RESPONDING TO DISABILITIES IN YOUNG CHILDREN WHILE TEACHING SOCIETAL NORMS AND REQUIREMENTS

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Griffiths Matthew

Abstract.
Early years education begins the process of preparing children for their adult lives through the inculcation of social norms. If children with a disability are to have a full role in the adult world, they also need to comply with their society’s social norms. This theoretical paper explores: the tensions between the recognition and valuing of difference and disability and the requirements of compliance with the social norms; how these tensions are manifested in early education systems; suggestions as to how these tensions can be addressed through preservice and in-service training.
The integration of children with disabilities into mainstream education focused on enabling the child to fit into the existing systems. Inclusive education focuses on changing the education systems so that they fit the children. So how far, and in what ways, should children with a disability be required to comply with the behaviour expected of all the other children and frameworks of conformity to social norms
The paper explores how practitioners of modern inclusive education theory can respond to the differences exhibited by young children who are significantly outside the norms for their age, in ways which respond to their differences but do not remove the role of early years education in beginning the teaching of compliance with the social norms
The main results refer to teachers’ uncertainty about reasonable exemption from the norms of age appropriate behaviour; how much latitude is helpful and how much damaging; what can, and should, teachers and other children tolerate; approaches for children whose behaviour is outside reasonable expectations.

Key words: Disability; social norms; expectations.

Introduction
Early years education begins the process of preparing children for their adult lives through the inculcation of social norms. If children with a disability are to have a full role in the adult world, they also need to comply with their society’s social norms.
A social norm. according to McLeod 2008 , is the accepted behaviour that an individual is expected to conform to in a particular group, community, or culture. They are the unwritten usually unconscious, rules about how to behave. They vary between community and community, society and society, culture and culture. Social norms are most noticeable when they are not followed. Very young children learn the expected norms within their family and immediate community, but it is when they enter the education service that they begin to learn the wider social norms that they will be expected to observe as they grow up. Norms provide order in society to the extent that is difficult to see how human society could operate without social norms. Human beings need norms to guide and direct their behaviour, to provide order and predictability in social relationships and to make sense of and understanding of each other’s actions. Early years teachers are instrumental in teaching these norms, although in many cases they are not aware of this. Children learn the rules of being part of a group, of obeying instructions, following routines and showing respect, as well as a myriad of rues which are specific to their society or culture. The inculcation of young children into the social rules and social norms of society is one of the most important roles of early childhood education.
Most of what I really need
To know about how to live
And what to do and how to be
I learned in kindergarten

Aim of the Paper
The aim of this paper is to explore: the tensions between the recognition and valuing of difference and disability and the requirements for beginning the teaching of compliance with the social norms; how these tensions are manifested in early education systems; suggestions as to how these tensions can be addressed to achieve the best outcomes for all our children.

Method.
The research aimed to explore how the modern inclusive education theory in early age education that promotes the concepts of differentiated teaching and learning can respond to the difficulties which some children with disabilities experience in learning and adapting to social norms. Interviews were carried out with the teachers of four children whose disabilities mean that they experience such difficulties. Teachers were asked in semi-structured interviews to give their views on reasonable exemption from the norms of age appropriate behaviour; How much latitude is helpful for the child with a disability; what can, and should, teachers and other children tolerate, and what not; approaches for children whose behaviour is outside reasonable expectations.
The children were:
Jake, aged five years, three months. Jake has Down’s syndrome, severe epilepsy which is moderately well controlled by medication. He attends mainstream provision, where he is much smaller and very much less able than his classmates. He has a full-time support assistant. He finds it difficult to comply with general classroom instructions and his behaviour is more typical of a 2 -3-year-old. His teacher does not know how much she should make him comply with the social norms of the classroom (with the help of his support assistant) and how much he should just be allowed to behave differently,
Rachel aged six years and five months. Rachel has cerebral palsy, resulting in spastic hemiplegia so that the muscles on the right side of her body are in a constant state of contraction. This means she has an awkward gait and writes with her left hand. Rachel has above average intelligence but at home she is allowed to behave in any way that she chooses, is never corrected and so she often refuses to carry out activities in the classroom, interrupts the teacher and other children and becomes aggressive if she does not win in competitive games. Her teacher does not know how much she should make her comply with the social norms of the classroom and how many allowances she should make because of Rachel’s disability.
Edward is six years and one month old. He is hyperactive, runs everywhere, sometimes over furniture and is unwilling to comply with the teacher’s instructions to the class. He sometimes destroys other children’s work. He has a full-time support assistant. His teacher does not know how much she should make him comply with the social norms of the classroom (with the help of his support assistant) and how much he should be allowed to behave differently.
Bobby is six years, 11 months old. He has been diagnosed with Asperger’s syndrome. He is of average intellectual ability. Bobby dislikes any changes in routines; appears to lack empathy;
talks incessantly about dinosaurs (about whom he is may be very knowledgeable); stares at other children; and often avoids taking part in classroom activities. His teacher does not know how much she should make him comply with the social norms of the classroom and how much he should be allowed to behave differently.

Results
The teachers interviewed were all uncertain as to how much they should acknowledge that the children are unlike the others in their class and therefore allow them to be different and not teach them to comply with the behaviour required of all the other children. All those interviewed erred on the side of making far more allowances than they would for other children and none had thought about the long-term impact of the behaviour of children with a disability on their later life opportunities.
Discussion
Even when early years’ teachers are not explicitly aware that they have a major role in teaching social norms, they have an implicit understanding of this major element of their role and are concerned to ensure that all the children in their charge:
• How many allowances should be made for Rachel’s behaviour?
• Should Bobby be stopped from talking about dinosaurs?
• Should Bobby have to take part in activities with other children, even when he resists this?
The two support assistants also had to make decisions about how far they should make Jake and Edward do the things that the other children are required to do:
• Should Jake hang up his coat, even though it is difficult for him and takes longer?
• Should Jake queue up with the other children for lunch and carry his own lunch to the table?
• Should Edward be punished for destroying another child’s drawing or can he not help it?
Conclusion
Far more thought needs to be give in both pre-service and in-service training for early years teachers to the particular requirements for the teaching of social norms to children with disabilities, as the inclusive model of education becomes more and more accepted, particularly in early years education. Discussions should include: reasonable exemption from the norms of age appropriate behaviour, particularly for children like Jake, for whom some form of exemption from a range of social norms will always be necessary, throughout his life.; how much latitude is helpful for children such as Rachel, Edward and Bobby, who have the possibility of leading normal adult lives, if they are not handicapped by inappropriate behaviour; what can, and should, teachers and other children tolerate, and what not; and what approaches should be taken with for children whose behaviour is outside reasonable expectations, so that they can learn to comply with the social norms that will enable them to live happier and more successful lives.
References
Robert Fulghum. All I Really Need to Know I Learned in Kindergarten
McLeod S. Social Roles. Simply Psychology. 2008

Worth sharing from the blog ‘theviewfromdownhere’:The thoughts and ideas of someone shorter than your average.

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I’m Disabled…Hurray!

It’s been over a year since I’ve written a blog. Should I apologise? Has anyone noticed? Does it even matter? Maybe not..! I created this blog because I felt I had something to say about disability, my experience of it and the world that we all live in. It’s been far too long since I last wrote something, and although I don’t feel like I owe anyone an explanation let’s just say, shit happened. Some good things, some hard things but all of them were things that didn’t feel appropriate to write about until the time was right. That time is now!

Full disclosure – this blog post is about the process of applying for the disability living benefit, Personal Independence Payment (PIP), transferring from the older version of Disability Living Allowance (DLA) and the physical and mental damage the process put me through. Spoiler alert: there is a happy ending and I’m so glad to be able to say that I didn’t lose it. The point of this post isn’t to argue my own case but to explain the process to those of you who may have heard the headlines about the number of disabled people deemed ineligible for the benefit and losing their motability cars and money for carers and assistants. I aim to explain what the process was like for me, having to fight for what I needed.

It’s a long one so maybe make a cup of tea before diving in..!

The drama and trauma of having to reapply for my disability benefit was something I knew was going to happen at some point ever since the Government announced it’s plans to change the Disability Living Allowance (DLA) over to Personal Independence Payment (PIP) back in 2012. Since the announcement, I felt a constant niggling sense of unease. My mum had applied for me to receive DLA soon after being diagnosed at two years old so the thought of having to reapply for this, and potentially losing something when I had no idea what life without the support was like, was daunting. The terrifying stories – stories from friends and in the press – of reapplying and losing the support left me feeling like a rabbit in headlights, unsure of which direction to turn and how to ensure I got the result I needed.

As a child, I was given a lifelong award to help with the additional costs that I would incur due to the condition I was born with and the impairments that were never going to disappear. Let’s face it, I was never going to sprout an additional 2 feet and my joints and skeleton were always going to look and function differently to the average Joe on the street.

When Mum applied for me, DLA came in two parts; the first part was for daily living which helped with assistance that you might need with everyday tasks such as dressing, eating, washing etc and the second was for mobility. This financial support could help with paying for adapted clothes and implements a non-disabled person does not require, paying for support needed to get from A to B or paying for mobility aids such as wheelchairs, crutches etc. At the time, it was decided I would receive the lower rate for daily care and the higher rate for mobility.

Fast forward to February 2017. With a thud a one page letter arrives from the Department of Work and Pensions informing me that my DLA will be ending in four weeks’ time and if I would like to, I could reapply for PIP. To do this I would need to call up and request an application form. If I chose not to reapply, the money I currently receive would be stopped and the car that is adapted and paid for with the money I am receiving would need to be returned within six weeks.

My heart literally stopped.

As I said, I knew this was coming so it wasn’t a surprise but I had heard so many terrifying stories of people’s unsuccessful applications. Like someone who had lost both their legs and had not been deemed “disabled enough” to receive the level of PIP that meant they qualified for the motability scheme and lost their car. And countless other stories like this. I was petrified of this happening to me.

To me, the most scary thing about all of this was losing my car. My car is my lifeline. It’s almost equal to my electric wheelchair; it’s my legs and way into the world. It allows me to leave the house and explore. It means I can live my life with as much independence as possible within my own capabilities. It means I can work and be a productive member of society and feel like I have purpose. Without my car everything would be harder or near on impossible. Public transport is just not accessible enough to make it a viable option. In my local area taxis are expensive and the chance of booking a wheelchair accessible taxi on a whim or within school time is zero. My wheelchair doesn’t fit into other people’s cars so the option of catching a lift with a friend or family isn’t an option either. Getting to work on time, buying food supplies, going for a swim or maybe seeing friends are all taken away from me if my car is taken away.

You see why the panic started to set in.

A week later, after having called the number from the letter and confirming I wanted to apply for PIP, my application form arrived in the post. This time there genuinely was a thump as it arrived because the form is HUGE! It’s 40 pages long asking questions that force you to dig deep into the pit of things you’ve buried and decided not to think about and just get on with life. If you’re new to the blog and don’t know me personally, my first post should give you a flavour of what I’m normally about: http://theviewfromdownhere.info/2015/02/09/welcome-to-the-view-from-down-here/ 

Thinking about what I can’t do and what I do differently to everyone else is not condoned by everyday Sam. I currently have quite severe arthritis in both my hips and am moving fairly swiftly towards a full replacement of my right hip. My condition is worsening; I’m in pain every single day and am medicated every wakening hour. That’s the truth but if I’m honest it’s not something I ever say out loud or admit to myself. This form forced me to explain my condition, how it affects me and what the near future will look like. Advice from friends and people I know who had gone through the process already was to go into as much detail as possible. Don’t assume the assessor will read between the lines or have an understanding or knowledge of my condition. With this in mind, in order to avoid doing myself short, I couldn’t shy away from any detail.

How did that make me feel? Honestly? Crushed.

I spent a week writing notes on every aspect of life. Cooking and making food. Washing and bathing. Dressing. Mobility and how I get around. I asked friends and my family to tell me about the things they noticed that I do differently or need support with because I was keen to avoid missing something out. My friends are honestly the best bunch of bloody rockstar girls anyone could ever imagine and threw themselves wholeheartedly into helping me. “Oh Sam, remember you find it hard opening tin cans and need help” “Remember you can’t walk upstairs so when I lived in a flat you had to drag yourself up them and were really tired afterwards” “You can’t reach things that I can” “When you walk you fall over all the time” “You walk slow and it really hurts if you walk too far” “All your clothes need to be adapted” “You can’t reach the shower head” etc etc etc.

After a week of going over all of this and ensuring each of the 40 pages, plus the additional pages of evidence I submitted, were complete, the feeling was not one of relief. My thick skin and hard exterior was cracked and broken. I felt different to my friends, vulnerable and in need of help, someone to be pitied rather than someone with purpose and potential. The form doesn’t ask what you’re good at, what you bring to the lives of those around you or what is good about your life. It asks you about all the hard things, the things that make you different to those who aren’t disabled and asks you to focus on your medical condition.

I cried for a night. Had cuddles with the people I love. Then I pulled myself together, albeit with a few dents and knocks to the armor.

Two months later, I receive a letter informing me I needed to attend a face to face assessment. The bottom of my stomach fell out the other end and I burst into tears.

This isn’t me but this is where the process had taken my mental health to. Between submitting my form over eight weeks ago to the point the letter arrived, I had done a good job of putting the whole thing to the back of my mind. It’s a skill I developed at a very young age when I knew operations and painful things were looming on the horizon; better to try and be in the moment than let worry overtake every waking hour. Good trick but when reality hits, it hits hard!

I’m proactive and practical so I got to putting into action all the advice I had been given from those who had already gone through the process. Make sure you request the permission to record the interview. Inform them you’ll be bringing someone with you. Getting my hands on recording equipment (much, much harder than it sounds) and ensuring I am 200% across everything I wrote on the form and ready to produce more evidence and explanation.

Let me just give you an insight into the shifty business of these face to face assessments. You may have seen the undercover footage on television from face to face assessments where the assessor is clearly lying, making things up or generally making a mockery of the system being fair. I was advised to record the interview myself so that I had evidence should I need to appeal the decision as many many people have had to do so over the last few years. I was informed that this would be possible but I would need to record using apparatus that create two identical copies and these copies would need to be hard copies rather than digital copies. I was not allowed to email a copy of the audio and was not allowed to use two separate recording devices. Think about this, then tell me where I would find such a thing! It doesn’t exist in your local Argos or supermarket. You might be able to buy something as niche as this but it would cost upwards of £400 and definitely wouldn’t arrive within the week in order for me to use at my assessment.

I won’t go into the who, how or where I managed to get my hands on the right equipment as it took a friend of a friend of a friend doing me one hell of a massive favour, but safe to say I was able to record it. This was only possible because I have access to the right people. Is that fair? Is that right? No. Absolutely not. The rules about recording your own assessment are so clearly put in place because the assessors are worried about what might be found and possibly what they would rather hide. It makes you wonder how they’re still able to get away with it.

So at the last minute I get my hands on recording equipment, my mum is coming with me and she’s ready to make notes in case they refuse me recording it. I’ve been awake most of the night, my hips are sore because I’m stressed and didn’t sleep and I’m on the brink of breaking. Luckily, my assessor is a nurse so although she isn’t a specialist in my condition, she at least has medical experience. She’s friendly enough and tries to put me at ease even if she does question my request to record the interview and delays whilst she double checks with Head Office.

The assessment takes almost two hours; the letter stated it would be one. She goes through the form I submitted and asks additional questions to clarify or plump out the evidence that I have written. At the end she does a short physical examination asking me to lift my arms, turn my head, raise my knees etc. I hand over one copy of the recording and leave the building. We get about 20 metres away, Mum asks me how I think it went, I burst into tears, she hugs me and we sob into each other’s shoulders standing outside Milton Keynes Train Station. It’s a new low for me but I simply couldn’t hold it together any longer. I felt like I had gone through an extended shouting match with a loved one: emotionally drained, angry, sad, frustrated and spent. Utterly empty with nothing left to give.

The job of building myself back up began again. Food, drinks, friends, cuddles, a well-timed theatre trip and lots of laughs did the trick. Again, the armour was back on but this time with a few more dents and knocks as unforgettable evidence of what had happened.

The 7th July arrives and post comes through the letterbox. Mum calls to say I’ve received a letter which looks like it might be from the DWP and did I want her to open it. The familiar stomach falling out from under me happens whilst I hear her rustling the envelope and silently reading it to herself. Finally, she eventually says I’ve been successful and received an ongoing enhanced award for both daily living and mobility. She keeps reading, and I don’t hear her. I’m crying big fat tears filled with relief. The heavy weight of dread was lifted from my shoulders and the space in my head that was filled with PIP worry suddenly became empty. I’m not losing my car and I’m actually receiving more support than I was before which reflects the change in my condition.

So it’s a happy ending. I’m receiving more support than before and my car is here to stay but does the end justify the means? The whole point of moving DLA over to PIP is to make savings, help cut the deficit and to stop all those benefit scrounging fake disabled people getting money for something they don’t deserve. I dread to think the amount of money the Government has spent on assessing whether I am disabled, from all the letters they’ve had to pay someone to write, to print and post, the people that have had to ready my evidence, conduct my face to face assessment and assess the report from this, the rent and electricity for the building that the assessment was held in.

Add it all up and it must equate to a small fortune just so they can conclude without doubt that yes, I am in fact, disabled.

But can I put this to you? In that moment, when I received the decision from the DWP, I realised for the last few months I’ve not been disabled by my medical condition I was born with, or by the inaccessible buildings or the attitudes of ignorant people around me. I was disabled by the Government, the process they had constructed and their attitude towards me.

They should be ashamed of themselves.

Holocaust Memorial Day. The Forgotten Massacre

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Anna Lehnkering was 19 years old when she was sterilised and  confined to a hospital. She was 24 when a doctor declared her “not useful.” She was gassed.  She had attended a special school, and had difficulty learning to read, write or use numbers.

The Nazis had decided that allowing disabled people to live and have children, led to the “unfit” reproducing more quickly than “the fit”. It was said that this weakened society’s ability to function efficiently, placing an unnecessary toll on non-disabled people.

The Nazis claimed that the social and economic problems that Germany experienced in the 1920s and early 1930s were due in part to the weakening of the population created by an unfair burden.

6c-holocaust-boy-2

Nazi propaganda in the form of posters, news-reels and cinema films portrayed disabled people as “useless eaters” and people who had “lives unworthy of living”. The propaganda stressed the high cost of supporting disabled people, and suggested that there was something unhealthy or even unnatural about society paying for this. One famous Nazi propaganda film, Ich Klage (I Accuse), told the story of a doctor who killed his disabled wife. The film put forward an argument for “mercy killings”. Other propaganda, including poster campaigns, portrayed disabled people as freaks.

After the propaganda came action. On the grounds that disabled people were less worthwhile and an unfair burden on society, a widespread and compulsory sterilisation program took place. This began in 1933, as soon as the Nazis came to power. The Nazi  euthanasia program – code-named T4 – for Germans who were not considered “useful,” such as those who were physically or intellectually disabled, or psychiatric patients deemed unworthy to live

Some 300,000 mentally and physically disabled people were exterminated. Between 1940 and August 1941 alone, more than 70,000 were killed, either gassed, neglected  or given lethal injections

The T4 Program involved  a string of six death camps – called “euthanasia centres” – set up across Germany and Austria. These centres contained gassing installations designed to look like shower stalls Two of the most notorious centres were at Hartheim Castle in Austria and Hadamar Institute, which is near Wiesbaden in Germany. Hadamar had a staff of approximately 100 people. To conceal its real purpose, it also operated as a normal crematorium.

Hitler ordered the suspension of the program in 1941 after opposition from groups within Germany, including Catholic churchmen. However, killings were restarted the following year in a more secretive way, and continued until the end of the war. Hadamar only ceased operation shortly before liberation by American troops in March 1945.. During this latter phase of the T4 Program, death was caused by  an overdose of lethal medication or by starvation.

Foetal Alcohol Syndrome

Posted on by under Birth and Babyhood, Pregnancy

The more alcohol a woman drink when she’s pregnant, the greater the risk she is taking with her baby’s health. Miscarriage, stillbirth, premature birth and small birth weight are all associated with a mother’s drinking alcohol during pregnancy.

Foetal Alcohol Syndrome (FAS)  affects the way a baby’s brain develops. First discovered by two doctors in the US in 1973, the seriousness of  the condition depends on how much alcohol a mother drank during pregnancy. The World Health Organisation quotes a 2005 US study which estimated that one in every 1,000 children are born with FAS (2).

What is foetal alcohol syndrome?

 

picture-of-girl

Children with FAS have distinct facial features including: small and narrow eyes, a small head, a smooth area between the nose and the lips and a thin upper lip. They also show the following symptoms:

  • Hearing and ear problems
  • Mouth, teeth and facial problems
  • Weak immune system
  • Epilepsy
  • Liver damage
  • Kidney and heart defects
  • Cerebral palsy and other muscular problems
  • Height and weight issues
  • Hormonal disorders

How FAS develops during pregnancy

When a pregnant woman drinks, the alcohol goes across the placenta to the foetus via the bloodstream The foetus’ liver isn’t fully formed, so it cannot metabolise the alcohol quickly enough.  At this stage, the baby has a high blood alcohol concentration. It therefore lacks oxygen and the nutrients needed for its brain and organs to grow properly. White matter in the brain, which is responsible for speeding up the processing of information, is sensitive to alcohol so when a mother drinks, it affects the development of her baby’s white matter.”

Timing is another medical factor in the development of foetal alcohol syndrome. A baby’s facial features are formed during weeks six to nine of pregnancy. Scientific evidence shows that mothers who drink during this three-week window are more likely to have babies with the facial deformities associated with FAS. Damage to the baby’s organs through drinking is most likely to happen in the first three months.

 

images (2)

FASD signs and symptoms

Foetal Alcohol Spectrum Disorder (FASD) is the umbrella term used to describe the conditions that occur in people who have been diagnosed with some, but not all, of the symptoms of foetal alcohol syndrome. Like FAS, FASD is caused by a mother’s drinking during pregnancy, and it affects the way a baby develops physically and mentally. There are no accurate records of the incidence of FASD in Western countries, but experts estimate that it may be as high as one child in 100 is born with FASD (

It is more difficult for a specialist to diagnose FASD than it is FAS. This is because children with FASD may not have facial deformities. It might not be until they start going to school and interacting with others that the following symptoms – which also affect children with foetal alcohol syndrome – show up:

  • Learning difficulties
  • Problems with language
  • Lack of appropriate social boundaries (such as over friendliness with strangers)
  • Poor short term memory
  • Inability to grasp instructions
  • Failure to learn from the consequences of their actions
  • Egocentricity
  • Mixing reality and fiction
  • Difficulty with group social interaction
  • Poor problem solving and planning
  • Hyperactivity and poor attention
  • Poor coordination.

Treatment for children

GPs can refer children with FAS and FASD to community paediatricians who are likely to investigate problems further with psychologists, psychiatrists, speech and language therapists and specialists for organ defects.

Dr Mukherjee runs a clinic for children and adults over six with FAS and FASD. He diagnoses FASD by excluding similar conditions such as Attention Deficit Hyperactivity Disorder (ADHD). “Then it’s about working with the child, parents and other professionals, such as teachers, to find a management strategy for the condition,” he says. “For example, parents can learn to repeat instructions for children and use simple language and teachers should allow them more time and provide extra supervision.”

Early diagnosis is key. Research shows that people who have FAS or FASD go on to experience “secondary disabilities” – those not present at birth – which could be prevented with appropriate support. These include mental health and alcohol and drug problems. “Early diagnosis allows the stability and management that children with FAS or FASD need to be invoked earlier,” says Professor McIntosh.

Advice for mums-to-be

We don’t know how much alcohol is safe to drink in pregnancy. It depends on various factors such as how fast a mum-to-be absorbs alcohol, her physical health, diet and what medication she is on. It’s why the government advises pregnant women and those trying to conceive to avoid alcohol altogether.

If you didn’t know you were pregnant and you have been drinking above the government’s lower risk guidelines, don’t panic. Talk to your doctor or midwife about any concerns you may have. Just because you may have drunk does not mean you have necessarily done damage. If you drink a lot of alcohol  and are pregnant and find it hard to stop, talk to your doctor about getting help.

“If you drink a low amount when you are pregnant your baby has a low risk of developing FAS or FASD,” says Dr Mykherjee. “If you drink heavily you have a high risk. If you don’t drink, there’s no risk at all.”

 

HIV/AIDS and Disability

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Around a quarter of people with HIV are unaware of their infection and at risk of passing on the virus to others through unprotected sex, according to public health officials. The growing relationship between HIV/AIDS and disability is an emerging issue and cause for concern as persons with disabilities are at higher risk of exposure to HIV.

Additionally, there is a growing understanding that persons living with HIV or AIDS are also at risk of becoming disabled on a permanent or episodic basis as a result of their condition.

Like any other person, persons with disabilities require information on HIV/AIDS and access to programmes, services, and resources. In most countries, the situation of persons with disabilities is further compounded by societal barriers that hinder their full and effective participation in society, including access to education. Despite the growing relationship between HIV/AIDS and disability, persons with disabilities have not received sufficient attention within national responses to HIV and AIDS. Furthermore, existing HIV prevention, treatment, care and support programmes generally fail to meet their specific needs. Persons with disabilities are often excluded from HIV education, prevention and support services because of assumptions that they are not sexually active or do not engage in other risk behaviours such as drug use.

Sexual and reproductive health service providers may lack knowledge about disability issues, or have misinformed or stigmatizing attitudes towards person with disabilities. Services offered at clinics, hospitals and in other locations may be physically inaccessible, lack sign language facilities or fail to provide information in alternative formats such as Braille, audio or plain language.  In places where there is limited access to medication, persons with disabilities may be considered a low priority for treatment.

Women and girls with disabilities are especially vulnerable to sexual assault or abuse.  Persons with intellectual impairments and those in specialized institutions are also at particularly high risk. Around the world, children with disabilities are a large proportion of the children and persons with disabilities not enrolled in school, which results in their exclusion from vital sexual and reproductive health education that is often provided in school settings. Low literacy levels and a lack of HIV prevention information in accessible formats, such as  Braille make it all the more difficult for persons with disabilities to acquire the knowledge they need to protect themselves from being infected.

A report  by Public Health England, in advance of National HIV Testing Week, shows there are now nearly 110,000 people living with HIV in the UK – demonstrating the continuing transmission of a disease once viewed as a virtual death sentence into a manageable long-term condition.

But it warned that around a quarter of these, 26,100, are unaware of their infection and at risk of passing on the virus.

“We can’t overstate the importance of testing for HIV to ensure an early diagnosis”

Valerie Delpech

However, it noted “encouragingly” that the proportion of people diagnosed with a late stage of HIV infection fell from 57% in 2004 to 42% in 2013.

The report shows around 6% of gay and bisexual men are now living with HIV, rising to 13% in London – with 3,250 newly diagnosed in 2013, an all-time annual high.

It is estimated that over 7,000 gay men have an HIV infection that remains undiagnosed and that an estimated 2,800 men acquired HIV in 2013.

The figures underline the need to further increase both the numbers and frequency of HIV tests, which is critical to tackling the ongoing high levels of HIV transmission, said the report.

While the large majority of black Africans do not have the HIV infection, the report also highlighted the fact that one-third of the 40,000 black African heterosexual men and women living with HIV in the UK do not know they have HIV.

“There is a dangerous complacency in our society about the challenge of HIV”

Deborah Gold

Dr Valerie Delpech, head of PHE ‘s national HIV surveillance, said: “We can’t overstate the importance of testing for HIV to ensure an early diagnosis.

“In 2013, people diagnosed with HIV late were 10 times more likely to die in the first year of diagnosis, compared to those diagnosed promptly. People who remain unaware of their infection are also at risk of transmitting HIV to others,” she said.

“Knowing one’s HIV status is the key to both effective treatment, and to preventing onward transmission. This is why we are promoting the National HIV Testing Week,” she added

Deborah Gold, chief executive of the National AIDS Trust, said: “Whilst we have passed the 100,000 mark for the number of people living with HIV in the UK, there is a dangerous complacency in our society about the challenge of HIV.

“The high rates of undiagnosed HIV are unacceptable but we are failing across the NHS and in the community consistently to offer HIV tests to those who need them, especially heterosexual men and women,” she said.

Progress is possible but there is still an immense amount to do to get everyone with HIV diagnosed in good time and meet the UN 90-90-90 target of just 10% undiagnosed,” she added.

 

Helping disabled children cope with bullying

Posted on by under Childhood

Children with a disability may be bullied. If this happens, it is important that action is taken to stop the bullying. That goes without question. However we  always cannot  protect our children from the bullies  so it is important to help  them build the resilience required to prevent bullying having the devastating impact it can have on a child’s life.

The points raised below may help you in bully-proofing your child

Do

Encourage Positive Emotions – It is essential that we provide o children with opportunities to have positive emotions. This sounds simple, but it’s easy to get distracted by practicalities of parenting so that we fail to provide them with enough opportunities to be joyful. Encourage children to find pleasure and humour in life. Although we should never overlook or fail to discuss their struggles, we should consistently provide children with opportunities to develop positive emotions hope by offering them situations in which they feel confident and encouraged.

Provide Social Support – The more our children feel like they have a social support from their family, the better they will handle negative social interactions outside the home. It’s important to make time to talk to children and to just be with them. Even if a child, particularly a teenager, is resistant to confiding, don’t give up. Try to find ways to let them know that you are there for them when they are ready to open up.

An extended family circle is also beneficial. Many children aren’t comfortable talking to their parents about certain things, but they may have a relative or family friend who they trust. The same holds true for their friendships with children who have a positive influence on them.

Even a child who is isolated from peers will do much better with family support. As he or she struggles to make friends, you can be helpful by exposing them to positive social situations: i.e. volunteering with them, taking them to community events, or participating in activities with friends of ours who have children around the same age. It is important to facilitate the forming of these social connections without being critical or providing too much pressure.

Find an Area of Interest– Helping children to find something that interests them and that they can excel in is a gift that can shape their lives.  Get them involved in activities that help them feel good about themselves. Provide them with a variety of opportunities to find what specifically appeals to the. It is important to support them in their excitement. It is also important not to confuse false praise with encouragement. Children can tell the difference, and they often feel confused when our compliments don’t match their accomplishments.

Teach strategies for coping with stress – Children must be taught how to calm themselves down when distressed or feeling aggressive. We can teach them to be aware of themselves and their emotions, while learning to regulate their reactions. It is important to help them develop the ability to remain calm, even in the face of bullying. The ability to see what is going on in their own minds and the minds of others will help children to recognize their own reactions and understand others better, so they can more effectively cope with bullies.

Promote Problem Solving Skills – To equip children with invaluable problem solving skills, we must show them how to be flexible in their responses. If a child faces a challenging situation, it is important to sit down with them and encourage them to think about the many possible courses of action available and which will yield the most benefit.  If, for example, they endure teasing from a friend, what can they do? Is revenge really the best option? Can they joke back and not “take the bait?” Does ignoring it really solve the problem? Should they talk directly to the friend about how the teasing makes them feel? Is it better for an adult to be present in the conversation?

We can teach our children to always ask themselves, how can I get help? How can I get more l support? And remember, the more adaptive we are in dealing with our own problems, the more adaptive they will be with theirs.

Orient Them Toward Future – Part of ensuring our children stay hopeful involves orientating them toward the future. Helping them plan for their future doesn’t necessarily mean knowing what college they want to get into or how many children they plan to have. It also doesn’t mean helping create a fantasy of a future that could never exist. It is more a matter of helping them focus on their real, everyday goals, such as a desire to visit a certain city or learning to drive a car. It can be a matter of making them aware of a heroic person who inspires them or introducing them to new situations that open them up to new ideas and opportunities.

Columnist Dan Savage started the “It Gets Better Project” to encourage struggling young people to have faith that they can get through bullying and adversity and one day enjoy a happy and fulfilling life. This message is one from which every adolescent can benefit. Teaching children that the future holds brightness and possibility is a lesson that can lift them through low times.

Lead by Example – In each of the previous suggestions, it is vital to lead by example. Telling children what to do and how to behave will rarely influence them as much as showing them how to handle difficult situations. Exposing them to the constructive approaches we take in finding solutions to problems in our lives encourages them to handle matters in a similar way. We should always aim to act in a way that is consistent with our values and provide our children with a model to do the same.

Don’t

Support Maladaptive Thinking – Negative thoughts contribute to a child’s insecurities and low self-esteem. Allowing our children to focus or dwell on a perceived weakness or negative trait is not constructive. Instead, encourage them to challenge their hostile self-criticisms and self-attacks. This form of maladaptive thinking, which is referred to as the “critical inner voice,” will lead a child to feel mentally defeated and victimized by circumstances.

The critical inner voice can contribute to stress, anger, and depression. It can make children gravitate toward activities that leave them feeling bad and avoid those that make them feel good. It may, for example, encourage them to be isolated, “Don’t leave your room. No one out there wants to see you.” It can encourage them to act out, “Why even go to school? You’re too stupid to learn anything anyway.” Allowing children to indulge in reflecting or acting on these critical inner voices can have harmful effects. Instead, encourage them to identify these negative thoughts and challenge them in their actions. Conquer Your Critical Inner Voice, a book I co-authored with Dr. Robert Firestone and Joyce Catlett, provides exercises for identifying and challenging this critical inner voice.

Be Critical, Coddling, or Ignore Issues – We all know the importance of supporting our children in new challenges. However, when our children take on something new to them, it is often hard to find a balance between pushing them too hard and doing too much for them. Ideally, we should try to put them in slightly novel situations in which they’re slightly uncomfortable and we’re there to back them up. We don’t want to over-push our children, leading them to feel abandoned or afraid. In this same way, we don’t want to overprotect them by speaking for them or stepping in too often, which teaches them to feel dependent or helpless. Most importantly, we should never pretend not to notice that there is a problem. Ignoring the fact that our children are struggling will only leave them feeling more alone than ever.

Dwell on the Negative – When a child goes through a negative experience, it is important to give them the platform to talk about it. Encourage the child to express what happened and how it made him or her feel. We can help children resolve any traumas they experience by reframing the experiences, so they can learn from them. This is not to say we should attempt to alter reality or ignore the fact that they were hurt by something. However, the more people mull over painful events or tell themselves stories about being victims, the worse off they are in terms of building resilience.

It is really unhelpful to promote the idea that the world is unsafe or that change is not possible. Instead, we should tell our children positive uplifting stories about our own challenges. “I used to be so shy that I sat alone every day at lunch. Then one day, I made a friend at school, and slowly I started to feel more and more comfortable talking to him. Then I grew more comfortable talking to other children. Eventually, I had a close group of friends who never made me feel embarrassed or shy.”

Avoid Dealing With Painful Events -When a traumatic event occurs, we shouldn’t encourage children in engaging to simply steer clear of anything that reminds them of the occurrence. For example, if a child was once bullied on a certain street, while carrying a certain backpack, we should help them to talk about the experience and help them process their reactions to it. Having them just take another street or throw away the backpack won’t resolve the experience in their minds. In fact, avoidant coping strategies will make them less resilient.

Never avoid talking about painful events. One of the biggest challenges in stopping bullying is that many children fail to disclose incidents in which they were abused. When we encourage our children to talk about bad things that happen to them, we help them make sense out of these experiences. Memories that are not made sense of by being expressed as a coherent narrative can have negative effects on children later in their development. They may start to show behaviour problems, increased fears, stress or anger, and become less social. Creating a coherent narrative helps make meaning out of experiences and form a sense of personal agency and closure.

So even if we are not able to protect our children from the bullies we can help them build the resilience required to not allow bullying to have the devastating impact it is capable of having on a child’s life. And this will provide them with an essential coping tool they can take with them into adulthood.

 

Mothers of autistic children in crisis. The need for better services

Posted on by under Adulthood, Childhood

In the UK and in other counties, public services are being cut. The cuts are made  to decrease national debts and to cut taxation because political parties want to be seen as making tax cuts to win over voters. Cuts in services have the greatest impact on the most vulnerable people. Amongst these are the mothers of  those severely autistic children. whose behaviour is challenging Fortunately few mothers end up in such crises that they kill or attempt to kill their child, but many live in fear of aggression and with too little support. The father of the child is often absent from their lives.

This post is to highlight two things:

  • the need for good educational and behavioural management services for autistic children from the time they are very young. These services decrease the frequency and severity of behaviour which will become increasingly difficult to manage as the child gets bigger;
  • the need for effective  support, respite and residential services for young people and adults whose needs are greater than their families can provide.

Without these services more tragedies will happen. Some will be dramatic, others the undramatic dreading of each new day.

‘I was told my autistic son exhausted all the services when he was a teen, including the state mental institution after which he was returned home to my care. At times I feared for my life. I feared for the lives of my other children. I was only told my son had failed all the services my county had to offer and that I should call the police when he became violent’

 

A 6-year-old autistic child from Newport, Oregon, died after his mother, Jillian McCabe, allegedly threw him off of the Yaquina Bay Bridge. McCabe called police Monday night and admitted she had killed her son London McCabe, and the boy’s body was discovered in Yaquina Bay shortly afterwards. Jillian McCabe, 34, of Seal Rock appeared in Lincoln County Circuit Court  for a preliminary hearing on charges of aggravated murder, murder and first- and second-degree manslaughter. A motion is expected to be filed later by Jillian McCabe’s attorneys to request a determination on her fitness to proceed, court records show.

 

Kelli Stapleton pleaded guilty to trying to kill her child by carbon monoxide poisoning, and was sentenced to between 10 and 22 years in prison. She has previously  blogged about her struggles with care and treatment for her daughter, Isabelle, She pleaded guilty to shutting herself and her daughter, then 14, in a closed van with two lighted charcoal grills. Although found unconscious, both recovered.  The plea to a charge of first-degree child abuse averted a trial for murder and led to a three-day sentencing hearing. Supporters urged leniency for their friend who, they and Stapleton’s former husband have said, was beaten and hospitalised as a result of her daughter’s increasingly violent outbursts.

Gigi Jordan was convicted of manslaughter in the first degree for giving her 8-year-old son Jude, who suffered from autism, a fatal dose of prescription pills . She faces 5 to 25 years in prison. Her defence team managed to convince the jury with a strange tale, claiming Jordan had been trying “to save [Jude] from a life of sexual torture” at the hands of his birth father. Jordan said her husband at the time was plotting her murder, and she didn’t want the boy to end up back with his abuser. Both men denied the allegations. The prosecution argued that Jordan killed her son, who was nearly non-verbal, because of his severe autism.

 

‘You guys do not have a clue. I want to kill my son! Yes I want to get help but let’s be real there is no real help any more. There is no help because there is no money in our agencies to help. Thank you all who keeps the tax cut stuff going. You have destroyed the safety net for people with mental illness. The only treatment I have been able to find for my 29 year old son is a day program that offers some group therapy. For me it’s just a babysitting service. My son is mentally ill, autistic, and mildly retarded with rage issues. He is 6′ and 240 lbs. He is mean.. My family has  drifted away because of his behaviour. I am in fear of my own safety. So yes I want him dead or gone. I have even thought about putting him out on the street in an unsafe area of a major city near me and just let the streets take care of him. He will piss off the wrong  person and he will be dead.’

 

 Health officials say the murder-suicide of a Canadian mother and her autistic son should serve as a wake-up call that drastic changes need to be made within the system.The bodies of 40-year-old Angie Robinson and her 16-year-old son Robert were found inside their home in Prince Rupert, British Colombia.Robert could not speak and would often express his frustration by head-butting walls and people and pushing and shoving his mother.A suicide note left  and her final Facebook post, showed his mother  felt she could longer manage  Robert and that Family Services could not provide adequate support.

Causes of learning disabilities and their impact on health

Posted on by under Adulthood, Birth and Babyhood, Childhood, Pregnancy

The World Health Organization (WHO) has defined learning disabilities as a state of arrested or incomplete development of mind. Somebody with a general learning disability is said to have a significant impairment of intellectual, adaptive and social functioning. A learning disability is not acquired in adulthood and is evident from childhood.

The term general learning disability has now been recommended in the UK to replace terms such as mental handicap or mental retardation. A child with a general learning disability or intellectual impairment finds it more difficult to learn, understand and do things compared with other children of the same age. The degree of disability can vary greatly, being classified as mild, moderate, severe or profound.

General learning disability is different from from specific learning difficulty such as dyslexia which means that the person has one difficulty such as in reading, writing but has no problem with learning in other areas.  It is characterised by generally poor performance in tasks such as learning, short-term memory and problem solving.

People with intellectual disabilities have an increased prevalence of health problems and their health needs are often unrecognised and unmet. For example, anxiety disorders are the most prevalent of the major mental illnesses and are present in 15–20% of the population but for people with intellectual disability, the prevalence of anxiety disorders has been shown to be much higher, particularly for hose with a mild to moderate intellectual disability. This is likely to be because they are aware that they are functioning less well than other people and because they find it significantly harder than others to cope with the demands of everyday life Anxiety disorders in people with intellectual disability can often be overlooked. Communication difficulties may make it harder for the person to describe their feelings and fears. Their difficulties may result in aggressive or destructive behaviour when they find situations difficult to cope with or are trying to avoid something which they find stressful

Although life expectancy is increasing, with people with mild learning disabilities approaching that of the general population, the mortality rates among people with moderate to severe learning disabilities are three times higher than in the general population, possibly due either to the impact of the cause of the disability, complex additional physical difficulties or because of less effective health care than the general population. The median age at death for people with learning disabilities is about 25 years younger than for those who do not have learning disabilities.

A classification of mild, moderate, severe and profound has been used to describe the degree of learning disability. However, this classification is in many ways inappropriate because each person with general learning disability must be assessed and treated as an individual. A person’s degree of intellectual impairment provides very little information about a person’s social, educational and personal needs, and the kind of help and support

About 2% of the population is estimated to have an intellectual impairment. It has been estimated that 1,191,000 people had learning disabilities in England in 2011, including: 286,000 children (180,000 boys, 106,000 girls) aged 0-17. As all children are assessed and monitored in infancy and all children attend school, it is likely that all or almost all of these children are receiving services to support them and their families

However of the 905,000 adults aged 18+ (530,000 men and 375,000 women), estimated to have an intellectual impairment only 189,000 (21%) are known to learning disabilities services. This means that the vast majority of adults with an intellectual impairment are not receiving services which would provide support for them and their families

The population for people with learning disabilities shows a sharp reduction in prevalence rates after age 49 due to reduced life expectancy. A sharp increase in prevalence for those under 20 may reflect increased survival rates among more severely disabled children.

The number of people with intellectual disabilities increased by 53% over the 35-year period from 1960 to 1995 as a result of improvements in socio-economic conditions, medical  care  and access to services for children

The causes of intellectual impairment include:

Genetic disorders such as Down’s syndrome, fragile X syndrome, Klinefelter’s syndrome and Turner syndrome

Metabolic disorders such as Tay-Sachs disease, Gaucher’s disease, Niemann-Pick disease) and Hurler’s syndrome.

Nutritional deficiency such as iodine deficiency.

Damage caused before the child is born by infections such as rubella; or by drugs or alcohol.

Damage caused during labour by prolonged labour, trauma, and deprivation of oxygen

Accidental or non-accidental injury, severe infections, poisoning or malnutrition   in infancy or childhood

For many people with an intellectual impairment there is no known cause

Autism spectrum disorders, sexuality and relationships

Posted on by under Adulthood

Autism spectrum disorders (ASD) are social communication difficulties which affect a person’s ability to understand socially appropriate behaviour. Therefore individuals with the condition are not necessarily aware, of or constrained by, the social rules which are observed by those who do not have an ASD. This presents difficulties for their development of sexual identity, sexual orientation and generally accepted sexual behaviours. These difficulties in turn influence the individual’s opportunity and availability for romantic and intimate relationships. Individuals with autism spectrum disorder typically have few or no friends and find it difficult to understand or follow the unwritten rules of sexual and relationship behaviour. They may engage in unacceptable behaviours in attempting to initiate romantic relationships and persist in pursuing a relationship even when it is very clear that the other person is not interested. This may lead to allegations of pestering, inappropriate physical contact or stalking.

People who have an ASD also have difficulties seeing situations from another person’s point of view. This can mean that they are unable to consider another person’s feelings, or they may think this person feels the same way as they do. For example, an individual with an ASD may have seen people kissing in the street; later they might approach someone they like, either someone known to them or a stranger, and kiss them. This might cause embarrassment or offence to the intended person, and their reaction may cause confusion and disappointment for the individual with autism. Perhaps they expected a more positive response: to be kissed or hugged back, as they saw happen with the couple on the street. Such examples demonstrate the complexities of socially appropriate behaviour. Individuals on the autism spectrum may need to be steered and supported by those around them to remember not to act on their impulses.

Several other characteristics of people with ASD interfere with the capacity to develop adult social relationships, which are necessary for developing sexual, intimate relationships.
Most significant is difficulty with social judgment, for example, missing nonverbal communication, poor eye contact, theory of mind (one’s ability to perceive how others think and feel, and how that relates to oneself) problems, and flexibility in responding to another person or situation. Lack of experience in peer relationships prevents the development of the usual ways through which adolescents learn about sexuality – from each other and from experimentation. Poor decision-making skills make it difficult to maintain the everyday details of a relationship, such as initiating dates, or remembering plans. Lack of flexibility and self-absorption, create significant areas of conflict in a potential relationship. Unregulated emotions, resulting in feelings that are too intense, or possibly misplaced, together, with a lack of awareness of the other’s response can prevent a relationship developing or quickly bring one to an end.

Many people with ASD have little self-awareness and do not understand their impact on others. People with ASD may have little knowledge about themselves. Part of what helps us create a sense of self is the ability to create an internal autobiography. People with ASD have difficulty in this area, as they frequently cannot describe their own emotions or are unaware of what they are feeling
or have difficulty controlling their emotional responses. As a result, many people with ASD lack the ability to understand themselves or respond to the social context around them. Self-advocacy, a crucial skill for maintaining one’s function in daily life, is something that can be very difficult for a person with ASD to learn. The ability to maintain personal safety without awareness of the environment or the behaviours of others can pose a significant danger.

People with ASD, either as a result of these difficulties or due to a true lack of social interest, can turn away from others into their own world. Self-absorption fosters another type of social disability. The need for aloneness or “down time” may be greater than the need to be with others, which may seriously jeopardize an attempt to relate to others in a more than superficial
manner. People with ASD frequently have little to no desire in sharing an all-consuming interest with others or attending to the interests of others, since there can be a lack of ability to detach from the area of interest without anxiety or distress.

The need for sameness and rigidity in daily routines may supersede one’s ability to flexibly respond to another person, for example, being unable to eat at another restaurant when only two specific restaurants are in that person’s repertoire.

Sensory sensitivities, such as the inability to tolerate touch or other physical sensations, sound sensitivities, or food texture issues can cause dating to be fraught with problems Such sensitivities can create intolerance of what may be considered part of the normal world. For example, sensitivity to sound may prevent someone with ASD from engaging in activities where airplanes may be heard overhead or babies may be heard crying. Sensitivity to touch can be especially difficult in relation to others, as those with ASD may not tolerate someone touching their skin or attempting to hug them. Heightened sensitivity may also affect the choice of clothes for someone with ASD, who may be un‐
able to wear clothes with sleeves or stripes made of particular materials,

Executive function impairments (impairments in decision-making skills, cognitive flexibility, impulse control, organizational skills, and planning) create another layer of social difficulty. Awareness of the passage of time may be compromised for someone with ASD and is an essential component of everyday function. Everyday memory problems or the ability to remember to plan and organize daily life activities can create social havoc. The ability to problem solve, make informed choices, or plan for the future becomes problematic.

All of these challenges are magnified when a person with ASD attempts to have an intimate emotional and perhaps sexual relationship. Intimacy is the sharing of emotional, cognitive, and physical aspects of oneself with those of another. A prerequisite for intimacy is the establishment of a firm sense of self-identity. Intimacy requires the flexibility to loosen one’s identity in order to feel the pleasure of merging with one’s partner in an emotional and physical connection. For all of the reasons above, a person with ASD may be unable to share with another or may be limited in his or her ability to do so.

There are various books which explain about forming relationships, for example the FPA book Talking together…about sex and relationships which describes how people make friends, become closer, become boyfriend and girlfriend, and eventually decide they would like to have sex with each other.

Fitzgerald, Harpur and Lawlor describe making friends at university, dating and how to be considerate towards other people’s relationships in their book Succeeding in college with Asperger syndrome. Luke Jackson provides some dating tips in his book, Freaks, geeks and Asperger syndrome, which have been suggested by his teenage sisters. There are also social skills or social groups in some countries which individuals with an ASD might like to attend.

People with Autistic Spectrum Disorder and Crime

Posted on by under Adulthood

People with autism spectrum disorder (ASD) may have characteristics that could make them both more likely, and less likely, to break the law. On the one hand, they may have trouble with aggression, controlling strong emotions, and understanding other people’s perspectives. They may have challenging behaviours that could attract police attention. However, they also tend to find rules helpful and follow them precisely , and laws are simply rules that they could be expected to follow.

 


Several research studies have found either no link between autism and violent crime, or could not reach a conclusion about a link. A Danish study found that people with Asperger’s Syndrome (a form of high-functioning autism) were no more likely than the general population to commit a crime; those with classic autism and “atypical autism” were less likely than other people to commit crimes.
Research on violent criminals with high-functioning ASD found that the offenders may have deficits in moral reasoning, understanding other people’s perspectives, and emotional control. These deficits could, potentially, reduce their responsibility for crimes they commit in some cases.

However, as the number of individuals with autism has dramatically increased in the last twenty years, so too have autistic defendants in criminal proceedings in proportion to the increase in overall numbers. Such cases are extremely challenging to the criminal court system because autistic individuals’ motivations, perceptions, and intentions are often difficult for courts to understand. Questions of mental capacity and criminal intent are particularly challenging. Communication difficulties and problems in recognising social signals may place people with ASD at a disadvantage when questioned by police. They may not be able to tell if an investigator is lying or manipulating them. As a result, they may make a false confession or fail to protect their legal rights.

Similarly, courts may fail to understand what prison sentences mean for autistic individuals. The issue of autism in criminal courts is likely to grow in significance as the large population of autistic children become adults. The kinds of criminal cases range from assault to murder and from charges related to child pornography to possession of weapons without license. Many of these criminal cases highlight the complex and disturbing ways in which criminal law is interfacing with the world of autism.
Despite the public interest in people with autism as criminals, they are more likely to be victims, according to experts. Children with disabilities are about three times more likely to be the victims of abuse or neglect than nondisabled children. Children with autism are bullied more often than other children, although they can occasionally be bullies themselves, according to research by the Interactive Autism Network.

Most of the legal contact that individuals with autism have is as victims.