The Extra Bridge: The Workers Listen

I’m adding in an extra chapter to this series because of what went down on my personal Facebook last night.

Knowing that some of my Facebook friends are practically ABA zealots, I decided to write a segment I sometimes call “Unpopular Opinion.” In this one, I put the ABA community to task for not appearing to listen to the autistic adult community when they give their critiques and suggestions for ABA and how it is executed. I also noted how ABA has monopolized the autism field, leaving little room for any other approaches. I then ended with a dig at the new healthcare bill by Republicans, adding that if it goes through then all of this may be a pointless rant. Then I sat back and waited for the incoming torpedoes.

They didn’t come, at least not exactly.

One person did come on defending ABA as the only evidence-based practice. I then explained down thread what I called the “Catch-22 Carousel.” ABA gets funding and put onto insurance because it is evidence-based, which takes away from funding for other approaches to conduct research to…prove they’re evidence-based. That aspect of the conversation stopped soon after I made that point. When they asked where the research was, I pointed them to Stanford’s Annual Autism Symposium, which takes place in about two weeks. They genuinely seemed interested in attending.

What really made the conversation, though, was the intrigue from others over other parts of the post. I had a great conversation with one former coworker about the effects of the healthcare plans on autism services (which included our job prospects), and another conversation about offering more support to autistic adults and what that should look like (employment/workplace support was high in priority). Just about everyone agreed that there should be a variety of therapeutic services for families and clients to choose from, and to not have that is a detriment to our overall goals and why we entered this field to begin with.

Most of my Facebook friends are ABA enthusiasts, so their silence did not surprise me. I was actually impressed with the ABA Specialist who wanted to hear more about the research into the other approaches, as opposed to just ignoring or shutting down when I made my point. Another friend from back home mentioned the PEERS approach, which I had never even heard of. My rant led to a new approach (at least new for me), and I am now going to go learn more about it.

Some of the parents, meanwhile, simply liked, loved, or thanked me for the post.

The conversations that sprang from that post made me think beyond my viewpoint, go and research some things as I was replying to others, and led me to new ideas. Sometimes speaking your truth can lead others to do the same, and sometimes, everyone listens and learns something in the process.

 

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.