In defense of distracting fidget toys

One problem with the way stim/fidget toys are discussed is that there’s often a false dichotomy drawn between good fidgets that help people to focus, and bad fidgets that distract people. Focus is not the only legitimate reason to use a stim toy.

Further, being focused on your surroundings isn’t always a good thing. Sometimes, the main reason a stim toy is useful is *because* it is distracting. For instance, some people use stim toys to distract themselves from trauma triggers. When an environment is triggering, it can be really helpful to have a way of temporarily ignoring it.

Some people use stim toys to distract themselves from pain or sensory overload. Distracting stim toys can be a way to take a break without having to leave the room. Fidget spinners in particular often work really well for this.

There are any number of ways to use stim toys. Some uses, like holding a rock in order to remind yourself where your hand is, have little or nothing to do with focus one way or the other. They serve a different purpose.

We shouldn’t let “they help with focus” be the only use of stim toys we acknowledge as legitimate. The other ways they are used also matter. And sometimes, getting distracted is the whole point.

Electronic books can make reading possible for people with executive dysfunction

Electronic books can be an important disability accommodation for a lot of people, including some people with normal vision. If you’re having a lot of trouble reading, or not reading as much as you’d like to, it might help to use electronic books.

There are a lot of steps involved in reading a print book. Some of these steps can be difficult or impossible for people with impaired executive function, autistic inertia, fatigue, chronic pain, or other conditions. Some difficult steps can be eliminated with electronic books.

In order to start reading a print book, you have to be able to do all of these things:

  • Have the book in a place where it’s available to you when you have time to read.
  • (Which can involve remembering to bring with you somewhere.)
  • (And keeping track of the book and not losing it.)
  • Decide to stop what you’re doing and do a different kind of task.
  • Figure out where the book is.
  • Go get the book.
  • Avoid getting distracted by other things as you find the book or get the book.
  • Figure out where you are in the book.
  • (Which can involve things like remembering the place.)
  • (Or using a bookmark, which comes with its own multi-step challenges like remembering that bookmarks exist and having one available.)
  • Open the book to the right page.
  • Avoid getting distracted by other parts of the book.
  • Get into a position in which you can read, which you can also sustain long enough to read for a significant among of time.
  • Actually start reading the book.
  • If you want to take notes or highlight, you also have to gather all your note-taking tools.
  • And not get distracted and forget what you’re doing.
  • And not forget where you put the book in the process.
  • That’s a lot of steps, any one of which can sometimes be difficult or impossible.
  • Using electronic copies can eliminate some of these steps, or make them easier.
  • This can be game-changing.

Some ways in which electronic copies can eliminate steps:

  • You can store your entire electronic library on one device (or synced to multiple devices).
  • If you know where your device is, then you know where all of your electronic books are.
  • This can mean you don’t have to physically search for anything.
  • (Electronically searching to remember where you put something can be much easier.)
  • You also don’t have to remember to bring a specific book. You just have to remember to bring one device.
  • (Which can be a device like your laptop, phone, or iPad which you’re in the habit of carrying with you anyway).
  • If you’re already using your computer, you don’t have to get up to go get your book.
  • You also don’t have to change positions.
  • Being able to stay in the same position and location can make it much easier to start reading.
  • It can also be easier to remember your place. A lot of software will leave the book open to the same place as when you were last reading it.
  • Searching can be easier, faster, and less distracting than flipping through a print book. (This isn’t true for everyone, but it’s true for some people).
  • Electronic bookmarks may also be easier to use than physical ones.
  • You don’t have to look for highlighters, pens, pencils or notebooks, all of that is right there in the book-reading software.
  • Eliminating these steps can make reading a lot easier.
  • Making it easier can make it possible.

This isn’t the right strategy for everyone; computers, phones and other devices have their own executive dysfunction pitfalls. But for some people, it makes reading much more possible.

Short version: Some people have trouble reading print books, even if they have normal vision. Sometimes the reason for this is that executive dysfunction (or another disability) makes some of the steps involved in starting to read a print book difficult or impossible. (Eg: people with ADHD might get distracted looking for the book.) For some people, using electronic books instead of print books can make reading much more possible. Scroll up for some specific reasons that electronic books can help.

Open letter to disability professionals

Dear disability professionals,

I’m not sure why, but I keep encountering disability professionals who try to deny that disability exists, or to downplay its importance.

It’s so extreme that disability professionals often try to convince people with disabilities that we are just like everybody else. Even when our differences are the reason that you have a job.

We are not just like everyone else. We are alike in that we are all human, with the same basic needs and capacities that go along with humanity. We are also different, in that we have disabilities and most people do not.

Disability exists. Disability is important. People with disabilities are different from most people people in ways that matter. And we need those differences to be speakable.

Our bodies are different. We can’t make this go away by smiling, being brave, and trying hard.

The differences in our bodies matter. Most people can do things that are physically impossible for us. Most people can do some things easily that are excruciatingly difficult for us. The specifics of which things these are depend on the person and the disability. They always exist. That’s what disability means, it means having a different kind of body, a body that can’t do certain kinds of things easily or at all.

For everyone, with and without disabilities, understanding the limits of what our bodies can do is a key life skill. Everyone’s safety depends on understanding that they do not have wings, and that they can’t fly. My safety also depends on understanding that I have impaired vision, motor coordination, and executive functioning. Understanding these things means I have chosen not to drive, and that I have found adaptive strategies that enable me to cook safely.

From my perspective, the fact that I don’t concentrate hard and try to drive isn’t so different from the fact that I don’t flap my wings and try to fly. All I’m doing is acknowledging physical reality, and making choices that fit with my understanding of reality. Some of the physical limitations on what my body can do are the normal limits that apply to all human bodies. Other physical limitations come from my disability. They’re all just physical facts, they’re all just things I need to take into account when I make decisions. 

But as a person with a disability, I learned young that only some limitations are ok to talk about. If I say “I can’t fly”, no one contradicts me. If I say “I can’t catch”, people say “just keep trying”. Both are physically impossible for me. Trying hard will not make either possible. Neither will being brave, smiling, or believing in myself.

For some reason, many disability professionals seem to believe that honesty about our limitations will somehow destroy our self esteem. Actually, the opposite is the case. They want us to believe that if we just smile and keep trying, we can do anything that we put our minds to. But it’s a lie, and we get hurt badly when we believe it.

When professionals refuse to accept our limitations, they force us to attempt impossible tasks over and over. There is nothing positive about this experience. We try and fail, and we watch others our age succeed at the same tasks. If we believe that we can do whatever we put our minds to, then we feel like it’s our fault for not trying hard enough.

It hurts when people yell at us for failing, and it hurts when people plaster on smiles and urge us to smile and keep trying. “Come on, you can do it!” doesn’t sound like encouragement when you know that you will fail. It feels like being told that you’re somehow screwing up on purpose, and that if you would just decide to be a better person, you’d suddenly be about to do it. This kind of thing can go on for years, and it leaves scars. We often come to feel like we are unworthy people, and that there’s something deeply flawed about who we are. 

It’s very, very important that people with disabilities understand that we are disabled. We need to know that our bodies are different, and that some things that are possible for most other people aren’t possible for us. We can’t stop being disabled through an act of will. Our bodies limit us. That is not a moral failing. It’s just a fact of physical reality. And it needs to be speakable.

Our bodies and our disabilities are nothing to be ashamed of.  We don’t have to be different to be good enough. We don’t have to be nondisabled to do things that matter. We don’t have to do impossible things to be worthy of love and respect. We’re people, and who we are is ok.

And for professionals – please understand that when you refuse to acknowledge disability, you are teaching people with disabilities to be ashamed of themselves. This is probably not your intention, but it’s an inevitable consequence of making disability unspeakable.

It is much better to tell the truth. It is much better to support us in understanding who we really are, than to push us to believe in an impossible dream. I could dream of flying or playing baseball, but it wouldn’t get me anywhere. By living in the real world and working with the body I actually have, I can do things that matter. And so can all of your clients. There is no need for silence, evasion, or shame. Disability is important, and it’s much easier to live with when we can face it honestly.

Meaningful echolalia

Some people communicate mostly in memorized phrases or allusions to stories and events.

It’s actually pretty normal to communicate in phrases and allusions. I think most people communicate that way at least some of the time. For instance, a lot of people make Shakespeare references in situations that have little or nothing to do with literature. A lot of prose and interpersonal communication happens that way.

This is interpreted very differently for some people than others. People without disabilities who mostly communicate in literal language are taken much more seriously when they make allusions and quotes.

When a nondisabled person says “The lady doth protest too much, methinks”, it’s assumed that they’re communicating and that what they say is meaningful. They are usually understood. This is the case even if there are no ladies present and they’re obviously not talking about a lady.

Similarly, when a nondisabled person says something like “A horse! a horse! my kingdom for a horse!”, this is understood as meaning something even if they obviously do not have a kingdom and are known to hate horses.

When someone with a disability communicates in exactly the same way, their communication is often written off as meaningless. It’s often seen as sensory seeking, or stimming, or a persversation, and having no communicative content whatsoever. This kind of communication is often ignored, and also often seen as a problem behavior to be extinguished by a behavior plan.

This is in part because there’s a widespread belief that autistic people are all hyper-literal and only understand literal language. That’s true of *some* autistic people. But there are also autistic people who have the opposite problem. There are people who find it nearly impossible to use literal language to communicate, but who can readily make references and use literary phrases. (This is true for other kinds of cognitive disabilities as well; it’s not unique to autism.)

People who can only communicate in references deserve to have their communication taken seriously. So do people who find references much easier than literal languages. Everyone else is allowed to use references to communicate; people with disabilities have the right to do so as well.

Here’s an example of a situation in which communication is often misinterpreted. Imagine a girl named Sarah:

  • Sarah doesn’t say very many words reliably. She can usually say a few things like mom, food, want, home, and SpongeBob.
  • Sarah watches SpongeBob a lot
  • She wants you and other people in her life to watch it with her
  • She says a lot of phrases from SpongeBob
  • (Eg: “I’m ready!”, “One eternity later”, “SpongeBob, you and I both know you’re just using me as a distraction so you don’t have to write your essay”, “Why is it whenever I’m having fun it’s wrong?”, “I’m ugly and I’m proud!”)
  • Sometimes, the assumption is made that her repetitive phrases are preventing her from developing standard language
  • Or they might think that TV is preventing her from developing standard language and that her access to TV is limited
  • Or they might think that she’s perseverating on SpongeBob in a way that’s preventing learning
  • When maybe what’s going on is that SpongeBob is *teaching* her language and communicative concepts, and she’s trying to use them to communicate
  • If so, she should probably watch more TV, not less
  • And it’s really important for people in her life to listen to her
  • And understand the references she’s making and what they mean to her
  • (Watching the shows with her is probably an important part of that; showing her other shows might be too)
  • If you want someone to communicate, you have to listen to them, even when their communication is unusual

A lot of this post about listening to people whose speech is unusual applies in this situation too.

Short version: Repeated phrases are often meaningful. Some people with disabilities communicate mostly in memorized phrases and references and allusions to stories and other things. Nondisabled people are taken seriously when they communicate this way. Disabled people who communicate in references should be taken just as seriously. (Even when they don’t communicate in literal language very often or at all).

AAC does not replace nonverbal communication

This is a continuation of a series on why I think it’s a mistake to ignore nonverbal communication in an attempt to force someone to use AAC. (The short version: it’s disrespectful, it undermines someone’s ability to communicate, and it prevents people from developing a valuable skill.)

One reason nonverbal communication is important for AAC users is that you always have your body with you. That is not necessarily the case for AAC devices.

AAC best practices say that someone should have them available constantly. In practice, people don’t. This is for several reasons. One is that it’s not practical to take a device to some places (for instance, most people are not willing to take a high tech device to the beach, and low tech devices are a lot more limiting.) Another reason is that sometimes people forget, or vastly underestimate how close a device needs to be in order to be immediately available. Or any number of reasons, some innocent and some horrifying, and many a mixture of both.

Also, people take devices away from AAC users. They shouldn’t, but they do. Sometimes it’s accidental; sometimes it’s on purpose. It’s never ok, but people do it a lot. If you’re teaching a nonverbal child to communicate, you need to keep this in mind when you’re considering what to teach them. You can’t assume that people will always treat them appropriately, and you can’t assume that they will always have their device. If they are capable of communicating with their body, it is an important skill for them.

Whatever else happens, someone always has their body with them. People can do a lot more if they can use their body to communicate. Communicating in body language can make it possible to communicate in a swimming pool. It can make it possible to communicate with dirty hands. It can make it possible for someone to indicate that their device isn’t within reach and that they need it. It can make it possible to communicate about pain in medical situations. It can make it possible to communicate when someone else doesn’t want you to, and has taken your device away. It can make friendship possible that otherwise wouldn’t be. And any number of other things, all of which are important.

And in order to be able to communicate with body language, people need opportunities to practice and develop this skill. If you ignore someone’s nonverbal communication to encourage AAC use, you’re making it harder for them to develop comprehensible body language. That’s not a good idea, because comprehensible body language is important. People won’t always have access to their device. They will always have their body.

Short version: Nonverbal communication is important for nonverbal people, but parents are often encouraged to pretend not to understand it in order to encourage AAC use. This makes it harder for people to develop body language that others can understand. One reason this is a problem is that people don’t always have access to their devices, but people *do* always have access to their bodies. Nonverbal people should have support in developing nonverbal communication, because it is an important skill.

AAC is not a cure

This is a continuation of a series on why I think it’s important to listen to the nonverbal communication of nonverbal people. Often, parents are encouraged to not listen or to pretend not to understand, so that kids will be forced to learn AAC and use words. I think this is a mistake, for any number of reasons. The first post focused on the general importance of listening.

Another problem with this advice is that ignoring nonverbal communication discourages people from developing their nonverbal communication skills. That’s a bad idea, because nonverbal communication is a very useful skill for nonverbal people. It should be encouraged, not discouraged.

It’s valuable for several different reasons (and I assume, for many reasons I don’t know about.)

One is that AAC is not a cure, and it doesn’t make nonspeaking people just like people who can talk. Nonverbal people who have communication devices are still nonverbal. Currently existing AAC devices can’t do everything that speech can do. For instance:

  • AAC devices mostly can’t do tone. Voices usually can.
  • AAC devices can’t go everywhere. Voices usually can.
  • AAC devices can be taken away much, much more easily than voices can.
  • AAC is usually slow. That makes interrupting hard-to-impossible. Voices can usually be used to interrupt.
  • AAC is usually fairly quiet. Voices can usually yell.
  • Symbol-based devices generally don’t have anywhere close to sufficient vocabulary for emotional or physical intimacy. Voices do.
  • Many AAC devices give others a lot of control over what someone can say. Voices are usually more flexible.

For a lot of these things, body language and movement can be a more effective way of communicating than using a speech device. For instance, putting up a hand to say “stop!” is a lot more likely to be understood quickly than using an AAC device to say the same thing.

Similarly, most symbol sets developed that touch on sexuality at all assume the main reason people need sexual vocabulary is to be able to report abuse. Most of them don’t have robust symbols for discussing sexuality and sexual desire — and most of them don’t have any symbols for emotional intimacy at all. Body language can communicate things that a system designed this way can’t.

Another reason AAC is not like speech is that people who are nonspeaking, are nonspeaking for reasons. And AAC does not make those reasons go away.

Some people are nonspeaking because words are unnatural, painful, and cognitively draining. People like that deserve to be able to communicate in ways that are natural and comfortable. And it’s important for people close to them to listen to their natural communication. Ignoring someone’s most natural communication it is a rejection of their personhood. It’s important not to do that to people.

It’s also dangerous, because someone who finds AAC cognitively difficult and draining is likely not going to be able to use it all the time. For some people, this can be especially true when it’s particularly important to communicate, or when they’re sick. If you’re responsible for someone and you only know how to listen when they use AAC, that’s dangerous. If there’s another way they communicate, it’s important to develop your ability to understand it. (Or, if you can’t, to find someone who can.)

Similarly, if someone has apraxia or other difficulties controlling their body well enough to point, their physical ability to use AAC is likely to vary. And it’s still important to listen to them when they aren’t able to use it in the ways they sometimes can.

Short version: Access to AAC is important. It’s not the only thing that’s important, and it’s not a cure. Nonverbal people who use AAC are still nonverbal. Body language and using one’s body to communicate are also important skills. (Not everyone can learn to do this. For people who can, it’s valuable.) It is not a good idea to discourage AAC users from using body language to communicate.

In defense of nonverbal communication

Lately, I’ve been seeing a lot of posts giving parents of nonverbal kids the advice “pretend not to understand your child so that they will be forced to use AAC and communicate in words”.

I think this is a mistake.

I think that if you want to teach someone to communicate, it has to be built on a foundation of listening to them. And that means listening to all of their communication, not just communication that happens in words.

I also think that all of someone’s communication methods are important, and that they all need to be respected. There isn’t one true method of communication. They all matter.

Communicating through body language is useful for all people. People who can talk are allowed to communicate through body language, and actively encouraged to develop the skill of doing so. It’s expected that, when I smile, point to things, frown, or whatever, that people will listen to what I’m communicating. Nonspeaking people deserve the same respect.

People say “communication shouldn’t wait for speech”. I agree with that. And I think it shouldn’t wait for words either. Because words may never come. If you wait for someone to reliably use words to listen to them, you may end up never listening to them. And everyone deserves to be heard.

And even if they will eventually use words and sentences, the things they’re saying *now* still matter. And listening to them is still important.

Presuming competence shouldn’t mean assuming that with the right support, people will eventually base most of their communication on words. Presuming competence should mean assuming that, with the right support, people will choose the means of communication that work best for them. Which may be speech. Or a voice output communication device. Or sign. Or body language. Or pointing to a letter board. Or speech. Or any number of other things. Or any number of combinations of things.

Short version: Everyone deserves to be listened to. If you want to support someone in learning to communicate, it has to be built on a foundation of listening to them — in whatever form their communication takes. Ignoring one form of communication to force them to learn a different form is not respectful, and probably won’t help.

Aftermaths of social skills lessons

Anonymous said to realsocialskills:

I’m autistic, I went to a group that was supposed to help me with autism-related issues, and they gave me some social skills advice that I honestly think was terrible. And the group was pretty terrible in general.

I ended up quitting for various other reasons, but it’s still sorta bugging me ‘cause what if they’re RIGHT.

The advice went like this: It’s okay to disagree with someone, but it’s never okay to explain WHY, because that’s pushing your opinion on them and that’s wrong.

realsocialskills said:

That rule is way too oversimplified to be useful. It’s true in some circumstances, and completely wrong in others — and completely useless at helping you to understand when it is and isn’t ok to contradict people.

The truth about social skills is that all rules are approximations at best. And often, as in this case, rules taught in social skills classes are completely useless and misleading.

Learning to be good at social interactions isn’t a matter of Learning the Rules; it’s a matter of learning to develop your judgement. Approximations and rules of thumb can help with this. They can’t replace the need to think for yourself and rely on your own judgement.

Social skills classes often teach people really destructive things about themselves and about social interaction. Here’s one way that can happen:

  • They tell you that autism (or whatever else) is preventing you from understanding social situations
  • They tell you that there are rules and that everyone else knows the rules naturally
  • They give you some simplistic rules and tell you to always follow them
  • The rules might sometimes be plausible-sounding or half-truths
  • Following the simplistic rules does not actually get the results they claim it does (because life is more complicated than that)
  • This can be really confusing
  • If you express this confusion to them, or say that it isn’t working, they attribute it to your autism and tell you to try harder or trust the process or something
  • They sometimes say this in a harsh way, they sometimes say it in a gentle or encouraging way. That difference is mostly aesthetic.
  • Either way, it amounts to the same pressure to believe them unconditionally and stop thinking for yourself

I suspect that something like that is going on here. The rule itself is useless. There’s no way to use it to tell whether or not it’s a good idea to explain your reasoning to someone you disagree with.

But it sounds just-plausible-enough to fuel self doubt, because there are some situations in which it really is mean to explain things to someone. (An example that’s been circulating on Tumblr recently: It’s ok to dislike Minions. It’s not ok to hassle kids about liking Minions or try to convince them that it’s bad and they shouldn’t like it.)

It can be hard to remember that these tiny kernels of truth aren’t actually meaningful. But they’re not. Kernels of truth in a simplistic rule don’t make it useful — and they don’t make the people pushing simplistic rules right.

Also – people who are wrong aren’t always wrong about everything. They may have told you some things that were true. They may have told you some true things that you didn’t know. And they may have told you some true things that you *still* don’t know. That doesn’t mean that their overall approach was ok, and it doesn’t mean you should trust them or doubt yourself.

I think, push come to shove, you have to think for yourself and develop your own judgement about these things. And sometimes that will mean that you make social mistakes — but they will be *your* social mistakes, and you will learn from them. It’s ok for autistic people to make social mistakes. Everyone has to learn this stuff, not just us.

Short version: Social skills groups can really undermine your ability to trust your own judgement. They give you simplistic rules that are impossible to follow, then blame you when it doesn’t work. It’s not your fault if this happened to you, and it’s not your fault if you’re having trouble recovering.

We are people

When I see a picture of someone who looks like me, it’s usually illustrating a tragic or demeaning story.

Sometimes it’s a picture of a child, illustrating a story about how difficult life is for parents of autistic children. Or a story about how the child’s favorite thing got turned into therapy. With depressing bullying statistics.

Sometimes it’s a picture of an adult, illustrating a story about how difficult life is for parents of autistic children once their kids reach adulthood. Or a bleak story about unemployment statistics. Sometimes it’s a story about a special business or sheltered workshop for autistics that the parent is proud to say their child is involved with. With depressing unemployment statistics.

Sometimes it’s a story about how an autistic person has a special talent. Maybe they’re an artist. The story is always about how mysterious and beautifully tragic it is that autism sometimes gives people special abilities along with significant impairments. The story will not take them seriously as an artist. It will be a human interest story about autism, and no art experts will be quoted — but the headline will probably say “autism does not define him.”

This gets corrosive. It can make the world seem bleak and hopeless. It can be hard to remember that this isn’t an accurate way to describe us. That we are, in fact, more than that.

In real life, we’re people, and we do things. We do things besides be miserable or be inspiring. We have thoughts and attributes that are not convenient to the tragic plots of newspaper articles. We’re people. We do real things. And we matter.

I am not a tragic story; I am not an illustration. I am a real person. And so are you.

Appearing to enjoy behavior modificiation is not meaningful

One common response to criticism of ABA is to claim that people subjected to it enjoy it:

  • “My child loves his therapist and asks to go to sessions!”
  • “All of my clients smile and have fun!”
  • “My ABA is play based!”

What people forget is that affect is a set of behaviors, and that behavior modification methods work as well on affective behaviors as they do on anything else:

  • You can reinforce people to look happy
  • You can reinforce people to praise therapy
  • It doesn’t have to be an explicit part of the behavior plan to happen
  • And it can keep happening even after you fade direct prompts or direct intentional reinforcers

ABA programs give the therapist massive power over the person. That power in itself can cause people to look happy, through a more subtle reinforcement mechanism than takes place on a behavior plan:

  • If you have power over someone in the way that behavior therapists do, they’re going to be highly motivated to please you
  • If they figure out that you want to believe that they are happy, they are very likely to act like they are
  • If you treat them better when they display the affect you want or praise you, they’re likely to act happy.
  • It doesn’t mean they’re actually happy
  • Or that what you’re doing is good for them

(Also, affect often is an explicit part of someone’s behavior plan. It is not at all uncommon for ABA programs to involve actively ignoring distress and withholding attention and rewards until someone looks happy. It is not at all uncommon for ABA programs to involve teaching people to smile, to hug, or to otherwise do things that would out-of-context indicate happiness, enjoyment, or affection. It doesn’t have the same meaning if it’s prompted or trained.)

Also, programs based on positive reinforcement involving controlling someone’s access to stuff they care about:

  • The first step in a program based on positive reinforcement is to find out what someone most enjoys or cares about
  • (This is called a preference assessment or a reinforcement inventory. Here’s an example.)
  • And then making sure they have no access (or limited access) to those things outside of sessions or other situations in which someone is actively reinforcing them to do something
  • Of course if someone’s only access to everything important to them happens in sessions they will ask for sessions
  • That doesn’t mean they like the fact that someone has that level of power over them
  • (No one likes being manipulated that way.)
  • That doesn’t mean they like the things that the therapist makes them do
  • That doesn’t mean the power dynamic is harmless
  • That doesn’t mean ABA is a good approach to teaching

People who can’t say no, can’t say yes meaningfully. Looking happy isn’t meaningful if you’re rewarded for affecting happiness and punished for looking visibly distressed. Making the best of a bad situation isn’t consent.