autism · journey to recovery · mental health · mental health blogger · mental illness · personal journey · Uncategorized

Autism and Self-Injurious Behaviours

Self-injury can be one of the most distressing and difficult behaviours that parents, carers, family members and people with autism themselves may face.

Sometimes referred to as self-harm, self-injurious behaviour is any activity in which a person inflicts harm or injury on themselves. About half of people with autism engage self-injurious behaviour at some point in their life. It can take many different forms, including:

  • head banging (on floors, walls or other surfaces)
  • hand or arm biting
  • hair pulling
  • eye gouging
  • face or head slapping
  • skin picking, scratching or pinching
  • forceful head shaking.

People across the spectrum and of all ages may engage in self-injurious behaviours at some point. People who engaged in self-injurious behaviours as children may return to these as adults during times of stress, illness or change.

Usual behavioural intervention approaches are not always appropriate. Seek professional guidance for any self-injurious behaviour which is difficult to manage or resistant to intervention, or for any behaviour which places the person at risk of harm.

Causes

The reasons a person engages in self-injurious behaviours can be wide and varied, and will often involve a complex interaction between multiple factors. People with learning disabilities told Self-Injury Support that they self-injure when:

  • they feel they are not listened to
  • they have been told off
  • they have little or no choice about things
  • they have been bullied
  • they are involved in arguments, or hear other people arguing
  • they are feeling unwell
  • they have memories of a bereavement
  • they have memories of abuse.

MEDICAL OR DENTAL PROBLEMS

People with autism may have difficulty communicating to others that something is wrong physically and particular self-injurious behaviours (such as ear slapping or head banging) may be their way of coping with pain or communicating discomfort.

MENTAL HEALTH ISSUES

Some self-injurious behaviour may indicate underlying mental health issues such as depression or anxiety.

REPETITIVE BEHAVIOUR

Repetitive behaviours, obsessions and routines are common in people with autism, and some forms of self-injury may be expressions of this feature.

DEVELOPMENTAL STAGES

Some self-injurious behaviour may be persisting remnants of earlier motor behaviours which occur during particular developmental periods (eg hand mouthing which may continue beyond infancy).

COMMUNICATION

Sudden self-injurious behaviour can get a very quick response from other people, and many such behaviours occur in people who have no other functional way of communicating their needs, wants and feelings.

  • Head slapping, or banging the head on a hard surface, may be a way of communicating frustration, getting a preferred object of activity, or reducing demands.
  • Hand biting may help someone cope with anxiety or excitement.
  • Skin picking or eye gouging may be a response to lack of stimulation or boredom.

LEARNED BEHAVIOUR

The person may learn that self-injurious behaviour can be a very powerful way of controlling the environment. A behaviour (eg head slapping) which was initially a response to physical pain or discomfort could eventually become a way of avoiding or ending an undesired situation (eg turning the television off, interrupting an argument taking place nearby).

Reactive strategies

Appropriate responses will vary according to the behaviour, but here are some pointers on what to do when the behaviour is happening. It is important when using any of these strategies that the person is also provided with opportunities to develop skills to communicate their needs more appropriately and to self-regulate stress and anxiety levels.

RESPOND QUICKLY

Intervene early, and respond quickly and consistently to incidents of self-injury. Even if the behaviour serves the function of gaining attention from others, it is never appropriate to ignore severe self-injurious behaviour.

KEEP RESPONSES LOW KEY

Limit verbal comments, facial expressions and other displays of emotion, as these may inadvertently reinforce the behaviour. Try to speak calmly and clearly, in a neutral and steady tone of voice.

REDUCE DEMANDS

The person may be finding a task too difficult or that they are unable to complete the activity at that time. Come back to the activity again later when the person is feeling calmer.

REMOVE PHYSICAL AND SENSORY DISCOMFORTS

Remove unpleasant sensory input. Provide relief for physical discomfort (eg pain killers) if a medical professional has advised this after seeing the person.

REDIRECT

Tell the person what they need to do instead of the self-injurious behaviour, eg “David, hands down”. Use visual cues such as picture symbols to back up instructions. Redirect to another activity that is incompatible with the self-injury (eg an activity that requires both hands) and provide praise and reinforcement for the first occurrence of appropriate behaviour, eg “David, that’s excellent playing with your train”.

PROVIDE LIGHT PHYSICAL GUIDANCE

If the person is having difficulty stopping the behaviour, provide light physical guidance, eg gently guide their hand away from their head, using as little force as possible. Immediately try to redirect attention to another activity and be prepared to provide physical guidance again if the person attempts to re-commence self-injurious behaviour. This approach must be used with extreme caution as it may escalate the behaviour or cause the person to target others.

USE BARRIERS

Place a barrier between the person and the object that is causing harm. For head slapping, place a pillow or cushion between the person’s head and their hand. For hand or arm biting, provide an alternative object to bite down on. For head banging on a hard surface, place a cushion or pillow between the surface and the person’s head. You can get removable padding that is placed temporarily on the floors or walls to minimise injury.

CONSIDER PHYSICAL RESTRAINTS

Some self-injurious behaviour can place the person at serious risk of harm. In these instances, it may be appropriate to explore the use of physical restraints such as arm restraints, gloves or helmets. These may also reduce the sensory experience and frequency of the behaviour.

However, physical restraints are very restrictive and should always be used under the guidance of a specialist to ensure they are used safely and appropriately, and with a plan to fade out their use over time.

Physical restraints do not address the cause of the behaviour, so they must never be used in isolation without teaching the person new skills which address the function of the behaviour.

CALL FOR HELP

In extreme circumstances or emergencies, call 999 for assistance.

Preventative strategies

Here are some ideas about how to prevent self-injurious behaviours.

RULE OUT MEDICAL AND DENTAL CAUSES

Visit the GP or dentist and seek a referral to a specialist if needed. Bring along notes about when the behaviour happens (ie what time of day and in which situations), how often it happens, when it first started, and how long it lasts.

THINK ABOUT THE FUNCTION OF THE BEHAVIOUR

Complete a behaviour diary, which records what is occurring before, during and after the behaviour, or a functional analysis questionnaire, to help you to understand the purpose of the behaviour. Make notes on the environment, including who was there, any change in the environment and how the person was feeling.

INCREASE STRUCTURE AND ROUTINE

Establish a clear daily routine to increase predictability and thereby reduce anxiety. Try to build a range of activities into the person’s routine to minimise boredom and restrict opportunities for the person to engage in self-injurious behaviour. Make plans for difficult times of the day. Increase structure and provide additional supervision and support to the person during these periods or activities. People with Pathological Demand Avoidance may need a less directive and more flexible approach than others on the autism spectrum.

PROVIDE SENSORY OPPORTUNITIES

Find alternative activities that provide a similar sensory experience and build these into the daily routine. Jumping on a trampoline or swinging on a swing may provide needed stimulation to the vestibular system (that head shaking or slapping may have previously provided). Providing the person with a bum bag of edible or safe objects to chew on that provide different sensory experiences such as gum, carrots, raw pasta or sultanas may reduce the need for hand or arm biting.

INTRODUCE COMMUNICATION TOOLS

Support the person to use other ways of communicating their wants, needs and physical pain or discomfort, eg by using visual supports such as pictures of body parts, symbols for symptoms, or pain scales, pain charts or apps.

REWARD APPROPRIATE BEHAVIOURS

Provide frequent encouragement to the person for engaging in appropriate behaviour and for periods in which they did not engage in the self-injurious behaviour. This will help the person learn that other, more appropriate behaviours bring positive outcomes.

Rewards can take the form of verbal praise and attention, preferred activities, toys, tokens or sometimes small amounts of favourite foods or drinks. Ensure that you clearly name the behaviour that you are rewarding, eg “Jane, that’s good waiting!” and ensure that rewards are provided immediately after the behaviour that you wish to encourage eg “You can spend 10 minutes on the computer now”.

It should be noted that some people with autism do not enjoy social attention. In these circumstances, verbal praise can cause distress and actually stop the person engaging in the desired behaviour in the future.

MEDICATION

Medication may help to reduce the frequency of self-injurious behaviour for some people. As with physical restraints, medication should be seen as a last resort approach to management and again, should never be used without teaching new skills and consulting a medical specialist.

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[Source: National Autistic Society]

eating disorder · journey to recovery · mental health · mental health blogger · mental illness · personal journey · Uncategorized

Do YOU have an eating disorder?

There are various different types of eating disorders and it can be difficult to spot whether a person’s food habits signify those of someone with an eating disorder. This blog post asks questions about your eating habits to determine if you may be struggling with food. It is not a diagnosis. Answering yes to the questions could indicate you have an eating disorder and you should seek advice from a doctor.

  1. Do you spend a significant amount of time worrying about your body, weight or shape?

  2. Would you say that food, or thinking about food, dominates your life?

  3. Do you worry you have lost control over how much you eat?

  4. Do you make yourself sick when you feel uncomfortably full?

  5. Do you believe that you are fat when others say you are too thin?

  6. Do you avoid food or eating? – OR – Have you experienced a lack of interest in food or eating?

    If you suspect that you or someone you know has an eating disorder, it is important to seek help immediately. The earlier you seek help the closer you are to recovery. While your GP may not be formally trained in detecting the presence of an eating disorder, he/she is a good ‘first base.’ A GP can refer you on to a practitioner with specialised knowledge in eating disorders.

    find your local eating disorder service here

    https://www.b-eat.co.uk/

    https://eatingdisorder.org/eating-disorder-information/

    http://eating-disorders.org.uk/

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autism · eating disorder · grief · journey to recovery · mental health · mental health blogger · mental illness · personal journey · savannah lloyd · Uncategorized

100 Reasons to Stay Alive

Suicidal thoughts make every minute of the day a struggle. We are often left questioning why we are still here and what the future holds for us. We wonder how we can keep living a life that has been so hard. We wonder if we’ll ever get better and get the help we need. Mental health problems can be frustrating, isolating, and deathly.

However, there are people out there who understand and want to help. Here are 100 reasons as to why you should stay alive if you’re currently struggling!

  1. to have hugs that last more than a minute
  2. a smile from someone special
  3. melted chocolate
  4. ice cream on a hot day
  5. adventures with friends
  6. recovery
  7. stargazing
  8. watching a sunset
  9. laughing uncontrollably
  10. you’ve made it this far
  11. building forts
  12. eating fresh baked cookies
  13. bonfires and hoodies
  14. graduation
  15. pregnancy and new life
  16. finding a person you love
  17. late night adventures
  18. overcoming fears
  19. dancing in the rain
  20. walking through the countryside
  21. making friends with nature
  22. life is beautiful
  23. movie nights
  24. foot massages
  25. saturday mornings
  26. you have forever to be dead
  27. to be happy one day
  28. you’re beautiful
  29. you can make a huge difference on the world
  30. moving to a new place
  31. getting a pet
  32. new clothes at summer
  33. dancing without care
  34. picnics with friends
  35. long drives
  36. waking up late
  37. to prove them all wrong
  38. to love and be loved
  39. the ocean
  40. very loud music
  41. days out
  42. watching a concert/play
  43. reading your favourite book
  44. conversations that last all night
  45. to plan for the future
  46. to learn new things
  47. you are important
  48. christmas morning
  49. someday the pain will end
  50. warm baths
  51. the first snow of winter
  52. first kisses
  53. sand between your toes
  54. flowers in spring
  55. pyjamas after a hard, long day
  56. new bed sheets
  57. water balloon fights
  58. thrill of roller coasters
  59. meeting your favourite celebrities
  60. fireflies
  61. icecream
  62. days spent outside
  63. the sound of water
  64. visiting a place from childhood
  65. all the places you’ve never been
  66. music whilst driving
  67. to look back at all the shit you got through
  68. buying new clothes
  69. meeting internet friends in real life
  70. to succeed
  71. to work in the career you’ve always wanted
  72. baby laughter
  73. sleep
  74. a hot cup of tea
  75. rules to break
  76. to help someone
  77. smiling at strangers
  78. dreams
  79. the last day of school/work
  80. taking pictures
  81. brownies
  82. bubbles
  83. water slides
  84. going on holiday
  85. to fall asleep on someone
  86. to be protected
  87. to grow
  88. to make new memories
  89. to look back on old memories
  90. to laugh at childhood pictures
  91. sit with animals and nature
  92. to be loved by a pet
  93. swimming on a hot day
  94. the first signs of autumn
  95. to binge-watch a series
  96. to live independently
  97. to get somewhere in life
  98. to breathe
  99. to grow
  100. so that you can say that you’re alive

 

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eating disorder · journey to recovery · mental health · mental health blogger · mental illness · personal journey · Uncategorized

All About Bulimia Nervosa

Bulimia is a serious eating disorder where people feel that they have lost control over their eating and evaluate themselves according to their body shape and weight. People with bulimia are caught in a cycle of eating large quantities of food (called ‘bingeing’), and then vomiting, taking laxatives or diuretics (called purging), in order to prevent gaining weight. This behaviour can dominate daily life and lead to difficulties in relationships and social situations. Usually people hide this behaviour pattern from others and their weight is often in a healthy range. People with bulimia tend not to seek help or support very readily and can experience swings in their mood as well as feeling anxious and tense.

They may also have very low self-esteem and self harm. They may experience symptoms such as tiredness, feeling bloated, constipation, abdominal pain, irregular periods, or occasional swelling of the hands and feet. Excessive vomiting can cause problems with the teeth, while laxative misuse can seriously affect the heart. Bulimia in children and young people is rare, although young people may have some of the symptoms of the condition. Bulimia usually develops at a slightly older age than anorexia. In some instances, although not all, bulimia develops from anorexia.

Behavioural signs

  • Bingeing – eating large amounts of food
  • Purging after bingeing – vomiting, over exercising, using laxatives or diuretics, fasting
  • Preoccupied with thoughts of food and life may be organised around shopping, eating and purging behaviour
  • Usually secretive about bulimic episodes
  • Mood swings
  • Feeling anxious and tense
  • Distorted perception of body shape or weight
  • Feeling of loss of control over eating
  • Feelings of guilt and shame after bingeing and purging Isolation
  • Can be associated with depression, low self-esteem, misuse of alcohol and self-harm

Physical signs of bulimia

Some of the more common signs of bulimia nervosa are:

  • Vomiting
  • Excessive exercising
  • Misuse of laxatives and diuretics
  • Disappearing soon after eating
  • Fatigue, lethargy
  • Feeling bloated
  • Constipation
  • Stomach pain
  • Swelling of the hands and feet
  • Periods stop or are irregular (amenorrhea)
  • Enlarged salivary glands
  • Calluses on the backs of the hand from forcing down throat to vomit
  • Electrolyte abnormalities/ imbalance
  • Gastric problems
  • Regular changes in weight

Worried you have an eating disorder?

Eating disorders are complex; there’s no single cause and not all symptoms will apply to all people. You may feel that you have a mixture of anorexia, bulimia and binge eating disorder or even alternate between them. Some people also find they are affected by other mental health issues, an urge to harm themselves or abuse alcohol or drugs.

Even if you don’t have these symptoms if you are worried and upset by something, anything, it is important you find someone to talk to. Don’t bottle it up.

Sometimes people worry about talking to someone because they feel their eating disorder isn’t serious enough, they don’t want to worry people or waste their time, or because they feel guilty, embarrassed or ashamed. Whether your eating difficulties began recently, you’ve been struggling for a while or you’re finding yourself relapsing, you deserve support and with this support you can overcome your eating disorder. Eating disorders are illnesses and you deserve to have your concerns acknowledged respectfully, to be taken seriously and to be supported in the same way as if you were affected by any other illness.

Discover more about the different types of eating disorders or how to access help and treatment as well as information and inspiration about recovery.

bulimia-treatment

journey to recovery · mental health · mental health blogger · mental illness · personal journey · Uncategorized

The Most Deadliest and Less Talked About Eating Disorder

When it comes to eating disorders, everyone has heard of Anorexia Nervosa and  Bulimia Nervosa. However, these are not the only types of eating disorders that exist.

EDNOS (eating disorder not otherwise specified) or now recognised as OSFED (other specified feeding or eating disorder) is the most common type of eating disorder and the most deadly – but no one seems to know about it or its consequences!

A person with OSFED may present with many of the symptoms of other eating disorders such as Anorexia Nervosa, Bulimia Nervosa or Binge Eating Disorder but will not meet the full criteria for diagnosis of these disorders. Diagnoses that fit within this criteria include atypical anorexia (anorexic behaviours but a normal weight), atypical bulimia (less frequent behaviours), purging disorder (vomiting without binging), and night eating syndrome (excessively eating after bed time).

This does not mean that the person has a less serious eating disorder.

OSFED is the most common eating disorder and the most deadliest.

It has a mortality rate of 5.2 percent — higher than both anorexia and bulimia — despite the fact its sufferers often look healthy.

Signs that a person is struggling with OSFED

The warning signs of OSFED can be physical, psychological and behavioural. It is possible for someone with OSFED to display a combination of these symptoms:

Physical Signs:
  • Weight loss, weight gain or weight fluctuations
  • Loss of or disturbance of menstrual periods in girls and women and decreased libido in men
  • Compromised immune system (e.g. getting sick more often)
  • Signs of damage due to vomiting including swelling around the cheeks or jaw, calluses on knuckles, damage to teeth and bad breath
  • Fainting and dizziness as a result of dehydration
Psychological:
  • Preoccupation with food and eating
  • Preoccupation with body shape and weight (in men this can be a preoccupation with increasing muscle bulk)
  • Extreme body dissatisfaction
  • Having a distorted body image (e.g. seeing themselves as overweight even if they are in a healthy weight range for their age and height)
  • Sensitivity to comments relating to food, weight, body shape or exercise
  • Heightened anxiety and/or irritability around meal times
  • Depression, anxiety or irritability
  • Low self esteem and feelings of shame, self loathing or guilt
  • ‘Black and white’ thinking – rigid thoughts about food being ‘good’ or ‘bad’
Behavioural signs:
  • Dieting behaviour (e.g. fasting, counting calories/kilojoules, avoiding food groups such as fats and carbohydrates)
  • Evidence of binge eating (e.g. disappearance or hoarding of food)
  • Frequent trips to the bathroom during or shortly after meals which could be evidence of vomiting or laxative use
  • Compulsive or excessive exercising (e.g. exercising in bad weather, continuing to exercise when sick or injured, and experiencing distress if exercise is not possible)
  • Eating at unusual times and/or after going to sleep at night
  • Changes in food preferences (e.g. claiming to dislike foods previously enjoyed, sudden preoccupation with ‘healthy eating’, or replacing meals with fluids)
  • Obsessive rituals around food preparation and eating (e.g. eating very slowly, cutting food into very small pieces, insisting that meals are served at exactly the same time everyday)
  • Anti-social behaviour, particularly around meal times, and withdrawal from social situations involving food
  • Secretive behaviour around food (e.g. saying they have eaten when they haven’t, hiding uneaten food in their rooms)
  • Increased interest in food preparation (e.g. planning, buying, preparing and cooking meals for others but not actually consuming; interest in cookbooks, recipes and nutrition)
  • Increased interest and focus on body shape and weight (e.g. interest in weight loss websites, books, magazines or images of thin people)
  • Repetitive or obsessive behaviours relating to body shape and weight (e.g. weighing themselves repeatedly, looking in the mirror obsessively and pinching waist or wrists)
  • Increased isolation, spending more and more time alone and avoiding previously enjoyed activities

Where to go for help:

If you suspect that you or someone you know has OSFED, it is important to seek help immediately. The earlier you seek help the closer you are to recovery. While your GP may not be formally trained in detecting the presence of an eating disorder, he/she is a good ‘first base.’ A GP can refer you on to a practitioner with specialised knowledge in eating disorders.

find your local eating disorder service here

https://www.b-eat.co.uk/

https://eatingdisorder.org/eating-disorder-information/osfed/

http://eating-disorders.org.uk/

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autism · eating disorder · journey to recovery · mental health · mental health blogger · mental illness · personal journey · savannah lloyd · Uncategorized · weight loss

Body Image and Eating Disorders

Body Image is our idea of how our body looks and how it is perceived by others. Having a negative or poor body image is strongly associated to Anxiety and Depression as well as eating disorders such as Anorexia and Bulimia. Obsessive and exhausting over-exercising behaviour, yo-yo dieting, reluctance to socialise, difficulties with relationships and financial problems are all associated with body image.

BEAT, the UK’S leading eating disorder charity, estimates that 1.6 million people in the UK have an eating disorder. 1.4 million of these people are female. People most at risk of developing an eating disorder are young women aged between 14-25. 1 in 10 secondary school students are affected by eating disorders.

Eating disorders have the highest mortality rate of any mental illness and many young people who develop anorexia or bulimia (as well as other eating disorders) will suffer serious long-term health consequences.

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Body Image and Young Children

A lot of research on body image focuses on adolescents. However, there is now evidence that suggests children develop negative body image much younger than we think. Children as young as 9 and 10 show disturbing levels of anxiety about their weight and physical appearance. By the ages of 10 and 11, 1 in 8 girls want to be thinner.

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10 Steps to Positive Body Image

  1. Appreciate all that your body can do.  Every day your body carries you closer to your dreams.  Celebrate all of the amazing things your body does for you—running, dancing, breathing, laughing, dreaming, etc.
  2. Keep a top-ten list of things you like about yourself—things that aren’t related to how much you weigh or what you look like.  Read your list often.  Add to it as you become aware of more things to like about yourself.
  3. Remind yourself that “true beauty” is not simply skin deep.  When you feel good about yourself and who you are, you carry yourself with a sense of confidence, self-acceptance, and openness that makes you beautiful regardless of whether you physically look like a supermodel.  Beauty is a state of mind, not a state of your body.
  4. Look at yourself as a whole person.  When you see yourself in a mirror or in your mind, choose not to focus on specific body parts.  See yourself as you want others to see you–as a whole person.
  5. Surround yourself with positive people.  It is easier to feel good about yourself and your body when you are around others who are supportive and who recognize the importance of liking yourself just as you naturally are.
  6. Shut down those voices in your head that tell you your body is not “right” or that you are a “bad” person.  You can overpower those negative thoughts with positive ones.  The next time you start to tear yourself down, build yourself back up with a few quick affirmations that work for you.
  7. Wear clothes that are comfortable and that make you feel good about your body.  Work with your body, not against it.
  8. Become a critical viewer of social and media messages.  Pay attention to images, slogans, or attitudes that make you feel bad about yourself or your body.  Protest these messages:  write a letter to the advertiser or talk back to the image or message
  9. Do something nice for yourself–something that lets your body know you appreciate it.  Take a bubble bath, make time for a nap, find a peaceful place outside to relax.
  10. Use the time and energy that you might have spent worrying about food, calories, and your weight to do something to help others.  Sometimes reaching out to other people can help you feel better about yourself and can make a positive change in our world.

autism · journey to recovery · mental health · mental health blogger · mental illness · personal journey · Uncategorized

World Autism Awareness Week [2017]

The 27th March to the 2nd April 2017 is World Autism Awareness Week.

The term ‘autism’ is used here to describe all diagnostic profiles, including Asperger syndrome and Pathological Demand Avoidance (PDA).Without understanding, autistic people and their families are at risk of being isolated and developing mental health problems.

Autism is much more common than many people think. There are around 700,000 people on the autism spectrum in the UK – that’s more than 1 in 100. If you include their families, autism is a part of daily life for 2.8 million people.

Autism doesn’t just affect children. Autistic children grow up to be autistic adults. Autism is a hidden disability – you can’t always tell if someone is autistic. While autism is incurable, the right support at the right time can make an enormous difference to people’s lives.

70% of autistic adults say that they are not getting the help they need from social services. 70% of autistic adults also told us that with more support they would feel less isolated. At least one in three autistic adults are experiencing severe mental health difficulties due to a lack of support. Only 16% of autistic adults in the UK are in full-time paid employment, and only 32% are in some kind of paid work.

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What is Autism?

Autism is a lifelong developmental disability that affects how people perceive the world and interact with others.

Autistic people see, hear and feel the world differently to other people. If you are autistic, you are autistic for life; autism is not an illness or disease and cannot be ‘cured’. Often people feel being autistic is a fundamental aspect of their identity.

Autism is a spectrum condition. All autistic people share certain difficulties, but being autistic will affect them in different ways. Some autistic people also have learning disabilities, mental health issues or other conditions, meaning people need different levels of support. All people on the autism spectrum learn and develop. With the right sort of support, all can be helped to live a more fulfilling life of their own choosing.

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How can you help?

You can help autistic people and their families by:

  • spreading understanding about autism – sign up to support the National Autistic Society’s Too Much Information campaign
  • donating to the National Autistic Society so they can continue to give millions of people information and advice about support
  • Talking about autism on social media and to friends and family
  • Sharing this blog post