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ASPartOfMe
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12 Jun 2023, 2:53 pm

Why Emotional Regulation Is Hard for Autistic Children

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More and more, the experiences and perspectives of autistic individuals are contributing to our understanding of neurodiversity, beyond the limits of the observable characteristics (usually by neurotypical researchers) that dominate the Diagnostic and Statistical Manual for Mental Disorders' (DSM) criteria for autism. One example is Chamak et al. (2008)’s analysis of autobiographical writings of autistic individuals, together with interviews, in efforts to explore their narratives relating to their inner experience.

Chamak et al. found that unlike autism's diagnostic criteria included in the DSM-5 (a dyad of challenges with social communication and restrictive and repetitive patterns of behavior), participants in their study described challenges with emotional regulation, along with others related to atypical perception and information processing. The researchers conceptualized the above variables as two overlapping circles that interrelate and influence one another.

Atypical perception and information processing include variables such as sensitivities to sensory information, a unique understanding of implicit social rules, finding adapting to transitions challenging, or a preference for detail focus and enhanced discrimination of differences, to name a few.

Statistics relating to high percentages of comorbid symptoms of anxiety and depression in autistic children make emotional regulation a priority for this population. The majority (67 to 79 percent) of children on the spectrum experience comorbid symptoms of anxiety and many (42 to 54 percent) depression (Mayes et al. 2010). Emotional regulation challenges are correlated with social and behavioral challenges (Mayes et al., 2011) and maladaptive externalizing and internalizing strategies such as aggression and self-harm (Folstein, 2012).

Guy et al. (2014) defined emotional self-regulation as a “complex and multifaceted construct that involves physiological, behavioral, and cognitive processes, which allow an individual to monitor, evaluate, and modify emotional reactions to accomplish one’s goals.”

In addition to the above-mentioned information processing characteristics, biological processes associated with emotional regulation include neuro-inflammatory reactions, atypical neurotransmitter activity, or altered brain structures (i.e. the amygdala). While some magnetic resonance imaging (MRI) studies found decreased volume of the amygdala in autistic adults (suggesting “underdevelopment of neural connections of limbic structures” (Shuid et al., 2020)), others found enlarged volumes of the amygdala and hippocampus, suggesting increased activity within these structures (associated with emotional and social challenges (Shuid et al., 2020))

Pitskel et al. (2010) found a relative lack of prefrontal-amygdala connectivity in autistic individuals when downregulating disgust emotion, in comparison to neurotypical peers, and a lack of modulation of insula. The authors implied that these findings suggest potential downregulation challenges for autistic individuals.

Another notable biological process associated with emotional regulation is a decreased respiratory sinus arrhythmia (RSA) in autistic school-aged children (Guy et al., 2014), a measure of heart rate fluctuations associated with the activity of the parasympathetic nervous system. The authors suggest that decreased RSA implies potential challenges for autistic individuals with downregulating internal states.

Strategies for Nourishing Emotional Regulation
A classic therapeutic strategy for addressing mental health concerns in autistic young persons, one that boasts the strongest research evidence, is cognitive behavioral interventions (CBI).

Wong et al.’s (2014) Evidence-Based Practices for Children Report lists CBI as a key evidence practice for addressing mental health challenges in autistic young persons. They suggest that cognitive behavioral interventions are helpful for use in “conjunction with other evidence-based practices including social narratives, reinforcement,” and can target a wide variety of emotions. CBI strategies explore cognitive processes and interpretations. They expand individuals’ awareness of their inner beliefs and thoughts, and how these impact their emotions.

An example of a CBI strategy is paying attention to thoughts and beliefs at times of experiencing a challenging emotion.

n addition to CBI, mindfulness has also been an effective strategy for supporting autistic young persons with emotional regulation. Mindfulness interventions target a variety of components such as nurturing present-moment awareness, naming feelings, practicing inner compassion and non-judgment, as well as making use of self-observation (Baer, 2006).

Despite many encouraging preliminary results, there are unfortunately insufficient meta-analyses (to date) that evaluate the effectiveness of mindfulness as a strategy for emotional regulation for autistic young persons, due to small and varied sample sizes as well as limited control groups, to establish mindfulness as an evidence-based practice alongside CBI.


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AardvarkGoodSwimmer
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12 Jun 2023, 8:05 pm

“Another notable biological process associated with emotional regulation is a decreased respiratory sinus arrhythmia (RSA) in autistic school-aged children (Guy et al., 2014), a measure of heart rate fluctuations associated with the activity of the parasympathetic nervous system.”

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Maybe the reason that some social interaction leaves us rather blah? ? (or one of the reasons)



CockneyRebel
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13 Jun 2023, 10:16 am

I'm over 40 and I still have a hard time with emotional regulation.


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Greyeagle
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23 Jun 2023, 4:20 pm

As a child, my emotions were all over the place. I was embarrassed at my own behavior around others. I was undiagnosed until my 60s, so of course I had no idea back then I would have been considered autistic. I was very intelligent and logic oriented, so having frequent emotional outbursts was not acceptable to me. Star Trek's Mr Spock became my role model and I thoroughly "got control" - to the point where even now, my emotions are so far in the background that I am usually unaware of them. Until they hit me like like a ton of bricks out of nowhere.



Edna3362
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23 Jun 2023, 4:23 pm

The only trait out of everything else that I want to get treatment and hopefully rid of.

Fixing EF issues can indirectly fix this particular issue.
Yet fixing this particular issue that I have meant I'd likely work around the rest of the EF issues altogether than wasting my time being an 'immature brat' over feelings.


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SharonB
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24 Jun 2023, 2:22 pm

Yep, at 50 I remain easily (over)stimulated and it builds. Sometimes I am not aware that I am agitated about something until it comes to my attention it's obvious. I probably could build into my schedule to do an assessment and consciously "come down".



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24 Jun 2023, 4:01 pm

And the upset, whatever it was, lasts for a long time. I’ve noticed that I am processing, reviewing and feeling bad about an interaction the other person forgot quickly.


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MuddRM
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24 Jun 2023, 6:40 pm

I usually lose it depending on what music I’m listening to at the time. For example, I usually lose it listening to Puccini’s La boheme or Madama Butterfly (which are tearjerkers to begin with), or I start reminiscing about my Shetland sheepdog (who Mom had put down 1 week after we buried Dad) or my basset hound.

I’ve been having even more issues since be evicted from what’s now my brother’s for having bad reactions to SSRI, as well as SNRI. I was told, in no uncertain terms, by my brothers my reactions to these medications were what killed my mother, and I was responsible for her death. I get reminded of that every time I try to speak to my brothers.



MuddRM
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24 Jun 2023, 7:03 pm

I usually lose it depending on what music I’m listening to at the time. For example, I usually lose it listening to Puccini’s La boheme or Madama Butterfly (which are tearjerkers to begin with), or I start reminiscing about my Shetland sheepdog (who Mom had put down 1 week after we buried Dad) or my basset hound.

I’ve been having even more issues since be evicted from what’s now my brother’s for having bad reactions to SSRI, as well as SNRI. I was told, in no uncertain terms, by my brothers my reactions to these medications were what killed my mother, and I was responsible for her death. I get reminded of that every time I try to speak to my brothers.



skibum
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28 Jun 2023, 5:29 pm

If people want my emotions to be regulated, they should stop triggering them.

I think that CBT has to be done very very carefully. In some cases it can cause more damage than good with Autistics.


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