5.4f Recognising and preventing distress

Think SPACE!
  • Sensory: did the practitioner identify challenges and plan for preventing and recognising distress in this client?
  • Remember that there can be multiple and intersecting neurodivergences.
  • Alexithymia: some Autistic people may struggle with identifying their own emotions.
  • Be curious: say ‘I can see there may be something going on for you’; ‘can you describe what is happening to you right now?’
  • Allow processing time; do not ask further questions.

KEY ISSUES

It is important to understand that Neurodivergent clients can have different reactions to certain situations and that distress may look different in each case. It is therefore advisable to understand what distress looks like for each client and what you can do to prevent this from occurring in the first place. In the first instance, this will form part of an initial assessment of needs (see section 5.2). However, there will also be circumstances where an assessment has not revealed this information (e.g., because neurodivergence was not known, client unconsciously reacts to dysregulation in the nervous system). In the event of sensory overload or other hypo/hypersensitivities (e.g., emotional overwhelm), it may be impossible for Neurodivergent clients to communicate present states or needs, and their responses may also be misinterpreted. 

PRACTICAL TIPS

Preventing distress

  • Establish and maintain clear boundaries (see section 5.4b, c, d).
  • Develop and maintain low-arousal spaces (sensory, facilitation, pace).
  • Practitioners should be aware of their own presentation as Neurodivergent clients may look to the space holder as a mirror for how to respond (low arousal words/presentation).
    • Supportive hand gestures.
    • Natural facial expression.
    • Open posture.
    • Voice: Appropriate volume, gentle tone even pitch.41
  • Modelling: Practitioners need to manage their own nervous system regulation (see Part 6).

Be observant for signs of dysregulation or distress

  • Pay attention to changes in body movement/body language.
  • Shutdown (the threshold of overwhelm has been reached and triggers a freeze response; too much activation in the nervous system).
    • Pale face.
    • Vacant expression.
    • Nonverbal.
  • Meltdown (fight or flight in nervous system response).
    • Increased stimming (tapping, fidgeting, need to use toilet).
    • Huffing and puffing.
    • Flushed.
    • Increased/excessive movement.
    • Moving forward.
OTHER CONSIDERATIONS
  • It may be difficult to recognise distress due to masking.
  • Masking is a survival strategy, and not always conscious.
  • It is not always known if someone is Neurodivergent.
  • Be forever curious!
  • Once you know the client well you will begin to notice small changes

(41) Aldred and Aldred (2023). Embodied Education: Creating Safe Space.
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