Here some suggested organisations that offer expert advice on SN.

triad of impairments - imagination - new info

(51 Posts)
ArthurPewty Mon 22-Oct-12 13:33:55

At the Women and Girls NAS conference i was at last week, Judith Gould and the other fabby ladies present clarified a big point.

They said they made a mistake / they werent clear enough in their original publications on the issue of the Triad of Impairments in ASD.

They didnt and never have meant "does this child have imagination". That is not the issue, whether or not a child has an imagination / can play with toys imaginatively/ symbolically.

The issue is social imagination.

Which is to say, can the child predict the outcome of a social interaction? Can the child understand and predict the ramifications of what they say and do? Can the child think through the consequences of their actions?

Just thought i'd share that.

Handywoman Tue 06-Nov-12 09:57:26

My DD2 (8 in March) had a mahoosive meltdown after spilling paint on her night dress on Fri (as described in the latest Friday night thread!). This happened while her friend was over for a play date. DD2 was screaming in her room and would not come down to say goodbye. Moments later, her friend had gone home (at the planned time) and DD2 tucked into her dinner like literally nothing happened. About an hour or two later I asked her gently and openly: "how do you think your friend felt when you were upstairs screaming and would not come down and say goodbye?". Her answer was a very innocent and genuine, "I don't know". She literally had no idea. Is this lack of social imagination? Lack of empathy? I have trouble figuring out the difference.

Either way I reckon this is not to be expected for a child of her age? Both the lack of awareness of the effect on people around... or the inability to even recognize how your friend might feel?

HW x

porridgelover Mon 05-Nov-12 12:47:29

Excellent thread.

One of the most insightful things I have done since starting on the ASD thing is to attend a talkability programme with our SaLT.
The big thing that I got out of it, was the role of playing imaginatively and socially with my DS.
I had not really realised how he cannot do this until it was spelled out for me.
For example, I was playing with DN 3yo while on the course. We had a chat about his tractor which he was playing on. I pretended to fill it with diesel. He pretended to pay me. I asked if I could check under the bonnet. He agreed and pretended to open it for me.
Here's where it jumped from what DN can do at 3 to what DS cant do at 7.
I said 'what this underpants doing in your engine? and pretended to pull one out. DN stopped, roared laughing, then got with the change in the game, and said 'thats where I keep my underpants!''. grin grin
Since then, I play with DS and constantly try to introduce this flexibilty but he hates it. Gradually, as I keep trying this, he gets better. But I cant do it if he's upset or tired.

HotheadPaisan Sun 04-Nov-12 16:15:54

Extreme demand avoidance, bane of our lives smile

I've just gone back to the PDA Contact Forum as things are desperate again (DS1 is only 6), I signed up there two years ago, I keep deluding myself that things are better, they're not, DS1 just can't refuse in quite the same way as he used to and he knows it. Once he cottons on that he can in fact we're doomed.

KeepOnKeepingOn1 Sun 04-Nov-12 13:56:17

DS1 used to have a meltdown regular as clockwork every Saturday morning when it was time to leave for karate culminating in him lying on the floor in a foetal position covering his ears. But I was unable to end it by cancelling karate as he would then have another meltdown ending the same way about not going to karate. Catch 22, damned if you do, dammed if you don't. I understand his behaviour better now but I don't know how to deal with extreme demand avoidance other than not making demands. When I tried short communication a la 'how to talk to kids..' eg 'DS, washing-basket' he had no idea what I meant ('yes, Mum, its a washing-basket') and needed literal step by step instructions.

Handywoman Sun 04-Nov-12 13:22:41

Yeah. This is a great thread.
Love this place.
Handy xxxxxxx

BsDad Sun 04-Nov-12 07:51:45

Hello,
I too had a lightbulb moment when reading this thread. It inspired me to write a blog post about it which you can read here:

www.autisticson.wordpress.com

I've said it before, but Mumsnet is such a lifeline in helping us to make sense of, and understand, our son's condition. Thanks everyone.

TheCreepingLurgy Tue 23-Oct-12 12:35:21

I agree rabbitstew, that "genderising" autism is not helpful to anyone. For one, it reinforces stereotypes about what is considered male and female behaviour. Only in the short term it may help with acknowledging the way some people (perhaps the majority of which is female?) express autism is indeed autism (and not OCD for example). But in the long term it will do more damage than good.

HotheadPaisan Tue 23-Oct-12 10:32:14

I was thinking that about DS1, and I would be considered to have 'male' traits. I can see we want to address the underdiagnosis of girls but I don't like things being grouped by gender.

It has taken me a year or two to understand ASD and I've been immersed in it. I am still learning, not sure how you get the info out there in a simple enough way for people to grasp whilst not discounting the responses of some kids with 'well, it can't be autism because...'

I missed the anxiety-based reframing/ reference point. Nearly all of DS1's difficult behaviours are driven by an anxiety-led need for control and fear basically, with a neurological root. Punishing him for this and not understanding is just cruel.

rabbitstew Tue 23-Oct-12 10:15:17

I'm not sure it's fair to call it the "female" expression of autism, either, though. My ds is a boy, but according to all these descriptions, has an incredibly female expression of his autism!

ArthurPewty Tue 23-Oct-12 07:19:04

you might've sat nect to me :D

I was the one nodding emphatically and YESing loudly in an American accent ;)

ArthurPewty Tue 23-Oct-12 07:18:36

"Yeah, that is what we often do too - we talk about a demand avoidant pattern of behaviours in an autistic profile. I agree the reframing of behaviours as 'anxiety based' rather than 'naughtiness based' is very helpful indeed."

YY yes yes yes this. YES.

TheCreepingLurgy Mon 22-Oct-12 23:40:08

ilikemysleep, thanks for your clarification. It is so true that the female expression of autism has not had the attention it deserves until recently, and that the current diagnostic criteria are based on males. Good that it is finally changing! But it may take a while before it is established, what with the view of Baron-Cohen's 'extreme male brain' being quite prolific in the media.

rabbitstew Mon 22-Oct-12 23:17:41

Thanks, ilike - that's really helpful. Although it sort of confirms my feeling that when my ds was younger, his behaviour was more apparently "autistic" than it is now because he was highly anxious but did actually have good reasons to be anxious... I don't see how a child could fail to be anxious if he was considerably delayed in learning to move as a result of low muscle tone, extreme hypermobility and poor motor planning skills, and so had no real control over his environment at an age when he was hyper aware of what was going on in his environment and had all sorts of genuinely unpredictable threats (eg toddlers his age) coming over to him and knocking him over (from which position he could not get up without help) without having any means to defend himself! I know if I were an adult stuck on the floor, unable to reach what I wanted or get myself from lying back to sitting, unable to express myself clearly verbally, unable to defend myself or get away from people invading my space and unable to express my free will in any meaningful way, I would be very anxious and might start soothing myself with repetitive activities which could be done without moving, like counting repetitively, etc...

mariammma Mon 22-Oct-12 23:05:58

Ilike, great description

This whole thread is brilliant... thanks Leonie

ilikemysleep Mon 22-Oct-12 22:47:24

Rabbit - this is just my opinion, others may well have different opinions. I think the nub of it is the 'different in intensity, scope or duration' just like the imagination thing.

Fact - there is no 'autistic' behaviour. Behaviour which people think of as 'autistic' is normal behaviour triggered in a context that would not usually trigger it in an NT person. For example, screaming meltdown involving total loss of control followed by rocking in a corner with head over hands - triggered by sudden death of partner in a road crash - absolutely appropriate. Same meltdown caused by lack of custard to go on apple pie (as in my house yesterday) - not appropriate.

So the anxiety responses you describe above are 'ordinary' responses to extreme stress - but the extreme stress is triggered by something much 'less stressful' (to the NT eye) than 'deserve' such a response - such as going to work a different way or having a supply teacher in the classroom, rather than having to give a major presentation in front of the entire management team, upon the outcome of which your job is dependent.

I don't think the processes are any different or possibly even any more 'deliberate', but they are triggered by 'smaller' or 'trivial' stressors.

That's how I think of it, anyway...

HotheadPaisan Mon 22-Oct-12 22:39:38

I hadn't thought about it like that, maybe. Anxiety is the number one problem for DS1, it's awful.

rabbitstew Mon 22-Oct-12 22:26:37

I've always wondered about anxiety and aspergers, and the fact that people can suffer from anxiety without having aspergers, yet most people when they are colossally anxious behave in a more "autistic" way (eg become more self-focused and incapable of dealing with external distractions, because they are having a hard enough time coping with their own concerns and just feel even more panicked if they try to think about anything else). Is the difference that the highly agitated/anxious person without aspergers is fully aware of the fact that they are closing down to a certain extent, and doing it deliberately in order to cope with their anxiety, whereas someone on the autism spectrum is unaware of that process taking place, because they have no state of non-anxiety with which to compare their behaviour???!!!!!

ilikemysleep Mon 22-Oct-12 22:19:37

Yeah, that is what we often do too - we talk about a demand avoidant pattern of behaviours in an autistic profile. I agree the reframing of behaviours as 'anxiety based' rather than 'naughtiness based' is very helpful indeed.

HotheadPaisan Mon 22-Oct-12 22:16:19

DS1 does both ilike. I agree PDA is just a form of autism, it's very useful to have the specific things about PDA pointed out though, DS1's diagnostic report talks about demand avoidance a lot.

ilikemysleep Mon 22-Oct-12 22:10:04

Leonie - apols, crossed several of your posts there smile

rabbitstew Mon 22-Oct-12 22:09:41

My ds is a girl with aspergers grin.

ilikemysleep Mon 22-Oct-12 22:09:13

Creeping lurgy*: I was at the same conference (and might even have sat next to Leonie without ever knowing!) and I think it's important to make the point that the clarification was specifically in relation to *girls on the spectrum. I think she was saying that girls may not have the same amount of restricted interests / repetitive behaviours/ lack of cognitive flexibility as are seen in many boys, but may still be on the spectrum, and that is where the clarification that 'social imagination' "counts" for diagnostic purposes and may be what you see in women and girls on the spectrum.

My pet theory is that in diagnosing girls you need to take a long term view; you may not see anything unusual in one meeting or one conversation ( or you may...but not always) but the social and relationship history will hold the clues. I don't think the ADOS works so well for girls, for example...

*Always in wonder*: 'PDA type' kids are kids on the spectrum who are 'actors' rather than 'reactors'. Rather than melt down in response to a situation or show anxiety by worrying or crying in anticipation their extreme anxiety prompts them to act to avoid the situation. The behaviours they will engage in to avoid are often devoid of social boundaries so very hard to cope with (one kids pees on his mother's bed, for example). I don't like the PDA label myself (can't be diagnosed by a psychiatrist as isn't in the DSM IV, for starters, which makes parents feel we are fobbing them off) as I think it's just an 'active - avoidant' form of autism. Never met a PDA kid who wasn't on the spectrum. No doubt at all the manifestation exists, but my view is it is definitely part of the spectrum. Just my opinion of course. Thank my lucky stars on a daily basis that my boy is a reactor (--even if he did melt down yesterday for 20 mins, aged 11, because there was no custard left--)

ArthurPewty Mon 22-Oct-12 21:42:29

And the slides on social imagination say:

"Social Imagination
* Girls have a better imagination and more pretend play
* Many have a rich and elaborate fantasy world with imaginary friends but have difficulty separating reality from fantasy
* Girls escape into fiction and some live in another world
* When inoved in solitary dollplay, they have a 'script' and may reproduce a real event or a scene from a book or film"

and

"Social Imagination Cont'd
* There is a lack of reciprocity in their social play and they can be controlling or domineering
* Social Imagination does not relate only to pretense or symbolic activities, it is the ability to use imagination in a social sense."

ArthurPewty Mon 22-Oct-12 21:38:16

having typed all that out, i came away from this conference knowing that I am on the spectrum too. (suspeced it before, now i'm pretty damn sure)

Judith Gould talked bout girls collecting facts ABOUT PEOPLE. I do that. I know exactly what film any given actor/actress has been in, and pride myself on being able to recognise them no matter what film it is. And voices/voice actors - I can tell you where i've heard that voice before, which other films, etc.

ArthurPewty Mon 22-Oct-12 21:35:50

The slide (from the conference materials handed out that day) says:

"The TRIAD

Social Interaction
Social Communication
Social Imagination

Associated with a repetitive quality of pattern of activities"

The slide on the special interests / perserverance says:

"Special interests and routines

* The Male stereotype of autism has clouded the issue in diagnosis
* Boys are more hyperactive and aggressive and have more interests in technical hobbies and facts
* Girls are more passive and collect information on people rather than things
* The interests of girls on the spectrum are similar to those of other girls - animals, soaps, celebrities, fashion
* Perfectionism is frequently seen in girls
* It is not the special intersts that differentiate them from their peers but the quality and intensity of these interests."

Join the discussion

Join the discussion

Registering is free, easy, and means you can join in the discussion, get discounts, win prizes and lots more.

Register now