Autism, Asperger’s and Oxford Georgina Heywood Student Welfare and Support Services Disability Advisory Service Tuesday 12 April 2016

Today.. • Common features and traits of Asperger’s Syndrome • Effects of AS on students at Oxford • Prevalence

• Getting a diagnosis • Support available

Asperger’s Syndrome • A pervasive developmental disorder within the autism spectrum characterised by a triad of impairments within the areas of : Social Interaction & Relationships

Communication

Imagination, Behaviour, Flexibility of Thought

Imagination, Behaviour and Flexibility of Thought • Strong adherence to routines and rituals

• Special interests; narrow focus; perfectionism • Resistance to change; difficulties with transitions • High levels of anxiety • Difficulties understanding deception in others; deceiving others • Unusual body language • Sensory issues

Verbal and Non-Verbal Communication • Literal interpretation of language • Pedantic speech style • Wide vocabulary; average or above average IQ • Tendency to dominate conversations • Tendency to be argumentative and inflexible • Echolalia / Palilalia • Issues in executive functioning

Social Interaction and Relationships • Poor social understanding / awareness of social rules • Lack of awareness of conversational partner

• Difficulties picking up on non-verbal cues • Unusual / limited facial expressions; eye contact • Difficulties engaging in group activities • Difficulties making friends; relating to others; understanding emotions

• Often history of bullying, manipulation, isolation

Conversational Activity

Profile of an AS Student “I know exactly how I am feeling but I can’t explain it!”

“People always tell me I’m rude or too abrupt, but I don’t know why”

“If I am fascinated by something, literally everything else is insignificant to me.”

always talk about the same thing but I don’t know what else to talk about”

“I find it difficult to look at people when they are talking as I get distracted by small details on their faces” “I find abstract concepts difficult to understand”

“I prefer to do things on my own” “I often notice small sounds when others do not”

“People say I

“I really like rules, I know where I stand with them and how to act.”

“Part of me wants to socialise but I find it so stressful and I do not like talking to strangers”

Co-Morbidity

Temple Grandin: Video

Prevalence of AS • Autism affects 1.1% of the population (Baird, G et al, 2006; Brugha, T et al, 2012) • Gender Differences Male:Female Ratio • 4:1 Rubenstein et al (2014) • 1:1 Dr. Judith Gould (2013) • 2:1 Richard Mills (2012) • 2:1 Professor Tony Attwood (2009) For every 3 diagnosed, there are 2 undiagnosed (Baron-Cohen, S et al, 2009)

Students with a Potential Diagnosis: How to broach the subject •

Raising possibility of diagnosis is not the same as making a diagnosis

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Diagnosis only needed if difficulties have an impact

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Talk about ways of processing information ‘differently’, not ‘incorrectly’

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Diagnosis may often be a relief for the student

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Screening tools can help structure this conversation and support a student’s decision to refer

Diagnostic Criteria- DSM V • Deficits in social communication and interaction - Deficits in social-emotional reciprocity - Deficits in nonverbal communication - Deficits in developing and maintaining relationships • Restricted, repetitive patterns of behaviour, interests or activities - Stereotyped or repetitive motor movements, use of objects or speech - Need for routines, resistance to change, inflexible / rigid thinking patterns - Highly restricted, fixated interests - Sensory difficulties • Symptoms must be present in childhood • Symptoms together limit and impair everyday functioning

Referral Pathways • GP referrals to psychiatrist or clinical psychologist with autism experience (private or NHS) • Autism Oxford • University of Reading Diagnostic Service: Centre for Autism

Diagnostic Activity

Support available at Oxford • Asperger’s Buddy

• Asperger’s Mentor • Institutional adjustments: tutorial groups; accommodation in college; examination arrangements • Equipment and software • Non-medical helper support

How to be AS Friendly •

Clear rules, with lack of ambiguity; short sentences

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Calm monotone voice, one question at a time and wait for answer

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Provide predictability; structure; follow through

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Understand the need for routine

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Provide social support to help loneliness without increasing social anxiety (IE Buddy Scheme)

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Say what you mean; clearly state expectations

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Use special interests to engage and connect

Other support services • ASPiration Service • Autism Oxford • National Autistic Society • Parents Talking Asperger’s (Banbury) • Oasis • Wrong Planet

QUESTIONS?