Cats Goes Autism-Friendly!

I got the privilege  to see this amazing play years ago, and loved it. Now, Cats will be adapted for an autism-friendly audience on Broadway this summer.

This is the seventh season of the Autism Theatre Initiative (ATI). The previous season included The Lion King (amazing movie AND an amazing play) and Kinky Boots. See the link below for more information!

Autism-Friendly Broadway

Autism @ Work Reception: Thoughts

This past Wednesday, I was able to attend the evening reception for SAP’s Autism at Work conference. It featured a Q&A panel with three known authors in the autism world: Steve Silberman, John Elder Robison, and Dr. Stephen Shore. Robison and Shore are both autistic.

I quickly became aware that this reception (and indeed the conference itself) was attended by both neurotypical and neurodiverse individuals. It was my first time attending such an event, which was a bit bittersweet; this should be the norm for such conferences. There were even color codes on the name tags, letting everyone know each person’s level of comfort with being approached. Silberman later explained that while this was common for the autism conferences/talks he attended overseas, it was the first time he had seen the practice here in the United States. This further let me know how far behind my country is with regards to autism awareness and acceptance.

It again became clear when I asked the panel about their experiences with regards to how black and brown communities approach autism. Silberman woefully admitted that he wished he could have included more people of color in his book NeuroTribes, and Robison stated that the racial divide in autism is yet another symptom of the racial divide in medicine and education overall. Silberman shared a quick story of how he spoke with a black man who, when Silberman mentioned that he wrote a book about autism, basically replied, “Oh, that’s the white people disorder.” To say that the story saddened me is an understatement, but I am glad that I mustered the courage to ask about the topic. It led to several great conversations with other attendees afterwards.

This is one of the aspects of autism acceptance that hasn’t been achieved yet. There is a general awareness of it for the most part in minority communities, but it is still not understood enough in those communities to warrant full awareness. I know people who still put autism in the same category as MR, or like the man in the example, do not think it affects their community at all. A Mexican mother whose autistic son is a client of mine is very nervous about having him attend regular classes once he starts school. She would rather have him in special education classes than to face the bullying that she feels he would suffer through in mainstream classes. It broke my heart to hear that, especially since I feel her son has the potential to be able to thrive in regular classes of interest.

I want to end on a positive note, though, so here it is: The entire two day conference is a strong indicator of a shift in the business world. Companies are starting to realize the potential autistic employees have and how having neurodiverse people on their teams will help their companies grow and thrive. They recognize that hiring practices and procedures need to change and adjust; do talented individuals really need to go through a face-to-face interview? Do HR departments know how to bring in more neurodiverse applicants (right now, the answer appears to be “no”)? The questions and situations are starting to be explored and asked, which is a great step forward. Institutions are starting the slow process of change.

Here are a couple of pictures from the reception, including the books I got signed:

This slideshow requires JavaScript.

An Autism Wish List

I’m traveling/on vacation right now, but I wanted to share an amazing post with everyone about Autism Acceptance Day. The author, who is an autistic woman, made a wish list of what she hopes to see for autistic individuals in the future. Number four particularly resonated with me, as I know that I am still working on this due to being a product of my environment when it comes to autism services. The goal of “normal” is still very much the norm, so to speak, and I would like to help change that, starting with myself. I am still a work in progress. I may do an post just on this subject in the future.

Enjoy!

https://anonymouslyautistic.net/2017/04/02/autism-acceptance-day-wish-list/

The Bridge: Behaviors, Part 2

Last week, I talked about the more difficult behaviors that can sometimes pose a danger to autistic individuals and/or others. There is another category of behaviors that are pretty much a benchmark of what we consider to be autism, and those are the ones I want to address here.

In the autism world, these behaviors are often referred to as stimming behaviors. They can range from verbal (repeating words, making unusual sounds), to physical (rocking, jumping) and all points in-between.

Let’s go to a new client for a moment. His name is David. David is 7 years old, and his parents are a bit flustered at how he often waves his fingers in front of his face. He will do this for hours if they let him (which they really don’t want to), and they want it to stop because it is keeping him for getting through the school day. It also draws attention when they are out and about. He always seems to get very excited when he does this.

The reflex move, of course, is to just tell him to stop. If they are particularly frustrated, the parents may physically move his hands to his sides or threaten to take away his favorite toys (Legos). This only makes him frustrated, which leads to either a meltdown or David aggressively doing the behavior even more. The truth is, there is a very simple reason why David does this action.

It makes him feel good.

There used to be a notion that these behaviors were a sort of torture for the client, and that the therapist/interventionist was “freeing” them from it by stopping the behavior by force (physically, verbally, or otherwise). Now that more and more autistic adults are speaking up, we are learning (or at least I hope we are learning) that the stimming behaviors are actually relieving the so-called “torture.” The difficult part for our clients is navigating an overstimulating, often unpredictable world. In my work, these behaviors signal that the client is trying to calm and steady themselves in the best way for them. When I see them, I want to find out why the behavior is happening. Either something in the environment has shifted, or there has been a build-up of uncomfortableness for the client.

Or, you know what? Maybe they just felt like being happy in that moment.

Much like the previous entry, a bit of detective work can go a long way. After doing some data collection, we discovered that the finger waving would often increase just before going somewhere that involved being in a crowd. We gave him a fiber optic wand as a possible sensory replacement, which he loved. The family also started giving him plenty of warning as to when they were going to go out. We even went a step further and created mini social stories about frequent places they visited (complete with pictures from those places). While David still waves his fingers sometimes (especially when excited), it has decreased along with his anxiety. We didn’t stop the behavior because it was “wrong,” we adjusted it and the environment so that the anxiety that causes the behavior would decrease.

To put it more simply: if someone bites their nails, forcing them to stop will just make them either do it more in secret, or lead to them switching to another tic. Uncover the source of the emotion behind the action first.

Finally, I wanted to share a blog post from another blog that I follow. The author touched on this very subject, and it is a great way to hear about stimming behavior from an autistic adult.

Oh the Ways We Love to Stim

Next week: About The Siblings…

The Bridge: About Eye Contact

One thing that I have noticed in the autism field is that there are very few autistic voices. This is unfortunate, because as workers we can learn a lot from those who have gone through the very therapy that we are now giving. Listening to the experiences of those on the receiving end is not just a good idea business-wise; in our field, it is just plain humane.

When it comes to eye contact, the main point that I have heard from autistic adults is that it is simply not easy for them. It is not a matter of being insubordinate or even stubborn, it is just difficult. I myself can attest to this: I have a hard time with eye contact as well. I often how to remind myself to do it, otherwise my eyes will just dart everywhere else. For me, it is very intense, and I can see immediately what the other person thinks of me through their eyes. That can be hard to face, because no matter how nice their words are, their eyes give them away.

So when I see interventionists and specialists trying to get eye contact by force, it makes me cringe, hard. While it is a valuable skill that helps you with nonverbal cues, forcing anyone into it (especially by physical restraint, which sadly I have heard of occurring) is just wrong.

I have to make eye contact enticing, something worth the action to the client. So, I hold up a desired object to my face, preferably aligned with my eyes. With Peter, it took a few times, but he eventually met eyes with me. I thanked him and gave him the object. I didn’t pull the object away if he didn’t make eye contact, because I knew he simply wasn’t comfortable enough yet. Once he was, the eye contact became more frequent. Eventually, he started looking at me first and THEN the object, indicating that he would like to have it.

Again, the key point was that I did not force him. I never held his face in place. I never punished him or withheld an object because he didn’t make eye contact. I didn’t want to punish Peter for doing what feels comfortable to him. I did want to teach him that he can ease out of his comfort zone (in his own time), and that there were good things to be had by doing so.

This simple action will now become the baseline for any other work going forward. Eye contact will lead to more interactions, and to the beginning stages of speech. If at any point I see Peter’s eye contact drop back into his comfort zone, I know that I either pushed too much or he simply needs a break. Either way, I take a step back (sometimes literally). In all of this (and I cannot stress this enough), I want to make sure that these initial steps are taken with care and an open mind. This will be important later, when the more challenging behaviors emerge.

Goal of session three: Start eye contact, while maintaining a suitable comfort level

Next week: We will start looking at some of the behaviors that “scare” newcomers to the autism field.

The Bridge: 3,2,1…Contact!

Last week, we met our new client and collected as much information as we could on them. Among the data that we gathered was the fact that they LOVE toy trains. So, guess what I brought to the next session?

Peter likes to line up the toy trains, and then rearrange the order. He gets very excited whenever he does this. Rather than deter him from the activity (which is sometimes the first instinct), I decide to take a different approach.

First, I do not give Peter all of the trains that I have. I keep at least three of them. When he starts lining his trains up, I start to do the same and match his enthusiasm. In fact, I may actually get more into the trains, though not enough to disorient him. While doing this, I don’t immediately interact with him. This is only the second session, and as a newcomer I do not have that privilege just yet.

Then, it happens.

Peter pauses and makes brief eye contact with me…but it’s longer than any time previous. He then goes right back to his trains. My immediate response is: “Peter, you looked at me!” in a quiet but enthused tone. With this I achieve two things: I acknowledge his communication attempt, and I indicate that I am happy with this action. After that, I go right back to my trains as well.

One of the biggest problems I see here from Interventionists and Specialists is a lack of patience and a need to perform. This is especially true if a parent/caretaker if observing the session. It’s normal to feel this way, to feel nervous about how the entire family is viewing you, your actions, and your expertise. It is important, however, to remember why you are there, and to trust your intuition. When reviewing video with workers after their session, or in feedback meetings following sessions, the workers often knew what they should have been doing, but became intimidated by what they thought the family wanted them to do. If you feel this happening to you, don’t be afraid to have a conversation with the family about what the expectations are. Are there certain therapeutic approaches that they prefer? How willing are they to try other possibilities? If the client is verbal, you can also ask them. I have had treatment plan meetings where the clients (in my case, autistic preteens) had a say in their goals and their progress.

Back to Peter. More than likely, I will not push him much further beyond eye contact on the second session. I will also make a point to explain my method to the parents so that everyone is on the same page. That will save you a lot of confusion down the road: lay a plan out to the family, and review what you worked on at the end of the session before you leave.

Goal of session two: Acknowledgement/contact

Next week, we’ll look at how to build on that “blink and you’ll miss it” eye contact.

PS- The title is an 80’s reference. Can my 80’s Babies guess what I’m referring to? 🙂

My Walking Buddy

Today, I was honored to be able to walk with over 30,000 others in my Bay Area city. It was refreshing to see so many people of different backgrounds, colors, and creeds come together to defend women and human rights. One of the best parts, though, was one of the individuals I got to walk with.

One of my friends moonlights as a respite worker for a former client of mine (I was the Program Supervisor for his case). He is 5 years old and autistic. His parents could not attend the Women’s March, but they agreed for my friend to take him with her. I hadn’t seen him in about 2 years, so I didn’t expect him to be too friendly with me. Still, I decided to stick close with her, her father, baby sister, and the boy in case they needed help during the march.

The boy handled the march beautifully. He made sure he was holding either mine or my friend’s hand as we walked. My friend explained that he starts blowing when he is getting overwhelmed (his variation of taking deep breaths). At one point, this happened while she was busy with her sister and could not hold him. I held my hands out to him, waiting to see if he was willing. After a second, he lifted his arms, and I picked him up. As long as he knew my friend was nearby, the boy snuggled into me and smiled.

We had lunch awhile later, and I sat with him while the others picked up the food. The two of us pointed at and talked about the different signs displayed on the wall (the restaurant has a 60’s theme), and I broke down “man” versus “woman” to him when he pointed to a picture of a woman and asked if she was a man. Looking back on it now, I believe he had in fact been processing the march in his own unique way, and was sharing his observations (like the fact that there were a LOT of women).

When he got his hot dog, he kept pushing it away. I noticed him gingerly touching the bun, and I asked, “Oh, bread off?” He responded, “Bread off, please.” I removed the bun, my friend put his hot dog on a fork, and he happily ate it.

As I walked back home about 20 minutes later after a goodbye hug and cheek kiss from the boy, I recalled how others responded to him. No one at the march gave him a dirty look if he accidentally stepped on their shoes. No one looked at him strange when he jumped up and down in excitement. In fact, people smiled at him…and they weren’t the “oh, poor you,” types of smiles. They were the “gotta love kids” smiles. I think that he felt that, because for the vast majority of the march, he was smiling and content (the only exception was when he got hungry).

I didn’t really have an endpoint to this, I just wanted to share a story that touches on this kiddo’s first time at a march, how calm he was, and how he charmed everyone around him. 🙂