Autism covers a wide range of symptoms, a wide range of individual coping mechanisms and even a wider range of predictable and unpredictable outcomes. This makes the word “autism” difficult to understand and even more difficult to explain.
In my training as occupational therapist many years ago, I found that I had an individual and successful personal intervention technique. I worked with some of the more difficult emotional problems in children referred to occupational therapy in the hospital setting. I ended up being successful in therapy intervention with cases that were complicated and not usually given to students or new graduates. This inspired my career and set me on the road to work with children. It also encouraged me to be alert and sensitive to the cues that children provide during their participation in different activities. My post-graduate training in sensory integration techniques complimented and enriched my techniques and observation skills.
It was only later in my career that I was introduced to autism. As from my first experiences with this disorder (rare initially but now often seen in therapy settings) I was intrigued by how these children, teenagers and young adults observed and experienced the world and their immediate environment. Many of the books, programs and intervention techniques did not make clear sense to me. Probably because I couldn’t find a clear cut answer to what this disorder exactly is. I was trained to observe accurately, to relate every observation to the client’s functional life and the impact it will have on function.
Personally, I find that this is the best starting point of any intervention – I observe and act according to what the individual client provides. I act according to the glimpses that I can see in their secret lives. To me each client resembles a pure eggshell with many secrets locked inside. So many times “behaviour” is an attempt to share what the client experiences inside this shell without knowing how to break the shell.
These clients do not know how to break the shell that sets them apart from their immediate environment that makes it difficult for them to make eye contact, to communicate and to share their experiences. They do not know how to overcome the barriers of sensory and emotional overload that prevents sharing.
These barriers create avoidance, in my opinion, often because they are too scared to “look out of the shell” as they know they will not be able to cope with the sensory and functional demands of the environment. How often have I been scratched or bitten because I pushed them to their limits, attempting to crack the shell, inviting them into an unfamiliar experience. Is this not what every one of “us” (without autism) would do if someone would put us on the end of a cliff and attempt to push us over the edge? We would scratch and bite in an attempt to stay safe, to avoid danger, to avoid being hurt, to avoid having to fly to safety. Especially if past experiences have taught us that we’ll fail.
I am disappointed when I read about programs and intervention techniques that use conditioning without very specific individual observations which pinpoints the client’s sensory and functional needs. There is a place to teach the autistic person specific strategies that will help to gain improved knowledge and skills but it should never be used without keeping in mind that this is a person, too scared to peep out of the shell, too scared to take a step into a world that doesn’t make sense.
Learning new skills shouldn’t be to train the client to abide to our norms and to what we think is appropriate. It should be to take this client’s hand, to provide a safe environment, to assist the client to take the first look and maybe the first step out of the shell. Not because they are scared of the consequences if they do not abide but because they feel safe and become interested in the world outside the shell. It should be the same feeling that you’ll have if you were pushed on the edge of the cliff but became aware of the skydiver behind you, the equipment surrounding you and the feeling that it will be safe to go over the edge of the cliff. You realise that you will be able to fly because you have support and equipment. But most of all you will feel safe because you understand a little bit of the method, the function and the experience.
I find the journey with each of these precious clients exciting, interesting and humbling. If you haven’t tried this perspective, I invite you to join my journey and experience.