Leading on from my previous post You don’t look autistic?, it seems that I might need to eat my words that no one looks autistic. Research in recent years indicates that autism may in fact have some physical attributes- in other words, there is actually an autistic look 🤯
Yep, I had to be peeled off the floor when I heard that- so many autists making jokes about not looking autistic and here we have science telling us that we do! 😂
So what does the research say?
Whilst there isn’t a specific definitive autistic look as with other genetic conditions like Down’s Syndrome, studies have identified the following facial features in autistic children:
Eyes are wider and spaced further apart
Broader upper face
Shorter middle face
Larger mouth and philtrum (i.e., the groove between your nose and mouth)
Others may also have a flattened nasal bridge, a longer philtrum, and a less pronounced chin
Similarly, studies suggest that 10-35% of autists have a larger head size than their neurotypical peers. The circumference of the head, particularly in males with autism, is much larger than average- a condition known as macrocephaly. This size difference is often linked to larger brain volume in childhood, thought to be caused by early brain overgrowth. Head size usually balances out in adulthood, but it may persist for some autists.
As with all autistic traits, not all autists may have these facial features (my mouth is so small my wisdom teeth had no room to grow), and the differences are so subtle it’s doubtful that the untrained eye will notice. The research is very limited, so these facial features may not even indicate an autism diagnosis, but still it’s a very interesting concept. Perhaps one day facial analysis may help speed up the autism diagnostic process.
Leading on my from my previous post about autism and ageing, this week I’d like to discuss whether or not people with autism look younger.
Yep, apparently there appears to be a link between autism and looking younger!
In my own experience, it has been mentioned that I look far younger than my age. I’ve always had a youthful complexion, but I’d just chalked it down to good skincare, genes and the lack of a man to turn my hair grey 😂 Never in my wildest dreams did I think that my autism might be linked to my appearance!
So let’s explore why autists look younger.
As I’ve discussed in my previous post about autism and joint hypermobility, some autists have co-morbid hypermobility conditions such as Ehlers-Danlos Syndrome (EDS). This causes structural tissues like collagen to be weaker and more elastic which causes stretchy joints. However, this increased elasticity can result in a more youthful appearance as the skin is more resistant to damage, which can delay or even prevent the appearance of wrinkles🫨
Facial expressions may also contribute to a youthful visage, as autists tend to produce facial expressions less frequently and for shorter durations than neurotypicals. A less expressive face = less wrinkles.
It’s also possible that our youthful appearance may be more behavioural than biological. A lot of autists tend to be introverted and prefer indoorsy activities away from the elements, especially those with light sensitivity. As a result, lower UV exposure may be preserving our skin from the ageing impact of the sun. My nickname was ‘Dracula’ as a teenager as I would spend summers indoors reading, often returning from sun holidays with little to no tan🙈. On another level, our tendency towards naivety, more childish interests and behaviours can make us seem younger by association rather than looks.
However, while the evidence does seem to suggest autists do look younger, there equally is evidence that some autists look a lot older. As much as EDS increases skin elasticity, it can also lead to thin, fragile skin that can be more prone to bruising, resulting in premature ageing. One study even suggests that autists experience a faster rate of ageing and that they have an older facial age. This may however be correlated to poor self care, lifestyle and the higher levels of biological stress experienced by autists, buuuttt the same can largely be said for neurotypical ageing🤷♀️.
Leading on from my previous posts about autism and love and sexuality, this week I’d like to discuss the psychological state of limerence and autism.
Who in the what now?
Yes it’s not a term I had heard of either, but it’s certainly something that I have experienced many times as an autist- I just never knew it was a thing!
Limerence is a strong feeling of infatuation with another person that may be confused for romantic feelings (though it can also happen in platonic relationships). We’re not just talking your regular crush, limerence can be an intense, intrusive, all consuming involuntary obsession, mirroring the experiences of addiction, withdrawal and OCD.
You’re completely consumed by your feelings for the other person whether you want to be or not. It can occur in a romantic relationship, with someone you barely know, or even someone you’ve never met like a celebrity. Unlike with real love however, the obsession is usually one sided, marked by uncertainty and driven by excitement, adrenaline, stress and confusion. It plays havoc with your mental health and in extreme cases can lead to compulsive behaviours like stalking and harassment. Autistic women are particularly susceptible to limerence as we have a tendency to make people our specialist interests.
So many times I thought I was in love in the past, but more and more since my diagnosis I felt that these incidences were passing infatuations. Limerence really hits the nail on the head. When I would fall for someone, I would fall hard out of nowhere for walking red flags, people that I did not want to be attracted to, but drawn I was. Lovesick is a good description of it as it’s like an illness. I would obsess over them, they would invade most of my thoughts, I’d say and do stupid things, getting high off the slightest interactions and becoming irrationally jealous when they would spend time with others. It’s not a want, it feels like a need, this compulsion t0 be with that person constantly.
On the surface it seems like a typical crush, but no crush is this destructive. Limerence wreaks complete havoc with your mental health. Like addiction, you can think of little else other than your next fix. You spend nights tossing and turning thinking of only them, feeling like you could burst or die if your feelings go unreciprocated for one more minute. You over-analyse every single interaction you’ve ever had, searching for the slightest shred of evidence that they feel the same, clinging on to the slightest scraps to keep the dream alive. Your thinking is so clouded you totally ignore every red flag or paint it green to keep the fantasy alive. Any time spent with them is marked by exhilaration, stress and anxiety all at once. There’s no calm like there is when love is truly there.
And when the bubble finally bursts it’s the worst feeling in the world as you grieve what never was. Well, maybe not always! Sometimes it’s a simple “thank you- next” depending on the severity of your limerence.
Is there any scientific reason why autists are prone to limerence?
As with many neurological aspects of the spectrum, it comes back to imbalances in neurotransmitters and hormones. Limerence triggers many of the same chemicals in the body that are released when in love, and given that so many autists have issues with alexithymia, it’s no wonder we can’t tell the difference. Autists often have dysregulated levels of key love hormones such as dopamine, oxytocin and serotonin which are involved in pleasure, reward, and attachment. So if these chemicals are out of whack, this can easily develop into limerence.
The object of your limerence is usually filling a gap in an attempy to balance the chemicals that your brain is desperately craving, so it’s kind of like a twisted form of self regulation- your brain creates these attachments to get it’s fix. Certainly some of my more serious attachments were formed during particularly tumultuous periods in my life with my brain forging these highs to counteract the lack of stimulation I was getting. Paramore’s song Brick by Boring Brick sums this up nicely- “You built up a world of magic, because your real life was tragic!”. 🫠🙈
Much better to find a healthier specialist interest like crafting or music- something that will stimulate the same chemicals with none of the side effects! 😉
Leading on from my previous post about autism and trips to the dentist, this week I’d like to talk about the dental issues that can be associated with autism.
Not more comorbidities Aoife?
Yep afraid so!
High percentages of autists face more dental issues than their neurotypical peers. 60-80% of autists will have cavities (20% higher rate than neurotypicals) with up to 82% of those experiencing tooth decay from lack of treatment. In addition, more than 78% of autists will experience gingivitis (a mild form of gum disease) and are more likely to engage in bruxism (aka teeth clenching and grinding).
So what’s the link?
These dental issues are largely influenced by lifestyle and sensory issues:
Autists tend to have restrictive diets preferring soft, sweet and sticky foods which can cause cavities
Mouth sensitivity can heavily influence dental hygiene behaviours. The taste of toothpaste, the burn of mouthwash, the sensation of brushing and flossing, not to mention routine dental work can all be overwhelming. When oral hygiene is poor, dental health naturally suffers
Side note- I had the opposite of this issue as I had a pica tendency towards eating toothpaste as a child 🙃
Poor motor coordination can also have an impact on dental health as brushing and flossing require fine motor skills that some autists may have issues with
Oral stimming behaviours like teeth grinding (for deep sensory pressure), tongue thrust, chewing or sucking on items can cause dental damage
Mouth breathing is also a common autistic behaviour which can negatively impact oral health. Autists tend to exhibit this behaviour for sensory reasons (like not liking the feeling of breathing through your nose), low muscle tone, and allergies
Lack of access to sensory friendly dental care can also be a challenge leading to untreated dental health issues
Whilst these issues are associated with lifestyle and sensory challenges, there are also a number of physiological dental issues linked to autism and connective tissue disorders. As we discussed previously, autists are up to 7 times more likely to have hypermobility or a connective tissue disorder (like Ehlers-Danlos Syndrome (EDS)) compared to neurotypicals. Connective tissues like collagen give structure to your gums, teeth, and bones, so if there is a tissue disorder, you may experience the following:
A narrow palate (aka the roof of your mouth) where your jaw grows up instead of out. This reduces oral space which can cause tooth crowding
Tongue tie (ankyloglossia)
Fragile teeth and gums
Missing permanent teeth (hypodontia)
A rare tooth shape called talon’s cusp where the tooth has an extra horn at the back or front of tooth (don’t look it up, I’m traumatized!)
Peg shaped teeth that are smaller and more cone shaped than other teeth
Jaw issues like clicking and dislocations caused by hypermobile joints
Anesthesia resistance where weakened structures can cause anesthesia to wear off more quickly (I have sadly been on the receiving end of this mid-filling 😬)
Whilst we can’t prevent the physiological dental issues, there are sensory friendly aids to promote good dental hygiene like flavourless toothpaste and silicone toothbrushes which may help prevent some of the dental issues associated with autism 🙂
This week I’d like to discuss a topic that many autists struggle with- boredom. We all know the feeling, that mental itch that makes you want to jump out of your skin, but for autists boredom can be so much worse.
Many autists, especially those with co-morbid ADHD, crave constant stimulation. As a result, boredom occurs more easily than neurotypicals. A simple lack of interest in a topic, if a task is too easy, or feeling overwhelmed can trigger boredom and autists will tune out fast. When this happens, it can lead to negative behaviours where an autist will act out and be destructive and disruptive, it might even trigger a meltdown in chronic scenarios (I have had this happen in work following months of tedious tasks🙈).
Boredom has always been a challenge for me. I constantly need to be working on something. In school I often got in trouble for reading/drawing/writing during class as I would get ahead of my work and need to keep my hands busy while waiting for the lesson to move forward. If anything they should have encouraged my habit for productivity in my downtime! 🤷♀️
But what does the science have to say?
As I’ve discussed previously, autists have higher levels of stimulating neurotransmitters and lower levels of calming neurotransmitters, so their neurons are firing excessively in the brain. When they aren’t able to channel this excess stimulation into something, boredom takes over which can lead to negative behaviours that cause problems. Autists also have dysregulated levels of the neurotransmitter dopamine- the chemical involved in motivation, pleasure and reward systems. When dopamine levels are low, motivation is low, so when an activity is not enjoyable, autists won’t have the brain power to engage and boredom will set in.
On another level, there have been reports from doctors claiming that FMRI scans of ADHD brains show that areas of the brain associated with pain light up when they experience boredom, suggesting that boredom might actually be a painful experience for neurodivergents. However, other neuroscientists have refuted this claim as the human pain response largely remains a mystery, so making this assumption from the data is a bit of a stretch.
You can imagine my surprise this week to discover that I have never written a post about overthinking and autism!
Before I was diagnosed, overthinking was probably one of my strongest autistic traits. My brain was often compared to a washing machine set on high spin going round and round and out of control. I analyzed every single detail of my life, rehearsed potential conversations and social scenarios (usually catastrophizing them), and mentally abused myself daily with self critique. I would spend hours on the pillow staring into space unable to sleep as my mind raced out of control. My brain would be going so fast my head would be on fire on the pillow with all the heat generated from my neural activity!
Granted, I still have a tendency to rehearse and think through scenarios from multiple angles, but I find it much easier to rein in the horses before they start to race. Knowing why my mind works the way it does was a huge help, enabling me to be much kinder to myself, but also firmly stop the thoughts when needed.
But are there any scientific explanations for why we overthink?
There are a number of potential reasons why autists overthink. Sensory sensitivities and social anxiety may trigger overactive thoughts as an autist tries to process overwhelming stimuli and social interactions. As autists can be quite detail oriented and rigid in their thinking, it can also be hard to pivot from certain thoughts leading to overthinking. On another level, overthinking could have a physical cause in the way our brains are wired. As I’ve discussed previously, autists have too many synapses (connections between neurons where information is exchanged) so the brain is over-connected. With so many extra connections and ways information can travel, perhaps over-connectivity could be contributing to the issue of over-thinking.
So is there anything that can be done to manage it?
Here are some of my top tips for reining in your racing thoughts:
Weighted blanket or a weighted plushie– weighted blankets have been a game changer in helping me to sleep at night. They are scientifically designed to dampen the chemicals that stimulate your brain so less stimulation means less racing thoughts
Keep your hands busy– diverting all your nervous energy from your brain to your hands is great to slow your thoughts. I took knitting back up in college to try to slow my mind and found it immensely therapeutic. I was so busy concentrating on what my hands were doing that my brain didn’t have any capacity to think about anything else. Similarly, I’ve found sculpture and cake decorating have the same effect, so get your hands stuck into a project!
Exercise– is there anything a good walk can’t cure? Exercise can be great to help manage overthinking. I find that spin classes are great to switch off as you have to concentrate so completely on the task you don’t have any space in your head for anything else
Talk it out– discuss some of your thoughts with a friend or family member. A problem shared is a problem halved. I buried so many negative thoughts for so long my mental health suffered greatly, but things got so much easier once I started to talk through my problems. You don’t need to shoulder your struggles alone
Write it out– similarly, writing out your thoughts can be very therapeutic. I’ve often found that the simple act of getting my thoughts on paper was enough to get them to leave my head
This week I’d like to discuss another more unusual autistic behaviour- pebbling.
Ah Aoife, you must be making these up now!
You couldn’t be more wrong!
Before I lose you completely, let me explain.
Pebbling is where an autist spontaneously shows their loved ones affection through thoughtful gestures and tokens. The behaviour is so named as it mimics the act of pebbling in penguins. Gentoo penguins mate for life, so when a male penguin is interested in a female, he will collect, smooth shiny rocks for her as part of the courtship ritual. If she is interested, she will use the pebbles to build a nest to lay eggs in. Here’s a clip of the penguins in action:
Autists often struggle with social interactions and displaying affection, but pebbling can be our way of making up for it. ‘I love you’ isn’t always easy to say, but pebbling does the talking. It’s our way of showing we love you and are thinking about you- a unique form of affection, communication and connection.
Personally, when I heard about pebbling, I immediately identified with it! I’ve been unconsciously pebbling the ones I love my entire life. If I’m out shopping, I will often pick up little trinkets that remind me of my loved ones and their interests, or I might grab their favourite treats to bring home. Other times I might bake their favourite sweets for no reason, or craft them something they might like, or just a simple gesture like offering to do something for them.
Not all autists display pebbling behaviours, and pebbling can take various forms, but it’s a pretty cool way to show love to the people you care about 🙂
This week I’d like to talk about a somewhat unusual aspect of the spectrum that has been brought to my attention in recent months- T-Rex arms.
Yes- you read that correctly, and no I have not joined the spectrum dinosaur brigade (I don’t think I’ll ever understand the fascination 🙈).
So what on earth are T-Rex arms?🦖
Well, it’s pretty much what it says on the tin. T-Rex arms are when an autist holds their arms in a position reminiscent of the mighty T-Rex- arms shortened and tucked into chest, hands bent forward and curled in like claws.
Ok… but how does this behaviour relate to autism?
This unique posture is commonly observed in autism (and in some overlappingADHD cases) with many autistic and ADHD content creators poking fun at the behaviour. Since I’ve been made aware of this phenomenon, I keep catching myself holding my hands in this position at random times- most notably when I’m in the middle of a busy task like baking or cleaning.
So why do we do it?
The reasons are quite varied. Some autists say it’s because it feels natural and comforting, some say it’s because they don’t know what to do with their hands. Others, like myself, see it as more of an accessibility issue, where you keep your hands close to your chest ready for action mid-task, or a spatial issue where you have greater control of your hands by clutching them close rather than at your sides.
Here’s where things get interesting. Scientists think that T-Rex arms are a form of stimming, so it’s likely to be a sensory related behaviour. They believe that autists keep their arms close to their chest as a natural coping mechanism to comfort and calm when experiencing sensory overload. In some cases T-Rex arms can be viewed as a sign of impending sensory overload, a form of non-verbal communication that experts advise parents to look out for so that they can anticipate a meltdown and take action as needed.
T-Rex arms have been particularly linked to sleep, with many autists adopting this position when they lay down at night. Experts believe that this helps neurodivergents to relax and sleep better, kind of like how weighted blankets work on the nervous system by applying deep pressure to release calming neurotransmitters. Maybe this explains why I often wake up with numb arms in the morning 🙈😂🦖.
Leading on from my previous post about autism and ADHD, this week I’d like to expand on the topic by discussing the concept of AuDHD- aka autism + ADHD.
ADHD has been getting a lot of online attention in the last couple of years with many adults getting late life diagnoses as knowledge of the condition has advanced. Up to 10 years ago, it was thought that both autism and ADHD were completely separate diagnoses with no overlap. Now, it’s thought that 30-80% of autists also have ADHD, with many discovering they had autism during an ADHD diagnosis and vice versa.
When I previously wrote about this topic, I estimated that I was mildly ADHD, but the more stories I have been hearing about the experiences of female ADHDers, I exhibit a lot more traits than I originally thought. Because I wasn’t fitting the classic impulsive/hyperactive model of ADHD, I never thought to dig much deeper, buuutttttt, just like autism, it turns out that there are differences in symptoms between men and women. The original research observed more men than women (there’s a whole history of women being under researched in medicine) and so it was believed to impact more males than females, but, as with autism, sex differences and masking behaviours have made it very difficult to diagnose ADHD in women. ADHD also operates on a severity spectrum which can make it difficult to pick up on.
With all this overlap, enter the concept of AuDHD.
One of the most fascinating aspects of AuDHD is it’s paradoxical nature:
Autists like routine, but ADHD makes it difficult to maintain
ADHDers crave stimulation, but autists get easily overstimulated
Autists are rigid with rules, timekeeping and planning, but ADHDers suffer from time-blindness, impulsivity and hyperactivity making it difficult to follow plans and rules
ADHDers can be messy and chaotic, but autists like order and systemising
Effectively in AuDHD, the paradoxes can camouflage each other, making it much harder to diagnose either disorder. It’s like having 2 different brains fighting for control, but only one or the other will win out at any given time. For example, today you might do a weeks worth of work, tomorrow you might struggle to find the dopamine to do anything.
At other times, the symptoms are symbiotic. For example in my case, I can have complete time-blindness when I’m in the middle of something, but if I need to keep an appointment, the social rules governing lateness force me to be on time. AuDHD is a constant seesaw between the two conditions, a separate presentation in itself.
While it’s not a separate diagnosis yet, given the prevalence of comorbidity, who knows what the future will hold as neurodivergent research increases.
Leading on from my previous post about the immune system, this week I’d like to talk about the interesting link between autism and allergies.
I’ve developed a lot of allergies during my lifetime- sticking plaster, grass, common medicines, certain shampoos, perfumes and hand soaps, and according to my blood work, I’m a tiny bit allergic to cow hair😂 Interestingly, I recently found out that there is a link between autism and allergies.
Studies have shown that children with autism tend to have higher levels of IgE and IgG (immunoglobulin E and G)- the antibodies that are produced in response to allergens. Other studies have suggested that autists may be twice as likely to suffer from food allergies and that boys with autism have higher rates of respiratory and skin allergies than their neurotypical peers.
But first things first, what exactly are allergies and what’s happening to your body?
An allergy occurs when the immune system thinks that normally harmless foreign substances are a threat to the body. The immune system then attacks healthy tissues in an attempt to defend the body against that substance, inflaming them and resulting in an allergic reaction. Symptoms can vary but common reactions may include itching, rashes, sneezing, headaches, nausea and swelling. Severe allergic reactions can cause anaphylaxis- a life threatening reaction where the immune system floods the body with chemicals which can cause it to go into shock requiring an Epipen injection.
So why might autists be more prone to allergies?
As previously discussed, the immune system tends to be abnormally activated in autists resulting in higher levels of inflammation and autoimmune diseases, making the body more likely to overreact to a harmless substance. Why the immune system behaves this way remains unclear. As with most autistic co-morbidities, an unknown genetic mutation likely underpins it. Furthermore as I’ve discussed in previous posts, some theories suggest that dietary sensitivities may contribute to autistic symptoms. Given that autists are twice as likely to suffer from food allergies, it’s possible that these could in fact play a role in autism.
A Is For Aoife Not Autism 