Neurodiversity

Autism

If you are autistic, have an autistic child or you’re a clinician working with autistic clients it is important to acknowledge that autistic people are more likely to experience symptoms of post-traumatic stress disorder (PTSD). Although research has yet to establish clear data, the rates of probable trauma in autistic people (32-45%) are higher than those who are non-autistic (4-4.5%) (Rumball et al. 2020; Rumball et al. 2021; Haruvi-Lamdan et al. 2020). As an autistic person you may be more likely to experience traumatic life events, particularly interpersonal traumas such as bullying and physical and sexual abuse. In the general population exposure to interpersonal traumas and a lack of social support increases the risk of PTSD (Brewin et al. 2000).

Researchers at Kings College London (Rumball et al. 2020) and Kerns et al. (2022) suggest that there are several other events that autistic people find traumatic. This includes abandonment by/loss of a loved one (for example a family member, pet or support staff), sensory experiences (loud noises, bright light, texture of everyday clothing and food), transitions and change (for example school transitions, routine changes with the seasons, (unpredictability in day-to-day life), social difficulties and confusion (for example difficulties interpreting social cues, misunderstandings, and conflicts) and events related to your own mental health difficulties (for example psychotic experiences).

As an autistic person you may also be more likely to find these experiences traumatic due to autistic characteristics such as sensory sensitivities, communication and social interaction differences, distress around changes to routines and distress if you are prevented from taking part in repetitive and restricted behaviours such as stimming. Some theories suggest that there are other factors associated with being autistic, which may mean an increased risk of developing or maintaining trauma symptoms. This includes neurological and genetic factors, detailed focused processing (in other words a tendency to focus on the details of a situation), increased rumination (unable to stop thinking about negative feelings and thoughts), inflexible thinking/ avoidance and emotion regulation difficulties.

Specific trauma responses in autistic people including hyper-sensitivity (beyond the individual’s baseline), repressed stims, an inability to regulate with body movement, shame spirals and shutdowns, forced/ inauthentic eye contact, submission to sensory-averse experiences, unmet needs, conditioned independence with extreme energy cost (burnout will follow), internal demand avoidance (fight/flight/freeze response to things we want to do), hypo-sensitivity- dissociation/ mind-body disconnection, repressed emotions, masking (subconsciously hiding distress or atypical behaviours), hidden disabilities like autoimmune conditions, disabling anxiety or depression, mania/ psychosis/ self-harm, and negative self-image.

Healing developmental trauma does not make an autistic person more typical. Trauma interventions can increase an autistic persons atypical behaviours as they re-connect with their genetically divergent body-mind. It is therefore important to remember that as an autistic person, you may need more support after trauma talking therapy, not less.

Attention Deficit Hyperactivity Disorder (ADHD)

Notably, If you have a diagnosis of ADHD or are supporting someone who has, several researchers believe that symptoms of child traumatic stress can be mistaken for ADHD and that the risk of misdiagnosis is high. This is because there is an overlap between ADHD symptoms and the effects of experiencing trauma. Unless symptoms are examined closely, the profiles of child traumatic stress and ADHD can appear to be similar. This diagram below demonstrates the overlapping presentations of ADHD and trauma. Body-based treatment approaches that are affective for dampening down arousal levels in trauma can also be effective for people with a diagnosis of ADHD.

What can be helpful:

The same body-based strategies for non-autistic people can be adopted for those who are neurodivergent and have been exposed to trauma. The following pages on this website describe strategies that are used by therapists at Trauma OT (including occupational therapy, sensory integration and processing, and ecotherapy).