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FAQs

AsIAm Autism FAQ

General FAQs

How do I know if someone is Autistic?

Autism, like many other neurodivergent conditions, is an invisible disability which exists on a spectrum. As a result, Autistic traits are not universal and are often specific to the person. Autistic adults can go without a diagnosis for years, often well into middle age. This is especially true of women on the spectrum who are prone to ‘masking’ their traits – that is to say, disguising them from their peers.

Can an Autistic person live independently?

With the right supports, Autistic people can live as independently as anyone else. It is important to stress that given Autism’s nature as a spectrum, support needs are often fluid. One Autistic adult may live independently but need certain supports for work.This may be the opposite for another.

Can an Autistic person work?

With the right support, Autistic people can enter the working world. Much like their neurotypical peers this depends on vocation, education, and levels of training. Some will work for a few hours on a defined task whereas others may pursue full-time work. ForAutism-specific supports there are organisations such as Specialisterne, AHEAD and Not So Different. These groups assist Autistic people in developing the skills to enter the workplace. Additionally, workplaces have a legal obligation to provide Reasonable Accommodations - these ensure employees with additional needs are supported in their place of work.

Is Autism an intellectual disability?

No. An intellectual disability is broadly defined as impacting on one’s adaptability and reasoning skills. An Autistic person may however be separately diagnosed with an intellectual disability alongside an Autism diagnosis.

What is the difference between 'Autism' and 'Autistic?'

‘Autism’ is a noun, a name for the Autism spectrum and its associated conditions.‘Autistic’ is usually an adjective used to describe behaviours and challenges linked to Autism. It is also used as a noun by several people on the spectrum as a means of referring to themselves. AsIAm has a policy of using identity-first language when referring to individuals on the spectrum as ‘Autistic’ rather than as person-first (i.e. ‘person with Autism’). Many Autistic people see their condition as a positive part of their personal identities and not as a disability. Some may find person-first language clinical and patronising. It’s important to acknowledge this and good practice to ask a person how they would like to be referred to.

Which professionals work with Autistic people?

Autistic people, depending on their support needs, may need to work with several professionals throughout their lives. This may be for diagnostic reasons, building self-development skills, or gaining self-management skills. 

These professionals includeCounsellors, Paediatricians, Educational Psychologists, OccupationalTherapists, and Speech and Language Therapists.

Why are more boys diagnosed with Autism than girls?

Boys are four times more likely to be diagnosed as Autistic than girls. However, it is not thought that boysare more likely to be Autistic. There are a few possible reasons for this mismatch.

It is likely that Autism is not being recognised in girls as often by communities, families, teachers and doctors because they are not considering it as an option for females. It is also likely that the current diagnosis process might be missing key signs in Autistic females.  

One of the possible explanations for the gender imbalance in Autism is that females are thought to be better at ‘masking’ their neurotypical behaviours than males are. Masking describes the process whereby individuals learn and mimic what is thought to be typical social behaviour. However, it is important to note that often girls are not aware that this is something they are doing - it is unconscious.  

Another possible explanation for the gender bias in diagnosis is that sometimes Autistic girls might develop strong interests that are considered more ‘typical’ for their gender, such as in glitter or horse riding. Additionally, girls might ‘stim’ in a way that is considered to be ‘typical girly behaviour’ such as twirling their hair. It is hugely important that more attention is given to decreasing the gender bias inAutism diagnoses as the lack of understanding can have a negative impact on these females' lives.  

What can happen for girls whose diagnosis goes unnoticed is that masking can become too much for them. Usually, during a girl’s teenage years the increase in hormones and general stress of the adolescent stages of development can intensify things. A build-up of many years of masking can lead the individual to a crisis or a breaking point.  

Sometimes a girl will attend therapy for anxiety, and they can often be misdiagnosed with personality disorders, but ultimately continue to feel like nothing is adding up for them.Receiving an Autism diagnosis can cause a sense of relief for many girls who have spent their lives masking their individuality. An accurate Autism diagnosis can bring many positive changes to Autistic girls’ lives, including greater understanding of themselves, a positive self-identity and a sense of belonging with a group of people who understand them.

Hopefully, as the stigma surrounding Autism reduces and our understanding improves, parents and the wider community will become better at recognising the signs in both their sons and their daughters, and seek a diagnosis at an earlier stage for their child.

Do vaccines cause Autism?

No – it’s been widely disproven that vaccines cause Autism in young children’s brains. The Royal College ofPhysicians in Ireland has conducted an in-depth study on the possible risks of vaccination and found this to be a myth with no medical basis.Accredited international medical professionals have carried out similar reviews investigating whether there is a connection between Autism and vaccines and their results have repeatedly found no link. 

For more information, visit the HSE website’s section on FAQs about vaccines.

What is the AsIAm Statement on Applied Behavioural Analysis (ABA)?

AsIAm, Ireland’s National Autism Charity, opposes the practice of Applied Behavioural Analysis (ABA) and associated therapies and practices. We do not undertake, support, or fund any projects which are ABA-based. We do not participate in any research which is ABA-based. 

The aim of any evidence-based therapy should be to empower an Autistic person to enjoy autonomy, and independence from their family and community. Any therapy which approachesAutism as a deficit, or which aims to make an Autistic person conform to neurotypical norms should be avoided as they constitute a breach of the fundamental rightsof Autistic people. This includes Applied Behavioural Analysis which has a deeply troubling history, and which has been cited by countless Autistic people in Ireland and internationally as a source of distress, trauma, and poor mental health. We do not believe that the principles and practices associated with this approach are compliant with the UN Convention on the Rights of Persons with Disabilities. 

As a national, non-profit, andAutistic organisation, we are focused on bringing about a society which accepts and embraces Autistic people. This means the correct, neuro-affirmative supports for Autistic people and their families, and for communities, public services, and businesses which respect, value and celebrate Autistic people. The focus of our advocacy and programmes is on advancing this aim. 

In engaging with community members and stakeholders, and in our communication strategy, we take an approach which maximises the opportunity to successfully promote and realise the rights of Autistic people. AsIAm exists to serve all Autistic people and their families. We deliver our services in a person-centred, non-judgemental, and supportive manner to all who engage in our programmes and activities. To learn more about non-ABA therapies, read our supports on Speech and Language Therapy and Occupational Therapy.

Social Interaction

How does an Autism Diagnosis affect social interaction?

It is important to remember that Autistic people often approach non-verbal communication differently in comparison to neurotypical individuals. They may not use or interpret hand gestures the same way as a neurotypical person. Due to differences in eye contact, an Autistic person might look away from the person they are speaking to. This can be confusing for those who are not used to speaking with Autistic people.  

Secondly, Autistic people are likely to be comforted by routine and predictability. Conversations with new people may be intimidating, especially if they happen in an unfamiliar environment. For example, an Autistic person may be adept at interacting in a classroom or workplace but might not know how to approach someone at a party ora sports game. 

Thirdly, Autistic people are often direct and straightforward in how they communicate, avoiding generic conversation topics in favour of topics they find meaningful. This can result in giving an impression of bluntness or disinterest.

How can I support Autistic people in social interaction

The way Autism is understood has changed a lot over the lastfew decades. Experts previously asserted that Autistic people had impairments in empathy or even had no interest in socialising. As a result, Autism supports were based on the idea that Autistic people lacked social skills and needed to learn the ‘right’ way to interact. However, the commonly perceived notion thatAutistic people have no ‘Theory of Mind,’ is now being challenged. 

Dr Damian Milton’s Double Empathy problem notes that empathy is a two-way interaction. Non-Autistic people struggle to understand the emotions of Autistic people just as much as the other way around. The difficulty may lie in how people with different ways of experiencing the world interact. When supporting Autistic people to socialise, bear this two-way process in mind. On a practical level, the best way to help is to identify which elements of social interaction are the most challenging for the person in question. If their difficulty lies in non-verbal cues or gestures, it might be helpful to make certain things more explicit through visual guides or narratives.

If they have difficulty initiating conversation, try to rehearse certain social scripts, with different scripts for different contexts. Autistic people should be encouraged to practise these interactions and reflect on how they went.This allows them to decide which strategies work best for them. Supporting an Autistic person in socialising should be about empowering them to express themselves and their needs authentically. It should not be teaching them to self-censor or feel there is something wrong with them for not wanting to talk about certain subjects. Try to look at social interaction through a ‘salad bar’ approach. Do not hand someone a set of rules: present them with options and let them choose themselves.  

How can non-Autistic people communicate more clearly with their Autistic peers?

Autistic people may require help in refining certain social skills, but the onus should not entirely be on them. Whether it is as a teacher, manager or even parent, neurotypical people should try to meet Autistic people halfway when socialising. If you find that an Autistic person is not responding to certain cues, try putting your language into words and making your thoughts and feelings more explicit. For example,‘these boxes are very heavy’ might be a clue to some people, but try saying ‘could you help me carry these’ to make your intentions clearer. 

This goes the same for non-verbal cues: tapping a watch may be a recognised sign of time running out, but informing the person will always be clearer. Autistic people often avoid eye contact due to the sensory overload this produces. If they are looking away while speaking or listening, they are likely doing this to concentrate fully on the interaction. Do not attempt to force eye contact from them - this will probably be a source of distress. It is a common misconception that Autistic people do not want social interaction or friendship. In reality, the challenges of social interaction can be intimidating or a source of anxiety for Autistic people.

In a friendship, both theAutistic person and the neurotypical person need to make an effort with communication. Neurotypical individuals should try to learn more about Autism, specifically about their Autistic peers. Try to learn what their interests are; this is always a sure way to get them talking. This does not mean you cannot express upset or offence in social interaction. It means changing the way youcommunicate this. Autistic people are just as capable as anyone else of being impolite or inconsiderate. 

If something an Autistic person does or says upsets you, consider why you are upset. Is this related to asocial convention you know they are not following? Was their behaviour a voluntary action or part of a ‘stim’? Weigh up each of these possibilities. If this is due to an involuntary action or stim, telling them to stop may make them feel self-conscious or anxious. If you are sure this isn’t the case, express how you feel about what they are doing. However, you should question whether what they are doing is harmful to others, or just making you uncomfortable. It is possible what you consider unusual or impolite might be subjective. Remember that the rules of social interaction are norms, not laws.  

How can I help a neurotypical child understand Autism?

Your non-Autistic child might not fully understand Autism. It is important to take time to explain to them the differences and preferences of the Autistic community and those of their sibling in particular, in an age-appropriate way. It is important for them to understand why your family might be different and may do things differently from others. This type of conversation can help them understand their Autistic sibling better and foster an environment of acceptance. There are many books available online that can help you to explain this to your child in an age-appropriate way, such as:

• ‘Autism in my family’ Sandra Tucker
• ‘What Autism can belike’ Sue Adams
• ‘Y’know that kid?’Noeleen Smith
• ‘The AwesomeAutistic Go-To Guide: A Practical Handbook for Autistic Teens and Tweens’ Yenn Purkis & Tanya Masterman.

Melt Downs

What is a meltdown?

Sometimes Autistic people experience meltdowns. A meltdown takes place when a person receives too much information for the brain to manage, be that communication or sensory stimuli.It may look like somebody becoming extremely upset, it may look like somebody becoming aggressive, and it may also look like somebody simply shutting down and not being able to engage.

How can I help someone who is having a ‘meltdown’?

Usually, our instinct when we see someone upset, our instinct is to comfort, talk, and reassure. If we see someone is angry, we confront or challenge them. The reality is, that neither of those is an appropriate response to somebody having an Autistic meltdown. When a person has a meltdown their brain is already dealing with too much information, so every interaction is adding fuel to the fire. A meltdown is a 90-minute process that takes place in the brain, and it is not something that can be stopped. So we want to make sure the person is safe and everyone else is safe. 

Other than ensuring safety, we should not talk to the person. If we have to talk to the person, it should only be one person saying the minimum. What we can do is reduce stimuli, turn off lights, and turn off music. If the person is in a public place, try to redirect other people away from the individual who is having the meltdown. People are often very embarrassed after a meltdown. Helping someone during a meltdown is about a less is more approach. You can talk to them when they have recovered.

Anxiety

What approaches can I use to manage anxiety?

Both Autistic adults and children can experience high levels of anxiety. There are many strategies that you can teach your child so that they can have lifelong skills in reducing their anxiety (e.g. meditation, deep breathing and taking a break). However, for most Autistic people, a lot of their anxiety stems from the environment around them, often stemming from a lack of understanding of Autism. This lack of understanding can mean that environments are stressful and not Autism friendly, and can also mean that Autistic people need to ‘mask’ or pretend to be someone they are not. This can be very stressful. Helping could mean reducing the amount of noise in the home or school. It could mean preparing a child for upcoming changes to their daily schedule. It could mean trying to find a school with a lower class size. It could mean being very open about Autism with everyone in your child’s life, and educating them that behaving “Autistically” is a valid way to be.

However, it is not always possible to change or control every environment. Sometimes changes need to be made around interacting in that environment. So for example, if a school with smaller class sizes is not possible, could there instead be very frequent movement breaks or quiet times in the garden throughout the day? As a society, we must be more aware of what it is that is stressful for Autistic people in terms of the education system, the workplace, and our environment and look at how we can change that. As a parent, if your child is highly anxious make sure that the home environment feels safe and calm for them. If you know your child becomes particularly anxious in school, you could prepare support for them when they come home, such as giving them a sensory blanket and a quiet environment.

Look at how you or your child’s energy is being spent. Balance the amount of energy they spend on various activities and tasks. If, for example, social interaction causes them to become anxious, balance that energy with something that they enjoy. Surround them with people who let them be themselves. Learn to understand your anxiety triggers and figure out whether you can change that or change how you interact with them. Finding coping strategies that work for your child might take a while but do not give up, small changes across the child’s environment and social world will build up to larger positive changes over time.

What calming strategies can I try at home?

There are several ways that you can create a calm Autism-friendly environment at home, therefore reducing anxiety and the risk of a meltdown.

Predictability is a great way to keep your child calm. As much as possible, have a predictable routine at home for your child. If you know of any upcoming changes to that routine, introduce them as far in advance as possible to prepare your child for a difference in their routine.

Providing sensory toys at home can be a useful way to help your child manage their anxiety. You do not need to buy expensive sensory toys, something as simple as a squeezy rubber toy or sparkly lights can provide a sense of comfort for your child when they are feeling anxious.

Engaging your child with something they are interested in is a great way to keep them calm, whether it is simply watching their favourite show, playing video games or discussing their special interest with them.

Create a calm sensory space at home. Reduce noise as much as possible, switching off radios or televisions playing in the background. Dim or switch off harsh lighting when possible.

Allow your child to be themselves, allow them to stim, move around and make noise if they need or want to. Suppressing these can cause a significant increase in anxiety over time. Meditation is a very useful tool for some people (not all) to manage anxiety. Learning to take deep breaths (while difficult) can be a very helpful tool. Teach them that when you take a deep breath in, your stomach goes out and when you breathe out your stomach goes back in. Even practising this for 1 or 2 minutes a day can help your child.

Labelling and understanding emotions can be difficult for Autistic children (this is not to be confused with difficulties with empathy, which is an Autism myth). Teach your child about their emotions. Reading books or watching videos about emotions can help your child better understand how they are feeling. Label emotions for them as you see them, e.g. “It looks like you are frustrated with that zipper,” and “You are sad the ice cream fell.” Ensure that learning about emotions doesn’t feel ‘school-like’ for your child, make reading together a fun activity. As your child begins to develop an understanding of their feelings, start asking them “How are you feeling?” or give the option between a couple of feelings. Creating discussion and openness about emotions is a good way to help your child identify and predict how they feel.

Sensory Processing

What are our senses and what do they control?

Most people will know our five basic senses – vision, hearing, smell, taste and touch. However, there are 3 other less-known senses – the vestibular sense, proprioception and interoception. It is best to think of Autism in the social model of disability. This means considering how the environment is disabling to an Autistic individual. Autistic people may be described as having sensory issues, but sensory differences is more accurate in describing the variety of ways our community processes the environment around us.

What is Sensory Processing?

Sensory processing is our ability to combine and understand information coming in from our senses. Our brain continuously receives information from all of our senses. Our brain then filters through this information in order to decide which information is important to attend to and which isn’t. Sensory processing is an automatic process. The purpose of this process is to enable us to be able to attend, organise and move our bodies and manage our emotions as efficiently as possible. Autism can cause a more varied experience of sensory processing.

What is Sensory Overload and why is it so common with Autism?

The purpose of our sensory processing is to keep us calm but alert in relation to what is going on in our environment. If individuals are not able to filter through the sensory information in their environment it can be more difficult to remain calm or alert. This build-up of sensory information is referred to as sensory overload. This can feel different for different people. An individual experiencing sensory overload may become irritable, anxious, upset or even completely shut down in their attempt to regulate their sensory environment. While sensory overload is not exclusive to Autism, it is experienced more acutely by Autistic people.

Our bodies have a number of automatic reactions that occur when faced with potentially threatening or dangerous situations. These reactions are called our ‘fight or flight’ reaction and are built into our bodies to enable us to escape quickly should that be necessary. Part of this ‘fight or flight’ reaction is that our senses become heightened or more sensitive.This begins with our eardrums changing shape to allow in lower-frequency sounds that we would usually filter out. Our eyes also become more alert and also scan the environment more frequently and rapidly. At a physiological level, our heart might begin to race, and our breathing might become quicker which pumps oxygen to our muscles so we are ready to run. Sometimes however, the ‘threat’ is not a physical one, i.e. we are not actually in physical danger, rather we experience psychological stress such as receiving unexpected bad news, having an exam or test or a falling out with a friend. But the reaction in our body can be the same.

Alongside the emotional upset, we will become more sensitive to sensation. For example, if we are feeling stressed and someone touches us we may jump because we have become more sensitive to sensory input. This in turn can make us more emotionally upset, so it can become a cycle of sensory sensitivity and stress. For Autistic individuals who tend to be naturally more sensitive to sensory input, minimising other stressors in the environment or routine is as important as sensory calming activities in preventing sensory overload.

What is Stimming?

Understanding stimming is crucial to encouraging coping strategies related to Autism and sensory processing. Self-stimulatory behaviours or “stimming” is a type of self-regulatory behaviour which often involves repetitive behaviours, movements or noises. Stimming may involve something like hopping from one foot to the other, repeating a word or phrase, flapping hands or something more subtle like playing with hair. In the past, stimming used to be something that people were trying to stop, mistaking it for ‘fidgeting.’

We now know that stimming is essential for Autistic people to be able to do this. Unfortunately, people who are stimming in public can face judgement or stigma. It is important to remember that while this behaviour may seem unusual this behaviour is very important to the individual and serves a purpose for them in relation to regulating their emotions, environment and behaviour. It is important that we normalise stimming in schools, workplaces and public spaces to ensure that Autistic people can regulate themselves and feel self to do so authentically.

Stimming can happen for a number of reasons. Sometimes it can be a way to express excitement or happiness, but it can also be a sign that the person is feeling overwhelmed and is trying to calm themselves. For example, an Autistic person who is experiencing sensory overload may begin stimming to cope with their environment, especially if there is no quiet space available. This means stimming can be a vital mechanism for preventing meltdowns.

How can a special interest help in everyday life?

A special interest can be used to help manage the sensory environment as well as manage everyday occupations that you may struggle with. A special interest could potentially help you with your organisational skills as typically your special interest is an area that you are particularly “organised” in. Think about how it is that you store the information about your special interests and you may be able to utilise the same strategies or techniques for other areas too. A special interest can also be a good starting point for increasing your social activities/groups. For example, you may be interested in bird watching, so joining a bird-watching club may be a good place to start if one of your goals is to make new friends or socialise more.

Therapy

How Can Therapy Help Me?

When anxiety builds up within us we can become extremely stressed both emotionally and physically and we may experience a meltdown. It is important that we have an outlet for any anxious feelings we experience so that it doesn’t build up within us. Talk therapy can be one of those outlets. In therapy, you can talk about any difficulties, worries or challenges you are experiencing and release some of the anxiety surrounding these things. Therapy is also an opportunity to speak about how you are, how you feel about your family, how you feel about the world around you and anything else you would like to discuss

What different types of therapy are there?

There are a wide variety of therapy options available and it might take a while for you to find what style of therapy is the best fit for you. Choosing a style of therapy depends on what it is you are looking for support with. Some types of therapy are:

Counselling and Psychotherapy: These are the most common forms of talk therapy and often therapists use a combination of counselling and psychotherapy techniques in their therapy sessions. Both counselling and psychotherapy aim to help a person understand their feelings and to feel better equipped to deal with challenges they might face. These forms of therapy are useful for people who are experiencing anxiety and general worries or are going through loss or grief.

Cognitive Behavioural Therapy (CBT): CBT focuses on examining how our thoughts, feelings and behaviours interact. CBT helps you reevaluate the way you think in order to change how you feel and behave. CBT would be helpful for someone who might be struggling with OCD or more serious forms of mental health problems such as depression, bipolar disorder or borderline personality disorder.

Dialectical Behaviour Therapy (DBT): This is a form of CBT focused on changing an individual’s behaviour patterns. DBT is usually used as a treatment for those suffering from depression, suicidal ideation or self-harming behaviours.

Mindfulness-Based Interventions: Mindfulness-based interventions focus the individual’s mind and body on the present, for example different kinds of meditation or breathing exercises. This style of intervention has been found to reduce physical pain, stress levels and mental health concerns.

Equine Therapy: Equine therapy involves activities incorporating horses and other animals in order to work towards feeling more physically and mentally well. Horses provide feedback for the therapist and the client about how they are feeling and the progress they are making, for example, if the client feels anxious, the horse too will reflect those anxious feelings.

Drama Therapy: Drama therapy is an active form of therapy which uses elements of drama and/or theatre to achieve therapeutic goals. For example, drama therapy might involve role-play which helps understand social settings.

What should I look for in a potential therapist?

One of the most important things to look for in a potential therapist is that they have undergone some training around the area of Autism, this gives you the best chance that the therapist understands your needs. Although being Autistic does not mean you necessarily need therapy, sometimes when you are Autistic you can deal with some additional anxieties or challenges and therapy can be a useful way of coping with these anxieties. You should also look for a therapist that provides the type of therapy you feel is most suitable for you. There are a number of types of therapies listed above but there are also many more to choose from.

On the IACP website homepage, you can find a therapist based on a “keyword search” like “anxiety” or “depression”. If you like, you could search for “Autism” here and see if there is anyone in your area with experience in the area. Do not worry if nobody in your area comes up: alternatively, on the IACP homepage you can find a therapist based on your location and you could narrow down this search by adding a “Therapeutic Service” you require. The therapeutic service is the area you are looking for support.

The most important factor you need from a therapist is someone you can connect with and feel comfortable with. It may take a couple of sessions before you begin to feel comfortable talking with your therapist, it does take time to build a trusting relationship. Gender isn’t something that is overly important when it comes to finding a therapist, you could go to someone of the same or the opposite gender as you. Most importantly, you need to feel like you can trust your therapist but this might take some time.

Do All Therapists Take Autistic Clients?

All therapists, once they have completed their essential training should have an understanding of Autism. It is important that therapists should broaden their services to accept a wider range of clients and should expand their level of service to meet the needs of Autistic people. Although professionals working in talk therapy should have the training and a basic understanding of Autism they might not feel they are fully capable of meeting your needs.

It might be useful to check in advance with your therapist if they have experience of working with Autistic clients before or to check what their level of understanding is to ensure you can receive the best therapy fit for you.

What happens in a typical therapy session?

It is important that Autistic people preparing for their first therapy session know what to expect. When searching for a therapist they will likely give you an idea, but it’s important to be fully prepared for therapy. There are a number of things that can happen during a therapy session but it can be broadly split into four categories: Current challenges, potential future challenges, skill building and aftercare.

Typically, a therapy session will start by discussing your past week or the time that has gone since your last session. If you had any challenges during this time you might discuss these a little bit more in-depth, discussing how you felt and what you could have done to make this experience easier for you.

If you have experienced trauma, your therapist is a good person to talk to about this. It is possible that discussing current challenges may lead to discussing past trauma. In fact, discussing current challenges may even help to pinpoint events you didn’t even realise were traumatic. This can be frightening and you may feel like you are reliving the trauma by going back over it with your therapist. But it’s important to stress that your therapist will be able to help you develop skills to make these challenges easier and allow you to feel some relief from the experience.

In talk therapy, your therapist will work on some skill-building activities with you looking at things like mindfulness, emotion regulation, anxiety building and resilience building. Sometimes, before you leave your therapy session you might finish the session with something more relaxing for you whether it be watching a video on YouTube or even something as simple as discussing your special interests. Finishing the therapy session with something you enjoy means that hopefully, you will leave the session feeling positive and secure.

What questions should I ask a therapist before starting my therapy?

Here are a number of suggestions of potential questions you could ask your therapist before you start your therapy with them.

• What is your understanding of Autism?
• Have you had any specific training on Autism?
• Have you worked with Autistic clients before?
• How often will the therapy sessions take place?
• Where does the therapy take place? Could you send me any photographs of the room that we will be in?

You do not need to ask all of these questions but if you are concerned about any of the above areas a therapist will be more than happy to give you some more information about any of your worries.

How can a therapist make therapy more comfortable for Autistic people?

There are a number of ways that a therapist can make the therapy environment as comfortable as possible for Autistic clients. If you are a therapist, below are some suggestions of ways that you can make your talk therapy services more Autism-friendly.

Consider lighting: You should avoid any kind of fluorescent lighting in the room. Also, flickering light can be distracting or anxiety-inducing for Autistic people so it might be best to leave candles unlit during your therapy session. Always ask your clients how the environment is for them, they will be experts at monitoring their own sensory environment.

Be clear in your use of language: When giving instructions to your clients be very clear in what you are saying. Give one piece of information at a time using literal language. Avoid using any metaphors or figures of speech. Be precise in when and where you will meet for your therapy sessions and be clear in the boundaries surrounding an appropriate therapy relationship and contact hours.

Provide stim toys: The word “stimming” describes self-stimulating behaviours, usually involving repetitive sounds or movements. An Autistic person might “stim” in order to help them regulate their environment by providing them with extra sensory input. Providing a number of small stim toys for your clients to use such as fidget spinners, gravity timers or silicone noodles will provide your clients with a means to regulate their environment and allow them to feel more comfortable to stim within the therapy environment.

Create an open space: Make sure your therapy setting isn’t cluttered and that there is enough room to move around. Encourage your Autistic client to stand up and walk around or pace the room if they feel they need to, this may be another way by which they regulate their environment.

Get to know your client’s special interests: Getting to know your client’s special interests is a simple yet effective way of establishing a relationship with them. You can use their special interest as a way to help them relax before the end of a session or to help them leave the session with a more positive outlook. Expressing interest in their special interest is a great way of building a trusting and positive relationship with one another.

Consider using visuals or role play to support your client: Your Autistic client may find it difficult to understand some social rules and this may be increasing their anxiety. Using simple visual representations of a scene or creating a social narrative is a great way to help your client visualise a certain scenario. Alternatively, you can practise role play with your client to help them learn how to manage certain social settings.

Be open to various methods of communication: Your client might use an App to communicate or might prefer to record messages for you rather than speak face to face. Be open and accepting of various methods of communication and be patient with your client, this will help them feel relaxed and accepted. Also, be mindful that eye contact might be something that your client struggles with. Consider providing a virtual therapy service in which you might deliver therapy via Zoom or Skype.

If I feel that I would benefit from therapy, where can I go for help?

There are many people in your life who are there to support you. If you feel like you are struggling with your mental health speak to a trusted adult whether that be a parent, another family member, a teacher in school or even a guidance counsellor. These people might suggest that you try talk therapy to help you manage your anxieties and worries. If you feel like you would benefit from therapy, a great first step would be to visit your doctor or your GP. The GP is the gatekeeper of everything health-related including your physical, emotional and psychological health. The GP might be able to recommend a therapist locally or will be able to let you know where you can find a therapist suitable for treating anxiety in Autistic clients. The Irish Association for Counselling and Psychotherapy (or the IACP) has a search function on their website that you can use to search for counsellors or therapists in your area. The Irish Association of Humanistic and Integrative Therapy (IAHIP) have a similar directory here.

Schools

How can a school change their teaching to better meet the needs of Autistic students?

There are a number of elements of the school environment that might make the learning experience more challenging for Autistic students, for example the sensory environment, transferability of skills from subject to subject or lack of direct or clear instruction. Sometimes Autistic students might need a lot more reinforcement to cement the concepts they are learning to their memory.  

Teachers must adapt their teaching styles to make sure they meet the needs of every student in the classroom so that each child can access the curriculum. Most importantly, teachers need to be aware of the child’s individual profile. Where do the student’s strengths lie? What parts of the curriculum do they find challenging?

Ideally, Autism Friendly education is best when it’s applied on a school-wide level, as done through AsIAm’s Autism Friendly School programme which provides Autism guidance not only to teachers but on a school-wide level. However, if a teacher wishes to start with more gradual changes or wishes to prove the value of Autism friendly teaching, there are a number of options available.

Sensory Challenges: If you are planning on conducting a science experiment in your class and you know that one of your students experiences sensory challenges when it comes to smells, perhaps you need to arrange for the experiment to be filmed for that student because they may not be able to sit in on the class.

Perfectionism: Another way a teacher can vary their teaching to best meet the student’s needs is by altering the timings that they use in class. For some Autistic students, they might feel pressure to do every element of their work perfectly which might mean that the work ends up taking them much longer to complete than it would for other students in their class. For example, you might limit the amount of time a student should spend on their work, saying that they are to spend no more than 20 minutes on an activity and it does not matter if they do not complete the work in that time.

Learning Styles: In terms of playing on a student’s strengths, teachers should use a variety of resources in their teaching. For example, students who are strong visual or aural learners might benefit from the use of video clips in the classroom. You could ask students to find an interesting YouTube video based on a topic they are learning in class. Teachers could provide students with different options for their homework such as a choice of 3 different questions or activities, each focusing on a different learning style.

Group Work: Sometimes in school, you are required to work in groups which can be challenging for Autistic students. A way that teachers can make this process a little bit easier for their Autistic students is by giving them a very clear, specific role in the group, for example asking them to be the timekeeper.

Note Taking: Some Autistic children might struggle with writing or typing notes or might not be able to keep up with the note-taking pace of the other students in the class. Perhaps you could suggest that the student take a photo of the notes on the board so that they can work on their notes in their own time. Alternatively, you might suggest that they focus on taking down key words or use visual forms of note-taking like an infographic or spider diagram instead.

What supports are available to educators wanting to learn to better support their students?

There are a number of ways that school staff can learn to support their students outside of the support provided by the Department of Education. The Professional Development Service for Teachers or PDST is an organisation which provides a great amount of support to teachers in terms of upskilling and further developing their knowledge in supporting the needs of students within the school. The National Council for Special Education, or the NCSE, provides educators with a support service in terms of education and behaviour for example additional training on specific learning difficulties. Schools must apply for these supports from the NCSE and continuously engage with them. This requires quite a lot of preparation from the school's management. The NCSE also provides advice and guidance to school management and leaders. There is constantly room for educators to reeducate themselves and further their knowledge of new skills or information in terms of special needs education, learning difficulties and more.

Above all, try to normalise discussing Autism in an open and inclusive way: Guidance for teachers is also available through school talks such as those delivered by our training team.

Employment

What laws support Autistic people in the workplace?

There are a number of Irish and EU laws which support both Autistic people and people with disabilities. These laws also combat discrimination against people with disabilities when they enter the workplace. Article 27 of the UN Convention on the Rights of Persons with Disabilities (UNCRPD) provides that every disabled person has the right to work, and provides a wide range of rights which allow people with disabilities to participate in the workplace on an equal basis as their non-disabled peers. These rights include the right to be protected from discrimination, to receive equal working conditions, to have equal access to training and career development opportunities and to on-the-job supports, and to have access to reasonable accommodations at work. The 2000 Equal Treatment Framework Directive intends to combat both direct and indirect discrimination on the grounds of disability. It also directs measures to accommodate the needs of disabled people. This includes making adjustments to the workplace, provided that this does not pose a ‘disproportionate burden’ to the employer.

The Equal Status Acts 2000 includes people with disabilities under its nine grounds of discrimination. The Employment Equality Acts has more specific measures which outlaw discrimination in the workplace on disability grounds against employees. This includes application forms, interviews, aptitude tests, equal pay, access to employment and vocational training, promotion and disciplinary issues. Section 33 of The Employment Equality Act allows employers to take ‘positive measures’, like hiring quotas or additional workplace supports. These supports are aimed at attracting people with disabilities and addressing discrimination against people with disabilities at work more widely.

What are Reasonable Accommodations and how do they apply in the workplace?

Reasonable accommodations refer to adjustments or modifications made in the workplace to provide equal opportunities and accessibility for individuals with disabilities, including those who are Autistic. These accommodations aim to level the playing field, enabling autistic employees to perform their job duties effectively and participate fully in the workplace.

What is Disclosure?

Disclosure means a person decides to share some aspects of their disability, difference or condition with others within their environment, such as at work, or in other settings such as with friends or with family.

The person has the choice on whether they wish to disclose their disability, along with how much information they want to reveal about themselves and to whom they wish to be open about their Autistic identity, or indeed any disabilities they may have.

Every Autistic person, as with other disabled people, feels differently about the disclosure process and how much, if anything, they want to reveal to others. For example, an Autistic person may feel that they need to disclose that they’re Autistic to their managers to obtain support at work, but may not feel comfortable sharing their diagnosis with colleagues, or vice versa.

Some people may, understandably, feel very reluctant to disclose any differences or disabilities that they have unless they encounter difficulties at work, and treat the process as a ‘need-to-know’. Other people might be very open and comfortable about their Autistic identity and may have no problems disclosing to colleagues to also raise awareness and educate colleagues at work, as well as to seek out support or accommodations for their needs. Others may feel that they have Autistic traits, but might not have the opportunity, means or the know-how to pursue a formal Autism diagnosis.

In any event, you should not feel pressured or obliged by anyone else to disclose if you don’t feel comfortable. All workplaces are obliged under the law to keep any personal information disclosed by you as confidential. All organisations also have a duty to provide reasonable accommodations if a disability is disclosed if the employee requests them.

How do I know what job I want to do?

Every year new kinds of jobs are being created for different tasks. There are careers today that wouldn’t have existed ten or even five years ago. The amount of choice can be overwhelming, especially if you’ve just finished education and are beginning your first serious search for a career. You don’t need to land in your dream job the moment you walk out of school or college. Few of us do and there’s no rule saying you need to have a definitive list of jobs that you can only work in.

A number of strategies you can try to work out where you want to work include:

  1. Book an appointment with your school’s or college’s careers guidance counsellor. These are trained professionals who offer advice and information to help people make realistic choices about what types of courses or jobs that they’d like to do in the future.
  2. Choose a job where you know you can use your interests to excel. One of Autism’s many strengths is that those living with it perform exceptionally well in areas which they passionate about. A visual thinker with an analytical mind, for instance, may do well in a designing or science-based career; or a non-visual thinker might excel in accounting or journalism.
  3. Look back at past job experiences and analyse where you performed well and not so well in. If you’ve held down work before, part-time or full-time, then it’s good experience to have when making a suitable career choice. Look back at tasks you performed well in and make a list of those strengths. Match them up with another list about areas you didn’t do so well in. Having a physical copy of your strengths and weaknesses will help you when reading through job descriptions and assessing yourself on whether the role suits you.
  4. Don’t be afraid to push yourself outside of your comfort zone. We can only ever develop our skills and understand our limits in practical settings. By trying different jobs, you’ll not only develop a better idea of where you want work, but also have a sense of what kinds of supports you might need in the workplace (NOTE: do this sensibly and with someone who you can rely on for critical feedback, like a family member or teacher).
  5. Make a list of what you’re good at and of the skills you know you aren’t so strong in. This will help narrow down your search as well as identify the types of supports on the job you might need.


At the end of the day, finding work is all about you and your needs, no one else’s. You need to find a job where you can be both productive and happy in. When beginning your search for work, it’s important that you’re honest with yourself about your strengths and limits. Dr Temple Grandin has noted that many people on the spectrum may struggle with demands on short-term working memory and that frequent social interaction with strangers can be tough.Every year new kinds of jobs are being created for different tasks. There are careers today that wouldn’t have existed ten or even five years ago. The amount of choice can be overwhelming, especially if you’ve just finished education and are beginning your first serious search for a career. You don’t need to land in your dream job the moment you walk out of school or college. Few of us do and there’s no rule saying you need to have a definitive list of jobs that you can only work in.

How can I manage job interview anxiety?

Few of us can say that we never get nervous about job interviews. It’s perfectly natural to get anxious when you’re preparing to talk about yourself to a group of strangers.

For those of us on the spectrum however, this process can be especially hard. We might find making eye contact difficult or answering questions in a comprehensive and concise way difficult. The very idea of sitting down with a panel of strangers and being examined by an unknown criteria may worry us so much that we might want to call the whole interview off and refuse the invitation.

Help is available. There are several employment support services who can assist you in searching for work, preparing for interviews and ultimately to hold down a job.

Some jobs may be more concerned with the skills or qualifications you have rather than your ability to communicate or socialise.

The key rule for a job interview is not to pretend to be someone you’re not – it just won’t work and will only raise questions. Be authentic, be polite, try to demonstrate your knowledge and the process will often much better than expected!

Remember, interviews are something you naturally get better at over time so if nothing else, they’re great opportunities to learn and to build your experience with them.

What organisations help Autistic people navigate the workplace and employment?

EmployAbility
EmployAbility services provide an employment support service for people who require support, whether they are experiencing illness, injury or are jobseekers with a disability. It is also a recruitment advice service for the business community. Your local EmployAbility service will give you employment help. It also gives employers access to a pool of potential employees, employment support for both employer and employer and guidance towards support grants.For more information, click here.

National Learning Network
A variety of access and training courses and support services are available to people needing specialist support in their search for work and within employment. Many of these courses are vocational and education programmes which can be accessed on a flexible basis. You can view a directory of the NLA’s offered subjects here.

The Transition Action Plan (TAP) is another NLN programme specifically for young Autistic people. It aims to ease the transition from school or children’s services to adulthood and a wide range of educational, rehabilitation and vocational opportunities are explored. TAP is only offered in Letterkenny, Co. Donegal, presently.

SOLAS
SOLAS provides online learning services in Further Education and Training (FET) courses. The courses are free, and you may be paid a training allowance for the duration of your chosen pathway. SOLAS also offers accredited apprenticeships in different trades, work placements as well as in-work supports.

Specialisterne Ireland
Specialisterne is a social innovator organisation aimed at upskilling and mentoring Autistic people within the Information Technology sector. The company recognises the special skills and unique advantages that Autistic individuals can bring to science and technology projects. It works with several major computer and software firms in offices across the world, offering assessments and job coaching for successful applicants to work within the business.

Careers Service Northern Ireland
In the Careers Service Northern Ireland, Disablement Employment Advisers (DEAs) help adults with disabilities find suitable employment or training. They can also advise employers about adapting the workplace or supporting disabled people at work. The Service also offers careers advice.

How can I cope with being in the workplace?


Coping in the workplace is not something which you perfect immediately or reach a certain point and have to do no more work at – it is something you must work at overtime and maintain throughout your tenure.

There will be times in any job where you feel a little stretched or are finding something a little bit difficult, equally at times there may be external factors in your private life which impact on your performance and happiness levels in work. While this is normal for all employees these times may be even a little tougher for those of us who already find the workplace a challenge.

In this section, we look at different coping strategies you can use to help identify problems and manage anxiety within the workplace.

Don't overdo it: Perfectionism is common with many people on the Autism spectrum. It can be as much a source of stress as it is of success. Setting unrealistic expectations of oneself, not taking time for a break, or viewing their work as a constant competition with their co-workers may wear a person out quickly.

It is important to take time for yourself and self-care. Make sure that you’re getting the right balance between work and play. Communicate clearly with your supervisor and employer about your needs at a time convenient for you both.

Keep the consultation going: It’s easy to forget to keep talking to your colleagues and employer about how you’re finding work and if you need any more help. In no job are all challenges associated with it made clear in the first day or even month. As personnel or projects change, as systems evolve or as your role in the business changes, difficulties come and go.

Make sure that your employer understands your needs as they evolve over time. Keep a regular consultation slot or structure that you have in place open. Even if you haven’t disclosed that you are Autistic to your employer, many will usually be prepared to support their staff when they find that something is challenging them or impacting on their performance.

Talk to someone: A friendly chat with someone we trust can do us a world of good if we feel things are getting on top of us. This person can be a friend, a family member or even a colleague in work. An external point of view on the situation can be refreshingly clear. If you aren’t comfortable with talking to them, counselling or professional support services are available. Depending on where you work, your employer may offer these services as part of the Human Resources department.

Try to keep work stress separate from home: Employers will usually expect that you won’t allow outside factors to influence your performance in work. If you are having a bad day at home, try and keep it separate to your working day and vice versa. If one thing is going badly for you, there’s no point in dwelling on it or having it impact on the other parts of your life.

For those of us that are Autistic, who are so often affected by anxiety, this is easier said than done. If something is really bothering or distracting you, mention to your employer or someone you trust in work that you are experiencing some difficulties outside of the job. This will help them understand what they can do to work around those obstacles.

Adapt your environment to support you: Autistic individuals can only work in an environment which works for us. If you find yourself working in a very chaotic setting or somewhere which is full of distractions or smells and sounds which you find difficult to deal with, try to adapt them to work for you.

Try and keep a clean work space so you are less likely to get distracted and if you find that you just can’t concentrate, speak to the relevant management about the possibility of working in a different surrounding based on your needs.

Focus on your strengths: Above is not an exhaustive list of concerns, but highlights just some of the more common problems. However, we don’t think it is every healthy to focus on the challenges and not the abilities we have.

Below are just some things you should feel really good about that you may be able to bring to a job:

• Honesty – many Autistic people are very upfront and don’t try and sugarcoat reality or twist things.
• Attention to detail – many Autistic individuals are sticklers for detail and perfection. Businesses need attention to detail and indeed that’s what many roles in any businesses are all about.
• Loyalty – when we build up trust with people or organisations, many of us are very loyal and will be happy to work with them and support them for many years. In the ever-changing labour market this is a real asset for any business.
• Focus and Drive – Many Autistic people have specific interests and are very driven in researching or working in them. Businesses like people who are passionate about what they do.
• Intelligence – Some of us on the spectrum not only are of average intelligence, some of us are even above average intelligence (particularly those of us diagnosed with Asperger’s Syndrome). Businesses need big brains!
• Ability to think differently – By our very nature, Autistic people think differently to those who are ‘neurotypical.’ In order for any business to advance, compete and innovate they need people who think that little bit differently.

How do I deal with the social aspects of work?

Socialising is an inevitable part of any workplace. Whether in a large retail store or in a small office environment, most jobs will require you to interact with another person at some point, be that a customer or a colleague.

These situations can present a number of challenges. Autistic individuals often work at our best either alone or with a select group of trusted individuals whom we’ve known for some time. This usually isn’t a practical environment where most of us begin a new job in, however, so working as part of a team of strangers, regularly liaising with customers and coworkers, or just taking part in day-to-day banter can be overwhelming activities in and of themselves.

Some strategies you can follow in your workplace include:

  1. Simply being polite to those around you goes a long way to making your workday much easier and even opening up opportunities to make friends and network.
  2. Let other people do most of the talking when getting to know them. You don’t need to lead a conversation, even if you started it. Listening is an important key to running a good conversation as well as building rapport with others. People are more likely to talk to those who they know will hear them out instead of someone who they don’t think is a good listener or who has to have the last word.
  3. Asking questions is a good way to show that you are interested in what someone has to say. It’s a highly practical and applicable trait to have when you need to know more about a particular offer or service your work is doing or when you just want to find out more about someone. Be careful not to ask too many though and keep your questions appropriate!
  4. If you’re finding working with other people especially challenging, consider mentioning this to your manager before you begin your shift. Explain your needs calmly and clearly. They might be able to accommodate you where you can work as part of a team but away from intensive interaction.


Don’t give up on the social side of things! After we finish school and college, opportunities to socialise and make new friends can diminish, but work can fill the vacuum in this regard. Consider trying to chat to staff or go on social evenings overtime, at your own pace – you might well get to enjoy it and meet people with common interests.

How to deal with the structure and routine of the workplace?

Many Autistic people like to do things in our own way, following our own routine or rituals. This can make the structure of some businesses hard to deal with. Meeting targets and deadlines can be particularly hard and some of us find it hard to work in big organisations when it can be unclear who we report to or what is expected of us. However, we do generally like solid structure and plans, so take the time to understand how the business operates as this can provide a sense of security. If you find meeting deadlines or negotiating the bureaucracy of a business difficult – speak to your managers who may be able to build a structure and plan that lets you work at a pace and manner suitable to you.

How can I make it easier to follow and understand instructions from management?

Autism can make it difficult to follow vague instructions or long lists of verbal commands from management. You can’t be expected to fulfil a task if you do not know or understand what is expected of you – therefore if you are confused simply ask for things to be explained to you clearer or even written down for you. It makes sense for management to empower you with the information you need and they should be only too happy to make sure you understand. If they’re especially busy or flustered and you feel uncomfortable asking them to be clearer why not ask a colleague or another member of management to explain the task to you.

Domiciliary Care Allowance and Autistic Children

What is Domiciliary Care Allowance?

Domiciliary Care Allowance is a monthly payment to fund support for children with significant complex needs, including some Autistic children. This payment is not based on any one disability, but on the impact of the disability. It applies to children “with a severe disability requiring ongoing care and attention substantially over and above that usually needed by a child of the same age.” Please note that terms such as ‘severe’ or ‘mild’ are not the most accurate in the case of Autism. It would be more accurate to say Domiciliary Care Allowance applies to Autistic children with higher support needs but not necessarily all Autistic children.

This support is for children under the age of 16. Once your child reaches this age, payment will cease but they will be eligible to apply for Disability Allowance. See our explainer here:

How do I apply for Domiciliary Care Allowance?

This payment comes from the Department of Employment Affairs and Social Protection and is NOT means-tested. This means that your child’s care needs are the only deciding factor for receiving payment, and DCA can be claimed alongside other payments such as Child Benefit. Children receiving DCA are automatically qualified for a Medical Card. The application form for DCA is long and complicated. We recommend you complete it gradually over several days.  

See our explainer on how to apply for DCA below:

How do I make an appeal if my application was refused?

If your application for Domiciliary Care Allowance is refused, this is not necessarily final. You have the right to have your application reviewed and to appeal the decision: Over 70% of refusals for DCA were reversed in 2020 through this method. The most common reason for refusal is a lack of supporting information, so carefully review documents relating to your child’s care. Make sure you make your appeal within 21 days of hearing the decision.

See our explainer on how to make your appeal below.:

GP Visit Card

What is a GP Visit Card?

GP Visit Cards enable you to visit a general practitioner for free. They are passes issued by the HSE and you may be entitled to one if you are not eligible for a Medical Card.

What does a GP Visit Card cover?

GP Visit Cards cover the costs of visiting a doctor at a general practitioner’s office. This will depend on the practice you attend, but most visits will typically cost anywhere between €60-€80.  The Card also entitles you to some additional healthcare services, such as public health nursing, social services and community care services.

The Card does not cover the costs of medicines that the doctor may prescribe to you, even if they are for treating a chronic condition. Some of these medicines may be covered by the Prescribed Drugs Scheme or the Long-Term Illness Scheme.

The Card does not cover out-of-hours GP services or hospital visits. Blood tests to diagnose or monitor a condition are covered.

Who’s eligible?

Anyone can apply for a GP Visit Card. There’s no age limit, but there are different types of cards for children aged 6 years old and under, older people aged 70 years old and over, and for carers.

All children aged 6 years old and under are entitled to a GP Visit Card. The GP visit card is available to everyone aged over 70 without an income test.

If you get Carer’s Benefit or Carer’s Allowance, at full or half-rate, you are eligible for a GP Visit card.

An Autism diagnosis in itself does not automatically entitle you to a Medical Card or a GP Visit Card.

How are applications assessed?

You must live in Ireland full-time and meet a means-tested criteria in order to qualify for a GP Visit Card.

This criteria will look at your income to decide if you are eligible for either a Medical Card or a GP Visit Card. It will decide if your income is at a level where refusing you a Card of either kind would cause financial difficulties for you. If you are under 16 years of age, your parent’s income will be decided on if you are eligible.

If you don’t qualify for a medical card, you are then assessed for a GP Visit Card. The criteria will also look at any social welfare payments you are currently receiving, whether you are out of work or in work. You must include all details of any payments that you are receiving, as your application may be disqualified if you do not.

If you are not currently receiving any social welfare payments, you do not need to include them in your application.

If you are currently working, include your most recent payslips in your application form.Check out the video below for more advice on filling out the form.

Occupational Therapy

What is Occupational Therapy?

Occupational therapy is a crucial support for Autistic people. It’s defined as therapy which supports people in developing and maintaining ‘meaningful activities.’ Activities are usually defined as skills necessary to daily living and working (in school or professionally.)  

An Occupational Therapist works with people of all ages who are experiencing difficulty managing everyday activities. This support focuses on the ‘occupation’ or activity that needs to be built up, and works backwards from this while considering the person’s access needs. In other words, it is about empowering someone to do something rather than targeting their condition as a problem to be ‘fixed.‘ This means that it can be considered part of a person-centred approach.

Occupational Therapists categorise everyday occupations into three areas – self- care, productivity and leisure. Self-care includes activities such as washing, dressing, brushing teeth and hair. Productivity describes activities relating to work, school or domestic tasks at home. Leisure includes examining an individual’s participation in their hobbies and interests.

How can I access an Occupational Therapist?

There are two main routes by which you can access an Occupational Therapist, through the public healthcare system or privately. Access to an occupational therapist is not based on diagnosis or diagnostic criteria instead it is a needs based service. This means the Occupational Therapist will want to know which every day activities you/your child is having difficulty with.

Both public and private routes to Occupational Therapy will provide you with an equal standard of care, however, unfortunately much like with Autism diagnosis there can be long wait times for public services.

In order to access Occupational Therapy through the public healthcare system a great place to start is visiting your GP. Explain your needs to the GP and they can provide you with information available services. If you are already working with a primary care therapist, early intervention team or disability network team there should be an Occupational Therapist working as part of that team/service. If you are looking for a private occupational therapist, the Association of Occupational Therapists of Ireland is a useful starting point.

Should I choose an Occupational Therapist who has experience working with Autistic people?

As Occupational Therapy is not a medical model of therapy or treatment, an Occupational Therapist will not focus on an individual’s diagnosis. Instead, the Occupational Therapist will focus on the individual and the occupations that they may struggle with.

However, given many Autistic people view Autism as part of their identity rather than a condition to be studied, it is important that providers of Occupational Therapy have a thorough understanding of Autism and the needs of Autistic individuals. It can be useful to identify your areas of concern before choosing an Occupational Therapist and trying to make your choice based on a therapist’s experience in these areas. Occupational Therapists may have undergone additional training in sensory processing or restricted eating for example.

Why might an Autistic individual require Occupational Therapy?

Occupational Therapists work with Autistic people in a number of areas. However, one of the most common reasons an Autistic individual may require the support of an Occupational Therapist would be when sensory processing difficulties are impacting their participation in everyday activities. Occupational therapists can support with a number of other experiences of daily living (e.g., sleep, sexuality, puberty, play, handwriting, friendship, money management, advocacy).

What role does an Occupational Therapist play in an Autism assessment?

For children, the Autism assessment is typically multi-disciplinary in its approach. Members of a multi-disciplinary team may include an Occupational Therapist, Speech and Language Therapist and a Psychologist who each assess the child and collaborate to examine needs and ultimately come to a conclusion of the child’s diagnosis. The role of an Occupational Therapist in the assessment of need is to focus on function (participation in everyday activities).

For young children who may be pre-verbal, the assessment will be an observational assessment in which an Occupational Therapist may observe motor skills, play and sensory processing. They also may interview parents based on how their child manages everyday activities based on their age and typical development such as brushing teeth, toilet training and getting dressed for example. For older children or teenagers or even adults, the Occupational Therapist may speak directly with the individual being assessed about their everyday occupations, sensory challenges and general functioning.

What is a typical session with an Occupational Therapist like?

It is important to note that an Occupational Therapist will not always work directly with the individual alone. Recent evidence suggests the occupational therapist should be focused on working at a universal level (e.g. within the child’s school), or at a targeted level (e.g., with the child’s class). By working with the people and environments around the child, there should be less need for individual input. Again, the focus should not be on changing the child, it should on changing the environment around them.

The number of sessions an required with an Occupational Therapist depends on someone’s level of need and personal goals. If your child requires the support of an Occupational Therapist, your first session will typically involve discussing your child’s strengths and needs in the 3 core areas; personal care, self-care and leisure. The course of the sessions will depend on these goals that have been set.

Occupational Therapists consider someone’s needs within the context of the demands of the activity and the environments. As a result, support can vary significantly from person to person. For example, if a child has difficulty with teeth brushing, the child may be given ideas to desensitise the mouth (support the person), use a flavourless toothpaste (change the activity) or try toothbrushing away from the noisy bathroom fan (change the environment).

Typically, you will visit your Occupational Therapist more frequently at the beginning e.g. once a week. This will be while you complete the assessment and decide on goals together. The phases between your sessions will likely increase as you are working on your goals. For example, you might move to once a fortnight or monthly. Eventually, once the Occupational Therapist sees you are implementing these skills at home, they may discharge you.

Your Occupational Therapist may also suggest that you attend group sessions or workshops. This would involve attending a sessions alongside people with similar difficulties or challenges to you. For example, an Occupational Therapist may hold a workshop about various sensory strategies to support you in school. If you are a parent who is visiting the Occupational Therapist with your child, they’ll probably mix parent education with one-on-one work with your child. It is helpful for you to learn the various skills that the Occupational Therapist is teaching your child so that you can help to support them in their learning and development at home and maintain the progress over time.  

Finally, the Occupational Therapist may also help parents or individuals communicate their sensory difficulties to schools or workplaces. This can be helpful in order to make the school or work environment a more comfortable place for the individual.

Autism and Self-Regulation Strategies

What simple regulation strategies can I use at home?

It’s important to stress that Autistic people have diverse support needs, so there is no one size fits all Autism approach to help them regulate. When choosing regulation strategies for use at home, start by paying close attention to your child (even write it down) to observe which senses the child seems to be seeking more input from and also when/at what times of day they seem to require more input. This helps narrow down which type of strategies e.g. visual or tactile etc to start with and whether the child may need something alerting or calming at that time. It’s important to note that some Autistic children may have developed their own sensory regulation strategy already. If this is working well and you may not need to change or add anything else at all! If this is the case, try to note how they self-regulated and see if it can be replicated in other environments.

Lastly, if the child’s sensory system is clashing with something in the environment e.g. a smell or a noise, consider changing the environment before adding more sensory regulation strategies for the child.

Heavy Work: Heavy work is a useful strategy that can helps you self-regulate whether you are under or over alert. This describes any activity which involves stretching or exercising the muscles or joints usually against resistance. One of the simplest heavy work strategies could be by going for a walk with a weighted backpack e.g., filling a backpack with filled water bottles. Trampolining is another heavy work activity which can help you to feel calm and relaxed (making sure that the child isn’t doing flips which tend to be alerting). If you are in school or work and cannot take a long movement break, a simple chair push up, wall push ups or even pushing your hands against the desk can be a great simple alternative. Yoga also is a heavy work activity that has been shown to reduce anxiety in Autistic individuals.

Swings: Swings are a very useful piece of equipment to regulate. The movement system (vestibular) is key in regulating information coming in from the other sensory systems too.  You can purchase both and outdoor swings from many mainstream and special needs toy suppliers.

Weighted blankets: Weighted blankets are great simple pieces of equipment that can help children to self-regulate at home. They can be particularly useful to wind down after school or before bed. It is important that these be no more than 10% of the child’s weight and should not be in any way restraining.

Fidgets: Fidgets are simple sensory tools that can help you concentrate or pay attention during work or school.

Deep pressure: If a child is very sensitive to touch, deep pressure can help reduce sensitivity. Parents can incorporate deep pressure at home in a variety of ways. Skin on skin methods such as a massage can be uncomfortable or ticklish for Autistic individuals. The ‘hot dog’ method is a useful alternative. This involves wrapping your child up tightly in a blanket, (leaving their head exposed so that they can breathe and never leaving the child unattended). Once they are wrapped in the ‘hot dog’ squeeze down along their body or use a massage or Pilates ball and gently squash along their body. As discussed, this helps to block every day sensations (like the feel of clothes) that many Autistic individuals find uncomfortable. Alternatively, massage balls or toys can be used to self-massage in order to achieve the same outcome. These methods work best if done regularly (as part of a sensory diet) in order to keep the child calm rather than using them once the child has become distressed.

Yoga and meditation: Yoga and meditation are other methods which can be very useful to help children feel calm and learn to regulate their own emotions or behaviours. Yoga targets key areas of Autism-related sensory processing such as proprioception and body awareness as well as breathing which can benefit and improve how an Autistic person will regulate their sensory environment.

How can I set up my home to be more accommodating for Autistic individuals?

There are a number of changes you can make to provide an Autism-friendly environment where it is easy to regulate.

• Choose calming colours throughout the home such as muted greens, blues, pinks, soft oranges and neutrals and avoid over-use of patterns throughout the home.
• Choose matt paint rather than sheen as this tends to reflect the light more.
• Ensure the house is as clutter-free as possible in order to keep a calm environment in the home.
• If your Autistic child is sharing a bedroom with one of your children, try and separate off their space so that they feel like they have their own private calm space that they can retreat for self-regulation. Dream tents are great ways to do this in a smaller space.
• Choose warm lighting rather than white or bright lights. Opt for using roller blinds rather than venetian wooden blinds which can reflect patterns of light through the house when the sun is shining.
• Consider where rooms are in relation to the kitchen if the child is sensitive to food smells. For example, maybe your child could do their homework at a desk in their bedroom rather than at the kitchen table in order to help them focus on the task at hand and not be distracted by their sense of smell.
• Some children may not like going into the bathroom to brush their teeth or use the toilet because of loud fans in the room. Can your child brush their teeth elsewhere or can the fan be replaced with a quieter alternative or is there another bathroom without a fan which they can use?
• Set up a sensory space in the home which your child can retreat to if they are feeling overwhelmed. Involve your child in setting up the sensory space in order to customise and tailor it to their needs. Allow them to choose sensory toys, fidgets or other equipment that might help them to feel relaxed and calm.

How can you set up a Sensory Kit at home?

While out in public sensory kits you may need a sensory kit that involves a wide variety of items such as ear plugs, sunglasses, scented tags, mints etc due to the typically more busy and changing environments involved in public spaces. At home choose a select few items that are important to your child. Your child’s sensory needs are unique to them and therefore their sensory kit should be customised to those needs.

Again, there is no one size fits all Autism approach to self-regulate. You might include items such as stress balls, fidgets, soft or weighted blankets etc. It may be a process of trial and error to find what works best for your child. When you do find items that suit your child it can be useful to buy multiples so that you have replacements on hand if they are to go missing or break etc.

What is a sensory room and what does it do?

Sensory rooms are created to help individuals meet their sensory needs. These are calm, relaxing Autism-Friendly spaces that individuals can go to in order to self-regulate. A child can visit a sensory space or a sensory room when they need a sensory ‘break’. A child may need a sensory break from their school day in order to continue to focus and engage with the curriculum. It is a space where a child can ‘recharge’ in order to continue about their day. A few items that can be useful for including in a sensory room can be a weighted blanket, a beanbag, controllable lighting, a rocking chair or swing, some books, some fidgets and ear defenders.

What evidence based occupational therapy programmes could I try?

Although there is no universal Autism-Friendly approach for regulation, there are methods to identify how your child will self-regulate. The Zones of Regulation is an evidence-based framework that can be used to teach children about emotional and sensory self-regulation. This framework can teach children to recognise their different emotions or zones based on a colour coded framework and how they can use strategies to return to their “green” or safe zone.

What should I do if my child uses harmful self-regulatory behaviours?

While self-regulatory behaviours are necessary and helpful for individuals to manage their environment, this does not always mean that people adopt safe behaviours when self-regulating. It can be difficult if your child chooses to adopt harmful self-regulatory behaviours such as nail biting or more harmful behaviours like hair pulling or even banging their head. In these cases, it is important that you work at finding your child a replacement behaviour for this self-regulation.  

Notice what it is that the self-regulation is providing them from a sensory perspective. For example, with hair pulling it is the sensation to the scalp or fingers they find regulating. Then try and find a suitable replacement activity that matches the sensory need, so with hair pulling you may try a fidget or perhaps a head massage instead. This may involve a certain amount of trial and error to replace the pre-existing behaviours.

With younger children particularly, you may also need to positively reenforce use of the new tool/strategy e.g. a sticker or reward chart until they get used to it. With patience and cooperation between yourself and your child can work towards finding a positive way for them to self-regulate without causing themselves or anyone else harm.

Autism and Life Skills

What challenges might an Autistic person face with self-care?

Self-care involves many of the everyday tasks we perform to keep ourselves healthy, hygienic and safe. Examples of self-care include brushing our hair, teeth, washing, brushing hair, shaving and many more. Self-care can be challenging for Autistic individuals especially for those who may struggle with sensory difficulties.

Some examples of sensory difficulties that an individual may encounter in relation to self-care include difficulties with the feeling of a toothbrush or the taste of toothpaste or struggles in relation to getting your hair touched, making hair washing and cutting difficult. Difficulties with textures of fabrics are also very common for example, seams, tags or harder materials like jeans etc., which could potentially pose problems with school uniforms or other dress codes.

The goal of an occupational therapist is to assist the client to be as independent as possible in every day activities. Sometimes this may involve modifying the environment, the activities or learning a variety of sensory strategies. As discussed before, the variety within the Autism spectrum means that some Autistic people may require greater support in certain learning life skills than others.

How can you support your child through the transition from childhood to adulthood?

Discussions of Autism are often dominated concern with childhood and education, but we must remember Autistic children grow up to be Autistic adults, who will require certain life skills. The best way to ease your child into the transition into adulthood is by taking it slowly, step by step. Treat the transition into adulthood like learning any new skill. Break the “skill” or transition down into components and learn each component step by step.

For example, learning new skills such as cooking, cleaning, personal hygiene or even managing your own finances can each be broken down into basic step by step instructions to follow. Some of these things can be introduced at a younger age such as helping prepare the dinner at an age appropriate level, introducing pocket money to begin understanding how to manage finances and helping with chores around the house.

You may have pre-existing systems that work for you and your child such as using phone reminders or colour coded systems to help with organisation. Use what you have learnt works best for your child and apply these to new tasks that they are learning.

Remember, you know your child better than anyone else, you know what works for them and where they need support. The more gradually you can prepare for the transition into adulthood, the easier this will be for your child.

What strategies can I use to develop motor skills and coordination at home?

Backwards chaining is a useful technique to learn any skills. Often learning the steps to learn a skill backwards can be a useful way to learn a skill. For example, pulling the last knot when tying laces. This helps the child feel the success of completing the task while reducing the stress involved with learning the task.

Visually representing a task is a useful way to help Autistic individuals learn. For example demonstrating the steps a task involves yourself or using pictures of each step as part of a social story which your child watches before getting them to try it themselves.

It is important to start the task in the simplest possible form and work your way up in terms of increasing the difficulty involved with the task. For example, when learning how to catch, start with a balloon rather than a ball as it is lighter and moves more slowly than a wall would. This will allow us to learn and improve hand-eye coordination and build these skills gradually.

Autism and Being Organised

Why do Autistic people sometimes struggle to organise themselves?

Autism can mean a number of differences in how tasks are understood, processed and completed and may require support being organised. Occupational Therapists can help with many of these issues.

Organisational skills involve being able to filter through all the information in our brain and to select the pieces of information that require our attention in order to prepare or complete a task. As a spectrum condition, Autism doesn’t automatically mean poor attention or prevent someone being organised. In fact, lining up toys in ordered patterns is a common indicator for early years diagnosis. However, there are certain factors which can affect task management.  

As a result of commonly experienced sensory processing difficulties, Autistic people may not have the same ability to filter through the sensory input they are presented with as neurotypical people. Autistic people may not be able to filter beyond the sensory overload of noise, smells or feelings that they may be experiencing in order to pick out and process the important information coming into the brain. As the brain is so busy processing sensory information it can be very difficult to process and organize any other information. Some may compensate by developing their own organisational approach, but this may be hard to transfer.

How can I stop forgetting to do something?

As humans we all forget to do things every now and then, that is okay! Regardless of Autism, it’s unrealistic to expect perfect memory and for people to be perfectly organized all the time. However, if you find you are forgetting the same thing continuously then there are a number of ways you can try and help yourself remember.  

One way to try and help yourself remember to do something is by attaching it to a part of your routine. For example if you tend to always forget to bring all your books into school for the day, maybe try incorporating this as a step in your morning routine. For example, every morning after you’ve eaten your breakfast, take 5 minutes to check your school bag and your timetable and make sure you have everything you need for the day. You could even make a morning checklist so you have a visual representation of what you have to do in the mornings before you leave for school or set reminders on your phone.  

If you enjoy structure and order, something that may be useful for you might be to colour code your daily schedule and match the colours on your timetable to a sticker on the books needed for the same subject.

What is Executive Functioning and how can it help me keep organised?

This is an important term to describe how Autism and other neurodivergent conditions affect someone being organised. Put simply, executive functioning is how our brain organises itself. Executive functioning describes a wide variety of concepts such as how we problem solve, abstract thinking and organizational skills. For example, our executive functioning is what will help us remember what variety of tasks need to be completed before a party or event. Our executive function helps us countdown the days in the lead up to the party and organise ourselves in advance of that date, like remembering to purchase a gift in advance of the party and remembering to confirm our attendance.

Part of organising yourself is understanding how your own executive functioning performs and where you might need extra support. For example, sometimes visual schedules can be used to support your executive functioning and remembering what to do. Even simply writing a checklist in a diary or on a whiteboard in a central place in the house including “buy a gift” and “confirm your attendance” will help you be more organised in the lead up to a task or event. Although this is a very simple example, the same principle applies to more complex tasks such as the lead up to a holiday or school exams. Scaffold your own executive function by understanding where it is that you can do simple tasks to provide yourself with more support.

How can a special interest help in everyday life?

A special interest can be used to help manage the sensory environment as well as managing everyday occupations that you may struggle with.  

A special interest could potentially help you with your organisational skills as typically your special interest is an area that you are particularly “organised” in. Think about how it is that you store the information about your special interests and you may be able to utilise the same strategies or techniques for other areas too.  

A special interest can also be a good starting point for increasing your social activities/groups. For example you may be interested in bird watching, so joining a bird watching club may be a good place to start if one of your goals it to make new friends or socialise more.

Language and Communication

How do I know what Autism language & communication sources I can trust online?

These days we can easily access lots of valuable information and resources online. However, it is important that we identify key, reliable and trustworthy sources of information. There might be local support groups in your area or even online on social media sites such as Facebook. These can be useful places to go to for advice. Linking in with people who have been in a similar situation to you can be a great first step when looking for support. You can also look to trustworthy websites such as

HSE
Irish Association of Speech and Language Therapists (IASLT)
National Autistic Society (NAS)
Middletown Centre for Autism

When looking online, be careful that the information you are looking at is reliable. It is important that any interventions you find are evidence-based. Sometimes, if you feel like you are struggling to find something that works, you may feel like you are willing to try anything to help your child. It can be a good idea to go back to your trustworthy sources of information mentioned above and ask if anyone has any experience with that intervention or strategy etc. You should also check with your GP or Speech and Language Therapist if they are familiar with what you have come across online.

Why do some Autistic people struggle to understand non-literal language?

Non-literal language is used in everyday communication. We use phrases like “it’s raining cats and dogs” or “I have a frog in my throat”, in our conversations. Autistic people can find this type of language confusing. One possible explanation for this may be that Autistic people are strong visual communicators. While we all engage areas of our visual processing systems while we communicate, Autistic people tend to access and use the visual systems in the brain in order to interpret all of the information that they hear. If you are using your visual system to picture these phrases or colloquialisms that come up in conversation it can become very confusing and difficult to get past this. For many Autistic people, they have to independently learn what people actually mean when they use these phrases and that can take quite a lot of time and effort. It can be useful to create visuals to explain what common phrases using non-literal language mean in order to help. You must be aware that if you are using non-literal language or even being sarcastic in your conversation with an Autistic person, it can be difficult for them to understand or pick up on.

What is echolalia and why does my child engage in it?

Echolalia is a repetitive communication. With echolalia, an individual might repeat a phrase or even a whole chunk of communication. An individual might repeat something they have heard immediately, or the repetition could be delayed, repeating the communication later that day or even on a subsequent day. Echolalia can be a part of language development; it can act as a stepping stone towards learning more about language. People might engage in echolalia as a mechanism for remembering the context or situation in which a specific phrase is used. Gradually, over time, the individual will begin to alter how they use these words to fit more into their everyday language. In the context of Autism, echolalia is a different way of learning and communication during language development.

What is Pica and how can a Speech and Language Therapist help?

Pica is an eating disorder which involves the consumption of non-food items. It is important to talk to your GP and healthcare team about this. A Speech and Language Therapist might play a role in the multidisciplinary treatment of Pica. A Speech and Language Therapist would focus on supporting the person to understand the difference between food and non-food items and investigating the point of view of the person who is experiencing Pica.

What is Verbal Stimming?

Verbal Stimulatory behaviour or verbal stimming describes how someone might repeat a word, a phrase, or a noise in order to regulate their environment. If an Autistic person finds their environment to be overwhelming, they might 'stim' as it is often referred to, in order to soothe themselves in some way. It is important to understand that this behaviour serves a purpose for the individual and if you aim to reduce or stop that behaviour, it could increase the individual’s anxiety. Stimming is a key part of Autism and understanding what a stim is expressing can be helpful towards their language development.

Why do people lose their ability to communicate in a certain way?

There is no simple explanation as to why this might happen. It is important that if your child’s language development appears to regress that we are patient and understanding while remaining positive and encouraging. Remember in the world of Autism everyone’s journey of language development is unique.

Why does language develop in different ways?

It’s important to remember that regardless of Autism, language development in the early years is extremely variable in all children. Each child is different. Verbal language will not develop at the same rate for everyone, sometimes it may not develop until later in life and some people will not use verbal language to communicate. This is okay. The trajectory of language development is different from person to person. For some people, they might have a large vocabulary of words that they use, but might be struggling to understand language or to understand the social aspects of communication. Building communication is about focusing on peoples’ strengths and supporting them in the aspects of communication that they find challenging.

What should I do if I am concerned about my child’s language development?

It is important that if our child’s language development appears to regress we are patient and understanding while remaining positive and encouraging. Remember, in the world of Autism everyone’s journey of language development is unique. You could refer to typical milestones of development to track your child’s progress. The HSE has some useful information about what you might typically see at different stages of your child’s development. If your child is attending any form of preschool, it could be useful to ask the teachers if they have any concerns about their communication and for some more informal advice, and they may be able to direct you somewhere that you can seek some further help.

If you are concerned about your child’s language development (especially if your child has not received an Autism assessment) in any way you can talk to a professional to get some general advice about what may or may not be typical language development. The outcome will be positive no matter what, it will give you peace of mind or it could be your first step to getting some extra support for your child. You can contact local Speech and Language Therapy services directly, or through your GP or other health worker.

What terminology should I use when describing my child’s language development?

People often describe language skills based on whether someone uses speech to communicate (verbal) or does not. In the past people typically used the term “non-verbal” to describe delayed language development. This term would suggest that an individual has no communication ability when they might be using an alternative means of communication, such as gestures, sign language or a communication device. The term “non-verbal Autism” could be offensive and an inaccurate description of an Autistic person’s language development. Some people prefer the term “pre-verbal” because this term would indicate that a person’s language is still developing and it does not deny their current abilities or what other abilities they might develop further in the future. Other terms used include “minimally verbal” and “early communicators”. If you have a term that you prefer you can request that other people also use this term.

What can I do at home to promote my child's language development?

The home is an ideal Autism-friendly space to start working on promoting your child’s language development. Communication is all about developing language skills in natural, everyday settings and learning in real-life scenarios. Communication centres on interactions, sending a message and understanding a message. At home, there are plenty of opportunities to interact. We must think, what opportunities for communication can I build into these interactions?

Parents can be really good at knowing what their children want. Even without speech, we can often predict our child’s needs or wants through subtle hints in communication such as a gesture or a facial expression. Sometimes, although we may be able to predict what it is our child needs, we must allow them to independently communicate to us what that is. For example, asking “Show me what you want” and allowing them to gesture to you what they are looking for. You could offer a choice between two items. These are very basic, but effective and Autism-friendly ways of encouraging your child’s language development.

Similarly, we can introduce opportunities for communication in routine activities. For example, use the gesture of brushing your finger across your mouth to indicate that you are now going to brush your teeth. This helps your child to understand what is coming next. What you may start to see is that your child begins to mirror this gesture.

Spend time watching what your child is interested in. Your child’s interests provide valuable ways of introducing communication at home. If your child is interested in a game for example, spend time playing that game with them, encouraging communication as you do so, feeding in relevant language as they are expressing interest in the activity. Imitation is another way to foster opportunities for communication with your child. If we mirror what our child is saying or doing, it allows them to notice us more. They realise that we are really noticing what they are doing and we are responding to them, meaning they will be more attentive.

Regardless of an Autism diagnosis, a parent is typically an expert in their child’s language abilities, noticing any developments and improvements in their communication. Use this expertise to your advantage! Support your child by gradually encouraging more challenging language or communication skills as you notice improvements.

Will Autistic people struggle to learn new languages?

There is no ‘one size fits all’ approach to language development and therefore we cannot make generalisations about Autistic people and their ability to learn new languages. Some Autistic people have very strong linguistic skills and will respond very well to learning more than one language. For other people, learning a new language will present an added stress or difficulty. It is important that we have a flexible approach to bilingualism. It is important that people who are interested in learning a new language are provided with the opportunity to do so and are supported in doing so.

What forms of alternative communication are available?

People do not need to speak in order to communicate. Communication is about sending messages to one another and how we understand these messages. There are many ways in which communication takes place e.g. hand gestures, facial expressions or eye contact with one another. Here are a few examples of forms of communication that Autistic individuals might use in place of verbal speech:

• Sign Language, e.g., Lámh and Irish Sign Language (ISL)
• Typing
• Using visual symbols, e.g., letter or picture boards, Picture Exchange Communication System (PECS)
• Using objects: objects of reference involve using objects to signify an event or activity, e.g. a lunchbox signifies that it is lunchtime
• Voice Output Communication Aids (VOCA), e.g., using an app on an iPad or tablet.

How can I support Autistic people in using their preferred form of communication?

Learning a new mode of communication can be challenging and it is important that people get support in doing so. One of the best ways that you can support someone in using their preferred form of communication is by immersing yourself in learning this new mode too.

Aided language modelling is the process of learning a new form of communication and modelling using it. It is a crucial part of learning additional forms of communication.

When learning any new communication system, it is important that the people in our close environment, whether it be the caregiver, teachers or even peers, also use this mode of communication so that the individual can see how it works and learn how to use it. This mirrors verbal language development, learning how to understand the messages that others send before sending messages ourselves.  

While it is important to identify a mode of communication that suits the individual it is also important to look at how we accept this method of communication. As our society becomes more accepting of individual differences, organisations become more flexible with the methods of communication they accept. For example, it is important that services allow various modes of communication and not just typical verbal communication. This includes someone who might prefer to communicate with you by text rather than in person or a teacher accepting that a student might prefer to record questions that they might have rather than ask them during class time.

We are open-minded about these differences because we value our connection with one another and we respect our differences. We must focus on individuals’ strengths, and what they can do and like to do, not what they find challenging. Be open-minded! Encouraging any change of behaviour can be challenging and learning a new method of communication is no different. Your child may become frustrated as they become familiar with this new method. Be patient, and remember that you play a crucial role in assisting your child in learning their new method of communication. It is important that the new method of communication becomes embedded in your everyday life. Set a reminder on your phone or leave some visual information on your fridge to remind yourself of what it is you need to do to help your child on this journey.

Will using alternative communication inhibit my child's ability to speak?

There is no evidence that suggests that using an alternative means of communication will stop or delay speech development. Using an alternative form of communication is a way to improve communication skills, by sending and interpreting messages back and forth. An alternative form of communication provides the individual with a voice, and an opportunity to relieve frustration and enhance their skills.

Remember that Autism is by no means the only disability which may necessitate alternative communication. Therefore, by becoming more accepting of these ways of communicating, we are making changes that will help a larger number of people.

How do you choose a form of communication?

Initially, when looking for an alternative method of communication to try it is important to gather as much information as possible. Look for recommendations from your trusted sources e.g., from a Speech and Language Therapist, from a Facebook community group you are part of, from teachers or parents in your parent support group. You should seek evidence-based methods. Being Autism-friendly means finding the best fit for the individual person’s support needs and alternative communication is no different. Think about your child’s strengths and try to match this method with those strengths.

What are visual supports and why are they important?

Verbal communication involves using words to send a message. Visual communication is a form of alternative communication which involves using a visual or graphic, such as a picture, video or sign, to send and receive messages. One of the main strengths of using visual forms of communication is that the message lasts longer, giving us more time to process it. Autism by itself doesn’t impede visual communication. In fact, research has suggested that Autistic people process language in quite a visual way. So if we can communicate visually, it can help us build on our own or our child’s strengths. Visuals are not only useful for Autistic children but other children too.

How do I use visual supports to communicate with my child?

There are many ways that you can use visuals at home to support your child. One way that we can introduce visuals at home is by using choice boards. You can provide your child with the opportunity to make their own decisions by helping them to understand their options visually. For example, you might provide your child with a choice between 2 of their preferred activities by showing them two photographs (for example a swing and a trampoline) supporting them to make their own independent choice.

One of the most useful ways we can use visual supports at home is by using visual information to describe what we are doing or what is happening. Visual schedules can indicate a step-by-step plan for the day, a useful tool for timetabling and planning. Using visuals we can show “first we are doing this, next we are moving onto this”. In this way, visuals can also be used to prepare for change and prepare for transitions. Visuals can help to reduce anxiety about what is unknown or unexpected.

You can also use visual schedules to explain where other people are. A picture of Dad at a desk indicates that Dad is at work for the day. You can also use visual cues to introduce flexibility or change at home. For example, to let your child know that it is a school day you could leave their school bag at the front door for them to see when they wake up. Whereas, if it is not a school day, there would be no school bag at the front door. Using the visual cue of the school bag effectively communicates to your child whether they are going to school that day or not.

You could use visual supports to help your child to express how they are feeling. You could use colours to indicate how you are feeling e.g. red when you are not feeling great or green when you are feeling good. Another way of expressing feelings through visuals could be by using a thermostat image or a scale and allowing your child to indicate where on that scale they are feeling. Visuals are also particularly helpful in providing a step-by-step of how to tackle difficult tasks. Visuals can help us learn to be more independent. For example, you could break the task of getting dressed down into a step-by-step format visually and over time. This will help the individual to independently get dressed. Sometimes when we break a task down step by step it can allow us to see how difficult a task truly is!