Understanding and Working with the Spectrum of Autism

An Insider's View

Wendy Lawson

• Publisher: Jessica Kingsley Publishers
• Year: 2001
• Print ISBN: 9781853029714
• eBook ISBN: 9781846422294
• Topic: Psychology
• Subtopic: Autism Spectrum Disorders
• Index: Psychology

To many of the people who live or work with an individual with an autism spectrum disorder (ASD), the processes by which those with autism make sense of the world around them may seem mysterious. In Understanding and Working with the Spectrum of Autism Wendy Lawson demonstrates these processes using comparisons from the non-ASD world to help professionals, families and carers to relate to and communicate with people with ASD better. Exercises at the back of the book encourage the reader to reflect on what has been discussed. The second part of the book contains chapters presenting a range of interventions and strategies for particular situations. Wendy illustrates her text with examples from her own life and from the lives of those she has met or worked with to clarify her points. She analyses ASD characteristics and examines interventions for dealing with social skills, anger management and self-esteem. Stress, its effects on the families of children with autism, and how best it can be alleviated, is also explored.

Wendy writes in the light of her personal experience of an autism spectrum disorder as well as that of the available literature to create a book that is both readable and wide-ranging, furthering understanding of the links and differences between neurotypical individuals and those with ASD. Her book is an essential introduction to ASD for social workers, nurses, health professionals and those working in related fields.

PART I

The Spectrum of Autism

General Concepts

CHAPTER 1

Keys to Understanding the Spectrum of Autism

I believe the cognitive processes that inform our experience of autistic spectrum disorder are:

•literality

•monotropism, or being singly channelled (serial concepts)

•thinking in closed pictures and non-generalised learning

•non-social priorities

•issues with time and motion

•issues with predicting outcomes

•difficulties with theory of mind (empathy lacks and empathy gaps).

Literality

Individuals with autism, especially children, tend to understand their world in literal terms. This means that we take the spoken word quite literally and respond accordingly. Families with an autistic child, therefore, experience much frustration and may even think that their child is simply out to make life difficult for them!

As people with autism we tend to find our sense of security in our rules, rituals and continuity of roles. These are literally interpreted and carried out ‘to the letter’. Therefore, it is very distressing when life does not go according to our expectations. This is one reason why we manipulate our environment and the individuals that share it with us. However, being able to gain the kind of reassurance that we need makes a big difference both to our lives and to the lives of those around us. It is an accepted fact that routines will change and one cannot always maintain sameness. However, one can teach coping strategies that allow for change to occur. Routine and structure are similar but different concepts. As individuals with ASD, we may experience extreme levels of anxiety; therefore, structured strategies to cope with change are essential.

The following examples are of words and situations taken literally:

•Two teenagers yelling at each other. Father comes into the room and yells ‘We don’t have yelling in this house’. The boys keep yelling.

•Young girl has her Mum’s newly baked cake in her hands. Mother says, ‘You can’t have that’. However, young girl knows that she can because she does have it! Young girl ignores mum and tries to walk away.

•Teacher says to Andrew ‘You do know that your homework is due on Tuesday, don’t you?’ Andrew says ‘Yes’, but, come Tuesday he does not produce his homework. Teacher only asked if he knew it was due. Teacher did not ask him to give her his homework on Tuesday!

•Mother says to her teenage son ‘I’m going out for an hour. Can you tidy your bed?’ The youth answers ‘Yes, Mum’. When Mum comes home the youth’s bed is still ‘untidied’. Mum only asked her son if he was able to tidy his bed; she did not tell him to tidy his bed.

•‘I am bored, can I play a bored game?’ ‘Of course you can, which board game would you like?’ ‘I want to play cards.’

•Mother says ‘This chicken is tough’. Boy replies ‘Does that mean it was difficult to kill?’

•Young man takes too much time to eat breakfast in the morning. Carer complains that because he is so slow, they are often late. However, when they go out for ‘fast food’, the young man eats his food quickly and attempts to clear the food from other people’s tables too! I suggested telling the young man at breakfast time ‘this is fast food’, might mean he eats his breakfast more quickly!

•Store detective says ‘You can’t take those. You haven’t paid for them’. Teenager replies ‘Of course I haven’t, I haven’t any money’.

There are many examples of literality in everyday life that pose potential trauma for individuals with ASD. The following two short stories illustrate some common thought processes.

James and the builder

James says to the builder: ‘I really am anxious for you to finish off the living room. My parents are coming to visit next week.’ The builder replies: ‘Yes, I’m able to give you some time to do that. I am off all day on Friday and there will be plenty of time to come over and finish those doors.’ However, by 11.00 on Friday morning the builder hasn’t arrived. James is pacing up and down the corridor feeling very anxious and upset. He wonders why the builder promised to be at his house all day on Friday. James is unable to concentrate on any of his assignments for university because he is waiting for the builder.

At 12.00 noon, James can wait no longer and he telephones the builder. ‘Why aren’t you here?’ James asks. The builder explains that he has some other jobs to finish, not just the ones for James. He tells James that the doors will only take a couple of hours to finish off and that he will be there after lunch, around 14.00. James puts the phone receiver down and feels a mixture of emotions. He feels silly and very cross. Cross, because the builder didn’t explain things to him properly. Silly, because the builder’s subsequent explanation made sense! However, unfortunately, he hadn’t been able to see that for himself and he now feels very frustrated. He should have been studying but was unable to concentrate because of the confusion and disappointment. Now he has to make up the time he lost.

Tracy goes to camp

The Year 7s had enjoyed their first camp together, and now, as they sat relaxing around the camp fire, Linda, the PE teacher began to play her guitar. Kim produced an enormous bar of Cadbury’s chocolate. As it passed between each camper, participants broke off pieces of the chocolate and passed it on. Eventually the decreasing bar of chocolate reached Tracy. Tracy, a 12-year-old with Asperger Syndrome received the chocolate, held it in her hands and looked down at it. There was silence over the rest of the group as they watched Tracy and waited. It seemed like an eternity, but finally Jane broke the silence. ‘You can’t have the chocolate, Tracy,’ she said. Tracy looked up. ‘Yes I can!’ she exclaimed. Jane reached over to take the chocolate away from Tracy. Tracy jumped up and began to run away.

Half a dozen members of the group chased Tracy for almost 20 minutes around the campfire and the tent site. Eventually, out of breath, Jane called out to Tracy. ‘Trace…take a couple of squares from the chocolate bar and please pass it on to Jill.’ As the other girls stopped and watched, Tracy stopped running. She bent over the chocolate bar and calmly broke off exactly two squares. She then looked up to locate Jill and moved across to give her the chocolate bar.

Murmuring spread through the group as they returned to their tents. ‘Why is Tracy so difficult?’ one child grumbled. ‘She really pushes her luck,’ another muttered. ‘I’m glad I’m not one of her friends,’ echoed a third.

The above story illustrates so well the issue of literality for Tracy. How can someone tell her that she can’t have the chocolate, when she actually does have it? For Tracy, holding on to the chocolate was a time of processing what she needed to do next. Her processing time was interrupted and she ‘lost’ her train of thought. Without clear instruction and structure to help her, Tracy is in a ‘mind field’ without a map! However, if Tracy had been given clear instruction about taking two squares from the chocolate bar to have for herself, and then to pass the bar to the camper next to her on her right, this scene might never have occurred.

Tracy has some great qualities. She is loyal, trustworthy, truthful and well committed to doing the tasks she chooses. She would make a good friend. However, because of her literality, as well as having difficulty with her own understanding of everyday issues, she is often misunderstood. This only adds to Tracy’s feelings of isolation. She would be a prime candidate for depression, mental illness or even juvenile delinquency.

Monotropism

Having the ability to focus in on one aspect of communication, or upon one interest at one time, has been called monotropism. Rigid monotropism often occurs in my world and I am said to ‘have tunnel vision’ or to be ‘only interested in Wendy’s interests’. Monotropism will mean, for many individuals with ASD, difficulties coping with ‘change’. For me this is demonstrated in my difficulties with change in routine, expectation, instruction, daily schedule, movement of attention and even incorporating another channel into the present scenario. For example, listening and then being required to participate in decision making (without due time to process information), thus moving from one channel to another.

Monotropism is also evident within the process of interpreting language. For example, when an individual with ASD is told that they are going to grandmother’s house, they might be quite upset if that action statement (going) is not enacted immediately. Going is a verb or ‘doing’ word. It is totally illogical to be ‘going’ later or soon. The abstract notions of ‘in a while’, ‘later’, ‘when we are ready’, and so on, do not compute if the term ‘going’ is used. However, one can prepare to go! Abstract reasoning is quite difficult and many ASD individuals find this very confusing.

According to Murray (1997), the interest systems of individuals with autism, unlike those of the neuro-typical population, tend towards ‘attention tunnelling, or monotropism’. Murray states:

Donna Williams’s (1994) analogy for this contrast between herself and ordinary people is that of a busy department store, which in her case can only open one department at a time. To have many interests concurrently active is the norm. This is called polytropism. Within the neuro typical population polytropism is one way of coping with a complex, changing, and only partially predictable environment: it involves spreading the supply of attention thin so as to maintain a degree of generalised readiness. Even the most flexible among us can find this multiply divided attention quite strenuous – we tend to seek recreation in activities which require a relatively narrow focus. (pp.3–4)

Like Murray I also believe that my discomfort at encountering ‘change’ is one consequence of my being attention-tunnelled or monotropic.

…it’s a lurch for them to be precipitated into a new tunnel. It makes them feel bad. Therefore engaging with them on the basis of their own interests is making it much more comfortable for them than bringing your own pressing interests to bear. In the long run a more accommodating, and more confident, individual may result. (Murray 1996, p.6)

Again according to Murray (1997)

…the integrative function of an interest system must depend very heavily on the individual’s capacity to recognise stable structures in their surroundings. For most of us the common culture supplies a huge stock of such structures. But in a relatively monotropic interest system which has achieved minimal connectivity compared with ours, and which has not been open to modification by other people’s expectations, then percepts will have much less scope for integration and be commensurately unlikely to make any sense.

At the same time, because of th...

Table of contents

• Cover Page
• Other Books
• Title Page
• Copyright
• Acknowledgements
• Contents
• Foreword
• Introduction
• Part I: The Spectrum of Autism: General Concepts
• Part II: The Spectrum of Autism and issues Related to Stress
• Part III: Ideas for Action
• Appendices
• Glossary
• References
• Suggested Reading List
• Subject Index
• Author Index