How to Identify Trauma in Autistic People

Autistic people are especially vulnerable to trauma. They often experience intense emotions, challenging environments, discrimination, and sometimes abuse, leaving them at risk of trauma. But communication can be difficult for autistic people, so the presence and cause of trauma can be harder to identify. It is important to seek professional help to identify and treat trauma. Assessing possible causes and symptoms can help you decide whether and when to make a doctor appointment.

Method 1

Method 1 of 4:

Considering Causes and Risks

1
Recognize common causes of trauma for autistic people. Autistic people can be traumatized by the same things that cause trauma in non-autistic people. Consider whether your loved one has experienced severe stress such as...^{[1]XTrustworthy SourceHelpGuideNonprofit organization dedicated to providing free, evidence-based mental health and wellness resources.Go to source}
- Natural disasters
- Abuse (emotional, physical, sexual) and neglect; witnessing others being abused
- War
- Injury or life-changing health problem
- Death
- End of an important relationship
- Sexual assault
- Trauma in the family (e.g. a boy traumatized by watching his father's trauma)
- Bullying, physical or emotional
- Witnessing or being impacted by a violent crime: burglary, mugging, road rage
- Exposure to adverse environment: bad educational environment, unsupportive group home, living in a country which treats disabled people poorly
2
Keep an eye out for bullying. Unfortunately, autistic people are vulnerable to bullies, as they may stand out more, and lack the social skills to handle the situation. Bullying incidents over time can lead to Post-Traumatic Stress Disorder in victims.^{[2]XResearch source} (This includes teasing, violence, rumors, exclusion, and cyberbullying.) Autistic people are at high risk for bullying, and this may lead to trauma.
- Bullying isn't always from peers. Authority figures could also bully them.
3
Consider how they are treated in therapy. There are many different "schools" of therapies aimed at helping autistic people. Unfortunately, some practitioners, types of therapy, and methodologies can end up psychologically harming the people they are supposed to help. For instance, compliance therapy, holding therapy (grabbing and restraining a person against their will), restraint, and seclusion can all cause trauma symptoms.^{[3]XResearch source}^{[4]XResearch source}^{[5]XResearch source} Watch for:
- Yelling
- Physical force and restraint
- Locking them in a room
- Making them "earn" access to breaks or beloved items
- Taking away comfort objects
- Withholding affection as a punishment
- Ignoring or punishing signs of upset feelings until they bottle it up
- Training them to act happy when they are not
- The therapist telling parents/caregivers to be harsh
4
Remember that autistic people can also experience emotional abuse, physical abuse, sexual abuse, and neglect—and may not be able to communicate it. Autistic people can experience severe psychological pain from being mistreated, even if they do not show signs the same way that a non-autistic person might. In addition, autistic people may be mistreated in ways related to their disability, including...
- Adults may label emotional distress or self-comforting behavior as "bad behavior" to be punished or eliminated.
- People who have experienced compliance training are at greater danger for sexual abuse, because they do not know how to say no or set boundaries.^{[6]XResearch source}
- If having their needs met is conditional upon certain behavior (e.g. no access to food unless they have a certain amount of tokens for obedience), that is abuse.
5
Consider non-trauma-related issues. There are many different stressors an autistic person could face, and not all of them are caused by traumatic events. Take the possibility of trauma-related and non-trauma-related issues seriously.
- Life changes, such as moving house or changing schools, causes stress.
- Anxiety and depression are common in autistic people, and may not have one single cause.
- Gender dysphoria can sometimes look like trauma, and may heighten when puberty starts. Helping the person transition to the correct gender, and surrounding them with supportive people, can ease the emotional pain and help the person become healthier and happier.
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Method 2

Method 2 of 4:

Identifying Physical Signs

1
Notice if the autistic person reports feeling unwell. Due to alexithymia, autistic people may have a harder time understanding their emotions, and may only notice physical problems. The autistic person may mention headaches, stomachaches, muscle tension, or other physical problem caused by stress.
2
Take regression seriously, without jumping to the conclusion it is caused by trauma. Under stress, an autistic person may revert to "younger" behavior: sucking their thumb, wetting their bed, losing the ability to speak, or no longer using a skill they had learned recently. This may be caused by trauma, or by something else.^{[7]XResearch source} Regression can be a difficult symptom to pin down in autistic people, because they may regress due to many different stressors, and they often hit milestones at their own pace.
- A number of stressors can cause autistic regression. It could also be from moving to a new home, too much pressure in therapy, illness, not enough downtime, and so on. Trauma is one of several potential causes.
- The autistic person has not permanently lost the skill. However, when "in regression" they are simply too overtaxed to use more sophisticated skills. If and when they have more energy again, they will most likely be able to use the skill again.
- Conversely, some teens become more independent after trauma, or oscillate between regression and independence.^{[8]XResearch source}
3
Notice serious changes in stims. Rocking and stimming can signal trauma in non-autistics, but is normal for many autistic people. Instead, notice if your loved one is stimming a lot more or a lot less than usual, or if they have adopted self-injurious stims when this was not a problem before. This can be indicative of a problem.
4
Consider changes in sensory processing. Stress may manifest itself as a more sensitive sensory system, and a traumatized autistic person may have their sensory issues worsen. For example, a young woman who ordinarily enjoys thunderstorms may start crying and covering her ears when she hears thunder.
- Your loved one may startle more easily than usual.
- They may have more frequent meltdowns, shutdowns, and instances of sensory overload.
5
Watch for changes in appetite and sleeping habits. Your loved one may eat less, overeat for comfort, or complain of digestive issues that they did not have before. They may face sleeplessness, frequent nightmares, or fatigue.^{[9]XResearch source}^{[10]XResearch source}
6
Notice the development of new touch-avoidance behaviors. Some autistic people get easily overwhelmed by physical touch, and this is not a cause for concern. But if your son who loved getting tickled suddenly hates it, or your sister who loved kisses starts panicking when kissed, this might be a sign that someone hurt them.
- If they suddenly become afraid of being with one certain person, it might mean that this person mistreated or hurt them.
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Method 3

Method 3 of 4:

Identifying Emotional Symptoms

Trauma can look slightly different in autistic people than non-autistics. Your loved one may experience some or all of these symptoms.

1
Keep an eye on your loved one after a potentially traumatic event. Because autistic people can have difficulty recognizing their own emotions, your loved one may not realize that their feelings are different from usual, or that they are suffering. This makes it especially important to speak up if you see them struggling; they may lack the self-monitoring skills to recognize it themselves.
2
Compare the person's current behavior with what is typical for them. Extreme behavior, personality shifts, and mood swings may follow trauma. Your loved one may start becoming more...
- Overachieving, overly compliant, eager to please, afraid to say "no"
- Hyperactive
- Passive, lethargic, flat affect (compared to their usual)
- Crying often, frequent meltdowns
- Acting out, aggressive, impulsive, angry
3
Notice signs of withdrawal from the world. The onset of a mental illness (PTSD, anxiety, depression) may be characterized by a person withdrawing from their loved ones, talking less and spending more time alone. This sign can be a symptom of trauma, and/or an illness such as depression. If your loved one begins self-isolating, it may mean that something is wrong.
- It is normal for autistic people to be introverted, have trouble making friends, not want to socialize much, and/or go through periods where they want more alone time. Compare your loved one's current behavior to what is normal for them.
4
Watch for avoidance behaviors. Your loved one may start avoiding things that remind them of the traumatic event,^{[11]XTrustworthy SourceHelpGuideNonprofit organization dedicated to providing free, evidence-based mental health and wellness resources.Go to source} whether this means crying whenever they see a pale man with a mustache or avoiding driving near the place where they had compliance therapy.
5
Pay attention if the autistic person loses interest in relationships and activities they ordinarily love. A traumatized person may get bored easily, lose interest in friends and hobbies, and show signs of isolation and depression. Try to involve the autistic person in conversations or pastimes related to their special interests and notice how they react.
- Not all autistic people will display this symptom; being able to be distracted for a little while does not disqualify them from being traumatized.
- Some autistic people may attempt to hide their pain from others and put on a cheerful mask in front of others because they think that's how to be nice. This can make trauma more difficult to detect.
6
Notice if the autistic person begins clinging to a person, place, or favorite object. It is normal for autistic people to have a favorite object or two, such as a stuffed animal or piece of string for stimming, and be upset if they cannot find it. However, if the person starts clinging and panicking at the slightest idea of being parted from the person or item, it suggests that they may not feel secure on their own.
- Do not try to separate them from a comfort object. Taking the comfort item away will not make the person feel better. Instead, work on getting them help for the fear that is causing them to cling, and in time, they will not need it so much.
7
Consider their ability to focus. Trauma can involve fatigue and difficulty concentrating,^{[12]XTrustworthy SourceHelpGuideNonprofit organization dedicated to providing free, evidence-based mental health and wellness resources.Go to source} so their performance at school may slip, or they may find it harder to maintain the same level of performance. Young children may appear listless and disinterested when offered an activity they usually enjoy.
8
Watch for a loss of confidence in themselves and/or others.^{[13]XResearch source}^{[14]XResearch source} Your loved one may become more insecure and withdrawn. They may have a harder time trusting others, because no one could prevent the traumatic event, or because people made things worse when they needed help.
9
Consider what your loved one talks about. If the autistic person seems to be fixating on fears, sadness, or death, then they are probably suffering psychologically. If they talk a lot about what happened, or about being upset, it's probably because they are upset.
- Obsession with safety or death^{[15]XTrustworthy SourceChild Mind InstituteNonprofit organization providing evidence-based care for children with mental health and learning disorders and their familiesGo to source}
- Blaming themselves for the event
- Fears that the traumatic event will re-occur
- Reporting frequent nightmares
- Suicidal thoughts
10
Recognize that grief and trauma move at different speeds for different people. If your loved one is traumatized, they may show it right away, or it may take weeks or months to surface. Keep an eye on them for a while in case it takes longer for symptoms to show.
- In general, males are more likely to show anger-type symptoms early on, where females are more likely to experience delayed and heavily internalized reactions.^{[16]XTrustworthy SourceChild Mind InstituteNonprofit organization providing evidence-based care for children with mental health and learning disorders and their familiesGo to source} However, your loved one may or may not follow this pattern, as individuals may vary in their responses to trauma.
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Method 4

Method 4 of 4:

Moving Forward

1
Take your loved one to a counselor or therapist. The person may benefit from cognitive behavioral therapy, psychotherapy, hypnotherapy, family therapy, and/or specific types of counseling like grief counseling.
- Try booking intake appointments with several different therapists, then seeing which one works best with your loved one. Ask your loved one if you'd like them to sit in on the appointment, or wait outside for them.
2
Encourage them to talk to you if they want. Your loved one may not be sure how to handle their feelings, so tell them that they can talk to you. This can help them know they can seek out help when they are having a rough time.
- Don't say that you'll listen, and then proceed to ignore or steamroll their feelings. Instead, listen and validate their feelings.
- If they come to you at a bad time, be honest. For example, "I'm really tired and I need a nap before I can be good at talking. I do want to talk as soon as I can be a good listener again. Can we talk after supper?"
3
Take care of yourself too. You can't be good at helping someone else if you haven't taken care of yourself first. Ask yourself what you need right now (a hug? a walk? a warm shower?), and then take care of yourself.
- It's okay to set boundaries if you're feeling stressed or drained. For example, if your loved one wants to talk but you're exhausted, just say "I'm feeling really tired right now, and it's not a good time to talk. I need to be alone. Maybe you could talk to Dad, or spend some time drawing pictures?"
- Consider joining a helpful support group or going into counseling yourself.
4
Be patient and kind to the autistic person. Your support can help them cope with the ordeal. Coping with trauma can be scary and challenging, and it really helps for them to know that they aren't alone.
5
Help make sure they get plenty of downtime. Autistic people in general need lots of relaxation time, especially if they are under additional stress. Giving them quiet time helps reduce toxic buildups of stress.
- Encourage them to work on their special interests. For example, if your daughter obsesses over writing or your friend really loves a specific TV show, they should spend lots of time with that. It can help them cope. Trying to keep an autistic person from spending time on their special interests can be painful for them.
6
Spend time doing fun things together. Emotional health isn't just about dealing with negative experiences; it includes making time for positive ones. Try to get some one-on-one time with the autistic person to hang out and do enjoyable activities together. Make positive memories and have fun.
- If they're a family member living at home with you, try to get some one-on-one time each day. If you see them less often, this may not be as feasible.
- Sometimes the person will want to have fun, sometimes they'll want to talk about feelings, and sometimes they'll want to be alone. Pay attention to their mood, and if you're not sure, just ask what they'd like to do.
7
Give them time and space to process their feelings. Healing from trauma can take a lot of time, so be patient. Keep the attitude of being in for the long haul.
- Sometimes, people find art helpful for coping with trauma. Try giving your loved one some art supplies, and encouraging them to draw or paint about whatever they feel like.
- Don't scold them for taking a long time to heal. Instead, deal with your frustration in private. They should focus on taking care of themselves, not on trying to hide their feelings around you.
8
Take their feelings seriously. Sometimes, your loved one may feel like talking about their pain. When they do, listen carefully and validate their feelings.
- Some autistic people struggle to understand their emotions. If they seem stressed, try asking questions like "Are you sad?" or "Are you worried?"
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