Auitsm and Echopraxia

Greetings Earthlings! 🙂

Leading on from my previous post on echolalia, this week I’d like to briefly discuss the phenomenon echopraxia.

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Yes I know, it’s another mouthful, but what exactly is echopraxia?

Echopraxia (also known as echomotism or echokinesis) is a type of tic disorder characterized by involuntary imitation of another persons actions e.g. waving a hand, touching your nose, kicking something, even facial expressions. Echopraxia is one of the core features of Tourette’s syndrome, however it has also been found to occur in ASD’s. It is often paired with echolalia, but it has been known to occur independently in autists.

I know what you’re thinking- imitation of actions is critical to early development in childhood and perfectly “normal” behaviour, so it seems like echopraxia might be reading into things too much. However, when this behaviour persists and becomes reactionary rather than a learning tool, then it can be viewed from a pathophysiological  perspective. As such, it can be very difficult to diagnose this behaviour in children. 

So what does the science have to say about echopraxia and autism?

There’s very limited research in this area, however experts believe that echopraxia is related to damage or dysfunction within the frontal lobe known as the action cortex of the brain- an area that is often implicated in autistic behaviours. Other’s have theorized that abnormalities in the mirror neurons located here may be responsible.

Nope, I’m afraid mirror neurons are not quite this exiting- mirror neurons are in fact a particular type of nerve cell that fires when a person or an animal acts and witnesses another person complete the same action. This type of behaviour has been particularly observed in primates, giving new meaning to the phrase ‘monkey see, monkey do’.

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In general, echopraxia is considered harmless, however if it starts to interfere with social functioning, then behavioural modifications, medications and psychotherapy are possible treatment options 🙂

Hope you enjoyed this post dear Earthlings! 😀

Have a lovely weekend!

Aoife

 

Autism and Eating Disorders

Greetings Earthlings! 🙂

This week I’d like to talk about a very common issue, particularly for women with autism- eating disorders.

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As discussed previously, mental health issues are quite prevalent among the autistic population. Because of this, many autists can go un-diagnosed as co-morbid mental health issues often mask the root autism diagnosis. This is particularly true of eating disorders for female autists where doctors will diagnose an eating disorder, but due to social masking tendencies will often overlook their autistic traits.

In fact this should really be one of the first things that doctors should assess when patients present with eating disorders as numerous studies have shown that there is a higher prevalence rate of autism in patients diagnosed with eating disorders (up to 20%). Evidence indicates that patients presenting with anorexia nervosa, bulimia nervosa and binge eating disorder (BED) have greater numbers of autistic traits than the general population.

Autists will often not benefit from conventional treatment for disordered eating so it is critical that it is identified early.

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So why are eating disorders so prevalent for those on the spectrum?

The reasons are varied, but tend to be either psychological or sensory related:

Psychological:

Some people on the spectrum develop eating disorders as a means to fit in, to attain the kind of figures that they see in magazines and perceive to be “perfect” or “normal”. Others develop eating disorders as a means of control, where the routine and rigidity can be a source of comfort to an anxious mind running on overdrive (interestingly this may have a scientific basis as starvation decreases levels of serotonin, which is heavily involved in anxiety and is often elevated in autism). Moreover, if exercise or particular foods become specialist interests, an autist may obsess and inadvertently develop a disorder as a result.

In some cases an eating disorder may be a simple matter of mind blindness where an autist simply does not understand that their eating behaviours are abnormal or dangerous.

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Sensory:

Sensory issues are commonplace for autists both with and without an eating disorder. An autist may be sensitive to different tastes, textures and smells which can make for a very restrictive diet depending on the severity. In some cases, eating may be so stressful that they may not eat very much at all to avoid an unpleasant sensory event.

For further information about autism and eating disorders you can check out the link below for advice and support:

https://www.bodywhys.ie/understanding-eating-disorders/key-issues/autism-eating-disorders/

Hope you enjoyed this post dear Earthlings! 🙂

Enjoy the weekend!

Aoife

Autism and Gait

Greetings Earthlings! 😀

This week I’d like to discuss another lesser known aspect of the spectrum- autism and gait.

As I’ve discussed previously, coordination issues are part and parcel with autism, however, what you may not know is that these coordination issues tie in with an autists gait- particularly for those with Asperger’s syndrome. In fact one of the lesser known diagnostic criteria in the DSM-V is that of an odd or unusual gait.

New technologies are even using gait analysis as an early means of detecting autism:

I know it seems an unusual trait, (let’s face it, we rarely notice a person’s walk) but researchers have observed that autists can have greater or even reduced step and stride length, increased step width, have unusual posturing, tend to walk on their toes, and are lacking in “motor smoothness” when compared with their neurotypical peers.

So why is an autists gait so unusual? What does the science have to say?

Thus far only a few studies have investigated the underpinnings of gait and autism (although the association has been known for decades), but as usual, the evidence points back to the brain. There has been a lot of debate as to which region is responsible for gait differences, however there is evidence to suggest that neurological alterations in the cerebellum (regulates motor movement) and the basal ganglia (a group of nerves involved in voluntary control of motor movements) in autists are the likely culprits.

Furthermore, those autists who tend to toe walk can develop a leg length discrepancy which can also contribute to their odd gait. Gait issues such as this can have a negative impact on the body as this can shorten your Achilles tendon.  Research shows that children with ASD’s tend to have a reduced range of motion in the knee and ankle when walking which may imply weakness around these joints.

It’s not all bad news however, as special orthotics can be used to help improve some of these issues.

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Hope you enjoyed this post dear Earthlings! 🙂

Have a lovely weekend!

Aoife

Pica and Autism

Greetings Earthlings! 🙂

This week I’d like to briefly talk about an aspect of the autistic spectrum which you may not be familiar with- pica.

So what exactly is pica?

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No not that guy! 😛

Pica is a type of eating disorder where a person has an appetite for things that are not considered to be food such as dirt, dust, chalk, hair etc.

It’s often seen in pregnancy however, almost 25% of autists display signs of this behaviour.

Thankfully I’ve never really had any weird cravings like that, however as I child I did like to eat toothpaste on occasion…what can I say Aquafresh just looked too much like sweets!! 😛

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Those red, white and blue stripes were just too tempting! I even think I used to recreate this Werther’s Original ad in the mirror pretending the toothpaste was the sweet! 😂

Anyway less of my weirdness, back to pica!

Joking aside, pica can be very serious if the substance that is ingested is toxic such as lead or if the item can cause an intestinal obstruction like hair ingestion.

So what does the science have to say? Why is this behaviour found in autism?

There does not seem to be one uniform cause of pica, however, pica has been associated with nutrient deficiencies (such as iron) and is thought to be the body’s subconscious way of replenishing the missing nutrients, which would be consistent with the often restrictive nature of an autists’ diet.

It’s also thought that pica may be a sensory response to stimuli in autists to relieve stress, anxiety, pain and discomfort or the item simply has a pleasurable texture. Pica may equally be interpreted psychologically as a means of seeking attention.

Science aside, experts say that the cause of pica may simply be that the autist is unaware that they are eating an item that is unconventional/unsafe.

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That’s all for this week Earthlings, hope you enjoyed this post! 😀

Have a great weekend! 🙂

Aoife

Autism and Change

Greetings Earthlings! 🙂

David Bowie: “Ch-ch-ch-anges-”

Autism: NOOOOOOOO!

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Yes, this week we’re going to talk about autism and change! 😂It’s a well known fact that autists do NOT like change. We like routine, structure, predictability- we like to be in control.

Historically, I’ve never been the greatest with change. As a child I went into a full-scale meltdown when the school banned chocolate (it’s pretty hilarious when I picture my 11 year old self wailing “I’m a chocoholic!” at the teacher!😂), I couldn’t sleep for 2 weeks after my sister changed the angle of her bed; worse still when we sold my family home, it took years to get my head round the loss. Sure, it may have only been 4 miles up the road, and I still went to the same school, but this one simple shift was as if a ton weight had been dropped on my fragile, pubescent head.

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New things can be a lot more complicated for an autist than the average person. You have to consider the sensory implications- how might a new smell affect you; will the taste of this new food make you sick; will this new top make you want to rip off your own skin? Last year I tried paint-balling for the first time without pausing to think of any potential sensory issues. The noise of the guns, the overpowering smell of the mask, the pain when I got hit- I was completely overwhelmed! I had to be removed within 10 mins after having a meltdown behind a tree! At least I drove myself there so I could make a quick escape to the PS4 to shoot things from the safety of my couch instead 😉

It’s not that an autist is not capable of change, it’s just oftentimes it can be a lot easier to stick with the status quo for fear of the unknown.

If it ain’t broke, don’t fix it! I know I like a particular dish at a restaurant, so why would I rock the boat and risk an adverse sensory reaction?

That being said, here are some tips to cope with change:

Take baby steps- you’ve got to learn to crawl before you can walk. Make small changes in your life and you’ll gradually learn to cope with bigger ones.

Challenge yourself- Setting goals to change something in your life can be a great motivator. Choosing to make a change on your terms can help to prepare you for the unexpected changes that life likes to throw at us.

Do the research– for any impending changes, take the time to educate yourself. If moving to a new place, familiarize yourself with the area- check out the amenities, the bus routes, use google street view to digitally walk around etc. The more you know about it, the sooner it becomes familiar which ultimately feels like less of a change.

Rewards and bribery– not always the best plan but it can help to incentivise behaviour change! As I’ve discussed previously, bribery worked to help me change my study habits as a teenager by trading hours of study for hours of gaming!

You can read more tips for coping with change in the link below:

https://www.autism.org.uk/about/behaviour/preparing-for-change.aspx

But might there be a scientific explanation for our struggles with change?

In 2017, researchers discovered that the posterior cingulate cortex of the brain is associated with changes in routine behaviour. As of yet this area has not been extensively studied, however the research would suggest that there is some level of dysfunction taking place in this cortex in the autistic brain. Current evidence indicates that there is poor connectivity, reduced metabolic activity and structural changes at the cellular level in the neurons within this region.

No wonder change is difficult if your brain is actively fighting against you! Perhaps the real change that is needed is our attitude towards an autists struggles with change; maybe then change won’t be so scary after all 🙂

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Have a good weekend Earthlings! 🙂

Aoife

Autism and Alexithymia

Greetings Earthlings! 🙂

Today I’d like to briefly elaborate on something that I’ve touched on in previous posts– autism and alexithymia.

So what exactly is alexithymia?

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Alexithymia is a personality trait wherein an autist may struggle to identify and describe emotions in themselves and in others. We feel emotions just like everyone else, we just aren’t always aware of what it is we are feeling. It can be incredibly frustrating (ironically I’ve often struggled to identify this emotion in the past 😛 ) knowing that you feel something but not having a clue how to verbalize it or process it properly. I’ve honestly spent days going “The thing is…it’s just…um..I dunno!” round and round my mind until I can figure out what it is I’m feeling!

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Thankfully as I’ve gotten older this happens less and less frequently.

Aoife’s Top Tip: as I’ve discussed previously, music can be quite beneficial when dealing with alexithymia. If I can’t identify an emotion, I tend to gravitate towards songs that sound like what I’m feeling or a particular lyric that resonates with my experience which can help get you past a rough patch 🙂

As many as 85% of autists may have varying degrees of alexithymia, but is there a scientific explanation for it?

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The science remains unclear, however some neurological studies may provide us with some clues.

Early studies proposed that there is a breakdown in communication along the corpus callosum between the emotional right and the logical left hemispheres of the brain when emotional information is transferred to the language regions of the brain. In one third of autists, the corpus callosum (a thick bundle of nerves which connect the hemispheres) is either partially or completely missing which could explain the struggles to identify emotions. Another study suggests that dysfunction in the anterior cingulate cortex of the brain may contribute to alexithymia, an area of the brain associated with empathy that appears to be weakly activated in social situations in autists.

So try not to judge us too harshly when we struggle to show empathy 🙂

Hope you enjoyed this post dear Earthlings!

Enjoy the weekend! 🙂

Aoife

Autism and Mental Health

Greetings Earthlings! 🙂

Did you know– autistic children have higher levels of depressive symptoms and are 28 times more likely to have thoughts of suicide than their neurotypical counterparts? 😲

bitmoji1256098968In recent years our awareness of and willingness to tackle mental health issues has increased significantly, however, the autistic community is often forgotten in our discussions.

Mental health issues such as OCD, anxiety, depression, eating disorders, ADD, psychosis, personality disorders and bipolar disorder are frequently co-morbid with ASD diagnoses, but aside from OCD and anxiety, you will rarely hear about these other issues in relation to autism. In fact, such mental health issues can even obscure ASD diagnoses in higher functioning autists as clinicians often diagnose the co-morbid condition without seeing the underlying ASD.

This is a particularly big issue for women on the spectrum as experts have found that we tend to exhibit greater depressive symptoms and higher anxiety levels than our male counterparts as we tend to internalize and ‘mask‘ our struggles. Moreover due to differences between male and female presentation of ASD’s and male bias in the development of the diagnostic criteria, women with autism are often misdiagnosed as having mental health issues, but the root ASD continues to evade.

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But are there any scientific reasons why mental health issues are so prevalent among autists?

A recently published study has suggested that perhaps the gut may influence an autists mental health. As gastrointestinal issues are often co-morbid with an ASD diagnosis, and as the microbes that live in the gut can have an influence on the brain and behaviours, it has been proposed that perhaps a “dysbiosis” or imbalance in gut microbes may have an influence on an autists mental health 😲

Interestingly studies have also identified an overlap between the genes that cause schizophrenia, bipolar disorder and autism wherein certain points on these genes encode proteins that are involved in the formation and strength of synapses (which act as chemical bridges between neurons) suggesting that these disorders may act through a similar neurological pathway. Moreover, dysregulation of neurotransmitters (biochemical messengers in the brain) has also been implicated in depression, anxiety, bipolar disorder, ADHD and autism (as we have discussed in multiple previous posts) indicating further neurological overlaps.

In short, it seems that the biological basis of both autism and mental health issues are intertwined, which could explain why so often the two walk hand in hand.

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Hope you enjoyed this post dear Earthlings! 🙂

Until next time!

Aoife

 

 

Autism- Atypical Language Use

Greetings Earthlings! 🙂

This week I’d just like to briefly talk about the use of atypical or unusual language in autism.

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Now you may have noticed in previous blogs that I don’t always use the most simplistic of language to express myself- I have always been fond of big words, and have a tendency to regurgitate these randomly in casual conversation.

One infamous incident was the time that I told my Maths teacher that I intended to drop to ordinary level Maths after I had been “ruminating” on it for the previous few days- my family have never let that one go! 😛 😂 Similarly, my supervisor nearly shot me for including the word “multitudinous” in my first publication! Needless to say it was pulled during edits 😛

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I was most interested to learn after my diagnosis that my verbosity (couldn’t help myself choosing this word! 😂)  is not uncommon among autists, particularly among those with Asperger’s syndrome. In fact the tendency to use more formalized language was first observed during Kanner’s original observations of autism back in the 1940’s and is included on the common list of diagnostic criteria.

So is there a scientific explanation as to why many autists tend towards atypical language?

Studies of individuals with damage to the right hemisphere of the brain have been known to have a proclivity for verbose language. Moreover, brain imaging studies of autists have shown that there is a tendency towards “rightward asymmetry” (a tendency for certain brain functions to be more specialized in the right side of the brain) in language areas versus their neurotypical peers. Taken together, alterations to the right hemisphere of the brain may explain why some autists prefer a more formalized use of language when communicating.

Alternatively you could just enjoy using big words as I do- like I always say, why use a smaller word when there are so many glorious synonyms floating around in the back of my brain!  😛 😉

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Hope you enjoyed this post dear Earthlings! 🙂

Until next time!

Aoife

Autism and Handwriting

Greetings Earthlings! 🙂

This week I’d like to talk about something that you may not be aware is an issue for autists- handwriting.

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Experts have noted that a large number of autists have difficulties with handwriting skills and in particular tend to have worse quality in forming letters than their age matched neurotypical peers.

Seems a trivial issue I know, but the affliction of “doctor’s scrawl” can be incredibly frustrating, and particularly challenging for written examinations.

In my childhood I picked up handwriting itself fairly easily (I was so proud that I was one of the few who could write their name before they started school! 😎), however, when it came to learning joined writing- that was an entirely different kettle of fish!

I was ABYSMAL (still am to be fair, unless I try hard! 😛 ). Everyone else in my class had no issue with handwriting, but just as with knitting, skipping, cycling and tying my shoelaces, I fell way behind. My mother even bought me loads of special inky/gel pens to try to encourage and improve my technique. Granted, I got there in the end (well sort of…it’s still an untidy scrawl, but it is joined up!), however, it was extremely frustrating to develop this skill.

So why is handwriting such a struggle?

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Based on the research it seems that the difficulties autists experience with handwriting are related to hand muscle strength and poor control of finger movements. Moreover, many of the regions of the brain associated with handwriting such as the superior frontal sulcus and the cerebellum, are altered in the autistic brain.

Some autists may also suffer from a co-morbid condition known as dysgraphia- a neurological condition that impacts handwriting and coherence (I’ll write a separate post on this at a later stage) which would explain why some autists struggle with handwriting tasks more than others.

So is there anyway to improve handwriting issues?

Time, practice and patience are key when it comes to handwriting difficulties, however encouraging an autist to use their hands more for such activities as colouring or working with play doh will help to improve finer motor skills, which will in turn help to improve issues with handwriting.

I also found in my experience, as simple as it was, that the pens my mother bought were quite useful in helping me to develop my joined writing skills. Although the inkier pens can be a little messy, there was far less resistance as they moved across the paper, allowing me to develop and better control my handwriting.

If however handwriting is proving particularly challenging, from an academic perspective it may be helpful to look into getting a scribe for exams or to ask your teacher if they will accept typed homework (I’ve strangely never had the same coordination issues with typing as I’ve had with handwriting!🤷)

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Hope you enjoyed this post dear Earthlings! 🙂

Have a great weekend!

Aoife

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