Counselling strategies for ASD in a neurotypical world

Autism Spectrum Disorder (ASD) represents a range of neurodevelopment conditions characterised by challenges in social interaction, communication and sometimes repetitive behaviours. 

However, it's crucial to acknowledge the unique experiences and strengths of individuals with ASD. As a therapist specialising in this area, I've seen firsthand the diverse capabilities and the distinctive ways individuals with ASD perceive and interact with the world.

The challenges of a neurotypical world

For those on the spectrum, navigating a world designed primarily for neurotypical individuals can be daunting. Common environments like bustling shopping centres, social gatherings, workplaces and intimate relationships pose distinct challenges. Sensory overload, difficulties in reading social cues and the pressure to conform to societal norms can lead to heightened anxiety and stress for individuals with ASD.

The role of counselling in ASD support

Counselling plays a pivotal role in supporting individuals with ASD. Tailored strategies can significantly alleviate the stress associated with these challenges. For instance, cognitive-behavioural therapy (CBT) has been shown to be effective in helping individuals with ASD manage anxiety and improve social skills. According to a study published in the Journal of Autism and Developmental Disorders, CBT tailored for ASD can lead to significant improvements in emotional regulation and social understanding.

The experience of living with ASD

Living with ASD is a journey of navigating a world that doesn't always align with how one perceives and processes it. Many of my clients have described feeling overwhelmed in social situations or misunderstood by those around them. Yet, they also bring unique perspectives, attention to detail and often, a high level of expertise in their areas of interest.

In a society that champions diversity, it's essential to recognise and support the needs of individuals with ASD. Counselling offers a bridge between the neurotypical and ASD worlds, fostering understanding, skill development and emotional support. By adopting tailored strategies and providing inclusive environments, we can make significant strides in ensuring that individuals with ASD lead fulfilling and less stressful lives.

Practical solutions for everyday challenges

Managing sensory overload: For situations like shopping in crowded places, sensory coping strategies such as noise-cancelling headphones or scheduled breaks can be beneficial.

Enhancing social interaction: Social scripts and role-playing exercises in therapy sessions can help individuals with ASD prepare for various social interactions, enhancing confidence and ability to engage with others.

Workplace adaptation: Workplace accommodations, such as a quiet workspace or clear, written instructions can make a significant difference in productivity and comfort for employees with ASD.

Navigating relationships: Couples therapy, including a therapist who understands ASD, can offer strategies for both partners to understand each other's perspectives and communication styles better.

Understanding ‘stimming’ 

"Stimming" refers to self-stimulatory behaviours. These are repetitive body movements or repetitive movements of objects. Stimming is not exclusive to individuals with ASD; many people find different forms of self-stimulation helpful for various reasons, but it is more commonly observed and pronounced in individuals with ASD.

Stimming in ASD is usually a way for individuals to manage sensory input, cope with anxiety or overwhelming emotions and express themselves. It can involve any of the senses and manifest in various forms:

Visual: Staring at lights, blinking or moving fingers in front of the eyes.
Auditory: Tapping ears, snapping fingers or vocal sounds like humming.
Tactile: Rubbing the skin, scratching or fidgeting with objects.
Vestibular (Movement): Rocking back and forth, spinning or pacing.
Taste and Smell: Sniffing objects or people, licking or tasting various things.

Types of stimming you might not know you are doing

Some forms of stimming are less obvious and can often go unnoticed. These might include:

Subtle hand or finger movements: Twirling hair, tapping fingers on a surface, or playing with rings or bracelets.

Facial gestures: Blinking excessively, wrinkling the nose or grimacing.

Verbal stimming: Subtle humming, whispering to oneself or repeating words and phrases under one's breath.

Cognitive stimming: Engaging in repetitive thought patterns, daydreaming or obsessively focusing on specific topics.

Emotional Stimming: Seeking out emotional stimulation like watching specific genres of movies or reading certain types of books repetitively.

Managing stimming

In therapy, the focus is often not on stopping stimming behaviours unless they are harmful or significantly interfere with daily life. Instead, the approach is usually about managing them in a way that is socially acceptable and beneficial for the individual. Recognising one's own stimming behaviours can be a part of self-awareness and self-regulation strategies taught in therapeutic settings.

Understanding and respecting stimming as a natural part of an individual's behaviour, especially in the context of ASD, is crucial. It's a valuable part of their way to interact with and make sense of their environment and internal experiences.

The misconception of ASD visibility

When thinking about Autism Spectrum Disorder (ASD), many envision it as a condition with overt and easily noticeable signs. However, ASD is a spectrum, and its manifestations can vary greatly. Some individuals might have ASD or show signs of it, but remain undiagnosed. Recognising these subtler signs and understanding how to support such individuals can be crucial for their well-being and development. Some subtle signs might include:

Social challenges: Difficulty in understanding social cues, maintaining conversations or forming friendships.

Fixed interests: Intense and focused interest in specific topics.

Need for routine: Preference for strict routines and difficulty coping with changes.

Sensory Sensitivities: Over- or under-reaction to sensory stimuli, like certain sounds, textures or lights.

Communication nuances: Taking things very literally, difficulty in understanding sarcasm or jokes.

Emotional regulation difficulties: Challenges in managing emotions, which may lead to anxiety or meltdowns over seemingly minor issues.

Supporting undiagnosed individuals

Empathy and understanding: Approach with empathy, acknowledging that their experiences and reactions are valid, even if they are not typical.

Encouraging assessment: If ASD is suspected, gently encourage them or their caregivers to seek a professional assessment. Early diagnosis can open doors to valuable resources and support.

Creating a supportive environment: Adjust the environment to accommodate their needs, like allowing for breaks in overwhelming situations or providing clear and concise instructions.

Educating others: Raise awareness about the diversity of ASD presentations among family, friends, and colleagues to foster a more understanding community.

Encouraging their strengths: Focus on their strengths and interests. Many individuals with ASD have remarkable talents and abilities in certain areas.

A clients experience of a supermarket

When someone with Autism Spectrum Disorder (ASD) feels overwhelmed in a busy supermarket, their experience can be both intense and multifaceted, involving a complex interplay of physical sensations, emotions, and thoughts. My client gave me permission to voice his experience.

"When I go into a supermarket, it's really tough for me. Right away, everything seems too much. The lights in there are super bright and hurt my eyes. And the noise! There's music, so many people talking and the beeping from the tills and machines, it all just mixes together and feels like it's closing in on me.

The smells are all over the place too. Like, I can smell bread one second and then cleaning stuff the next and it just makes my head spin. If someone bumps into me, it feels really intense, almost like a shock.

I start to feel really scared and panicky in there. My heart beats super fast and I can't catch my breath. I want to run out, but also feel bad about it. I think, ‘Why can't I just do this simple shopping thing like everyone else?’

My thoughts get all jumbled. I try to tell myself to calm down, but it doesn't work. I can’t focus or remember what I need to buy. It’s like everything is too loud, too bright and too much and all I can think about is how much I need to leave.

So, yeah, going to the supermarket isn’t just shopping for me. It’s like facing a huge wave of things that just hit all my senses at once, and I feel kind of stuck and overwhelmed."

As a therapist responding to a client who has just described such an overwhelming experience, my first reaction is to validate their feelings, offer comfort and explore coping strategies.

It's also crucial to practice self-compassion. Experiencing anxiety and sensory overload is a common aspect of ASD and it's not a personal failing. We can explore together more about what environments feel safer and how we can make necessary tasks like shopping more comfortable. 

Getting a diagnosis

Getting a diagnosis of Autism Spectrum Disorder (ASD) through the National Health Service (NHS) in the UK can be a lengthy process, with waiting times varying by location, often ranging from three to four years. Despite this delay, there are considerable benefits to obtaining a formal diagnosis.

Firstly, a diagnosis provides personal insight and self-awareness. It helps individuals understand their experiences and behaviours, especially in areas like social interaction, sensory processing and communication. This understanding often leads to self-acceptance and a better grasp of one's unique way of experiencing the world.

Secondly, a diagnosis opens access to various resources and support. It enables individuals to receive specialised educational programs and therapies, such as speech, occupational, and behavioural therapy. Additionally, it can lead to necessary accommodations in school and work environments.

Moreover, understanding one’s ASD diagnosis leads to tailored strategies for managing challenges. Individuals can develop more effective coping mechanisms for sensory sensitivities and emotional regulation and can benefit from targeted life skills training.

There is a need for heightened awareness, empathetic acceptance and strategic adaptation to foster a more supportive and inclusive environment for individuals with ASD. 

By continually refining and implementing specialised counselling methodologies and promoting a broader societal understanding and accommodation of ASD, we can make significant strides in enriching the lives of individuals with ASD within a predominantly neurotypical world.