacting or supporting an autistic person.

Task boxes, envelopes and files

Store work or belongings in set places, so they aren't misplaced or forgotten.

Times of day, days of the week

You can use times of day (morning, afternoon or evening) or days of the week to help plan and organise tasks, social activities and other events. For example, Saturday is shopping day, Wednesday is bills day, Thursday night is homework night.

Social stories™ and comic strip conversations

Social stories™ and comic strip conversations can be a good way of illustrating the consequences of an action. They can help people to understand why it's good to be organised, and what might happen if we don't meet deadlines or attend an activity at a particular time. Find out more about Social stories™ and comic strip conversations.

Teaching materials: time and sequence

You may find that teaching materials such as sequence cards, games, timers and clocks help some autistic people to understand the concept of time and sequences. Materials like this can be used at home and at work.

Budgets

We all need to learn how to manage our money, to budget, control spending and pay bills. Many autistic adults will manage their own money or bills, to varying extents, while children may have pocket money. It can help to set out very specific guidelines about managing money and the consequences of spending. Try our free managing money online module.

At school

Homework, assignments and deadlines can cause great anxiety for some people. Others will not register their significance. The following strategies can help:

clear monitoring

regular meetings with teaching staff

colour coding of files.

Some people may need help in understanding the end goal of what to them may seem continuous work and deadlines.

Processing of instructions can be difficult, so it may be useful to use communication books, online learning environments, and voice recordings to reduce the pressure on the student of trying to remember what they are supposed to be doing.

At work

Strategies to use in the work environment include:

using files and colour to identify and clarify the importance and deadlines for particular pieces of work.

making a clear to do list at the beginning of the day - you can then cover up or mark off work which has been completed

arranging regular meetings with your line manager to ensure work is understood and is progressing

using the computer programs available to help organise work - for example colour coding emails relating to importance of response

using the calendar as a reminder for meetings or deadlines.

Further information

Read about the Brain in Hand digital self-management support system.

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Organising and prioritising - a guide for all audiences

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Autistic people can find organising, planning and prioritising difficult but there are many tools to help.

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Social communication skills in the classroom

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Social communication skills in the classroom

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Victoria Honeybourne, a Senior Advisory Teacher for Speech, Language and Communication Needs, explores the social communication difficulties of autistic students in the mainstream classroom and offers some strategies to support them.
Social communication skills

Social communication is complex and we are all continually learning these skills through childhood, adolescence and beyond. This type of communication covers many different areas.

Body language

Body language includes the facial expressions, gestures, movements a person makes, as well as their posture, eye contact. It also includes touch, proximity and personal space.

Voice

The voice can communicate various meanings according to its tone, intonation and volume as well as stress and emphasis.

Conversational skills

This is about understanding how to initiate and end conversation, taking turns, asking and answering questions. It is also about maintaining the topic of and changing it appropriately, giving sufficient information, and being relevant.

Social conventions

Social conventions include politeness, manners and following the unwritten rules. They are about adapting language and communication to the audience and context, including cultural awareness and appropriateness.

Interpersonal skills

Interpersonal skills cover making friends and maintaining friendships, negotiation, sorting difficulties and assertiveness.

Emotional intelligence

Emotional intelligence is the ability to recognise and identify emotions in oneself and in others, being able to manage them and express them appropriately and requires self-awareness.

Differences for autistic students

Autistic students may have some differences in social communication. These are likely to be different for each individual but might include:

finding eye contact uncomfortable

differences in facial expression, gestures, hand flapping, needing more / less personal space

finding too much sensory input overwhelming which increases anxiety and therefore decreases the ability to communicate

difficulties in eliminating background noise

differences in using and interpreting tone of voice and intonation

having a literal understanding and use of language

being honest or direct which can appear rude or abrupt

finding the dynamics of group conversation difficult

alexithymia (difficulties in identifying own feelings)

differences with theory of mind and understanding what other people know / need to know

not having the innate desire to connect on a social level with others

lacking in confidence and self-esteem which can affect communication and assertiveness.

How to help in the mainstream classroom

The following strategies are particularly useful for autistic students but will also help many other children with various speech, language or communication needs.

Model what you want to see from the student: don't use a loud voice when you are in a quiet area; use a calm and neutral tone of voice. A loud voice may come across as shouting or angry. Be explicit: explain why the rules and expectations are in place, including the unwritten rules. Some students may just need it outlined explicitly. Have clear and consistent rules and routines in place; if a rule doesn't make sense consider getting rid of it!

Try not to mislabel feelings: accept all feelings as equally acceptable and valid. Saying something like 'Oh you must be so disappointed' might not actually reflect what the child is feeling inside if they interpret situations differently. This might lead them to begin to distrust their intuition or begin to believe that it is not okay to feel how they do. Some students might find it easier to express their feelings through Lego therapy, art therapy or music therapy.

Don't expect eye contact if this is uncomfortable for the student; instead, suggest the students turn their bodies to face you so that you know they are listening even if they cannot make eye contact.

Provide quiet spaces and keep them quiet. Some students will need time and space to recover from the social interaction of the rest of the school day. Make these spaces accessible to all to remove any stigma attached with using them. Eliminate as many sensory distractions in the environment as possible.

Support group work: allocate the groups and put pupils with supportive peers. Make sure all group members are certain what the task is and what the expectations are. Try to allocate specific roles (e.g. note-taker, timekeeper) to make it easier for pupils to join in. If you are teaching skills in a social communication group, remember that the key point is to help students transfer this knowledge back into the classroom and real-life situations, otherwise they will not see the relevance.

Provide structured activities for break or lunch time. This can be easier than unstructured socialising. Use everyday opportunities: modern foreign language lessons are a great opportunity to discuss communication and conversational skills. Drama is an opportunity to explore body language and facial expression. English is an opportunity to discuss characters' motives and feelings.

Remember that the aim of teaching social skills is not to make somebody less autistic but to give them social knowledge which will enable them to interact with a greater range of people and in a greater range of situations with more confidence.

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Social communication skills in the classroom

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Victoria Honeybourne discusses social communication difficulties and offers some strategies to help autistic students.

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Making friends - a guide for autistic adults

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Making friends - a guide for autistic adults

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If you struggle to make and maintain friendships and relationships you can end up feeling socially isolated.

You might find social situations difficult or overwhelming. Sometimes it may feel as though other people know, intuitively, how to communicate and interact with each other. Of course, this is not necessarily the case. As an autistic person, you may feel that your social differences mean other people don't understand you.

Getting the right support and information can help you in developing new friendships and making them long term fulfilling ones.

What is social isolation and why might I feel socially isolated?

Many autistic people experience social isolation. This may be due to a range of reasons. For example:

you may feel like non-autistic people are unwelcoming, or don't want to interact with you

you may prefer to be on your own and enjoy your own company

you may want to engage with others but lack the confidence or the skills to do so

you may find it difficult to maintain contacts due to a lack of understanding of small talk and other conventions of social behaviour

you may be trying to avoid repeating a past negative experience in a social situation, such as bullying

you may need a higher level of support for activities than your family, friends and/or carers are able to provide

you may live independently, without family, support workers or a social network

you may not be aware of suitable activities in your local area.

What can I do about it?

Planning and developing social interaction

It might be useful to plan in times where you can either meet existing friends and family or look to meet new people. You might want to use a timetable or schedule for your week.

Routines can provide reassurance and comfort, but can limit social interaction with other people. In order to overcome restrictive routines, you could plan to:

gradually introduce change by identifying one new place to go to every week - for example a local shop

focus on places where it is possible to meet new people. In time, you may get to know people you see regularly

practise a few bits of small talk, such as 'How are you today?'. This may help to reduce your anxiety about making contact with people.

Managing anxiety

Anxiety can limit your ability to socialise. If you experience extreme levels of anxiety in social situations, it might be useful to talk about this with your GP. A medical professional should be able to offer support and advice and may be able to signpost you towards support services.

Qualified counsellors can often offer information on techniques that may reduce anxiety and develop social skills. Sometimes advice can be provided via the phone or email or a home visit may be arranged.

The NHS often offers counselling following a GP's referral. It is important to contact a qualified counsellor with specialist knowledge and understanding of the autism.

Finding social groups

You may feel more motivated to join a social group where the members have similar interests to your own. Having common ground, or something members enjoy talking about, makes it easier to start and maintain a conversation.

find local support groups and projects aimed at autistic people

search online for information about local activities, sports clubs, talks, or groups in your area

learn a new skill. This can often lead to making new friends. Your local college might run adult education courses in things like art, IT and cooking

ask your manager at work or other members of staff about after-work activities, if you are in employment.

If you prefer communicating online, you could join our online community, which has forums specifically for autistic people. Find out more in our 'Your next steps' section below.

Taking part in a group or activity

Once you found an activity that interests you, get in touch with the group leader, find out what the format for the activity is and ask for further information.

You may need to become a member of some social groups to attend meetings, which might mean paying a fee. You should ask the organiser about this and find out whether you'd need to make a one-off payment or commit to a weekly, monthly or annual fee.

Should I tell people that I'm autistic?

If you are attending a group that isn't specifically for autistic people, it's up to you whether you tell people about your diagnosis. Giving people this information can give them a better understanding of your needs and the group may be able to offer additional support. However, deciding to 'disclose' is a big decision. Some autistic people have told us that, for them, disclosing left them vulnerable to bullying. If you are joining a group where you don't know anyone, you could try talking about this issue with your family or friends, or with the person who organises the group.

Is this the right group for me?

To make sure the activity is right for you, you may try going along as an observer at first.

If you feel you may need additional support to take part in the activity, ask if a family member, friend or carer can come along or if the group could provide some extra support. Add the activity or group meeting to your calendar.

Don't feel pressured to attend for the whole of the activity or meeting, or to go on your own - especially at first. Over time you can increase the length of time you stay, eventually aiming to attend the whole session without additional support.

If you have any issues at the group, discuss these with the group leader so that they can be resolved as soon as possible.

Meeting new people

When meeting new people it might be useful to have some prepared questions or introductions to start the conversation.

Examples of topics you might start a conversation with might include:

Some people may enjoy these 'small talk' topics. To others, they may seem uninteresting or unnecessary. It completely depends on each person and their interests. However, 'small talk' can often progress into more in-depth conversations and you may find you have things in common with the person you are talking to. For instance, you may like the same TV show, book, film, or have similar taste in music.

There are certain topics that are best to avoid such as:

How does a conversation end?

Watch out for signals that someone wants to end a conversation with you. These may include:

If you aren't sure whether they want to carry on with the topic, you could say 'Would you like me to tell you more?' or 'Would you like to talk about something else?'.

Recognising how others are feeling

What is appropriate to say to a person will depend on how they are feeling about the subject. You may find it difficult to tell how someone else is feeling. They might not actually say how they feel and you might find it difficult to read body language and facial expressions.

If you are not sure how someone is feeling, you can ask them how they feel.

Sometimes people don't tell the truth because they want to make the other person happy or not cause offence. Some people call these 'little white lies'.

If someone is upset about something you've said or done in a conversation, it doesn't mean they don't like you. Saying sorry usually helps. If you are not sure why the person is upset, you can ask.

Try not to be too hard on yourself. Remember that each person is different and that there is no 'right' or 'wrong' way to socialise. A lot of people (both autistic and non-autistic) find social situations difficult, particularly when talking about feelings.

Tools like Mind reading can help you to recognise emotions.

Getting formal support with socialising

You may need some additional support and help from outside of your family and friends to get involved in social activities. You can request more formal support through your local authority and their social care team by requesting a community care assessment.

Your next steps

You can also access support and friendship by joining our online community.

There are also lots of other autistic people that offer advice online about making friends, such as Purple Ella's video  'Autism and Friendship', which explore strategies for overcoming relationship difficulties.

Read the Spectrum, our quarterly magazine (available in print and online) written by and for people on the autism spectrum. It also has a  pen pals section.

Join Circles Network, which offers support to people of any age who are isolated or at risk of isolation. A circle of support, sometimes called a circle of friends, is a group of people who meet regularly to help an individual accomplish their personal goals.

Visit the Asperger syndrome Meetup website. Meetup aims to help people all over the world contact each other and they have a section dedicated to Asperger syndrome.

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Making friends - a guide for autistic adults

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If you struggle to make and maintain friendships and relationships you can end up feeling socially isolated. You might find social situations difficult or overwhelming. Sometimes it may feel as though other people know, intuitively, how to communicate and interact with each other. Of course, this is not necessarily the case.

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Children with autism and social interaction

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Children with autism and social interaction

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Children with Autism and Social Interaction

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Children with autism often find social interaction challenging. This post breaks down those difficulties & advises how we can assist with social situations.

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Research into how autistic people interact with each other and create shared understanding

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Here we talk about different forms of communication and strategies for supporting autistic people

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Autism Spectrum Disorder: Communication Problems in Children