Tag Archives: Mental Health

Autism and Aspergers

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I wrote this article for people who I work with.  I hoped it might help families understand a bit more about autism and especially Aspergers Syndrome.  Many of the individuals we advocate for here at SAtA, have austism as well as a learning disability.

Autism is sometimes known as the hidden disability because it doesn`t show on the outside.  It is a very complicated developmental disability that causes problems with social interactions and communication and the clues can start when a child is very small, even before they are two or three years old. Autism can cause delays in learning and can also bring about many kinds of behavioural problems from infancy, right through to adulthood.

Individuals with autism can have very different ways of being so generally, autism is thought of as a “spectrum disorder,” or a group of disorders with similar features.  Some individuals may have mild signs or symptoms while others may have very serious issues, but they all have an autism spectrum disorder.

Aspergers syndrome sits on the autistic spectrum.  Interestingly the diagnosis of Aspergers is now being used less commonly and has been replaced with the new term Autistic Spectrum Disorder, which covers just about everything.  There is widespread concern about this which was recently highlighted and discussed in the Guardian:

http://www.guardian.co.uk/society/2012/dec/02/aspergers-syndrome-dropped-psychiatric-dsm

People with Aspergers can be similarly mildly to significantly affected.  Many individuals who are mildy affected may be able to function well in their community and live a more or less ordinary life.  Others less fortunate may be so severely affected that the symptoms are completely debilitating and they are unable to function in an ordinary sense at all.

Simon Baron Cohen is a professor of Developmental Psychopathology (and also cousin to the actor Sacha Baron Cohen of Ali G fame).  He has researched and specialised in Autistic Spectrum Disorder and has had several books and eminent articles published on the subject.  He has devised a questionnaire which can be taken by anyone and which pinpoints whether or not you are showing any autistic traits.  Although this is definitely not a diagnosis, I found it enlightening.  Having gone through the test with several friends, family and colleagues, I would imagine that around 75% of the general population sit somewhere on the autistic spectrum.  The link is below if you want to have a go.

http://www.wired.com/wired/archive/9.12/aqtest.html

Thousands of people worldwide go through their lives living with the uncomfortable effects of autism or Aspergers and haven`t got a clue that this is what has been troubling them, their families and friends for all of their lives.  In other words they remain undiagnosed which is a shame because many people who have had a diagnosis report how relieved they are to have an explanation for their varied symptoms.  It can make sense of chaos and a diagnosis can offer people options to bring about change.

Here are some of the challenges a person with aspergers can bring into a relationship:

They often find social situations extremely uncomfortable, people with aspergers find making friends easier said than done and often don`t have any friends to speak of.  Eye contact is difficult or impossible to maintain and they cannot read facial expressions so they can often speak at inappropriate moments, or say something offensive, not understanding they have done so.  When speaking they may go on without a break.  They cannot recognise when it`s the other person`s turn to speak or even if the other person doesn`t find the topic interesting.  It`s possible to turn away from someone with aspergers when they are talking and they may continue with or without your attention.  They may exhibit odd expressions of movement as in Tourettes syndrome or they might adopt  a vacant expression while they talk, sometimes for a long time.

People with autism are often above average intelligence, they can also be funny and charming and so they are very attractive to people who are looking for someone to nurture.  Unfortunately for the person in a relationship with an individual who has autism, they may find that their own emotional needs remain largely unmet because the person with autism simply cannot relate to someone else`s needs.  They are unable to empathise or give back some of that nurture to their non-autistic partner who probably has to seek that kind of emotional sustenance elsewhere.

Someone with aspergers may find it very difficult to recognise when they are becoming wound up.  Most neuro typicals (people who do not have autistic traits) know the signs when they are becoming angry, for example, shortness of breath, a redness of neck, a raising of blood pressure.  The person with aspergers on the other hand, can get more and more wound up and unable to distinguish these feelings from any other, suddenly break out in an explosive display which may include verbal abuse and damaging property.  In other words, put the ornaments away!

I remember last year, speaking to a woman who was married to a man with aspergers.  He worked in the army and had a very successful career, largely because people with aspergers seek repetition so the every day order and routine of the army suited this man perfectly.  He knew what to expect and his work was nothing to be scared of or become stressed about.  The flip side of this tale though is that his appalling behaviour at social functions especially at family parties, resulted in him being banned from all future visits.  So, living with someone with aspergers is definitely not easy but if you enjoy a challenge…..

There is no cure for autism.  Some behaviours can be changed through CBT  (Cognitive Behaviour Therapy) or NLP (Neuro Linguistic Programming.)  The cause is not yet understood but researchers are leaning more and more towards autism having a genetic cause so the autistic traits may run in families.

Lots of people who have autism or aspergers or any other diagnosis on the spectrum are often labelled as someone with a disability.   Having worked with many people who have aspergers or autism, I prefer to think of people with autism as someone who is marvellous and unique.   🙂

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Nurse training.

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In 2001 I had decided that my true calling in life was to be a nurse, so I began a seconded degree in Mental Health nursing at Birmingham University.  I have to say it was one of the most challenging decisions I have ever undertaken and no matter how many  times I employed tricks to remember the order of things, you know  `the hip bone`s connected to the thigh bone` etc. it remained very difficult for me to achieve the standards I knew must be met.  So I didn`t enjoy it all that much, however I met some very nice students there and some pretty far out tutors as well.  Some of the physiology lectures were so enthralling there would be standing room only, yet occasionally I would meet a student so lacking in social awareness or empathy of any kind, I used to think they would be hopeless next to an inanimate object never mind a human being.  I used to wonder what brought them to nursing when it was so clear, they didn`t like people at all.

Every year all students have to work at a placement and there are a number of tests you must pass during a placement in order to continue the course.  For me, one of these was learning CPR and the other was giving my first injection.  The placement was at a large residential nursing home for older people and as I`ve always enjoyed the company of older people; I was looking forward to it.  The manager was an affable Irish man with ruddy cheeks.   I got on with him from the start and it was only when I was a few days into my stay there that I realised he had a problem with drink.  He would slip up the road to the pub at every possible occasion to top up and was the subject of much, highly unprofessional gossip amongst the staff.   In spite of being mildly pissed most of the time, he was an efficient man who ran a tight ship and the standards of care in the home were maintained at an extremely high level. 

 The residents liked him and so did I.

When it came for me to demonstrate CPR to him, he brought out the plastic torso of half a person affectionately known as Jane and laid her on the floor.  Never mind Vinnie Jones telling us `you only kiss your wife` in those days it was de rigeur to place your mouth over the mouth of the person in trouble.   A plastic shield was strategically put in place as protection in case anyone threw up.  I was ready, my patient was ready, my merry manager observing me as I began the CPR.   Unfortunately I must have blown a bit too enthusiastically into Jane as there was a sudden loud bang and both her lungs quickly deflated.  `My God, you`ve blown her up,` my manager stated the obvious, looking at me incredulously through pink rimmed eyes.  He was right and poor old Jane was a gonner!  I think that must have been the prelude to the new ad`s telling us to press hard and fast to Staying Alive……

On another occasion I had to give my first injection.   It being Mental Health nursing, many of the residents had long term mental health issues and were on all kinds of med`s  some of which can only be administered  into the buttock.  It`s quite tricky injecting into the buttock.  You have to divide it mentally into quarters and then make sure you miss a particular area where there are many nerves which can be damaged, irrevocably so.  You also have to ensure you have the correct dosage of medication in the needle.  Nurses have to learn drug conversions which I always found extremely difficult.   I remember my then husband testing me and saying with a playful smile upon his face as I got it wrong for the umpteenth time,  `Helen you`ve just converted enough lithium into our hypothetical needle to knock out most of Acocks Green…..`    Oh how I laughed.

Anyway the old lady who was kind enough to be my guinea pig flinched,  just a tiny bit as the needle went in and she of a thousand injections commented, very generously I thought, `not bad for a first attempt.

Sadly, the manager was sacked but not before he passed me with flying colours.  I was sorry to see him go.  Drink`s a bugger isn`t it.   I only completed year one of my nursing degree as the  following year I went to live in Darwin.   Ever since that time I have been known as Helen, one third of a nurse.