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  • Elaine Benardout

Understanding Autism

Definition of Autism

“Autism is a neurodevelopmental condition of variable severity, with lifelong effects that can be recognised from early childhood.

It is chiefly characterised by difficulties with social interaction and communication and by restricted or repetitive patterns of thought and behaviour.” Autism means the way you think about and experience the world is different to most people.



A diagnosis of autism can only be given by a psychiatrist.

If it is felt that a young person might be on the autistic spectrum, they would be referred to CAMHS to pursue a diagnosis. The clinician will use a diagnostic tool to decide whether the person is autistic.


Social communication & social interaction challenges

Autistic people can have difficulties with interpreting both verbal & non-verbal language such as gestures or tone of voice.

Some autistic people may be non-verbal or have limited speech, while others have very good language skills but struggle to understand sarcasm or tone of voice.


Other challenges might include:

Taking things literally & not understanding abstract concepts.

Needing extra time to process information & answer questions. Repeating what others say.


Social interaction

Autistic people may struggle to “read” people –recognising orunderstanding others’

feelings & intentions & expressing their own emotions. This can make it very hard to navigate the social world as it may make them

appear insensitive.

They may seek out time alone when overloaded by other people. They might not seek comfort from others. They might appear to behave “strangely”

or a bit “socially off”. They might find it hard to form friendships.

Repetitive behaviours

The world can be very confusing for autistic people as they struggle to understand its unwritten rules. They may use routines and rituals to help keep their anxiety at bay & keep life as predictable as possible.

These routines may include things like always eating the same foods, wanting to wear the same clothes, the same route and so on. Changes to routine, particularly unplanned or lastminute, can be extremely distressing & anxiety provoking for autistic people.

Some autistic people may use repetitive movements, such as hand flapping or rocking to calm themselves. These are often called stimming.


Sensory issues

Some autistic people may be over or under sensitive tosounds, touch, taste, smell, light, colours, temperature or pain. They may find certain background noises unbearable, while a neuro typical person would not even notice.

Autistic people may avoid situations as a result. Places such as schools, workplaces, shops & restaurants may be particularly overwhelming and cause sensory overload.Simple adjustments can help make environments moreautism-friendly.


Theory of Mind

The ability to understand and attribute mental states, such as beliefs, intentions and emotions, to oneself and to others. It plays a crucial role in human social interaction and communication, allowing individuals to interpret and predict the behaviour of others based on their mental states.

Autistic people can struggle with this, it is sometimes known as “mind blindness”.


Extreme anxiety

Anxiety is a real difficulty for many autistic people,particularly when in social situations or when facing change. It can affect them both psychologically & physically and can have a serious impact of their quality of life, as well as that of their families.

It is important that autistic people recognise their triggers & find coping mechanisms to help reduce their anxiety. This is hard to do when you have difficulty recognising & regulating your emotions.

Over a third of autistic people have serious mental health issues as a result.



When it all gets too much for an autistic person, they can go into what we call a meltdown or shutdown. Meltdown – this happens when the person is totally overwhelmed &temporarily loses control of their behaviour. This can be verbal – shouting, screaming, crying or it can be physical – kicking, lashing out, biting, throwing, smashing.

In children & young people meltdowns can be mistaken for tantrums & people can be very judgemental about this.


A shutdown

Appears less intense to the outside world but can be equally debilitating. This is when a person goes completely quiet &“switches off”.

Shutdowns are a passive way of dealing with being overwhelmed. This can be just as difficult for an autistic person as a meltdown.

For both meltdowns & shutdowns, the person needs time to recover and regroup.



Masking is when someone hides or disguises part of themselves to fit in with others.

All of us use this tool to some extent. Masking might involve supressing behaviours that are soothing to an autistic person but that others find “odd”. This can include things such as stimming, special interest and so on.

An autistic person may also “copy” the language and behaviours they see around them, as a way of trying to fit in, without necessarily fully understanding them.

Studies have shown that masking can be detrimental to one’s mental health. It is also exhausting and prevents a person from being true tothemselves. The more understanding there is in the world, the less masking will be needed.


Practical Support & Strategies

Getting their attention

• Always use the person’s name at the beginning so they know you are talking to them.

• Make sure they are paying attention before you ask aquestion or give an instruction.

This will look different for different people.

• Use their hobbies or interests to engage them.


Processing information

Too much information can lead to overload.

• Say less & say it slowly.

• Use key words.

• Pause between words and phrases & give time for a response.

• Don’t use too many questions.

• Use less non-verbal communication

• Use visual supports

• Factor in the environment

 Avoid open-ended questions

• Keep questions short.

• Only ask the most important questions.

• Be specific e.g. did you enjoy lunch, rather than how was your day.


More communication tips

Reactions to “no”

• “No” is often used when there is danger. If it’s a safety issuelook at ways of explaining.

• If you are saying “no” because their behaviour isinappropriate, you might want to change your reaction. Trynot to shout, a calm reaction may help de-escalate.

• Set clear boundaries so they know where and when certainbehaviours are acceptable.


Avoid the following:

• Irony

• Sarcasm

• Figurative language

• Rhetorical questions

• Exaggeration


Obsessions & Repetitive Behaviour – what can we do?

An obsession or a hobby?

Is the interest limiting the person’s social opportunities?

Is the interest impacting on their learning/ job?

Does the interest cause significant impact to others?

Can the person stop the activity/ interest independently?

If yes, then the interest may have become an obsession.


Repetitive behaviour – why?


An attempt to gain sensory input, e.g. rocking, flapping hands.

An attempt to reduce sensory input, e.g. focusing on one thing may reduce the impact

of other less desirable things.

To deal with stress & anxiety & to block out uncertainty.

Does the behaviour restrict the person’s opportunities?

Is it age appropriate?


Managing Anxiety

Self-regulation skills are any activities that help a person to manage their own emotions & behaviour.

Helping the person to identify when they feel stressed or anxious and then how to use strategies to reduce this, will help with their behaviour.

Some strategies to try include: Use of a stress ball.  Taking 10 deep breaths


Autism & Anxiety - Why might autistic people experience anxiety?

Difficult social situations & sensory environments can increase stress & anxiety

A sense of being misunderstood by non-autistic people.

Masking or camouflaging.

Changes to routine, particularly when unexpected.

Difficulty identifying, understanding & managing emotions.


Meltdowns - What is a meltdown?

 It is an intense response to an overwhelming situation

 This overwhelm leads to temporary loss of control of behaviour

 It’s not a temper tantrum & is not naughty or bad behaviour

 Meltdowns happen because the person is totally overwhelmed & it is difficult to express this

 An autistic person may also shut down & refuse to interact.

What should you do in that moment?

 Don’t judge them!

 Give the person time – they will need to recover from information or sensory overload

 Make space and do what you can to reduce sensory overload e.g. turn off music, dim the lights

 Calmly ask them if they are ok but don’t push for a response


Meltdown - Anticipating a meltdown

 A person might show signs of distress before they get to a meltdown

 They might exhibit anxiety by pacing or seeking constant reassurance

 They might rock or become very still

 See if you can prevent the meltdown by:

 Using distraction

 Diversion

 Calming strategies

 Remaining calm yourself


Identifying the causes

 Keep a log or diary to help identify what is overwhelming them

 STAR chart - Patterns might emerge that help you makechanges or predict


Minimise Triggers

Sensory Considerations - These can be very triggering so try to minimise these wherever possible.

Think in advance whether the person has any sensory issues that might be triggered where they are going.

Try to find ways to work around these or minimise them without stopping the person doing the thing they want or going to the place they want to go to


Change in routine

Consistent, predictable routines and structure are very important for autistic people, changes to these can be very distressing.  

You might use picture symbols to explain the change. Give the person an opportunity to express their frustration with this in an appropriate way e.g. hitting a pillow, ripping paper, then follow with a calming activity.





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