Autism in the Adult Shifting Autistic Characteristics Across The Lifespan: Adolescence
Join Dr. Regan for the second episode in this series about how autistic characteristics may shift across the lifespan. This episode focuses on the life season of adolescence. Stay tuned for the next episodes in the series to hear about hormonal shifts in women and autism in the aging adult (50's and beyond).
Recognizing Dysregulation on the Autism Spectrum: Fight, Flight, Freeze
Dr. Regan's Resources
New Course for Clinicians: ASD Differential Diagnoses and Associated Characteristics
Book: Understanding Autism in Adults and Aging Adults, 2nd ed
Book: Understanding Autistic Behaviors
Autism in the Adult website homepage
Website Resources for Clinicians
Read the Transcript:
1
00:00:03,340 --> 00:00:08,560
Hello and welcome to this episode of Autism in the Adult podcast,
2
00:00:08,940 --> 00:00:10,030
I am your host,
3
00:00:10,040 --> 00:00:11,550
Dr Theresa Regan.
4
00:00:11,560 --> 00:00:13,980
I am a neuropsychologist.
5
00:00:13,990 --> 00:00:23,750
The director of an adult diagnostic autism clinic in central Illinois, and I'm the mother of a teen on the autism spectrum.
6
00:00:25,140 --> 00:00:45,660
We are starting the second episode of a four part series today and the series is about characteristics of autism that fluctuate or shift across the lifespan according to different seasons in life of the individual or changes in the environment.
7
00:00:46,340 --> 00:00:53,960
And our first episode in this series was that foundational information about shifting characteristics,
8
00:00:53,970 --> 00:01:06,460
shifts in how the individual experiences the characteristics and how those around them experience or are impacted by these autistic characteristics.
9
00:01:07,840 --> 00:01:08,500
Today,
10
00:01:08,500 --> 00:01:09,700
in the second episode,
11
00:01:09,700 --> 00:01:26,360
we're going to focus on the time period of adolescence in the lifespan and talk about why that can be such a huge shift and why there can be so many changes for the individual at that time.
12
00:01:27,540 --> 00:01:47,860
one of the things we covered last time is that the changes in how we experience ourselves and express ourselves are often impacted by characteristics of the person that would include their physical development,
13
00:01:47,860 --> 00:01:49,540
the development of the brain,
14
00:01:49,550 --> 00:01:56,220
the biochemistry of the body and the brain also... things like the environment.
15
00:01:56,230 --> 00:01:59,770
So what kinds of demands are in the environment,
16
00:01:59,770 --> 00:02:05,860
what kind of assistance and structure are within that environment at the time.
17
00:02:07,340 --> 00:02:18,860
Things that may shift may also include coping strategies that we've learned certain things we've learned to mask something or to cope with something and regulate ourselves better.
18
00:02:20,040 --> 00:02:24,360
Let's start with the physical person during adolescence.
19
00:02:25,240 --> 00:02:37,980
So one thing that happens of course is that the physical body has been developing and changing and during adolescence there's just a lot of acceleration in that we've got a lot more muscle mass,
20
00:02:37,980 --> 00:02:39,510
you've got a lot of height,
21
00:02:39,520 --> 00:02:41,560
the voice changes etcetera.
22
00:02:42,140 --> 00:02:48,110
And the person at the end of that whole cycle has a different body in many respects.
23
00:02:48,740 --> 00:03:09,660
And one of the things that clients on the spectrum have discussed with me is that for people who like consistency and predictability and who they are and what's happening sometimes this season of having a different body can really be frustrating and upsetting.
24
00:03:10,140 --> 00:03:13,100
And I've had clients say,
25
00:03:13,110 --> 00:03:14,240
you know,
26
00:03:14,250 --> 00:03:16,420
this is not my body.
27
00:03:16,430 --> 00:03:20,920
I really want my 10 year old body back because that was me.
28
00:03:20,930 --> 00:03:37,320
It felt like my internal person was connected to that physical person and to have so many things change without my permission so that I'm a different height and weight and I just don't feel like this is my body anymore.
29
00:03:37,320 --> 00:03:39,430
I just don't like it.
30
00:03:39,440 --> 00:03:44,090
I want to go back in time and to have my original body,
31
00:03:44,090 --> 00:03:46,650
the body that fits my personhood.
32
00:03:50,140 --> 00:03:55,270
Sometimes this will come out where people say I as an adult,
33
00:03:55,280 --> 00:04:04,660
focused a lot on staying at the weight of 118 because that's what my weight was when I stopped getting taller.
34
00:04:04,660 --> 00:04:07,190
So when I graduated from high school,
35
00:04:07,190 --> 00:04:13,440
I was 118 And I really can't tolerate being 120.
36
00:04:13,450 --> 00:04:16,770
I can't tolerate being 100 and 10.
37
00:04:16,780 --> 00:04:34,080
I need to be kind of that same foundational number that I associate with my body and I don't want it to change as you can predict by thinking about the lifespan of the individual.
38
00:04:34,740 --> 00:04:42,370
This stress related to unexpected or unplanned changes in the body,
39
00:04:42,380 --> 00:04:45,460
can really happen across lots of life seasons.
40
00:04:45,940 --> 00:04:49,750
So adolescence is certainly a big one,
41
00:04:49,760 --> 00:04:51,790
pregnancy is a big one,
42
00:04:51,800 --> 00:04:53,270
aging is a big one.
44
00:04:54,060 --> 00:05:00,960
we can all relate to wanting our younger body back and for the individual on the spectrum,
45
00:05:01,340 --> 00:05:14,160
the angst of feeling disconnected with their personhood when their body changes may maybe even more acute that this really has happened without my permission and I do not like it.
46
00:05:15,440 --> 00:05:20,340
The brain also has been doing a lot of development during this period of time.
47
00:05:20,350 --> 00:05:22,800
And as we talked about in the first episode,
48
00:05:22,800 --> 00:05:30,110
the brain itself does not stop developing as a part of the body until about 20, 21,
49
00:05:30,480 --> 00:05:33,010
that early adulthood phase.
50
00:05:33,020 --> 00:05:36,310
So the brain is not grown,
51
00:05:36,310 --> 00:05:44,260
is not fully developed until the person is really out of high school and starting that young adulthood phase,
52
00:05:45,640 --> 00:05:51,760
This development of the brain includes things like thinking at a different level,
53
00:05:51,770 --> 00:05:55,260
challenging what you've always been told,
54
00:05:55,640 --> 00:06:01,250
trying to graduate into more abstract ways of thinking conceptualized thinking.
55
00:06:01,740 --> 00:06:14,260
So there's a lot of changes in the brain itself and the anatomy and the connections and that can impact how autism feels or is expressed during that time.
56
00:06:15,440 --> 00:06:19,070
The chemistry of the body and the brain also shifts.
57
00:06:19,080 --> 00:06:21,300
And so we talked about this before,
58
00:06:21,300 --> 00:06:31,990
that hormones are meant to change the body and the brain and they do and the impact can really feel quite dramatic,
59
00:06:31,990 --> 00:06:33,850
especially during adolescence,
60
00:06:34,440 --> 00:06:44,320
where sometimes that's just this period of the perfect storm for the most centered individual.
61
00:06:44,330 --> 00:06:44,720
You know,
62
00:06:44,730 --> 00:06:56,240
every person probably has stories about adolescents when they were tearful or yelling or or stomping off,
63
00:06:56,250 --> 00:06:57,620
jumping on their bike,
64
00:06:57,620 --> 00:07:03,530
riding away whatever the drama of that period of time may have been for you,
65
00:07:03,540 --> 00:07:17,120
you can relate to that feeling that this hormonal storm for someone that already has some dysregulation difficulty can also be pretty profound.
66
00:07:17,130 --> 00:07:21,260
So it's even harder for me to stay centered.
67
00:07:21,270 --> 00:07:41,150
It's even harder for me to keep my emotions in check or to um focus or get rid of that anxiety or sleep well that this regulation and you can go ahead and listen to the series on regulation that was not too long ago,
68
00:07:41,150 --> 00:07:44,640
a four part series if you want to know more about that.
69
00:07:44,640 --> 00:07:53,760
But the ability to stay centered and even it's just more difficult once those hormones kick in.
70
00:07:54,140 --> 00:07:58,660
And even more so for the person who struggled to begin with,
71
00:07:59,440 --> 00:08:05,040
it's also true that the body and the brain become sexualized during that time.
72
00:08:05,050 --> 00:08:17,850
And so there are even these additional layers of emotion and physical response related to the sexualization of the body that the person has to navigate.
73
00:08:18,540 --> 00:08:19,290
You know,
74
00:08:19,300 --> 00:08:20,960
it's just not.
75
00:08:21,440 --> 00:08:25,960
this is the time of life anymore when please, thank you, and sorry
76
00:08:25,960 --> 00:08:29,610
was going to help you connect with people around you.
77
00:08:29,620 --> 00:08:39,860
There's this really complicated social environment now and that also includes this sexualization of some relationships,
78
00:08:42,440 --> 00:08:44,470
a psychological task.
79
00:08:44,470 --> 00:08:48,150
So we're still talking about the individual at this moment,
80
00:08:48,150 --> 00:08:56,400
but I want to stop and talk about not the physical piece but the psychological task of much of adolescence.
81
00:08:56,590 --> 00:09:05,180
If you're familiar with Erik Erickson and his work with the tasks that we all have at different seasons of life.
82
00:09:05,190 --> 00:09:12,560
He would say that the adolescent's job is to navigate this journey of identity.
83
00:09:12,940 --> 00:09:14,260
Who am I?
84
00:09:14,640 --> 00:09:21,410
Who am I as separate from my parents or from my family history and I'm my own person.
85
00:09:21,410 --> 00:09:21,930
If so,
86
00:09:21,930 --> 00:09:26,360
what does that look like and how can I connect with my tribe?
87
00:09:26,370 --> 00:09:27,310
Where is my,
88
00:09:27,320 --> 00:09:28,160
my people,
89
00:09:28,160 --> 00:09:42,090
my tribe... peer relationships really are an important piece of the connection at that time where I switch from not so much having my best friend be mom or dad anymore or Joey down the street,
90
00:09:42,090 --> 00:09:49,260
but I really switched toward a lot more peer companionship that I'm going to connect with...
91
00:09:49,640 --> 00:09:51,170
A romantic peer...
92
00:09:51,170 --> 00:09:57,440
I'm going to connect with peer groups at my school or in my neighborhood or at my part time job.
93
00:09:57,450 --> 00:10:01,220
And these people may have different values than my parents had.
94
00:10:01,230 --> 00:10:05,960
And I may explore all these different ways of being and thinking.
95
00:10:06,240 --> 00:10:10,860
And my parents no longer seemed to have all the rules,
96
00:10:11,040 --> 00:10:11,380
uh,
97
00:10:11,380 --> 00:10:13,240
and all the keys to life.
98
00:10:13,250 --> 00:10:17,940
And so this process of navigating life,
99
00:10:17,950 --> 00:10:20,640
navigating the social environment,
100
00:10:20,650 --> 00:10:23,060
navigating all of the um,
101
00:10:23,940 --> 00:10:32,360
the reasoning and facts and cognitive pieces that a person might think throw as far as what do I believe?
102
00:10:32,740 --> 00:10:39,380
Do I believe the same thing my parents do and where can I connect?
103
00:10:39,390 --> 00:10:43,460
Where can I belong and find connection with other people?
104
00:10:45,540 --> 00:11:00,550
What we see in the autism community is that there can be a lot of gender diversity that overlaps here and part of it can be this feeling that this is not my body.
105
00:11:00,940 --> 00:11:01,370
Um,
106
00:11:01,380 --> 00:11:09,510
I don't feel connected to the community of people who were born female or born male,
107
00:11:09,510 --> 00:11:11,060
whatever the case may be.
108
00:11:11,070 --> 00:11:13,360
I don't identify as that.
109
00:11:13,360 --> 00:11:14,730
It's not my identity.
110
00:11:14,730 --> 00:11:16,310
I don't feel connected to that.
111
00:11:16,310 --> 00:11:19,060
I can't connect with the peer group in that way.
112
00:11:19,740 --> 00:11:23,510
And in the case of this emerging sexuality as well,
113
00:11:23,510 --> 00:11:26,300
that I'm looking for my identity,
114
00:11:26,300 --> 00:11:27,760
I'm looking for my group.
115
00:11:28,140 --> 00:11:33,660
And there's this gender diversity journey for some people on the spectrum.
116
00:11:34,440 --> 00:11:41,200
So a lot of the research shows that although we would expect to see two um,
117
00:11:41,210 --> 00:11:45,430
autism within any group throughout the world,
118
00:11:45,430 --> 00:11:47,980
whether it's a um,
119
00:11:47,990 --> 00:12:02,160
type of nation that we're looking at or whether it's a city or That about 2% of people in any particular area would be on the spectrum and within the gender diverse community that's higher.
120
00:12:02,640 --> 00:12:11,870
So the research says about 5-8 % of the gender diverse community maybe on the spectrum,
121
00:12:11,870 --> 00:12:14,560
I suspect it's somewhat higher than that.
122
00:12:15,140 --> 00:12:15,490
Um,
123
00:12:15,490 --> 00:12:21,180
but certainly there's that process of understanding the physical body,
124
00:12:21,180 --> 00:12:23,510
understanding the peer group connection,
125
00:12:23,510 --> 00:12:36,190
seeking that out and this who am I kind of journey in addition to changes in the person that can make,
126
00:12:36,200 --> 00:12:36,630
um,
127
00:12:36,630 --> 00:12:40,060
some added stress during a life season.
128
00:12:40,840 --> 00:12:51,020
There are also a lot of changes to the environment of the individual who's in that adolescent period within autism.
129
00:12:51,020 --> 00:13:03,450
What we see is that the autistic individual has more difficulty than their peers with things like independent daily activities and behavior.
130
00:13:04,040 --> 00:13:11,590
What that means is that this person may have this brilliant sense of math or music or art.
131
00:13:11,600 --> 00:13:15,460
Their head may be filled with facts and ideas.
132
00:13:15,470 --> 00:13:16,190
Um,
133
00:13:16,200 --> 00:13:20,990
but their ability to just kind of flow through the day and get things done.
134
00:13:20,990 --> 00:13:23,200
Like I'm going to take my shower,
135
00:13:23,200 --> 00:13:26,550
I'm going to throw my laundry in as a high school student,
136
00:13:26,550 --> 00:13:27,790
I'm going to learn to drive,
137
00:13:27,790 --> 00:13:30,140
I'm going to learn how to save money,
138
00:13:30,140 --> 00:13:31,530
I'm going to learn to cook.
139
00:13:31,540 --> 00:13:31,960
You know,
140
00:13:31,960 --> 00:13:34,280
that kind of stuff is just harder.
141
00:13:34,280 --> 00:13:37,690
Like I can name all these physics equations,
142
00:13:37,690 --> 00:13:44,400
but I just can't catch up with my peers in this area of being independent and,
143
00:13:44,410 --> 00:13:59,840
and this um kind of emerging into adulthood and this disconnect between the neuro typical peer and the individuals on the spectrum who's going through adolescent that gets bigger,
144
00:13:59,850 --> 00:14:00,660
wider,
145
00:14:00,660 --> 00:14:03,780
The gap gets wider with age.
146
00:14:03,790 --> 00:14:05,590
So as you know,
147
00:14:05,590 --> 00:14:07,190
a five year old,
148
00:14:07,200 --> 00:14:15,050
there's some gap there where neuro typical peers are doing more independently typically than the autistic individual,
149
00:14:15,440 --> 00:14:16,600
but you know,
150
00:14:16,600 --> 00:14:22,360
there's not a whole lot of independent things that a five year old is being asked to do.
151
00:14:22,840 --> 00:14:26,560
But when you get to middle school high school young adulthood,
152
00:14:26,570 --> 00:14:27,210
whoa,
153
00:14:27,210 --> 00:14:33,460
the independent demand just skyrockets and this gap becomes more and more visible.
154
00:14:33,840 --> 00:14:34,300
Um,
155
00:14:34,300 --> 00:14:39,150
and although the person may really be ahead with academic knowledge,
156
00:14:39,540 --> 00:14:44,670
this person may be really feeling the gap of cash,
157
00:14:44,670 --> 00:14:47,680
how do my peers get through life this way?
158
00:14:47,680 --> 00:14:49,170
This is really overwhelming.
159
00:14:49,170 --> 00:14:50,740
I have a lot of anxiety,
160
00:14:50,740 --> 00:14:54,250
I feel like I don't know how to navigate all these things.
161
00:14:55,840 --> 00:15:14,950
So the environment begins to demand more independence and the autistic individual going through this adolescent period starts to fall behind more and more with what's expected as far as independent daily behavior.
162
00:15:15,440 --> 00:15:24,460
So can you approach a teacher and ask a question or talk to your teacher about,
163
00:15:24,840 --> 00:15:25,090
hey,
164
00:15:25,090 --> 00:15:31,150
I think the reason I am falling behind in math is that I don't understand this core concept.
165
00:15:31,160 --> 00:15:36,790
Can you help me understand this or can they approach their peer and say,
166
00:15:36,790 --> 00:15:37,190
hey,
167
00:15:37,190 --> 00:15:41,230
do you want to go to the dance with me or hey,
168
00:15:41,240 --> 00:15:44,540
I think we had kind of a rough interaction back there.
169
00:15:44,540 --> 00:15:46,360
I really didn't mean to,
170
00:15:46,740 --> 00:15:47,540
um,
171
00:15:47,550 --> 00:15:48,010
you know,
172
00:15:48,010 --> 00:15:49,440
criticize you,
173
00:15:49,450 --> 00:15:51,860
I think it was a misunderstanding.
174
00:15:52,640 --> 00:16:05,850
So this increased demand for communication from the individual that mom is going to be calling the school less and the students going to be doing the talking more often than before.
175
00:16:09,330 --> 00:16:20,250
There are demands for independence in self care that all of this hygiene and grooming and eating independently and making sure you drink water and wear deodorant.
176
00:16:20,740 --> 00:16:27,820
These things start to become the person's responsibility instead of the parents' responsibility.
177
00:16:27,820 --> 00:16:34,790
And they're just can be a gap there where the expectation for independence is growing,
178
00:16:34,800 --> 00:16:38,950
but the person is struggling to keep up.
179
00:16:40,240 --> 00:16:45,170
There are increased demands with independence within what we call executive function.
180
00:16:45,200 --> 00:16:51,320
So that ability to plan and organize and multitask time management,
181
00:16:51,320 --> 00:16:57,850
These things that the person becomes more and more in charge of... these become harder and harder.
182
00:16:58,240 --> 00:17:14,450
These are things that are always difficult on the spectrum to some extent and the gap again becomes larger as the demand becomes larger. chores are things that the person is supposed to start doing.
183
00:17:14,450 --> 00:17:14,850
You know,
184
00:17:14,850 --> 00:17:23,770
can I start to do my laundry or I'm in charge of um caring for this pet that the family has or doing the dishes.
185
00:17:24,540 --> 00:17:32,350
Can I message my doctor through the electronic medical record and ask a question and then driving?
186
00:17:33,340 --> 00:17:33,700
You know,
187
00:17:33,700 --> 00:17:39,160
driving can be a milestone that feels overwhelming for the individual on the spectrum.
188
00:17:39,640 --> 00:17:47,830
And I looked this past year at the clinic patients I've seen across several years.
189
00:17:47,840 --> 00:17:55,800
I took ages 16 through 20 who individuals who had uh,
190
00:17:55,810 --> 00:17:57,860
no intellectual disability.
191
00:17:58,440 --> 00:18:16,270
And I saw that 80% of the clients I have seen in the clinic either did not do any driving by the age of 20 or they were significantly anxious about driving where I only drive to this one place and that's it.
192
00:18:17,340 --> 00:18:23,750
So there can be this kind of overwhelming sense that things happen too fast on the road.
193
00:18:23,750 --> 00:18:25,070
Things are overwhelming.
194
00:18:25,070 --> 00:18:27,650
Or what if I make the wrong choice?
195
00:18:27,660 --> 00:18:28,750
What if I crash?
196
00:18:28,750 --> 00:18:37,370
What if I hurt someone in the midst of this increasing demand for independence?
197
00:18:37,380 --> 00:18:43,350
There's also this reduction in structure or helpful support,
198
00:18:44,540 --> 00:18:46,470
as we said before,
199
00:18:46,480 --> 00:18:51,940
the person starts to be encouraged to be their own self advocate.
200
00:18:51,950 --> 00:18:54,690
And I don't know about where you live,
201
00:18:54,700 --> 00:19:05,170
but self advocacy is a word that's used more and more once you get into middle school and high school and college and even in the workplace,
202
00:19:05,840 --> 00:19:12,260
it means that the individual is in charge of doing their own talking to people.
203
00:19:12,840 --> 00:19:16,760
Self advocacy means that you can um,
204
00:19:16,770 --> 00:19:18,610
look at your situation,
205
00:19:19,840 --> 00:19:30,760
think about why it is that you're struggling and what you need to make a plan for improvement and approach someone in your situation and talk to them about it.
206
00:19:31,240 --> 00:19:33,800
So I approach my guidance counselor,
207
00:19:33,800 --> 00:19:35,440
I approach my professor,
208
00:19:35,450 --> 00:19:44,080
I approach my boss and I initiate this discussion and we come to an agreement about what a good plan would be for.
209
00:19:44,090 --> 00:19:48,540
Let's say for me to arrive on time for me to get my work in on time,
210
00:19:48,540 --> 00:19:49,270
et cetera.
211
00:19:49,540 --> 00:19:54,680
So parents start to play less of a role and the,
212
00:19:54,690 --> 00:20:05,070
so the structure and the support starts to be pared back while the demand is increased socially,
213
00:20:05,070 --> 00:20:07,960
things are more complex as well.
214
00:20:08,440 --> 00:20:19,010
So gone are the days where running around and chasing each other and playing tag and hiding things is really a great social interaction.
215
00:20:20,240 --> 00:20:32,660
I remember talking to some parents who were saying what great socialization their child had as a youngster and that when they would go to the park,
216
00:20:33,140 --> 00:20:37,030
the child would play with other kids for example.
217
00:20:37,740 --> 00:20:54,870
But when I asked what kind of play it typically was it was that the child would chase other kids and other kids would chase the child and they would laugh and play and fall and which is good for that age group.
218
00:20:54,870 --> 00:20:55,770
That's fine.
219
00:20:56,340 --> 00:21:07,180
But it's also this kind of instinctual physical play that puppy dogs can play and little kids know how to play that and it's a fun game,
220
00:21:07,200 --> 00:21:23,160
but it doesn't really require the social skills and the social navigation that middle school relationships require right when you get from physical to play to this more relational connection,
221
00:21:23,180 --> 00:21:32,670
that's where you can see some of the social things really begin to be much more difficult and the person really can't navigate that?
222
00:21:33,140 --> 00:21:35,770
How do I start a relationship?
223
00:21:36,340 --> 00:21:38,580
How do I maintain this relationship?
224
00:21:38,580 --> 00:21:42,520
How do I understand this relationship?
225
00:21:42,520 --> 00:21:43,770
What just happened?
226
00:21:44,740 --> 00:21:46,960
Why did this relationship end?
227
00:21:47,540 --> 00:21:49,920
Why did they misinterpret me?
228
00:21:49,920 --> 00:21:51,770
Because that's not what I meant.
229
00:21:52,740 --> 00:22:07,160
So there there becomes a lot more at stake and a lot more complexity when you're navigating not physical play and not play dates that your mom organized,
230
00:22:08,140 --> 00:22:13,770
but you're really navigating your own emerging adult relationships.
231
00:22:14,840 --> 00:22:24,160
Another thing that happens is that life becomes less predictable.
232
00:22:24,940 --> 00:22:27,590
It's not your life in a box anymore.
233
00:22:27,620 --> 00:22:30,320
You know when you're in first grade,
234
00:22:30,320 --> 00:22:35,500
you know that next year you go to second grade and the next year you go to third grade,
235
00:22:35,500 --> 00:22:43,530
fourth grade and life has this very predictable rhythm where you know where you go next.
236
00:22:43,540 --> 00:22:47,910
Now you don't know what classes will be like or what your teacher will be like,
237
00:22:47,920 --> 00:22:52,240
but you're going to the same school or you're switching schools,
238
00:22:52,250 --> 00:22:55,560
but you have the structure ahead of you.
239
00:22:55,940 --> 00:23:00,430
There's still something that propels you along and when you get to the next place,
240
00:23:00,430 --> 00:23:07,960
there's a structure in place for you and someone will tell you where you're going to be next.
241
00:23:10,040 --> 00:23:12,260
When you get to the end of high school,
242
00:23:12,640 --> 00:23:14,580
at least in the United States?
243
00:23:14,590 --> 00:23:17,440
What happens is that people start to say to you,
244
00:23:17,440 --> 00:23:19,060
what are you going to do next?
245
00:23:20,640 --> 00:23:23,530
What are you going to be when you quote grow up,
246
00:23:23,540 --> 00:23:24,860
what do you want to be?
247
00:23:25,340 --> 00:23:39,850
And they'll say things like you can be anything you want to be the whole world is your oyster and you start to see that your peers are no longer following the same path as every other peer,
248
00:23:39,850 --> 00:23:43,460
that everyone is kind of making their own path.
249
00:23:44,240 --> 00:23:46,970
And the person on the spectrum can feel like,
250
00:23:46,970 --> 00:23:47,450
well,
251
00:23:48,140 --> 00:23:49,710
what am I supposed to do?
252
00:23:49,710 --> 00:23:49,910
What,
253
00:23:49,920 --> 00:23:52,060
what is my life supposed to look like?
254
00:23:53,240 --> 00:23:54,600
Where is the path?
255
00:23:54,610 --> 00:23:56,870
Show me the path and I'll follow the path.
256
00:23:56,880 --> 00:24:00,200
But to forge my own path,
257
00:24:00,200 --> 00:24:04,360
may not actually feel that empowering or exciting.
258
00:24:04,940 --> 00:24:08,770
I kind of like to know that I'm on the correct path.
259
00:24:08,780 --> 00:24:11,800
I like to know how to meet people's expectations.
260
00:24:12,240 --> 00:24:14,910
I like to know that I'm not getting lost.
261
00:24:15,180 --> 00:24:18,860
I like to know that I'm not taking a risk that it's not unsafe.
262
00:24:20,140 --> 00:24:24,060
So the future becomes more self propelled.
263
00:24:25,340 --> 00:24:35,680
And this can also be a task of young adulthood that is daunting to the person with neurology that likes to know,
264
00:24:35,680 --> 00:24:36,060
like,
265
00:24:36,840 --> 00:24:38,570
did I get an A on that,
266
00:24:38,670 --> 00:24:39,000
you know,
267
00:24:39,000 --> 00:24:40,230
did I do it right.
268
00:24:40,370 --> 00:24:42,060
Is this where I'm supposed to be?
269
00:24:43,140 --> 00:24:49,260
So here we have the picture during adolescence that the internal self,
270
00:24:49,740 --> 00:24:52,400
the psychological biochemical,
271
00:24:52,400 --> 00:24:56,050
physical self and the external life,
272
00:24:56,540 --> 00:24:58,570
the supportive structure,
273
00:24:58,630 --> 00:25:06,170
the demands on the individual are creating this sense of just a lot less stability.
274
00:25:07,140 --> 00:25:07,550
You know,
275
00:25:07,550 --> 00:25:09,730
my internal self is less stable.
276
00:25:09,730 --> 00:25:11,680
I feel all over the place.
277
00:25:11,690 --> 00:25:14,080
I'm crying one minute I'm laughing.
278
00:25:14,080 --> 00:25:15,700
One minute I'm throwing something.
279
00:25:15,700 --> 00:25:19,710
One minute I have all these demands on me.
280
00:25:19,720 --> 00:25:21,920
People seem to be figuring this out,
281
00:25:21,920 --> 00:25:23,820
but I can't figure it out.
282
00:25:23,830 --> 00:25:25,020
I can't sleep,
283
00:25:25,020 --> 00:25:26,050
I'm anxious.
284
00:25:27,040 --> 00:25:35,560
Um And there's all this stuff that goes along with this less stable season.
285
00:25:37,140 --> 00:25:38,950
The person on the spectrum,
286
00:25:38,950 --> 00:25:40,820
as we said earlier,
287
00:25:40,830 --> 00:25:43,400
with relationship to regulation,
288
00:25:43,400 --> 00:25:48,450
they're more likely to get dis regulated just from a neurological perspective.
289
00:25:48,940 --> 00:25:57,860
And dis regulation looks like fight where it's any externalized expression of being unsent erred,
290
00:25:57,880 --> 00:25:59,410
I'm crying,
291
00:25:59,410 --> 00:26:00,730
I'm melting down.
292
00:26:00,730 --> 00:26:01,920
I'm screaming,
293
00:26:01,920 --> 00:26:03,080
I'm throwing something,
294
00:26:03,080 --> 00:26:06,460
I'm shouting and arguing at you and I'm slamming doors.
295
00:26:07,440 --> 00:26:09,060
You get flight.
296
00:26:09,740 --> 00:26:11,850
I can't go to school anymore.
297
00:26:11,920 --> 00:26:12,970
My stomach hurts.
298
00:26:12,970 --> 00:26:14,270
I need to come home.
299
00:26:14,840 --> 00:26:16,830
I'm staying in my room.
300
00:26:16,840 --> 00:26:18,810
I'm not going to eat at the table.
301
00:26:18,820 --> 00:26:19,950
I have homework to do.
302
00:26:19,950 --> 00:26:21,170
I'm not coming out.
303
00:26:21,940 --> 00:26:33,360
You get this social withdrawal and freeze is also part of this regulation that if you force me to I will sit sit here physically.
304
00:26:34,040 --> 00:26:36,640
But psychologically I'm offline.
305
00:26:36,650 --> 00:26:39,400
I can't process what's happening anymore.
306
00:26:39,410 --> 00:26:41,000
I'm checked out.
307
00:26:41,010 --> 00:26:42,820
I'm staring at the wall,
308
00:26:42,830 --> 00:26:46,470
I might be having a seizure that's not electrical.
309
00:26:46,480 --> 00:27:01,360
I might lose my memory for parts of the day and all of that is this dis regulation and the dis regulation of adolescents can be quite a bit more noticeable that there's this real crisis of regulation.
310
00:27:02,140 --> 00:27:09,760
But also what I see in the clients that I serve is that the regulation difficulty can all of a sudden look different.
311
00:27:10,140 --> 00:27:12,770
So that would not be unusual either.
312
00:27:13,140 --> 00:27:20,460
So what I see is that sometimes if little kiddos were under reactive to their environment,
313
00:27:20,470 --> 00:27:24,360
they were less reactive to what's going on around them,
314
00:27:25,740 --> 00:27:33,170
they may look really um compliant and passive and go with the flow.
315
00:27:33,640 --> 00:27:39,060
But what that really is is that they should have some response to what's going on in the environment.
316
00:27:39,060 --> 00:27:41,760
But instead they just lack a response.
317
00:27:41,770 --> 00:27:44,130
And if someone tells them to sit up,
318
00:27:44,130 --> 00:27:44,750
they set up.
319
00:27:44,750 --> 00:27:47,330
If someone tells them to go here or there,
320
00:27:47,330 --> 00:27:47,970
they do it.
321
00:27:47,980 --> 00:27:52,170
But they don't have a lot of reactivity to what's going on.
322
00:27:53,340 --> 00:27:54,440
And adolescence.
323
00:27:54,440 --> 00:28:03,820
This may be a person that flips into an over reactive state or an elevated reactive profile where oh my gosh,
324
00:28:03,820 --> 00:28:07,340
the littlest thing happens and I react to it now.
325
00:28:07,350 --> 00:28:17,230
So I have like this flip from passive to so elevated in my response or you can have vice versa.
326
00:28:17,240 --> 00:28:19,310
Where as a little kid,
327
00:28:19,310 --> 00:28:25,910
this person was melting down and rolling on the ground and biting people and now as an adolescent,
328
00:28:25,920 --> 00:28:33,030
they can't get out of bed and they're sluggish and they don't eat and they don't have momentum for activities.
329
00:28:34,040 --> 00:28:38,790
That could also be something that you see where there's this dis regulated state,
330
00:28:38,800 --> 00:28:40,410
but it looks different,
331
00:28:40,420 --> 00:28:49,170
but it's still dysregulation and it's still uh kind of falls within what we talked about in that past series.
332
00:28:52,540 --> 00:28:57,740
Some people feel like with biochemical and hormonal changes,
333
00:28:57,740 --> 00:29:00,960
that their anxiety really is elevated.
334
00:29:01,390 --> 00:29:09,260
Sometimes there are self harm behaviors that may look like cutting or um hitting yourself,
335
00:29:09,270 --> 00:29:10,460
biting yourself,
336
00:29:10,840 --> 00:29:12,850
banging your head on the wall.
337
00:29:14,340 --> 00:29:18,450
Sometimes there are elevated sensory concerns where,
338
00:29:19,040 --> 00:29:19,560
you know,
339
00:29:19,560 --> 00:29:24,290
this food never bothered me before or noise or whatever,
340
00:29:24,290 --> 00:29:29,110
but all of a sudden I just really can't tolerate the sensory environment,
341
00:29:29,110 --> 00:29:38,050
It's too much and that can be part of this physical and environmental season of dis regulation.
342
00:29:40,040 --> 00:29:57,310
Now I do wanna um say that this I think is a really good summary of what I tend to see during adolescence as far as shifts in the qualities of autism and people I do want to say however,
343
00:29:57,310 --> 00:30:00,570
that I work in a clinic.
344
00:30:00,580 --> 00:30:17,160
So people come to me during adolescence when they are struggling and so I really don't get to see folks that have improved through adolescence and are doing better and not needing to come through.
345
00:30:17,640 --> 00:30:36,360
So I'm fully aware of that piece as well and I have seen people in my community and in my personal life and in my friendships that have had a bit of a smoother course as well where the sensory issues have really come down by adolescents,
346
00:30:36,740 --> 00:30:39,490
there's a bit better social connection.
347
00:30:39,500 --> 00:30:40,570
Um,
348
00:30:40,580 --> 00:30:43,760
executive functions not that much of a problem.
349
00:30:44,440 --> 00:30:58,770
So you can certainly see this variety of individualized um kind of seasons and my purpose and talking about this isn't to say,
350
00:30:58,780 --> 00:30:59,880
oh gosh,
351
00:30:59,880 --> 00:31:01,350
when people get to adolescence,
352
00:31:01,350 --> 00:31:02,450
that's going to be rough.
353
00:31:02,840 --> 00:31:03,180
No,
354
00:31:03,180 --> 00:31:20,360
it's just to point out that it is an individualized season of life and that just because autism is neurologic in its base doesn't mean that there there aren't shifting seasons and how that feels or how that looks.
355
00:31:20,840 --> 00:31:25,990
And I think whenever that happens in your life or the life of those,
356
00:31:25,990 --> 00:31:26,860
you love that,
357
00:31:27,340 --> 00:31:27,880
um,
358
00:31:27,890 --> 00:31:28,330
you know,
359
00:31:28,330 --> 00:31:31,090
certainly it's likely to happen for you.
360
00:31:31,090 --> 00:31:34,180
It may be adolescents for someone else.
361
00:31:34,190 --> 00:31:34,580
Uh,
362
00:31:34,590 --> 00:31:34,950
you know,
363
00:31:34,950 --> 00:31:40,550
maybe pregnancy or menopause or even just life seasons that aren't physical,
364
00:31:40,550 --> 00:31:41,540
that oh,
365
00:31:41,540 --> 00:31:47,360
my parent dies and that's a season where my body is really responding differently.
366
00:31:49,240 --> 00:32:09,790
I hope this information gives you a context for recognizing when you're going through those ups and downs of season and normalizing that these kinds of things can shift If you would like to review strategies for regulation.
367
00:32:09,800 --> 00:32:22,560
I encourage you to go back to our regulation series not too long ago to look at strategies for centering and feeling better in your own skin.
368
00:32:23,640 --> 00:32:26,810
And I'm looking forward to the third episode.
369
00:32:26,810 --> 00:32:32,270
We're going to focus on next time and this is going to have to do with hormonal shifts.
370
00:32:32,740 --> 00:32:39,170
A lot of that will talk about the experience of females on the spectrum,
371
00:32:39,170 --> 00:32:41,540
just because they're tend to be,
372
00:32:41,540 --> 00:32:46,870
of course more discreet hormonal shifts in the lives of women.
373
00:32:47,540 --> 00:32:50,560
This will include menstrual cycles,
374
00:32:51,040 --> 00:32:51,980
pregnancy,
375
00:32:51,980 --> 00:32:52,920
breastfeeding,
376
00:32:52,920 --> 00:32:53,950
menopause.
377
00:32:54,340 --> 00:32:54,840
Um,
378
00:32:54,840 --> 00:33:03,360
so some of these hormonal shifts will also impact males on the spectrum and some will be more specific to females.
379
00:33:03,740 --> 00:33:14,360
But I really hope you can join us next time as we start rounding out this series on shifting characteristics in autism.