Trauma, Poverty, and ASD

Living with Autism Spectrum Disorder (ASD) can present unique challenges, especially as it pertains to experiencing trauma and living in poverty. Recent research suggests that individuals with ASD are at an increased risk of experiencing adverse events, which may lead to trauma or PTSD, compared to those without ASD (Lobregt-van Buuren, E., Hoekert, M., & Sizoo, B., 2021). Additionally, it has been found that “the probability of reporting one or more [ACEs] was higher in children with ASD compared to children without ASD, and this difference is especially pronounced in lower income families.” (Lobregt-van Buuren, E., Hoekert, M., & Sizoo, B., 2021).

For information on the interaction between poverty and trauma, visit this blog: Trauma and Poverty

Due to the complexities of ASD, there is often an underdiagnosis and undertreatment of trauma and symptoms of adverse events among individuals with ASD. This blog post will outline information collected by Ella Lobregt-van Buuren, Marjolijn Hoekert, and Bram Sizoo in Chapter 3: Autism, Adverse Events, and Trauma of the book Autism Spectrum Disorders. 

Lobregt-ban Buuren, Hoekert, and Sizoo (2021) discuss that the underdiagnosis and undertreatment of trauma and adverse events in individuals with ASD can be partially attributed to the unique symptoms and communication challenges associated with ASD, including the following: 

 

• Stressful Events Not Meeting DSM-5 Criteria for PTSD

There are certain adverse events that can be traumatic to individuals with ASD, but do not meet the criteria outlined in the DSM-5 for diagnosis of PTSD. A very common adverse event experienced by some individuals with ASD that does not qualify for a PTSD diagnosis is bullying. 

 

• Differences in Sense-Making

Individuals with ASD may perceive adverse events differently from others without ASD, potentially causing them to experience an event as traumatic when it is not perceived as traumatic for someone without ASD. 

 

• Limited Recognition of Unsafe Situations

Individuals with ASD may find it difficult to recognize when a situation is unsafe. If a potentially traumatic event goes unrecognized as unsafe, it will not be spontaneously shared with a caregiver or someone who can help and therefore makes it difficult to identify traumatic incidents. 

1. Diagnostic Overshadowing: when symptoms of trauma are attributed to ASD rather than symptoms from a traumatic or adverse event. 

There are several instances in which symptoms of trauma can look like characteristics of ASD. Some include the hyperarousal seen after experiencing a traumatic event which can be conflated for hyperactivity seen in ASD. Another example is emotional or social detachment experienced with PTSD that is conflated for deficits in social-emotional reciprocity in ASD. 

By understanding the unique challenges individuals with ASD face, caregivers and clinicians can work together to identify and provide appropriate support for those who have experienced adverse events and trauma. One particular intervention that has been created specifically for individuals with ASD to assess and identify trauma is called The Interactive Trauma Scale. This tool allows individuals to self-report on their experiences with trauma or adverse events, since research suggests that parent and teacher reports miss information on an individual’s experience and symptoms with trauma (Thornton, 2019). While this field of research is emerging, it may be comforting to know that research is being conducted to help develop interventions that address the specific needs of individuals on the spectrum who have experienced trauma. 

Please seek the help of a mental health professional if you or your child are experiencing negative mental health concerns following the exposure to a traumatic experience or set of circumstances.

References: 

Lobregt-van Buuren, E., Hoekert, M., & Sizoo, B. (2021). Autism, adverse events, and trauma. Autism Spectrum Disorders, 33–42. https://doi.org/10.36255/exonpublications.autismspectrumdisorders.2021.trauma 

Thornton, L.. (2019). Identifying trauma in children with autism. Kennedy Krieger Institute. https://www.kennedykrieger.org/stories/potential-magazine/fallwinter-2019/identifying-trauma-children-autism