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A case study of two autistic children supported by the Accept Approach: a new acceptance based strategy Series: Good Autism Practice (GAP) ; 22 (2) 21-31: 2021- https://ihc.idm.oclc.org/login?url=https://www.ingentaconnect.com/contentone/bild/gap/2021/00000022/00000002/art00004
- The author is a specialist teacher and autism advisor for Local Authorities in the West Midlands. He was diagnosed autistic at 30 years old and is a proud parent of two autistic children. In 2019, he began developing 'the Accept Approach' which is a new acceptance based approach aimed at helping to support autistic children and young people who do not respond to traditional autism strategies. This paper reflects on the impact that the Accept Approach had with two autistic children who were not attending school due to high levels of anxiety. Both children responded well and returned to education and feedback was positive from their parents.
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An evaluation of a community based swim programme for autistic children Series: Good Autism Practice ; 21 (1) May 2020: 25-32- https://www-ingentaconnect-com.ihc.idm.oclc.org/contentone/bild/gap/2020/00000021/00000001/art00004
- It is often the case that autistic children and young people engage in less physical activity than their peers. Such activity has known physical and mental health benefits. Potential barriers to engagement include a lack of locally based programmes which autistic children can access, the need for high adult - child ratios, the initial reluctance of the child to engage due to the sensory and social demands, and the fact that staff who work in physical pursuits often lack the confidence and skills to work with autistic children. This paper describes a community based programme at a local swimming pool set up for autistic children and young people aged from 3 to 17 years. A bespoke swimming programme (Autism Pictou County Swim Programme, New Glasgow, Nova Scotia, Canada) was used and staff and parents were trained to understand the principles and some of the challenges that autistic children might face. Discusses the findings.
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An evaluation of sensory diets and the impact on sensory processing, engagement and the wellbeing of autistic children Series: Good Autism Practice (GAP) ; 22 (1) 38-58: 2021- https://ihc.idm.oclc.org/login?url=https://www.ingentaconnect.com/contentone/bild/gap/2021/00000022/00000001/art00005
- The sensory challenges for autistic children and adults alike can seriously affect their wellbeing and their ability to access and benefit from experiences. Over recent years, there has been an increasing focus on how sensory needs can be ascertained and then how these might be addressed to lessen their effects. In this small study within a resource base in a mainstream primary school, the author worked with a specialist occupational therapist (OT) and parents to devise a sensory diet for five autistic children. The Autism Education Trust (AET) Progression Framework was used to monitor change. While it is not possible to claim it was this work that led to some of the improvements seen, the study does provide some good ideas on sensory assessment and on ways to support children who are over or under sensitive to sensory stimuli. Developing the knowledge of the whole staff of the school and working closely with the children's parents were key aspects so that experiences and ideas are shared and built upon and future children can benefit.
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An exploration of the Pathological (or Extreme) Demand Avoidant profile in children referred for an autism diagnostic assessment using data from ADOS-2 assessments and their developmental histories Series: Good Autism Practice (GAP) ; 21 (2) 33-51: 2020- https://ihc.idm.oclc.org/login?url=https://www.ingentaconnect.com/contentone/bild/gap/2020/00000021/00000002/art00005
- This paper is in two parts. The first part analyses the scores on Module 3 of the ADOS-2 of 136 children diagnosed with autism following an autism diagnostic assessment at a specialist multidisciplinary clinic. From all the information collected during the assessment, it was concluded that 65 (47 per cent) of the children in this sample had both autism and a Pathological Demand Avoidant (PDA) profile. The authors therefore compared scores on Module 3 of the ADOS-2 of the two groups. They concluded that these scores successfully differentiated children with autism only, from those with autism with a PDA profile. The ADOS-2, Module 3 may therefore be a useful assessment tool for qualified clinicians to use as part of their diagnostic formulation. The authors acknowledge that this does not constitute evidence that autism with a PDA profile is a discrete autism subgroup or that similar types of behaviours to those observed in the PDA profile are never observed in other groups of children, as this study only included children diagnosed with autism.
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Attachment theory and attachment difficulties: supporting autistic children and young people in residential school settings Series: Good Autism Practice (GAP) ; 22 (2) 51-58: 2021- https://ihc.idm.oclc.org/login?url=https://www.ingentaconnect.com/contentone/bild/gap/2021/00000022/00000002/art00008
- In this paper, the authors, Dr Felicity Hepper (a child and adolescent psychiatrist), Kathleen Bartlett (an assistant psychologist) and Mary-Clare Fearn (a music therapist) argue that some autistic children and young people who attend residential schools also have an attachment disorder and that their needs arising from attachment difficulties also need to be addressed. The paper is in three parts and starts by describing different attachment styles and then goes on to suggest how these might manifest in a child's behaviour and how staff might be supported to understand this. The final part makes suggestions on actions likely to help autistic children to feel secure in a residential school setting, especially when coping with daily transitions between staff and between home and school. The authors state their aim is to be a 'good-enough' in-loco parent with a positive regard for the child, providing warmth and encouragement. By liaising effectively with parents and other family members to understand the underlying reasons for some of the child's responses and actions, staff can then deal sensitively and appropriately to the challenges they face and the child will slowly develop their trust in others and feel secure in their attachments.
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Autism : a personal commentary on changes in knowledge and attitudes seen during the last 20 years Series: Good Autism Practice ; 21 (1) May 2020: 36-42- https://www-ingentaconnect-com.ihc.idm.oclc.org/contentone/bild/gap/2020/00000021/00000001/art00006
- "The aim of this paper is to pass on to others what I have learned in the hope of challenging and short-circuiting the often misleading information about autism that is still present in much public and even professional discourse. This is a personal, but I hope informed, perspective based on my involvement in raising funds for autism research and in seeking to stimulate better evidence based policy. I focus first on changes in knowledge about autism and then on whether and how attitudes are changing as a result."
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Autism, librarianship and their fit Series: Good Autism Practice (GAP) ; 22 (2) 32-39: 2021- https://ihc.idm.oclc.org/login?url=https://www.ingentaconnect.com/contentone/bild/gap/2021/00000022/00000002/art00005
- The author was late diagnosed with Asperger syndrome and works as a librarian at the University of London. In this paper, she considers why librarianship is often cited as an appropriate career for able autistic people. She argues little has been written as to why this might be and so uses her own personal experience to suggest which characteristics often seen in autistic people, lend themselves to the profession. The author also identifies some of the issues that might arise in the workplace and how these might be addressed. She makes the point that much of this applies to other fields and so the paper has relevance to other types of employment. The Editor welcomes more papers written on the workplace experiences of autistic adults.
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Autistic doctors: is there a problem? Series: Good Autism Practice (GAP) ; 22 (2) 40-43: 2021- https://ihc.idm.oclc.org/login?url=https://www.ingentaconnect.com/contentone/bild/gap/2021/00000022/00000002/art00006
- Dr Tom Berney is a retired Developmental Psychiatrist who has had a lifetime interest in autism. In this short paper, he sets out the positive contribution autistic doctors can make and outlines some of the issues that might arise in the working environment for them and their colleagues or patients and possible solutions. With the increasing emphasis on admission criteria and the professional standards being set, he warns that the profession might exclude some people in the future by virtue of their diagnosis and argues that this would be a great loss. In this issue of the GAP Journal, there is also a paper by an autistic librarian who raises similar issues. The Editor would welcome papers which highlight the contribution of autistic employees and which illustrate workplace adjustments that have made a significant difference.
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Children and young people's views and experiences of an autism diagnosis: what do we know? Series: Good Autism Practice (GAP) ; 21 (2) 52-65: 2020- https://ihc.idm.oclc.org/login?url=https://www.ingentaconnect.com/contentone/bild/gap/2020/00000021/00000002/art00006
- This paper reviews some of the recent literature on the views of children and young people about their diagnosis of autism and its effects. Despite the fact that this is the key group for whom it matters, there is very little to guide parents and professionals on how to give the diagnosis to a child or young person or on post diagnostic advice. Professionals write reports often with the best intentions but may not seek any feedback on the impact of what they write. The GAP Journal has published a number of papers on this topic over the years on the nature and content of written reports (Loomes, 2017) and on how to share the diagnosis with children and young people (Fletcher, 2013; Miller, 2015) and in 2018 Miller published a book on all the work he did as an advisory teacher. What is apparent from the findings of the literature review in this paper, is that where others have a positive view of autism, then the child and young person is also likely to develop a positive view of self and their future. This is an obvious point but as there are still many who receive negative comments or people who hold a deficit view of autism, then it is vital that work is done to counter these messages. While autism does present many challenges, focusing on what is working well and on what the child or young person loves and enjoys is likely to lead to positive outcomes. This is a view expressed very well by the father of an autistic child, John Williams, in his book, My Son's not Rainman, where for some years he and professionals alike were often so focused on his son's challenges and deficits that they failed to notice and appreciate the joy and achievements he experienced.
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Continuing the education of autistic pupils while focusing on family wellbeing during the Coronavirus Pandemic Series: Good Autism Practice (GAP) ; 21 (2) 5-10: 2020- https://ihc.idm.oclc.org/login?url=https://www.ingentaconnect.com/contentone/bild/gap/2020/00000021/00000002/art00002
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Diagnosis of autism in older women: reflections of a psychologist and a client Series: Good Autism Practice (GAP) ; 22 (2) 59-65: 2021- https://ihc.idm.oclc.org/login?url=https://www.ingentaconnect.com/contentone/bild/gap/2021/00000022/00000002/art00009
- Tamara May works in autism research and is a psychologist in private practice in Melbourne, Australia. Carol Adams is a Professor at Durham University working in the field of sustainable development accounting and accountability, including accountability for social justice issues. In this paper, they explore the issues in diagnosing autism in women and make recommendations for diagnostic assessment. The process of Carol's diagnosis from first suspicions to the confirmation of autism is presented. Carol talks about the process of completing the assessment tools and the response to getting her autism diagnosis. Tamara identifies some of the current issues in the diagnostic assessment of autism in adulthood, and both make suggestions for how the process can be enhanced.
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Exploring bullying in autism through a content analysis of autobiographies Series: Good Autism Practice (GAP) ; 22 (2) 5-11: 2021- https://ihc.idm.oclc.org/login?url=https://www.ingentaconnect.com/contentone/bild/gap/2021/00000022/00000002/art00002
- Bullying is sadly an all too frequent occurrence for autistic children and adults which leads to low self esteem, loneliness, anxiety and depression. Autistic children and young people often fail to report this to teaching staff or their parents, so it remains hidden. This paper by Mary-Ellen Huxter summarises a piece of research which was submitted as a dissertation in partial fulfilment of the requirements of the degree MA Child and Adolescent Mental Health (MA CAMH) at the University of South Wales. The nature of bullying in childhood is explored from the perspective of eight autistic adults from their published autobiographies. Mary-Ellen analysed the contents and describes the forms of bullying they all experienced and its effects. She notes what these adults thought helped them to cope with being bullied and suggests how staff in schools and other settings might respond to bullying.
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Factors which promote or hinder physical activity for autistic children and young people: a literature review Series: Good Autism Practice ; 21 (1) May 2020: 15-24- https://www-ingentaconnect-com.ihc.idm.oclc.org/contentone/bild/gap/2020/00000021/00000001/art00003
- Autistic children and young people generally take part in less physical activity than their typically developing peers. As a result, they are at risk of becoming overweight and suffering ill health (eg heart disease and diabetes). There are also known benefits in taking regular physical exercise in terms of stress reduction and enhancing both physical and mental wellbeing. Research has often focused on the effects of physical exercise, but there has been less focus on the factors that hinder or promote autistic young people from taking part in physical activity. The authors of this paper, who are students at Farleigh Dickinson University in New Jersey, therefore conducted a literature review to examine these factors. This paper provides ideas on how staff and parents alike can encourage and enable more autistic children and young people to engage in physical activities.
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Issues in persistent non attendance at school of autistic pupils and recommendations following the reintegration of 11 autistic pupils Series: Good Autism Practice (GAP) ; 22 (2) 12-20: 2021- https://ihc.idm.oclc.org/login?url=https://www.ingentaconnect.com/contentone/bild/gap/2021/00000022/00000002/art00003
- Catrina is a specialist teacher and an educational consultant and trainer who supports many schools and nurseries in Wales and the South West of England and is the founder of Neuroteachers, a training and coaching company for educators. In this paper, she argues that official data shows that autistic pupils in the UK often have periods of prolonged absence from school. Staff are keen to help pupils back into school, but Catrina argues that there is rarely 'a quick fix' and that it can be helpful to think in terms of the pupil having a serious injury or physical illness, where staff would not expect a quick return to school. Triggers for non attendance may be a specific incident or the result of longer term social exclusion or feelings of failure. Worries about home and family members might also contribute and so a thorough analysis and understanding of the issues contributing to their non attendance needs to be made. Catrina and others believe that autistic pupils are often traumatised by their experiences and so using trauma informed approaches can be successful. She presents a case study to illustrate the points she makes and adds to this with details of ten other persistent non attenders. This paper fits well with the Accept Approach described by Aaron Yorke in this issue of the GAP Journal and the paper on bullying by Mary Ellen Huxter. Taken together, these serve to give ideas on what might be helpful.
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Misdiagnoses and late diagnosis of autism in adulthood: Ruth's reflections with her therapist Series: Good Autism Practice (GAP) ; 22 (1) 73-77: 2021- https://ihc.idm.oclc.org/login?url=https://www.ingentaconnect.com/contentone/bild/gap/2021/00000022/00000001/art00007
- In this opinion piece, Ruth, a Registered Manager in Adult Social Care, and Elin (a psychologist and therapist), consider the impact on Ruth of not being identified as autistic until the age of 46. Prior to this, several mental health professionals had viewed Ruth variously as psychotic or as having a personality disorder. She was put on high doses of anti-psychotic medication for some years. This short piece does not include the perspective of the professionals who have assessed Ruth in the past, so it is not possible to establish how they reached their conclusions and missed autism. Ruth and Elin suggest possible reasons for this. These include the fact that Ruth had experienced abuse and trauma in her young life (not uncommon in autism); and that she had significant sensory processing issues. In addition, they argue that many mental health professionals lack an understanding of the presentation of autism in girls and women and so look for different explanations and may rely on the previous conceptualisations of their colleagues rather than taking a fresh look at the person before them. They end this paper by reflecting on the impact of late diagnosis and how life might have been different. While all those involved in the field of autism know many autistic people, like Ruth, who have been misdiagnosed and given inappropriate or ineffective treatments, it is the hope that as autism becomes a compulsory part of the initial training in health, education and social care that the proportion of those who reach adulthood and who require support, meet professionals who understand their needs and work effectively together with them.
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My father's death : the thoughts and perspectives of an autistic woman Series: Good Autism Practice ; 21 (1) May 2020: 33-35- https://www-ingentaconnect-com.ihc.idm.oclc.org/contentone/bild/gap/2020/00000021/00000001/art00005
- It is often written that autistic people respond differently to events and that other people have difficulty in reading their emotions and gauging their emotional state. There is a risk then that if an autistic child or adult does not express their emotions in a conventional or typical way and appears to be unaffected by an event, that parents and carers offer less support. In the case of the illness or death of a friend or relative, this can mean that the autistic person is not fully informed or invited to the hospital or funeral, for example. In addition, formal counselling or the opportunity to talk about the event may not be offered. This personal account by Emma is very powerful and may be helpful for others living or working with autistic children and adults experiencing difficult life events.
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Neurodiversity, autism and sexual violence Series: Good Autism Practice (GAP) ; 22 (1) 97-98: 2021- https://ihc.idm.oclc.org/login?url=https://www.ingentaconnect.com/contentone/bild/gap/2021/00000022/00000001/art00010
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Pupils' views on visual timetables and labels in mainstream primary classrooms Series: Good Autism Practice (GAP) ; 21 (2) 11-22: 2020- https://ihc.idm.oclc.org/login?url=https://www.ingentaconnect.com/contentone/bild/gap/2020/00000021/00000002/art00003
- The use of visual timetables and other visual supports such as labelling materials, places and people with words, symbols and/or photos has been advocated by many to enhance communication and understanding, particularly for children with special educational needs. These are used by staff in mainstream and special settings, and parents and carers also often develop these for use at home. A number of studies have been conducted to explore the value of these from the perspective of the adults who implement them but few studies have sought to obtain the children's views. In this paper, the authors who work at Queen Margaret University (MR); within the NHS Lothian Speech and Language Therapy Department (MR); within the Additional Support for Learning Service (JB and LJ) in Edinburgh; and at the University of Edinburgh (BLK and KC) report on a study they conducted to gain the views of 109 pupils with (36) and without additional support needs (73) attending two mainstream primary schools. They conclude that most pupils in both groups found visual supports useful but that they could be more involved in deciding how these were implemented and updated.
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Queerly autistic: the ultimate geode for LGBTQIA+ Teens on the spectrum [book review] Series: Good Autism Practice (GAP) ; 22 (1) 99-99: 2021- https://ihc.idm.oclc.org/login?url=https://www.ingentaconnect.com/contentone/bild/gap/2021/00000022/00000001/art00011
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Quiet voices: using creative research methods to increase participation and the voice of learners often overlooked Series: Good Autism Practice (GAP) ; 22 (1) 13-23: 2021- https://ihc.idm.oclc.org/login?url=https://www.ingentaconnect.com/contentone/bild/gap/2021/00000022/00000001/art00003
- Gaining the perspective of pupils, students, and adults on their experiences of school, college and university and other forms of provision is now considered essential, both ethically and logically to design, modify and create effective policy and practice. Ways of obtaining these views are still in their infancy though and much work needs to be done, not least with individuals whom providers find it hard to engage and communicate with effectively. In this small scale study, Helen Evans, works collaboratively with two autistic students to elicit the views of eight fellow learners at a specialist Further Education College. Walking maps, photo elicitation and other creative research methods are developed and data collected on the type of support given and the benefits of the project to all concerned. The Editor would welcome other papers that give practical ideas on how the voice of those who often remain silent can be heard and acted upon.
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The AuVision project : a collaboration between autistic students and non-autistic staff to understand the student experience within a higher education institution Series: Good Autism Practice ; 21 (1) May 2020: 5-14- https://www-ingentaconnect-com.ihc.idm.oclc.org/contentone/bild/gap/2020/00000021/00000001/art00002
- This paper reports on a co-produced project to explore the experiences of autistic students at university. The project team comprised seven autistic students, two academics and a mentor. Together they designed the research and developed the research methods, conducted the interviews and focus groups and analysed the data. Two sets of recommendations were made on the basis of their findings, one set specifically for autistic students and the other for the wider student body. A web based resource was developed and can be found at https://auvisionsite.wordpress.com/ along with the full project report and executive summary.
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The experiences of autistic adults with chronic pain conditions Series: Good Autism Practice (GAP) ; 21 (2) 66-76: 2020- https://ihc.idm.oclc.org/login?url=https://www.ingentaconnect.com/contentone/bild/gap/2020/00000021/00000002/art00007
- In this study, the author gained the views of 35 autistic adults suffering from chronic pain conditions. They were asked about their age at diagnosis for both conditions and whether these diagnoses were formal or informal. Questions then focused on the impact of these conditions on their lives and for details on sources of support, including their views on health care workers and the strategies they used to cope. It seems clear that having both conditions is very debilitating and adults can hide both from families and colleagues, thus often adding to their distress. The sample was almost entirely female and further research is needed to ascertain whether more females than males have both conditions and whether their experiences differ.
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The pros and cons of being an autistic parent Series: Good Autism Practice (GAP) ; 22 (1) 87-96: 2021- https://ihc.idm.oclc.org/login?url=https://www.ingentaconnect.com/contentone/bild/gap/2021/00000022/00000001/art00009
- Many parents of autistic children are autistic themselves and yet there has been relatively little research on what this experience is like for the parents. In this paper, Shona Murphy who is autistic and has two autistic children, interviewed five autistic mothers and one autistic father to explore their experiences. The literature on this topic often shows that parents with a disability are unfairly judged and stigmatised and not given the support they seek. Other literature suggests that having similar issues to your child can mean that parents are more empathic and able to understand and meet their child's needs more effectively than other parents. Although the sample is small and the parents might have opted in because they were dissatisfied with services, their accounts suggest, and Shona concludes, that there is a need to help professionals appreciate that parenting might look different when one or both parents is autistic, in order to avoid making negative judgements which might lead to further distress rather than being helpful.
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To what extent does the 'Double Empathy Problem' impact on the assessment and grading of autistic students' creative writing? Series: Good Autism Practice (GAP) ; 22 (1) 24-37: 2021- https://ihc.idm.oclc.org/login?url=https://www.ingentaconnect.com/contentone/bild/gap/2021/00000022/00000001/art00004
- In this paper, the author explores potential reasons for the difference in marks given to autistic students, relative to their typical peers. As an English teacher, she had noticed that the grades given to autistic students at GCSE were generally lower and suggests this may be due to the fact that assessors do not value some aspects of their written work. She conducted a small scale study where she compared the creative writing of 11 autistic students with 11 non autistic students matched for cognitive ability. The findings suggest that teaching staff and examiners need to develop their understanding of the different attributes demonstrated by autistic authors to reflect these in the grades given.
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Transforming the practice of teachers within a mainstream school setting using Appreciative Inquiry and Transactional Supports from the SCERTS model Series: Good Autism Practice (GAP) ; 21 (2) 77-98: 2020- https://ihc.idm.oclc.org/login?url=https://www.ingentaconnect.com/contentone/bild/gap/2020/00000021/00000002/art00008
- The author of this study was the Lead Teacher of an Autism Provision (AP) in a mainstream primary school. She worked with three teachers in the main school to enhance their autism practice. Using an Appreciative Inquiry approach, the staff reflected on their current practice with the author and set goals to develop this, using the Transactional Supports advocated within the SCERTS model. This led to positive changes in their understanding and the strategies they used. The author makes the point that focusing on changing the actions of the staff rather than changing the children was important. As the founders of SCERTS and other practitioners maintain, this is easier, more respectful and likely to be more effective.
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Use of the Thinking Patterns in Autism Profiling Model within a diagnostic assessment service for autism Series: Good Autism Practice (GAP) ; 21 (2) 99-117: 2020- https://ihc.idm.oclc.org/login?url=https://www.ingentaconnect.com/contentone/bild/gap/2020/00000021/00000002/art00009
- In this paper, the authors, who are Advanced Specialist Speech and Language Therapists, discuss the use of the Thinking Patterns in Autism Profiling Model in an autism diagnostic service for children and young people. The early version of this model was designed by Isobel Tollerfield in 2014 and then revised over time and evaluated during her dissertation work for her Master's degree. It has been incorporated into the autism diagnostic assessments conducted and maps the skills and understandings of the child or young person against four quadrants that Isobel and Heather feel encom- pass the key areas of difference in autism. A visual profile is created which enables parents and practitioners to understand what the individual is able to do and then gives ideas and areas to work on. The profile then forms part of the final assessment report given to families and the GP and other relevant professionals. The authors set out the key components of their diagnostic assessment service and show how, over time, they endeavoured to make this more efficient and useful. Data are presented over a six year period from 2013 to 2019 to show the changes in the characteristics of those referred, in waiting lists and in the time taken for the assessment. This paper will be of interest and value to all those engaged in diagnostic assessment and will help them to reflect on their practice and how it might be enhanced.
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Using the special interests of autistic children to facilitate meaningful engagement and learning Series: Good Autism Practice ; 21 (1) May 2020: 43-64- https://www-ingentaconnect-com.ihc.idm.oclc.org/contentone/bild/gap/2020/00000021/00000001/art00007
- Many autistic children and adults have strong special interests (SI), some of which change over time and others which continue into adulthood. Accounts from autistic people commonly state how important these are to them. For example, they can bring great joy and lead to a positive state of flow (McDonnell and Milton, 2014); they can lead to the development of a high level of skill and knowledge; they can serve to distract or motivate an autistic person when in social situations and may lead to employment. Yet, in the past it has been argued that not all SIs are useful or that too much time is spent on them to the exclusion of other pursuits. As a result, SIs have not always been incorporated or built upon within a school context and may actually be discouraged. In this paper, Lydia Davey, an experienced Specialist Autism Teaching Assistant, describes a means of identifying a child's special interests and then links these to the curriculum to aid differentiation. She creates an SI map for three children and explores the views of staff in using these over a four week period. Discusses the findings. Includes a "Special Interests Questionnaire" for parents and children to work on together.
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Why supporting self-awareness for autistic people is of mutual benefit Series: Good Autism Practice (GAP) ; 22 (1) 6-12: 2021- https://ihc.idm.oclc.org/login?url=https://www.ingentaconnect.com/contentone/bild/gap/2021/00000022/00000001/art00002
- Sue Hatton is an experienced teacher and adviser on autism, latterly working in adult residential social care settings. Sue met Pamela Hirsch, 20 years ago and has been part of Pamela's Circle of Support for 15 years. In 2003, they wrote a book together detailing some of Pamela's experiences, entitled Conversations in Autism (Hatton and Johnston, 2003). Pamela was late diagnosed as having Asperger syndrome when she was 46 years old. In this paper, she and Sue discuss some of the events in Pamela's life and explain how her autistic thinking and actions have influenced her decisions and actions, at times for good and at other times, placing her in risky situations. Now at the age of 72, Pamela continues to appreciate the support of her Circle of Support and members of her Circle have gained so much from listening to Pamela.
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