Introduction to autism
Seeing the world very
Ros Bunney
First of all, have a go at playing
this game:
• Identify the following
What colours are these?
A: 1. Red
2. Blue
3. Green
4. Yellow
Did you get it right?
What colours are these?
A: 1. Crimson
2. Blue
3. Emerald
4. Blond
Did you get it right?
What colours are these?
A: 1. Scarlet
2. Azure
3. Leaf
4. Blond
Did you get it right?
What colours are these?
A: 1. Scarlet
2. Sapphire
3. Leaf
4. Buttercup
Did you get it right?
What colours are these?
A: 1. Crimson
2. Azure
3. Emerald
4. Yellow
Did you get it right?
Now ask yourself these
• Did you understand why the same
question had a different answer each
• Were you able to work out which
answer would come up?
• Did you find yourself getting bored or
frustrated with the task?
• How did the exercise make you feel?
Life seen through the autistic
• For many autistic people, life is like a
game in which you don’t know the
• Other people know the rules, but every
time you think you have them worked
out, they change.
• These changes seem random and
patternless, so they can never be
For example:
• Banging a drum makes an interesting
booming noise.
• Banging a tambourine makes an interesting
tinkling noise.
• If you bang someone hard enough, they
make an interesting crying noise.
• You are usually allowed to do the first 2 of
• Someone usually stops you if you try to do
the third one.
Why should this be?
• All three involve banging
• All three make a nice noise.
• So why should the “rules” of
the game change in the third
You and I know the answer to
• We can empathise. We put
ourselves in other people’s
• We know that it hurts when
someone thumps us, and so
we don’t do it to other people.
Autistic people can’t think like
• They lack the ability to empathise.
• So to them, this change to the “rule” about
banging things is completely arbitrary.
• This gives rise to anxiety – if I can bang a drum
or a tambourine but not a person, how am I to
know what other things I’m allowed or not
allowed to bang?
• How about a teapot? Or a cat? Or a banana?
• They have no way of working out the answers to
these questions – all they can hope to do is
learn and memorise which ones are allowed and
which are not.
Sometimes the rules change.
• Brother and sister are messing about, playfighting.
• One gives the other a playful slap. They fall about
laughing, and, crucially, MUM AND DAD DON’T
• Ok, so now the rules have changed.
• Sometimes it is ok to bang someone else.
• How am I to know when it’s ok and when it’s not
• It would be completely beyond the ability of most
autistic people to work out the answer to this
question, even though it seems obvious to us.
An unsafe world
• A world where everyone else
understands the rules, even when the
rules change without warning, feels
very scary to someone who doesn’t
understand the rules.
• The person has to do things to make
the world feel safe.
Things that make the world feel
• Only ever eating the same few foods.
• Only playing with the same few toys.
• Repeatedly fiddling with the same
• Always visiting the same shops and
• Always doing things at the same time
every day or on the same day every
These things give predictability
to life
• These things are the autistic person’s own
rules which they can impose on the world.
• They won’t change because the autistic
person has made them up himself.
• Even when the person no longer likes
something (e.g. goes off a particular food or
activity) he/she will continue to do it so that
the world stays predictable and safe.
Factors beyond the person’s
• For one person every day has to start with eating
cornflakes. This gives the day a “safe” start.
• What happens when the cornflake packet is empty?
• Now the whole day is unsafe.
• For another, every Tuesday, Dad comes to visit.
• What happens when Dad is sick or on holiday?
• If things like this can change, suddenly the world is a
very scary and unsafe place again, and this can
cause a huge amount of stress for the autistic
Other things that make the world
• Some people are very sensitive to
sensory stimuli.
• They quickly get “overloaded”.
• This causes feelings of panic.
• When you enter a room, you notice the
important things, but during the course
of your life you have learnt to “filter
out” the things that don’t matter to you.
Autistic people notice
• Literally everything.
• They don’t have a “filter out” mechanism.
• They don’t distinguish between important
and unimportant things.
• They notice every stain on the carpet, every
sound that is to be heard, the colour of the
pen on the sideboard, the leftover smell from
last night’s dinner, the bit of grass stuck to
your shoe.
What is important?
• They can’t guess which is the “important” thing you want them to
• It might seem obvious to you, but all the impressions they are
getting on entering the room are equally strong, so they don’t
know which one they’re meant to focus on.
• To you, it might be important that the person looks at you and
listens to what you want to tell her.
• To her, that bit of grass stuck to your shoe might be the thing that
most strikes her, so she might concentrate on that and not hear
what you are saying.
• How is she to know? These are your “rules” to the “game”, not
hers. From her perspective they are random and unpredictable.
• Why should your words be more important than that bit of grass
on your shoe? Both are in the room, and both are attracting her
attention. How is she to know which one matters?
• Only yesterday, when she came in from the garden, you made her
wipe the grass off her shoes so she didn’t tread it into the carpet.
• So once again, the rules seem to have changed.
Distinguishing what is important
• While you are talking to the autistic person, you may
need to give her some other cues to help her understand
what she needs to focus on.
• You may know that she understands the question “Would
you like a drink?” so you can’t understand why she
ignores the question.
• She has heard the question, but she has also heard your
breathing, the song playing on the TV, the birds singing
in the garden and the dustbin lorry pulling up outside.
• She has no way of knowing which of these sounds
matters at the moment.
• So help her – stand in her line of vision and attract her
attention. Ask the question again, “Would you like a
drink?” but this time, show her a cup or glass so that she
has a visual clue to help her focus on what she is being
Some sensory impressions are
• For some autistic people, sounds can be overwhelming.
• In a room where people are talking, the TV is on and
there’s a tinny noise coming from someone’s i-pod,
they can find the combination quite literally unbearable.
• For others, it’s the opposite. Sounds are interesting –
the more the better. Let’s have a combination of TV,
CD, electronic keyboard, music video on the computer
and personal stereo.
• For someone like this, silence may be unbearable, so
falling asleep in a quiet house at night may be nearimpossible.
• Other people react similarly to strong smells, bright
colours, certain tastes or temperatures – e.g. being
unable to eat ice cream, or certain textures – e.g. not
liking playdoh.
Get to know the individual
• Like the rest of us, autistic people are all
different and have their likes and dislikes.
• It’s just that their likes (e.g. hand dryers) may
come to dominate their lives, and their
dislikes may make life impossible and – once
again – unsafe.
• The only way to deal with this is to get to
know the person and adapt the environment
as much as possible for his or her comfort.
Tell me what I’m thinking about
• I have an image in my mind at
• I’d like you to tell me what it is.
• I’ll give you a moment to think
about it.
• Ok – what am I thinking of?
Check if you were right.
• Did you know I was thinking about a
blue lorry?
Of course not.
• You can’t see what’s going on inside
my head.
• Many autistic people don’t know this.
• If they are thinking of something, they
assume you know about it.
• Therefore, even if they can easily tell
you in words, they may not bother to
do so because they think you already
The smarties test
• This is used as a test to see if a child is
• The child is shown a smartie tube and
is asked what is inside. Most children,
whether or not they are autistic, will say
• The lid is taken off, and they are shown
that the tube in fact contains pencils.
What’s inside?
• The lid is then replaced, and the child is
asked, “If I showed this tube to Mummy, what
would she think was inside?”
• Most children will answer, “Smarties”.
• Autistic children will usually answer,
• This shows that because they know in their
own mind that it contains pencils, they
assume that Mummy will know what is in
their mind.
Suppose you are caring for an
autistic person
• He comes home from a day out.
• You ask him what he has done/seen.
• Depending on his mood, he may humour you by telling you, or
he may refuse to answer.
• Either way, he sees the question as pointless because he
assumes you already know.
• Or he may want you to comment on something that happened
while he was out. He won’t tell you what it was, because he
assumes you already know what he’s thinking.
• If you don’t give the response he is looking for (which you
can’t, because you don’t know what he’s thinking) he may get
very agitated because he thinks you are being deliberately
difficult or awkward.
• Once again, the “rules” of the “game” of life have changed, and
life suddenly seems very unpredictable and scary, giving rise to
high levels of stress and anxiety.
How can this stress and anxiety
be defused?
• You can’t reason the person out of it (“I’m sorry Dad
couldn’t come today because he was ill. Don’t
worry, he’ll come next Tuesday as usual”).
• That kind of reasoning will only work later on once
the anxiety has been dealt with. Right now the
person is in an emotional head-space which is way
beyond the reach of reason.
• The only other way, from the autistic person’s point
of view, is to replace this unmanageable emotional
pain with a manageable physical one.
• This is why many autistic people self-harm when
they don’t get their own way.
• It might look like a temper-tantrum, but it isn’t.
• It’s a frantic attempt to make this scary, unsafe world
seem safe and predictable again.
Pre-empting the stress
• The best way to deal with this kind of stress is to pre-empt it.
• If you know the minibus isn’t going to be available next week to
take the person to the day centre, tell her as soon as you know.
• She will experience some anticipation anxiety, but you can help
her to deal with this by sitting down and planning how you will
spend the day instead.
• At first she may refuse to consider doing anything other than
going to the day centre, but once she begins to realise that this is
not an option, she may start to think about alternatives. Try to
offer something that the person really likes, so that the alternative
is seen as a treat.
• Over the next few days, keep reminding the person about the
change of arrangements. Go over the new plans and talk about
what she will be doing instead.
• Often the person may want you to role-play the substitute activity
(“Pretend walking to the park”) so that she can picture in her mind
what it will be like.
• All this helps to restore some predictability and safety to her world.
Unexpected changes
Some changes can’t be anticipated (you go out to the minibus and find
it has a flat tyre, so the person can’t be taken to the day centre).
This is bound to cause stress and anxiety and a strong reaction – you
can’t prevent this, you can only limit it.
Stay with the person. No matter how frantic and agitated she
becomes, remain calm and speak quietly and slowly.
Acknowledge her feelings and that you understand why she feels this
Try as far as possible to prevent her from self-harming.
At the first lull when you can get through to her, suggest an alternative
activity which you know she likes.
As soon as possible, use this chosen activity to distract her from the
It may take a very long time, but eventually some autistic people will
come to learn that even a sudden change like this can be faced and
survived without disaster, and some people may become better at
learning to accept sudden changes.
For others, this kind of unpredictability in life remains too frightening
and they never really learn to deal with it.
Facial expressions
• Identify the moods behind these facial
This is how they may look to an
autistic person:
• Most autistic people can’t tell, just by looking
at your face, whether you are happy or sad,
cross or friendly, relaxed or worried.
You will need to spell out
everything in words.
• Tell him that you’re smiling because you’re
• Or that you’re looking friendly because you
like him.
• Or that you’re frowning because you’re not
pleased with him.
• Or that you are looking worried because you
are sad to see him hurting himself.
• You can’t assume that he will infer any of this
from your facial expression.
It’s a bit like this:
• When I was in the garden, I saw a :
• hérisson. You don’t know what that is? Well, it’s the
same as an
• Igel. Still none the wiser? It was a
• erizo. Still don’t get it? Try
• ježek.
• Give up?
• Facial expressions are as mystifying to autistic
people as foreign languages are to us.
• (Actually it was a hedgehog that I saw. You couldn’t
understand that until I explained it in English. An
autistic person won’t understand your facial
expression until you explain it in words.)
Say exactly what you mean
• Don’t say, “I’ll cut you some slack this morning
because I know you’re tired.”
• Instead say, “I’ll let you stay in bed this morning” –
then remember to say how long for – “for an extra
half-hour” or “until ten o’clock” – otherwise the
person will expect to be staying in bed until the
morning is over, because that is exactly what you
have said.
• Similarly, don’t say, “I want you to be quiet” or the
person will be anxiously waiting to know when he is
allowed to stop being quiet.
• Instead, say “I want you to be quiet for ten minutes.”
Figurative and literal language
• Autistic people tend to take everything
• They don’t understand metaphors.
• We use metaphors far more often than we
• One autistic person thinks a cassette tape is
a sharp cutting implement because someone
once said to her, “I’ve recorded a tape for
you, but I’m sorry the last song cut off.”
• She took the word “cut” literally.
Autistic obsessions
Autistic people often have obsessions with mechanical things because their
behaviour is predictable and apparently purposeful.
Having wet hands can be an unpleasant sensory experience, and so hand
dryers are important.
What’s more, a hand dryer is easy to understand. It consists of a box which
attaches it to the wall, and a fan which blows air over a heating element which
heats up the air so that it dries your hands more quickly.
Most importantly of all, hand dryers do this predictably often. And they do it
with a specific purpose – to get rid of that unpleasant wet sensation from your
This makes hand dryers, for some autistic people, VERY IMPORTANT.
Far more important than people, who are unpredictable.
Far more important than any other part of the outing you are on.
Why did you go to the shops? To play with the hand dryer in the public loo.
Maybe you also did some shopping, but that wasn’t why you went.
Why did you go to the zoo? To play with the hand dryer in the loo. Maybe you
happened to spot a few animals, but that wasn’t why you went.
Why did you go to the swimming pool? Because it has LOADS of hand dryers
and hair dryers too. Maybe you swam while you were at it, but that wasn’t why
you went.
Hand dryers are the important thing. They ARE the meaning of life.
Dealing with obsessions
• Asking a person with autism to give up their
obsessions is like asking you to abandon your
husband and children for someone else’s
• But obsessions can be managed.
• Playing with a hand dryer can be used as a reward
for good behaviour on an outing, and withdrawn for
unacceptable behaviour.
• Listening to a hand dryer on the Internet can be used
as a reward for good co-operation at home.
• Outings can be planned to interesting places that
have hand dryers, and the hand dryer either saved
up to the end of the visit as an incentive, or used at
the start and got out of the way so that the rest of the
visit can be enjoyed – or both.
People with autism
• Like the rest of us, people with autism have abilities
and talents, likes and dislikes, and areas of difficulty
and frustration.
• Asking “what does an autistic person want out of
life?” is a bit like asking what a blue-eyed or lefthanded person wants out of life. They are all
individuals with their own dreams and aspirations.
• Autistic people can be difficult to get to know, but
the effort is very rewarding as so many of them are
interesting and likeable people when you get to
know them.
• I hope this brief introduction helps you to
understand them a little better, and that your life is
personally enriched by working with them!
Suggested reading
• The Curious Incident of the Dog in the
Night Time by Mark Haddon, as well as
being a great story, is a fascinating and
realistic insight into the mind of an
autistic person.

Introduction to autism