By Judith E. Lipson, M.A., LPC

I hope that one of the reasons that you follow my work is to continue to understand various ‘differences’ from a more expansive view. This article is about autism. It’s when we understand the “why” of something that we can truly learn to accept it for what it is. Autism is not a condition to cure, but rather it is a series of conditions that causes or allows the individual to interact with their inner and outer environment differently. Sometimes this brings about challenges, but that’s most frequently due to our rigid societal expectations and assumptions. Let’s all learn to recognize the aspects, and see the gifts that are part of this spectrum, so that we no longer view it as a “disorder”.

Q:  What is autism?
A:  Autism isn’t one condition. It’s a collection of related conditions that are so intertwined and so impossible to pick apart, that professionals have stopped trying. If you only check one or two boxes, then they don’t call it autism, they call it something else. Here’s a graphic of the various aspects. Remember that autism is a spectrum condition. Some individuals with autism (sometimes referred to as autistics) have less of one of these issues, or it may no longer be apparent. According to the DSM-5, autism is a life-long condition that can ease in intensity and life-challenging ways, but it doesn’t go away. And remember: If you’ve met one person with autism, then you’ve met ONE person with autism.

Q:  Is the person ‘an individual with autism’ or ‘autistic’?
A:  That’s actually a good question and you will get differing responses. Initially we referred to these folks as autistics. Then perspectives about disabilities changed and it was considered most appropriate to see them as individuals who are not defined by autism, but rather who have autism (recognizing that they have many other facets to define them). I work with a lot of folks on the spectrum, from many age groups, and am frequently told that they recognize how autism informs their daily lives, and thus very positively and proudly define themselves as autistic (along with their other descriptors of spouse, parent, employee, artist, writer, etc.)

Q:  I hear that it is harder to identify girls and women on the spectrum.
A:  It does seem to be more difficult since females present differently than males.

All the literature, clients that I talk to, and my experiences with my own clients acknowledge that recognizing and diagnosing autism in those who are born female can be more challenging. Some believe it’s because many girls seem to intrinsically find it easier to mimic peers as well as others’ socialization. Additionally, they are less likely to have the same types of areas of interests as their male counterparts, so their identity on the spectrum is less recognized.

My intention in this section is to provide you with a variety of links that can better inform you. I hope you find this information beneficial. I encourage you to reach out with questions, and to let me know about any professionals that you have met who are adept at diagnosing ASD in the AFAB (assigned female at birth) population.

From the article, Why Do Many Autistic Girls Go Undiagnosed? by the Child Mind Institute: “Autism is a developmental disorder that is marked by two unusual kinds of behaviors: deficits in communication and social skills, and restricted or repetitive behaviors. Children with autism also often have sensory processing issues. But here’s the hitch, according to Susan F. Epstein, PhD, a clinical neuropsychologist. ‘The model that we have for a classic autism diagnosis has really turned out to be a male model. That’s not to say that girls don’t ever fit it, but girls tend to have a quieter presentation, with not necessarily as much of the repetitive and restricted behavior, or it shows up in a different way.’ Stereotypes may get in the way of recognition. ‘So where the boys are looking at train schedules, girls might have excessive interest in horses or unicorns, which is not unexpected for girls,’ Dr. Epstein notes. ‘But the level of the interest might be missed and the level of oddity can be a little more damped down. It’s not quite as obvious to an untrained eye.’ She adds that as the spectrum has grown, it’s gotten harder to diagnose less-affected boys as well.”

In the article: Autism is Still Under-Diagnosed in Girls and Women, they propose four ways testing should change: “From an autistic woman’s perspective, the diagnostic assessments need rethinking:

• they should consider autistic strengths and not focus solely on deficits and impairments. Sometimes autism isn’t considered because of the presence of strengths
• they should incorporate the common lived experiences of autistic women. These have now been well-documented by autistic women, many with successful careers and yet areas of difficulty
• the differences between the presentation of autism in females and males should be reflected in the diagnostic criteria
• autistic people should be included in the design and content of diagnostic tests.”

Why Camouflage Autism? specifically talks about a female’s potential for camouflaging their autism.

Developing a Positive Sense of Identity by Dr. Michelle Garnett explains more about spectrum women developing a positive identity and includes many insights to recognizing ASD in females. It also discusses the benefits of identifying it earlier, as well as the uniqueness of having ASD as a woman.

Autistic Women in the Workplace provides guidance to identify one’s career, and to recognize greater understanding of the special challenges as well as the special gifts that autistic women (or women with autism) can provide. Gifts can include leadership skills, teamwork, communication skills, and work ethic. Some of these items might surprise you; I encourage you to read the article. The author also discusses guidance for receiving accommodations in the workplace.

And learn how to address social challenges at work as an autistic adult.

The Boston Globe article entitled What Happens to Autistic Children Once They Become Adults offers a bit more generalized approach to ASD and careers. This article highlights some amazing work programs that have been developed in Florida and Massachusetts.

There are many resources for folks with ASD who are in relationships. I happen to love this article since it approaches healthy relationship-building from both the ASD and neurotypical perspective. How to Be the Best Partner to an Autistic or Neurotypical Person is both enlightening and refreshing. 10 Things You Need to Know About Your Autistic Partner is also enlightening.

Anytime we talk about autism I think it is imperative to have an opportunity to better understand meltdowns. This article about meltdowns, written by one with autism, offers an outstanding opportunity to understand the process and the experience. By the way, this is not a quiz asking you to select the correct choice for each item. Rather, each issue provides a variety of ways to understand what is really happening. Please read each item (A through E) that completes each phrase so that you can better understand your family member who experiences meltdowns.

And here’s a related article about autistic burnout. The authors explain that it is different than depression (though depression might be incorporated in the symptoms) because there is increased sensory sensitivity and the need to isolate in order to recover.

Q:  Why does my student with autism make a prolonged noise when I begin to speak, but stops when I stop talking?
A:  Sometimes individuals are highly triggered by sounds, yet by covering it with something they can control (tapping, shrieking, etc.) it is easier for them to deal with the original sound.

Q:  I have been told that my student’s behaviors are stims. What does that mean? I feel that they are distracting and disruptive for my student and I want to know how to make them stop.
A:  Stims or stimming is shorthand for self-stimulating behaviors.  These are actually quite helpful for your student as they help them to soothe their (overly) reactive nervous system in the moment. I was at a conference once where the presenter suggested that we try to mimic these behaviors on our own to see how it feels. Most neuro-typicals do indeed find them soothing. Regardless, it is soothing for your student. I was also cautioned by this presenter to be careful when trying to stop a stim, as it will be replaced by something else, which might not be as socially or classroom acceptable. Here’s a graphic that explains more about stimming.

Q:  How do you teach appropriate eye contact?
A:  First of all, let’s understand the possible reasons why those with ASD or other individuals avoid eye contact:

• Some cultures discourage looking into another’s eyes.
• If the individual has misaligned eyes (eyes that don’t work together adequately), uncomfortable distortions can occur prompting them to avoid looking at an individual’s face. Misaligned eyes, which are typically not recognized by an untrained professional or without a neuro-vision exam, can also cause challenges with reading, eye-hand coordination, balance and/or depth perception. Click here for a questionnaire provided by a neuro-vision clinic.
• Individuals who have experienced abuse have often learned that it is safer to not look someone in the eyes.
• Intuitive, empathic individuals may avoid eye contact because they “know everything there is to know about the person, and feel it in their own body”. (I originally learned about this from a 17 year old student who explained this to me with those words.) The answer to the next question offers a strategy for this.

If it is still deemed appropriate to teach eye contact you can suggest that the individual make brief, but regular or occasional visual contact with the individual’s face, possibly looking at the eyebrows instead of the eyes.

Q:  How do I tune down how sensitive I can be?
A:  Part of this answer is energetic, part of it is how you think about things.

• You don’t need all the possible information to know how to respond, so bring in less.
• Turn down your senses just like you turn down the volume of the podcast or music that you are listening to.
• Understand that it is not your job to take care of everyone, or to ‘save the world’.
• Practice energy modulation and drain your receptacle. (Listen to this short clip to learn how.)
• Practice radical acceptance for having this gift.

Q:  I’m wondering how autism (ASD) and ADHD may be reflecting a more evolved state.
A:  The theory that I offer here is not based on research or data, yet I have heard it discussed by others. I believe the increase in the number of folks with ASD or ADHD may be related to the fact that they are neurologically more sensitive to their environment. We know that these folks tend to be Sensitives. It makes sense that if they are highly attuned to their 5 senses, then they are also sensitive to various factors in our environment. This includes a hyper-reactivity to sensory input as well as various chemicals, additives, and drugs in our food, air and water. All of this can lead to medical conditions as well as neurological over-stimulation leading to meltdowns and other difficulties.

There are also benefits with these heightened awarenesses. These individuals at their core often have a very evolved awareness of Oneness. They seem to have a clearer sense of peace, goodness, and compassion for others and are more in touch with our similarities than our differences. They have a very clear sense of right vs wrong and are often quite frustrated with the state of the world. Hence, I’m very pleased that their numbers appear to be increasing as we need citizens who are more prone to bringing light, goodness, and compassion to our systems as well as enlightened relationships with each other.

Hans Asperger said, “It seems that for success, in science or art, a dash of autism is essential. For success the necessary ingredients may be an ability to turn away from the everyday world, from the simple practical, an ability to rethink a subject with originality so as to create in new untrodden ways.”

And as stated by Albert Einstein, “No problem can be solved from the same level of consciousness that created it.”

Judy Lipson is a Licensed Professional Counselor and educational strategist in West Bloomfield, MI. She helps clients of all ages who have learning difficulties, work or school related anxiety, ADHD, Asperger’s Syndrome or Autism Spectrum Disorders, and those who wish to Remember and Become ‘Who You Really Are’. Contact Judy at 248.568.8665 and judylipson@spiralwisdom.net, and visit www.JudyLipson.com for more information.

This article is for informational purposes and is not meant to replace medical care.

By Judith E. Lipson, M.A., LPC

I had never intended to work with folks who deal with significant traumas, so when my colleague and friend suggested that I accompany her to see Bessel van der Kolk who was speaking in Ann Arbor on trauma, I insistently told her no, several times. But Barb can be very persistent and so I signed up for this great opportunity. I can’t thank her enough! This is one of those trainings that has greatly informed my work with Sensitives.

Dr. van der Kolk taught the group about the common responses that individuals frequently experience emotionally, relationally, and especially physically as a result of their traumatic experience. Because of his information, I suddenly had this ah-hah about the Sensitives that I work with and recognized how their experiences can be understood in the context of trauma that we recognize professionally and as a society. (I now refer to major illness, assault, accident, war, abuse, and neglect as the big T traumas). This information has informed my work ever since, and is key to what I teach my families, my clients, and professional groups about Sensitives.

Sensitives are those who are highly attuned to one or more of the 5 senses (taste, touch, see, hear, smell) and are typically also very intuitive, empathic and energy-aware. At the time of that conference, I already knew of the strong sensory awareness in the autistic population and was seeing it in folks who often experience ADHD and/or anxiety. I began to see the students and adults that I worked with as being on this sensory continuum of Sensitives. I focused on identifying these folks and helping them and others to focus on their strengths while mitigating their weaknesses. At the time I had only a few techniques to address the challenges for Sensitives. These included explaining the situation to their loved ones and their teachers so they can ‘walk a mile in their shoes’; recommending the removal of fluorescent lights, using natural lighting, and generally dimming room lights to address light sensitivity; and teaching the individuals how to modulate their empathic gifts.

Dr. van der Kolk explained that after a trauma the body becomes extremely reactive physiologically to subsequent triggers. Professionals began to recognize this after WWI when the soldiers came back “shell shocked”. In 1980 we diagnosed it PTSD (Post Traumatic Stress Disorder), and realized that it applies to events other than war like accidents, serious illnesses, assaults, abuse, etc. Subsequently, professionals learned specialized treatments including EMDR (Eye Movement Desensitization and Reprocessing) to address this disorder. (Incidentally, if you are interested in a cutting-edge treatment, check out Havening.org).

The training further explained how if an individual experiences a trauma after successive other traumas (warfare, childhood abuse or neglect, etc.) that their physiologic responses, behaviors, and emotions are likely to be more intense and persistent. And that’s when I understood the physiologic effect with highly sensitive nervous systems (Sensitives). Imagine if you will a sense that is most pronounced for you: maybe it is a particular item of clothing that you find minimally tolerable, or walking on a crowded street in a bustling city, or having to stand near a very loud sound source, or having to stay in the presence of an individual that you just can’t stand. Now imagine that discomfort happening all day long and you can’t make it go away, because it won’t or can’t stop, or you are not allowed to get away from it. This is the experience of a Sensitive – being inundated in life, in school, and even within their own body 24/7 (there are those who say that sleep doesn’t effectively push a pause button on this sensory input) without significant relief. And THIS was my ah-hah: that Sensitives are living with repetitive little t traumas, and the body is responding similarly to how we understand the responses of folks who have suffered the more traditional big T traumas.

Having this new information about the experiences of Sensitives means that I can use a new set of options when working with them and when explaining their situations to others. One of these new awarenesses is to understand that most Sensitives aren’t having tantrums, but rather are experiencing meltdowns. Meltdowns can be best understood in terms of the sensory overload that is occurring from 24/7 input. Their system (physiology) just can’t take one more thing. Remember the story of the straw that broke the camel’s back? This is what is happening to sensitives when the sensory input from their 5 senses or their own or other people’s emotions becomes too much and takes them from ‘0-60’ for seemingly no apparent reason. But now we can understand that there definitely ARE reasons, and we need to identify them and help minimize them where possible.

A term that I have heard used to describe common behaviors of those in the autistic population is PDA – Pathological Demand Avoidance. It seems to refer to a negative trait where the individual refuses to comply with what is requested. It is akin to ODD (Oppositional Defiant Disorder). With my new understanding of Sensitives and trauma, I see these avoidances as a distinct effort to protect oneself from overwhelm. With that understanding one wouldn’t use a punitive or behavioral approach, but rather a look at the antecedents to see how we can reduce or remove the triggers creating the overwhelm.

When we understand the effects on the body, we realize that to approach treatment from only a cognitive or behavioral approach means to miss a critical part of the experience of the individual. To address the physiologic effects of the body I (and others) use techniques that include:

• EMDR (Eye Movement Desensitizing and Reprocessing)
• Havening (Havening.org)
• Tapping (Emotional Freedom Technique; TheTappingSolution.com)
• Breath work
• Mindfulness practices
• Relaxation
• Movement
• Somatic work which includes watching the body, the breath, the body tension, etc., and providing opportunities for the body to release the trapped trauma response. (These include the work of Bessel van der Kolk, Peter Levine, Ron Siegel, Patricia Ogden, Stephen Porges’ polyvagal theory, etc.)

I was recently listening to a podcast by Dr. Brene Brown who was interviewing Oprah Winfrey and Dr. Bruce Perry about their new book, What Happened to You? Dr. Perry, a neuro-biologist and trauma specialist says, “Instead of asking what is wrong with these kids, ask what happened to these kids?” He then suggests the consideration of the What Do You Expect Disorder? He continues to explain that any pattern of behaviors that activates your stress response system and leads to an alteration in how that system is functioning, leads to an overactivity and an over reactivity. All kinds of people have tiny little experiences that activate the stress response system. And if that pattern is prolonged enough, it leads to the very same changes in the brain as a big T trauma, and is an underestimated and underappreciated component of the trauma narrative.

In light of Dr. Perry’s work and my observations, I encourage you to always look at the antecedents (that which comes before the troubling behavior), particularly those that are in the sensory realm and those that are clearly triggering emotions for your individual. As you do, walk a mile in their shoes in order to see the significance of those antecedents. Then strive to minimize their intensity and frequency, and to teach your individual the necessary skills to tolerate that which cannot be changed.

Judy Lipson is a Licensed Professional Counselor and educational strategist in West Bloomfield, MI. She helps clients of all ages who have learning difficulties, work or school related anxiety, ADHD, Asperger’s Syndrome or Autism Spectrum Disorders, and those who wish to Remember and Become ‘Who You Really Are’. Contact Judy at 248.568.8665 and judylipson@spiralwisdom.net, and visit www.JudyLipson.com for more information.

This article is for informational purposes and is not meant to replace medical care.

By Judith E. Lipson, M.A., LPC

Recent statistics indicate that 1 in 68 children are on the autism spectrum; however autistics are not the only ones who experience sensory overload.

It is very likely that you know someone professionally, in your social group, or in your family who is neuro-sensitive. Sensitives can be autistic or neuro-typical (without autism). Over the years in my practice I have seen many children and adults who are neuro-sensitive. As their prevalence increases, so does their sensory awareness and responsiveness.

There is much speculation as to why there are more individuals who experience the world in this way. It could be evolutionary, neurological or the additives, drugs and pesticides in our food network.

Regardless of the cause, with the increasing number of individuals affected, there is a responsibility to learn how to best support Sensitives. There are a number of traditional approaches provided by occupational therapists, behaviorists, and speech and language therapists. There are also less-conventional approaches. I wrote about these in Setting Boundaries and Energy Cleansing.

You are encouraged to increase your awareness of the many situations that can create difficulties for the neuro-sensitives in your life so that you can support that individual or help to bring about systems change.

SCHOOLS

Kids spend the majority of their day in these environments for twelve or more years. We can reduce their sensory impact and ease their experiences.

LIGHT SENSITIVITY: Fluorescent lighting creates visual and auditory challenges. Highly sensitive individuals are bothered by the pulsations that fluorescents emit, as well as the sound from light ballasts. Light sensitivity can also affect reading: ease, accuracy, memory, concentration, and comprehension. Using natural or incandescent lighting in schools and at home can increase your child’s relaxation, reading skills, and even their willingness to do homework.

RECESS AND PHYSICAL EDUCATION: Weak muscle tone and poor coordination increase the likelihood that sports and team activities may not be a positive experience. Loud echoing sounds, close proximity and lack of structure add additional difficulties. Encourage involvement in individual sports like swimming, bowling, tennis, golf, track, cross-country and martial arts.

SOCIAL: Educator Richard LaVoie explains that everything in school, and life, is a social decision. Social situations are typically not easy for Sensitives: should they attend to the words, the tone, the body language, or the energy of the speaker? These are rarely congruent. To assist, provide explicit instructions for nearly every social scenario. It’s not uncommon for them to fail to generalize one situation to another. For assistance, do an internet or book search for “social stories”.

MEDICAL

To avoid triggering an exaggerated startle response, explain the action and its purpose before physical contact, or when approaching with a medical instrument. Also, anatomical pictures trigger some Sensitives.

DOCTOR OFFICES: Try to arrive on time, ask to be brought into an exam room quickly, and to be seen promptly to avoid anxious waits, an overly stimulating waiting area, and possible meltdowns.

HOSPITALS: Imagine this scenario: A medical concern; agitation; bright fluorescent lighting; naked under the irritating fabric of an uncomfortable gown; sounds; communication challenges; lack of medical knowledge; presumed loss of rights; fear of stimming (self-soothing) in public; lack of privacy for solitude or toileting. Neuro-sensitives will require a great deal of support in these environments.

ENTERTAINMENT

Encourage social activities. Movies, bowling and even cruises are now offering autism/sensory-friendly options.

MOVIES/THEATER: Loud volume, darkness, and the expectations for silence and for sitting still for periods of time can seem impossible – and are likely to lead to meltdowns or “inappropriate behaviors”.

RESTAURANTS: With planning and instruction, the potential difficulties of too many menu options, the inability to sit still, and conversation challenges with wait staff can be made successful.

MALLS AND LARGE VENUES: Large expanses of space can make a neuro-sensitive unaware of their body and lose their sense of self. The emotions and energy of other people, bright lighting, fragrances, and temperature changes outside the different stores are physically uncomfortable and overwhelming to their senses.

EMOTIONS: Even exuberance and joy can over-stimulate their system.

Neuro-sensitives have a highly aroused nervous system and lack the ability to process the information from their bodies and their environment without triggering an over-reactive fight-or-flight response. It is imperative to remember that any subsequent behavioral outbursts are a reaction to their sensory system overload. These meltdowns are not the equivalent of tantrums.

Benjamin Franklin said, “An ounce of prevention is worth a pound of cure.” Teaching neuro-sensitives a variety of coping skills and encouraging them to use these strategies is extremely beneficial. When possible take the initiative to modify their surroundings by assessing the potential impact of the five senses, energy awareness, and empathy, as well as expectations for social interaction and communication.

Doing so for your neuro-sensitives will ease the situation and minimize or avoid meltdowns or discomfort.

Judy Lipson is a Licensed Professional Counselor and educational strategist in West Bloomfield, MI. She helps clients of all ages who have learning difficulties, work or school related anxiety, ADHD, Asperger’s Syndrome or Autism Spectrum Disorders, and those who wish to Remember and Become ‘Who You Really Are’. Contact Judy at 248.568.8665 and judylipson@spiralwisdom.net, and visit www.SpiralWisdom.net for more information.

This article is for informational purposes and is not meant to replace medical care.