Current research suggests that over 1 in 100 people may be on the autistic spectrum. However Autism Spectrum Disorder (ASD) is largely misunderstood as people with ASD have an increased risk of psychiatric illness but only 50% having intellectual disability. The College of Psychiatrists of Ireland are today running an Autism Seminar on pathways of care/service for adults with Autism Spectrum Disorder (ASD). This is sure to be an informative and eyeopening event for our members.
The programme for this seminar includes a superb panel of speakers, including, amongst others, Adam Harris social entrepreneur and Founder – CEO of AsIAm.ie Organised by Dr John Hillery, Prof Louise Gallagher and Dr Linda O’Rourke, this is an important meeting for all psychiatrists with an interest in the development of psychiatric services for adults with ASD.
Dr Linda O’Rourke wrote the following blog post in advance of today’s seminar.
There needs to be a lot more emphasis on what a child can do instead of what he cannot do’
– Temple Grandin
Autism, Asperger’s syndrome, autism spectrum disorder, pervasive developmental disorder and other synonyms are commonly used to refer to a single condition in which both children and adults struggle with social interactions, communication skills and repetitive, ritualised behaviours. But autism is more than this. In truth it is not a single anything, it is a diverse heterogeneous varied array of incredible human beings with savant skills and advanced logical thinking. Over seventy years on from its first description we still see varied depictions of those with autism in media and news reports. In 2016, ex-doctor Wakefield, familiar to some for his discredited 1998 Lancet publication linking autism and the MMR vaccine, resurfaced with the controversial documentary VaXXed. In March 2017, RTE aired the more balanced and uplifting Autism and Me showing Irish children and young adults living with autism and April saw Sesame Street proudly introduce Julia, a character with autism. In May, Irish media ran the heart-warming stories of Robert Gagno’s victory in the World Pinball Championship saying autism made him a better player and Cork’s Baldy Barber cutting a 16 year old client’s hair in the family car knowing it was his safe place.
The previously held belief that autism spectrum disorder was associated with an intellectual disability is quickly fading as research shows this to be true in as little as 30% of cases. Autism advocate and Professor of Animal Science at Colorado State University Temple Grandin describes autism as ‘part of who I am’, author Kerry Magro said:
Autism can’t define me, I define autism.’
Ireland’s Adam Harris, who himself has Asperger’s syndrome, founded AsIAm.ie to push us toward a more inclusive Ireland. Awareness and understanding of autism spectrum disorder is growing. We now realise that 1% of our population live with autism, that’s nearly 46,000 Irish men, women and children.
As psychiatrists, we also know that autism can be associated with significant social suffering, physical and psychiatric morbidity and increased mortality as those with autism are more likely to be single, unemployed and living in the company of others. They can experience greater unmet social and healthcare needs often associated with increased carer burden, parental stress, marital discord, poor child-parent relationships, poor child-sibling relationships and a lower quality of life. Mortality rates are 2 to 5 times higher and rates of mental illness can be as high as 84% including depression, anxiety, ADHD and suicidal behaviour. The chance of developing a mental illness is proportional to the severity of one’s autistic symptoms. Insistence on sameness, an extensive repertoire of fixed rituals and routines, hyper-reactivity and hypo-reactivity to sensory input, a fear of change or difficulty accurately predicting another’s intent, actions or emotions are seen to result in illness such as depression and anxiety.
Early detection and intervention are essential in preventing the development of mental illness in those with autism. A unified approach between primary care, social care and psychiatry can achieve this by providing access to healthcare, education, employment, advocacy, mentors and keyworkers. The Autism Spectrum Disorder Bill 2017, currently progressing through the Oireachtas, could provide the required legal framework to develop necessary services within the Republic of Ireland. Now is the time to expand services for the Irish cohort of 46,000 children and adults with autism spectrum disorder.
Photos from the event:
