Autistic individuals are at greater risk of experiencing Adverse Childhood Experiences (ACEs) and other forms of trauma throughout their lives. Those Autistics with higher support needs and who can not reliably speak may be at greater risk. There’s a saying in the community of Autistic adults: “We don’t know what Autism without trauma looks like.” Studies have shown that Autistic people are more likely to experience incidents as trauma, more likely to be victims of trauma, and are more likely to develop PTSD.
Types of trauma:
Trauma can come from a single event. It can be chronic or occur repeatedly over time. It can also be complex in that a person experiences multiple traumas over time in various situations or pervasive and constant in such a way that influences typical development.
Sources of trauma:
For decades, the goal of Autism intervention has been to make Autistic people act like they aren’t Autistic. Being encouraged to deny and divorce yourself from who you are comes at a cost. For non-speakers with difficulty controlling their bodies, it isn’t possible. However, they know what behaviors are desired, and being unable to meet those expectations at any time causes guilt and shame. Other sources of trauma include but are not limited to:
Bullying by peers
Bullying by professionals and caregivers
Forceful treatment interventions that include restraint
Emotional neglect
Physical neglect
Physical abuse
Verbal abuse
Sexual abuse
Addressing trauma in non-speaking Autistics
Some trauma can be caused unintentionally by parents, caregivers, or professionals. This can include attempting to expose an Autistic person to a sensory trigger to desensitize them without understanding that this is not likely to happen and doubly so when forced. Most abuse is perpetrated by caregivers or people paid to provide care or a service to the Autistic child or adult. Anyone who has access to an Autistic non-speaker one-to-one can abuse them. Most sexual abuse encounters take less than 10 minutes and can be as fleeting as a few seconds.
Anyone can be the source of trauma
Anyone can be an abuser including other children
Signs of trauma: Signs of trauma in Autistic people can be difficult for non-Autistic families and professionals to spot because they often mirror Autistic and ADHD traits or expected ones. Unfortunately, many of the common problem behaviors associated with Autistic people are actually Autistic people’s trauma responses that are identified only as being a part of Autism.
Behavior changes:
Withdrawal
Fearfulness
Refusal to return to environments without trusted caregivers or at all
Self-harm or an increase in self-harm
Aggression or an increase in aggression
Sexual acting out behaviors
Reluctance to get undressed
Sudden fearfulness of strangers, or public spaces
Regression of skills such as any speech they previously had, toileting
Separation anxiety
Increase in repetitive behaviors
Inability to cope with situations they previously could (decreased ability to mask)
Increase in emotional lability or explosive outbursts
Somatic signs
Becoming ill when returning to a place they commonly go
Developing headaches, stomach pain, or new and repetitive GI issues
New trouble sleeping
Nightmares
Heart racing without physical exertion
More sensitive startle response than usual
If you suspect trauma in a non-speaker, here’s how you can help:
Never stop attempting to find a communication method that works for them. Many non-speakers for motor disorders and training the body to perform new skills is exceedingly difficult. Provide access to a method that is open-ended like writing, typing or a pointing to spell method like Spell to Communicate. Healing from trauma without being able to talk about the lingering issues is extremely difficult. There are other actions you can take to support healing.
2. Learn about trauma-informed care and parenting and implement it across their lives. Trauma-informed approaches include:
Creating safety
Earning trust
Empowering the individual
Leveling power differences and allowing autonomy and collaboration
Accountability and responsibility for any mistakes
Offering access to peers for support if appropriate (this can be in the form of books written for children featuring children recovering from trauma)
You can learn more about trauma-informed approaches here https://www.traumainformedcare.chcs.org/what-is-trauma-informed-care/
3. Prevent further trauma. Protect the Autistic person from trauma from old and new sources. Do not trust a person you suspect of mistreating them a second time. Pay attention to who they react to. How an Autistic person responds to others is not predictable and they may not respond the way you expect to a dangerous person, but they will have a response. Pay attention and make changes as needed. A best practice is to have the Autistic person be cared for in a setting with more than one trusted adult. Ask about how bathroom breaks are handled at school. Ask for 2 people to do this task for everyone’s comfort and safety.
4. Talk to them about trauma and abuse. Explain what actions are abusive. You can explain this in age-appropriate terms.
5. Talk to them about trauma responses. Explain that people who are victims feel complex feelings of sadness, emotional pain, worthlessness, guilt, or shame. Explain that these feelings are normal, but the worthlessness, guilt, and shame are not deserved.
6. Focus on self-esteem and anti-ableism. Explain that they are not worth less because of their disabilities. Some Autistics will have been told this by bullies or abusers and they need to repeatedly hear contrary messages of love and acceptance.
Here’s an example script:
One in every four people have disabilities. It’s a normal part of life. And there are times in most people’s lives when they are temporarily reliant on others such as when they are children, elderly, pregnant, injured, or ill. Your needs are just as important as anyone else’s. Being disabled is not a bad thing. You aren’t a burden. You are so loved.
Regularly offer honest praise and affirm your relationship’s importance. Many Autistic people are sensitive to rejection. Non-speakers are no different even if it isn’t obvious in the same ways. Note: the focus on raising self-esteem should be a daily activity. Read affirmations, talk about your genuine positive feelings, and maintain healthy boundaries.
7. Co-create a routine with the Autistic person. Routines and predictability create comfort and a sense of safety, but be mindful that about half of Autistic people also have ADHD and crave novelty. You will likely know if this is the case for the individual. If they crave novelty, they may enjoy a hybrid of a predictable routine with a novel experience on a predictable schedule. Preserve the routine as near sacred.
8. Indulge the Autistic person in pleasant sensory experiences based on their preferences.
9. Indulge the Autistic person in their special interests. Special interests lead to joy. They may also be a source of a hobby or vocation in some cases, but the goal is joy.
10. Incorporate meditations. Listen to guided meditations or read them from a book. It’s best to use sources that are trauma-informed because being mindful when you are having a PTSD episode can be harmful. Read here for more information https://psychcentral.com/health/trauma-informed-mindfulness#clinical-practice
11. Offer access to creative pursuits. Creating paintings, drawings, or even playdoh sculptures is therapeutic.
12. Offer access to physical exercise. Trauma is held in the body and movement helps to release it.
13. Offer access to books on trauma, recovery from trauma, and books on Autistic experiences by Autistic people. This may mean reading aloud or listening to books on audio. There are dozens of books written by non-speakers that can be found here: https://autismbooksbyautisticauthors.com/non-speaking-authors/
14. Be prepared for some emotional experiences. Trauma is going to come out and it’s not going to be neat. Your ability to stay calm in the middle of inexplicable meltdowns creates a safe space for healing from trauma you may not know about.
15. Circle back to communication. The Autistic person in your life with fair better at processing trauma if they are able to share what happened and how they feel about it.
Helping a non-speaking through trauma recovery is a trying and wholly worthwhile effort. Come back to this list regularly and keep working on communication.