Tag: social skills

keeping your privacy in the aftermath of a suicide attempt

Real Social Skills

fenisoffended asked:

I’m visibly disabled as the result of a suicide attempt. Do you have any advice on how to respond when people ask what happened?

I think it’d be uncomfortable to tell casual acquaintances or strangers etc that I attempted suicide, but I don’t really know what else to say other than a flat-out lie.

(It was an overdose, so saying the cause without mentioning suicide would also make people uncomfortable and they might think less of me)

realsocialskills said:

I think there are three basic approaches that allow you to keep your privacy without lying:

  • Tell a partial truth
  • Use humor to deflect the question
  • Say that you don’t like to talk about it

Telling a partial truth works by saying something that is true or true-ish, doesn’t cause their mind to jump to suicide, and (ideally) doesn’t invite further questioning. Some possible phrases along these lines:

  • “It’s an old injury”.
  • “I’m used to it.“

If you want to use humor to deflect it, one way to do it is to tell an absurdly obvious lie, eg:

  • “I lost a fight with a penguin”.
  • “You know how they say not to look directly at the sun? They’re right.”
  • “Alien abduction.“

Absurdly obvious lies mean (and are at least sometimes understood to mean) “I don’t want to talk about this, and I’m giving you a way to drop the subject without having to state explicitly that you asked an inappropriately personal question.” There’s an affective piece of how to pull this off that I’m not sure how to describe. It requires a certain tone of voice and body language.

You can also say explicitly that you don’t like to talk about it.

  • Bodies are personal and you have no obligation to answer questions about yours
  • If you say that you don’t like to talk about it, it’s best to follow that up with an immediate subject change
  • (If you follow it with a pause, some people will reflexively try to fill the pause by asking why you don’t like to talk about it)
  • It might work best to keep your tone polite and friendly at first, and then get more firm if they push the issue

eg:

  • Them: So, how did your face get to be like that?
  • You: I don’t really like to talk about that. How about that local sports team we both like? Can you believe they lost to that team we all hate?

Other things that mean “I don’t want to talk about it”:

  • “That’s a long story.” (plus immediate subject change)
  • “That’s kind of private.” (plus immediate subject change)

None of these are foolproof, but they all work at least some of the time.

Short version: If you don’t want to talk about something, telling a boring truth, an absurd obvious lie, or saying you don’t want to talk about it are all sometimes effective methods.

Taking a troubleshooting approach

Real Social Skills

Content note: This post is my answer to a scout leader who asked a question about my objection to describing things pejoratively as “attention seeking behavior”.

justmethesecond asked:

Hey, you made a recent post about attention seeking behaviors and how there are a lot of normal things that involve seeking attention.

But I have a question, as I staff at scouting and we have some kids that do demand personal attention when that is inconvenient or impossible for us to give (such as in a group activity, when you have ½ adults on 20 kids)

To elaborate a little bit further, the behavior things I am talking about are mostly kids that talk individually back at you when explaining things to a group (or in other ways, such as crying or trying to play (physical) games with you).

These types of behavior aren’t bad but they do sometimes limit our ability to explain things to a group of people.

And I was wondering how to deal with that?

realsocialskills said:

A couple of things:

There is no generalized way to deal with that. It depends on the situation.

Part of what you need to do is identify the problem more specifically:

  • Attention seeking isn’t the problem in itself
  • The problem is that the group activity isn’t working
  • Part of the problem *might* be that some kids need to learn what’s appropriate and what isn’t
  • Part of the problem *might* be that kids are being willfully disruptive and need to know that you won’t tolerate it
  • The problem might be something else entirely, and almost certainly has components that aren’t “that kid has a behavior problem” or “that kid is attention seeking”
  • There are a lot of possibilities, and I’ll get to some of them later in this post

Here’s why you shouldn’t call this “attention seeking behavior”:

  • “Seeking attention” is not an objective description of behavior; it’s a very vague theory about why someone might be doing something.
  • There is no such thing as generic “attention seeking behavior”
  • From your perspective, everything that annoys you by getting your attention when you don’t want to, can’t, or shouldn’t pay attention may feel the same
  • But it’s *not* all the same from the perspective of the kids who are annoying you
  • They’re doing what they’re doing for reasons, and the reasons are specific and individual.
  • (And they may or may not have anything at all to do with attention)
  • Eg: A child may be crying *because they’re upset*, and it might not be about you at all. They may in fact find the crying humiliating and be hoping that no one notices.
  • A child who is trying to play a game with you isn’t just generically trying to get attention. They’re trying to play a game. Which they may be doing for any number of reasons
  • A child who talks to you during the announcements might be trying to give input, ask a question, focus their attention, or any number of other things
  • Don’t collapse all of that into “attention seeking” as if it’s all the same.

Here are some troubleshooting tips:

Consider whether your expectations are age-appropriate:

  • Little children have a short attention span
  • They can’t sit and listen very long
  • They can’t wait very long for a turn to do something active
  • If you’re having problems with multiple kids, it’s very likely that you’re asking them to do something that they’re really too young for
  • If you’re asking kids to attend for longer than is reasonable for kids their age, *you’re* the one who is inappropriately seeking out attention when it’s not possible
  • (And just like you’re not doing it maliciously, kids who are disruptive are probably not doing it maliciously either)
  • It might be time to change how you do announcements and activities

Make sure the group knows your expectations:

  • It’s easy to assume that kids know the rules when they don’t
  • Things that are obvious to adults are not always obvious to children, especially young children
  • Kids are not born knowing how groups work
  • And different groups have different rules
  • Don’t assume that kids *know* that they’re not supposed to talk individually back at you when you’re addressing a group (there are actually environments where that’s allowed)
  • Don’t assume that kids *know* you’re not supposed to try to play side games or whatever
  • It can help to have a group conversation about rules
  • It’s particularly helpful if you get the kids’ input about the rules in that conversation
  • It’s likely that kids know things you don’t about what needs to be spelled out explicitly
  • And also things you don’t about what the rules need to be
  • Don’t do this as a punishment. Do this as a group conversation about rules. If it’s well into the year, you can say something like “So we realized that we forgot to set rules for the group. This week we’re going to start by setting the rules together.”
  • Many of the kids in your group will have done an exercise like this before; it’s a fairly common thing to do with kids
  • (Be careful though, don’t say things like “but you agreed to these rules!”. This isn’t really an agreement. This is you setting rules from a position of authority, and getting some input from kids about what the rules should be.

Redirect:

  • If you’re not saying in the moment that something is a problem, it’s important to start doing that
  • If you don’t object, some kids might be assuming you’re ok with it
  • Don’t be mean, but do speak up, eg:
  • “You can ask questions when I finish talking”
  • “I can’t play with you right now”.
  • It also helps if you can phrase it by telling them what you *do* want them to do, eg:
  • “Try and tag someone. I bet you can tag (specific kid).”.
  • If kids have trouble telling when it is and isn’t ok to talk, try having an object that someone holds when it’s their turn to talk.

Talk to the kids who are having trouble individually:

  • Talk to them about what’s going on (out of earshot of other kids)
  • Talk to them about why some of the things they’re doing are a problem
  • They might actually not know — no one is born knowing how to act in a group, and some kids need to have it explained explicitly
  • Even if you’ve had a group conversation about rules, it’s possible that they don’t get it
  • Or that they can’t follow the rules as they stand
  • It’s important to ask them what they think is going on
  • And if there’s a reason it’s not working for them
  • And if they have ideas about solving the problem
  • Kids don’t always know, but sometimes they do
  • And knowing that you care makes a difference

Parents also might be able to help you:

  • Parents (usually) know their kid better than you do
  • This is particularly true of elementary-aged kids
  • Most parents want to help their kids
  • Most parents have at least half a clue about what is helpful to their kids
  • Don’t use calling parents as a punishment
  • Do talk to parents when there’s a problem in your group and you don’t know what to do about it
  • (Be more cautious about this with older kids; teenagers have a developmental need for more privacy)
  • (Also be cautious about this if you suspect abuse. Talking to parents who are likely to be harshly punitive is not likely to make things better)
  • Say explicitly that this is not a punishment and that you’re asking for help
  • They will likely have helpful suggestions
  • (Not always; some parents are unreasonable. But a lot of parents are very helpful, if you listen to them).
  • Don’t assume parents are right; do listen to them. They often know things you don’t.

Ask for advice from a teacher:

  • Teachers spend all day working with groups of kids
  • Not all of them are good at it; but some of them are
  • Good teachers will know things you don’t about how to make activities and announcements work
  • If you know a teacher who you respect, ask them for advice
  • Ask these questions specifically:
  • “I’m having trouble with some kids in the scouting troop I’m running. Could I ask you for some advice?”
  • “Is this something that’s reasonable to ask of kids this age?”
  • “Do you have any advice about how to manage this problem in a positive way?”
  • “Do you know about something else that works well?”
  • Listen to what they say and consider why they’re saying it, but ultimately trust your own judgement. You are the one working with kids directly, and you’re the one who is ultimately responsible. Don’t do something that you think is wrong.

Google resources for teachers:

  • There are a *lot* of resources for teachers on the Internet
  • Most things that are relevant for teachers are also relevant for scout leaders
  • You can google activities for kids the age you work with, then consider which things on the lists are likely to work for kids you work with
  • Positive classroom management is also a good thing to google (particularly for the age you work with)
  • Not all teacher resources are good; seek out information, and use your own judgement about which advice to take

Consider the possibility that your environment is causing pain:

  • Scouting often takes place in physically uncomfortable outdoor environments
  • That may be intolerably painful for some of your kids
  • Are they being painfully bitten by bugs? If so, do they have bug spray? Are they using it? Is it working?
  • Are they getting sunburned? If so, maybe you need to change the procedure for making sure that all kids put on sunscreen.
  • Is the sun shining painfully into their faces?
  • Are they inhaling campfire smoke?
  • Are they sitting in a painful position?
  • Sitting cross-legged on the ground or floor is physically painful for some kids
  • (Likewise sitting on benches with no back support)
  • It might be that they’re trying to do things that will get them out of that position
  • If you suspect that this is a problem, try having kids sit in chairs and see what happens
  • Or try sitting around a table kids can lean on and see what happens
  • This is particularly likely to be the case for older kids or heavier kids
  • Positions often become intolerable as kids get bigger
  • It also might help to alternate between sitting activities and standing or moving activities in shorter intervals so that kids aren’t sitting as long

Are they hungry or thirsty?

  • Often when kids are disruptive, it’s because they’re hungry or thirsty
  • At certain ages where kids are growing rapidly, they’re hungry a *lot* of the time
  • Kids won’t necessarily realize that enough to ask
  • And they also may have been taught that asking is pointless because no one cares whether they are hungry or thirsty
  • Being proactive about this might help
  • Try making water easily available without kids having to ask for it (eg: by requiring them to carry water bottles)
  • If you’re not already doing a snack at the beginning of the meeting, try doing that
  • If you are already doing that, try making it something more substantial
  • Low calorie snacks suitable for adults who are trying to lose weight are *not* good snacks for the purpose of feeding hungry children
  • (Eg: celery sticks are not a good snack to get growing kids through a scout meeting; celery sticks with peanut butter might be. A handful of pretzels is not a good snack; cheese sticks might be.)
  • If you’re on a camping trip or something, you may need to feed the kids more often than you realize
  • If this is a problem, it’s probably *also* a problem for the kids who *aren’t* disruptive, so don’t just do this for the disruptive kids. Assume that all of the kids may be hungrier and thirstier than you realize

Don’t be mean:

  • If something feels mean, don’t do it
  • If you’d think it was mean if someone did it to you, don’t do it
  • If something is humiliating toward a kid, don’t do it
  • Don’t punish kids in front of other kids
  • It’s ok to say something like, “Not now” and redirect
  • It’s not ok to yell, or say something like “I’ve told you this over and over, why don’t you get it?”
  • (If you need to take a kid out of an activity and talk to them about it, have the conversation out of earshot of other kids)
  • Don’t have a big reward event and exclude some kids from it

Some kids need 1:1 support:

  • Some kids need a lot of help to do some things
  • If that’s the situation, the problem isn’t that they’re misbehaving
  • The problem is that they need more support than they’re getting
  • This may or may not be a problem you (or their parents) can solve
  • But it is something that should be on the table as a possibility for some kids
  • A caution about that: Sometimes people leap to the assumption that any kid they’re having trouble with needs a 1:1, and it’s usually not true.

Sometimes the solution is to change the activity.

  • No amount of clarifying rules and expectations will help if you’re asking a kid to do something they’re not capable of doing.
  • Or if you’re routinely asking them to do something that is extremely difficult and only barely possible for them
  • Or if you’re asking them to routinely do something they find actively distressing
  • If there are insurmountable barriers to a kid participating in an activity, then the activity probably needs to change
  • Some kids need to be actively doing something in order to pay attention
  • Some kids need attention in order to pay attention
  • A kid having these needs is not a behavior problem; it’s a support need

Thoughts on changing activities:

  • Some activities require a lot of turn-taking, passive listening, and waiting
  • Those are not great activities for kids who need a lot of feedback in order to know what to do
  • They’re also not great activities for kids who need to be actively participating in order to focus
  • If you have kids in your group who have that need, it is likely a good idea to switch to doing activities in which everyone is actively doing something most of the time
  • For instance:
  • Red Rover probably won’t work well with kids who have trouble with passive waiting
  • And a circle activity in which only one person at a time does something is likely to be even worse
  • Games in which everyone is actively playing, like tag or Simon Says, are likely to work much better
  • This is also true of group conversations:
  • Long conversations with a big group require a lot of passive listening. That’s a problem for kids who need to be active in order to focus
  • Having kids discuss things in small groups or with a partner might work better

Sometimes you can change an activity by creating a way for kids who’re having trouble a way to focus:

  • Eg: Kids who have trouble in groups might be able to focus if they take notes
  • Or if they have a fidget toy to fidget with
  • Or if they have a specific task (ie: if everyone is supposed to be preparing a campfire and they’re climbing on you, it might help to ask them to gather wood from a particular area)
  • A caution about this: Don’t use this as a reward or as a punishment.
  • Don’t assume any particular approach will work. Don’t single a kid out over their objections. (eg: If a kid doesn’t want to take notes or use a fidget toy, don’t make them just because someone on the internet says this helps some kids)
  • Sometimes minor modifications work; sometimes they don’t. When they don’t work, it’s time to try something else.

This isn’t an exhaustive list — there are a *lot* of things worth trying and thinking about. The important thing is to take a troubleshooting approach and to keep trying to identify and solve the actual problem.

Short version: Sometimes when you’re responsible for kids, they do stuff you don’t like. This is often treated generically as “attention seeking behavior”, but it shouldn’t be. Kids have much more diverse and complex motivations than that. Instead of calling it “attention seeking”, or ignoring them, adopt a troubleshooting approach to the problem. Taking a troubleshooting approach is much more likely to enable you to identify and solve the actual problem. Scroll up for some specific troubleshooting suggestions.

Not being believed

Real Social Skills

Content note: This is a post about ABA, and not being believed about the harm ABA does.

A reader asked:

People don’t believe me when I say I was a victim to ABA abuse, not even my parents.

I was misgendered routinely, I could not drink water even though this was harmless and was often asked to write my name even though this was effectively pointless.

How should I convince people I was really abused?

Am I just whining and should I “get over it” because that’s not “real abuse” and I’m not autistic?

realsocialskills said:

It’s not your fault that therapists hurt you. It’s not your fault that people don’t believe you. What people did to you matters, even if no one believes you.

ABA is degrading on a level that it can be very hard to recover from or even describe. The basic methodology of ABA is finding out what you care about most and using it to get compliance with arbitrary demands.

I’ve written some here and here and here about the kind of damage that does, and that’s only scratching the surface.

Increasingly, one of the things behavior therapists demand is that you pretend that they’re not controlling you. They often go so far as to demand that you act like you like what’s happening and believe that it’s both necessary and enjoyable. And they do that even as they make you do obviously pointless things (like writing your name over and over), and even as they do obviously awful things to you (like denying you water and misgendering you).

That kind of thing can mess with your mind really badly, especially when you’re surrounded by people who don’t believe you.

It’s not your fault that people don’t believe you. They can refuse to acknowledge what people did to you; you can’t make it go away. It matters even if no one around you cares.

You will probably always have to deal with people who don’t believe you. Most people are reluctant to believe that therapists ever hurt people in ways that matter, and ABA has a particularly effective publicity machine. Some people will say that you’re whining, that you’re lying, and that the things you’ve described don’t happen. They’re wrong. It matters that people hurt you in the name of helping you. It’s horrible that people who you should be able to trust don’t believe you.

Some of them may eventually come to understand. Sometimes people come around, in the long term. But you don’t have to wait for that in order to be ok, you don’t have to explain it to them if you don’t want to, and what happened to you matters whether or not people believe you.

Also… You are not alone. What happened to you shouldn’t happen to anyone. There is a community of people who know that it’s wrong to treat people that way. Making connections with people who believe you might help a lot.

It’s much easier to hold on to your perspective if you’re not doing it alone. This is hard. It’s also possible. You’re ok.

Short version: Abuse matters even if no one believes you. That said, making connections with people who believe you can help a lot. You are not alone, even if really important people in your life don’t believe you.

Relieving childcare pressure without watching kids

Real Social Skills

chartreuse-chasmophilous asked

There’s a problem in my family: my cousin and his wife are in quite a tight spot (little kid, both work full-time, even overtime sometimes, not a lot of money), and receive little to no support from my cousin’s parents.

As my mum (his aunt) was always really close to him, we often help them instead, both with money and babysitting (esp during the holidays). I’d like to help them as well, but I’m rubbish with kids (she’s four and very hyperactive). Is there another way for me to support them?

realsocialskills said:

Probably.

I don’t know them, so it is hard for me to say what they need help with.

The best way to find out might be to ask them, possibly by saying something like: “I’m not comfortable watching children, but I’d really like to find other ways to support you. Is there another way I could be helpful?”

That said, asking an open-ended question might not make it possible for them to tell you what they did. Open ended questions don’t tell them much about what you are and aren’t ok with. If you don’t know what someone is likely to feel comfortable helping with, it can be really hard to ask for help.

So it might be better to offer something specific.

You may be able to help with childcare needs indirectly:

  • People who have young kids and no childcare have to take their kids with them to a lot of places
  • That makes a lot of errands take longer
  • It also makes them more draining for both the parent and child
  • Eg: Parents who have no childcare have to bring their kids to the grocery store
  • At best, this means that grocery shopping takes longer because they have to supervise their kid and shop at the same time
  • And they have to bring their kid even if their kid is too tired to tolerate it well
  • Then the kid is miserable, and the parent has to deal with caring for a miserable (and probably uncooperative) kid in a public place while judgmental strangers stare at them
  • And it’s likely that both parent and child will be upset even after the errand is over
  • And it can interfere with sleep and make the next day difficult as well
  • If you can do some of their grocery shopping for them, that can relieve childcare pressure without you having to watch any kids

Some other things that might help to relieve childcare pressure:

  • Picking up their mail
  • Picking up their prescriptions when they or their child is sick
  • Dropping off things that they need transported
  • Being at their house for the plumber/cable company/etc so that they don’t have to take off work (which means they have more time off available to deal with child-related things)
  • Household tasks that are difficult to accomplish with children who need close supervision (eg: mowing the lawn if they’ve got one)

It’s ok for people with disabilities to want attention

Real Social Skills

A lot of things that people with disabilities do get pathologized as “attention seeking behaviors”, whether or not they have anything to do with wanting attention.

That’s not the only problem with the whole concept of “attention seeking behaviors”.

Another problem is that there’s actually absolutely nothing wrong with wanting attention. In fact, all communication involves seeking attention in some way.

Taken literally, here are behaviors that involve seeking attention:

  • Saying hello
  • Asking if someone is ok
  • Writing a blog post
  • Performing on stage
  • Teaching a class
  • Waving to someone
  • Asking a question
  • Reporting a problem
  • Commenting on something
  • Posting on Twitter

“Attention seeking” isn’t a neutral technical term. It’s professional jargon for saying “this person becomes unworthy of attention when they do this, and so we’re going to aggressively ignore them.”

That’s a value judgement, generally a very harsh value judgement. There’s nothing scientific, technical, or medical about that kind of judgement. And it’s a very cruel thing to do to people who don’t deserve it.

Short version: Calling something an “attention seeking behavior” isn’t a technical term; it’s a (generally unwarranted) insult.

When people keep asking why you don’t have kids

Real Social Skills

A reader asked:

I’ve had a hysterectomy and I live in a region where it’s very odd (like, statistical outlier odd) for a woman not to have kids by my age.

So it’s fairly common for people to continue to harass me about why I don’t have kids and not take any of the polite attempts at diverting the subject as hints to leave me alone until I tell them the truth.

Then when I tell them the truth they get mad and say that it’s too much information. Any advice for dealing with this?

realsocialskills said:

It might help to be direct about saying it’s a personal question.

I’m not sure how your conversations are going. I’m getting the sense that they might be something like this:

  • Them: So, why don’t you have kids yet? When are you going to have them?
  • You: Nice weather we’re having. But it’s summer and so it will probably rain soon. Do you think it will cause flooding again?
  • Them: Oh, probably. It usually does. But what about kids? Are you seeing anybody? Fertility doesn’t last forever.
  • You: So, I have this great new recipe for a seven-layer congealed salad.
  • Them: Children are a blessing. Life really can’t be complete without them.
  • You: That may be true, but I had a hysterectomy, so it’s not happening. Now can we please talk about something else?
  • Them: Why would you tell me something like that?!

It might help to add a warning layer before you tell them the truth. One possible layer: Saying it’s personal and that you don’t want to talk about it, then an immediate subject change:

  • “That’s awfully personal. I don’t like to talk about this.”
  • “That’s private medical information.”

Another possible layer: Asking rhetorical questions that warn them that they might not actually want an answer. This can make it harder for them to blame you, and more likely that they’ll back off:

  • “Do you really want the gory medical details?”
  • “That’s a very personal question. Do you really want to ask that?”
  • “Are you sure you want an answer to that?”

Another possibility: Answering the question in a way that’s a bit less graphic but still gets the point across:

  • “It just hasn’t been in the cards.”
  • “I can’t have children.”
  • “I’m sterile.”
  • “It’s not medically possible.”

If you’re in the South, there are some nuances about how to make people feel bad about asking inappropriate questions that I don’t really understand. (Which is part of the reason I don’t live there anymore.) It’s mostly a matter of affect. I know that it involves inserting a certain kind of pause and icy body language that tells someone they’ve crossed a line, but I don’t know how to do it or describe it well. If anyone who is better at that wants to weigh in, that would be welcome.

Short version: If your attempts at subtly deflecting intrusive questions are failing, it can help to more explicitly say that the question is too personal and that you don’t want to answer it.

Organizing fun gatherings

Real Social Skills

A reader asked:

Ever since my depression got better, I been doing more leading in get-togethers. Like inviting people over to my house and suggesting what we’re going to do. But I feel like people don’t have as much fun at my activities as those led by my other friends. I take a lot of input on what we do, and I tell funny jokes.

Is there anything else I can do when leading a group, formally or informally, to help people relax and have fun?

realsocialskills said:

I think you might be pushing yourself too hard.

If people are having fun and liking your get-togethers, that’s success. You don’t have to be the best or the most fun for what you’re doing to be good enough. It’s not a contest, and it’s ok if you’re not as skilled at throwing parties as some of your friends. It’s a skill set that you can develop over time.

That said, from the way you’ve described things, it sounds like your gatherings might be happening this way:

  • You invite people over
  • They come over
  • You spend time deciding together what to do
  • Then you do the thing together

If you’re doing it that way, it might be making your gatherings less fun than they could be. Negotiating with a group about what to do isn’t very much fun, and it can set the tone for the gathering being less fun.

Also, if you don’t pick the activity in advance, there will usually be someone who wanted to hang out who doesn’t want to do the activity that the group decides on. That person usually won’t be very happy, and that can make things less fun for everyone.

If that’s how you’re doing it, your gatherings are likely to become more fun if you decide on an activity in advance, like this:

  • Pick something that you and some friends like
  • Invite them to come do that thing with you
  • People who want to hang out and want to do that thing will come
  • People who don’t want to, won’t come
  • There won’t be any tiresome negotiation phase of the gathering
  • No one will be stuck in an unanticipated activity that they don’t enjoy

Some examples of activities you can decide on in advance:

  • A game night (either a specific game, or whatever games people decide to bring)
  • Going to the new Exciting Movie in a series you like
  • Going out to dinner together
  • A dinner party at your place
  • Getting together for movies and popcorn at your place (better if you pick the type of movie in advance, or maybe even the actual movie)
  • (Here’s a post about things some people like to do at Halloween parties)

In any case, organizing fun gatherings is a skill, and you’ll get better at it as you get more experience. You don’t have to be perfect or the best for your gatherings to count as successful. If you like them and most of the people who come like them, that’s success.

Short version: Picking an activity in advance and inviting people to do it is likely to be more fun than gathering a group of people and deciding together what to do.

ABA therapy is not like typical parenting

Real Social Skills

Content note: This post is about the difference between intense behavior therapy and more typical forms of rewards and punishments used with typically developing children. It contains graphic examples of behavior programs, and is highly likely to be triggering to ABA survivors.

A reader asked:

I just read your thing about people with disabilities and their interests. Don’t people do the same thing to typical children? Restrict access to things enjoyed until act ABC is completed? For example, growing up, I was only allowed to watch tv for 1 hour a day IF I finished all of my homework and schoolwork related things first.

realsocialskills said:

It’s not the same (although it has similar elements and I’m not a huge fan of the extent to which behavior modification techniques are used with typically developing children either.)

Here’s the difference: Most children actually should do their homework, and most children have interests other than television. Typically developing children are allowed to be interested in things, and supported in pursuing interests without them becoming behavior modification tools.

(Another difference: intense behavior modification is used on adults with developmental disabilities in a way that would be considered a human rights violation if done to typically developing adults.)

Using behavior modification tools for one or two things in a child’s life isn’t the same as doing it with everything in someone’s life. Intense behavior therapy is a violation on a level that it’s hard to describe.

Intense behavior therapy of the type I’m talking about typically involves:

  • Being surrounded by people who think that you’re broken, that all of your natural behavior is unacceptable, and that you need to be made to look normal in order to have any hope of a decent future
  • Having completely harmless things you do pathologized and modified (eg: having hand flapping or discussing your interests described as “a barrier to inclusion”)
  • Having those things conflated with things you do that actually *are* a problem. (eg: calling both head banging and hand flapping “sensory seeking behavior” and using the same reinforcers to eliminate both)
  • Being forced to stop doing things that are very important to you, by people who think that they are pointless and disgusting or “nonfunctional” (eg: using quotes from TV shows to communicate)
  • Being forced to do things that are completely arbitrary, over and over (eg: touching your nose or putting a blue ball in a red box)
  • Being forced to do things that are harmful to you, over and over (eg: maintaining eye contact even though it hurts and interferes with your ability to process information)
  • Having everything you care about being taken away and used to get compliance with your behavior program (eg: not being permitted to keep any of your toys in your room)

(Behavior therapy often also involves legitimate goals. That doesn’t make the methods acceptable, nor does it make the routine inclusion of illegitimate goals irrelevant.)

Here’s an explicit instruction from a behavior expert on how to figure out which reinforcers to use for autistic children:

Don’t assume that you know what a child with ASD likes. It is important to ask a child, observe a child or perform a preference assessment. When asking a child about reinforcers, remember that multiple reinforcement inventories can be found on the Internet.

You can also simply sit down with a child and ask them questions like “What do you like to do after school?” or “What’s your favorite food?”or “What toys do you like to play with?”

When observing a child, set up a controlled environment to include three distinct areas: food, toys, and sensory. Then allow the child somewhat free access to this environment.

Watch and record the area that the child goes to first. Record the specific items from this area that the child chooses. This item should be considered highly reinforcing to the child.

Continue this process until you have identified three to five items. Remember that simply looking at an item does not make it reinforcing, but actually playing with it or eating it would.

Notice how it doesn’t say anything about ethics, or about what it is and isn’t ok to restrict access to. This is about identifying what a child likes most, so that it can be taken away and used to get them to comply with a therapy program. (Here’s an example of a reinforcement inventory. Notice that some examples of possible reinforcers are: numbers, letters, and being read to).

People who are subjected to this kind of thing learn that it’s not safe to share interests, because they will be used against them. That’s why, if someone has a developmental disability, asking about interests is often an intimate personal question.

This isn’t like being required to do your homework before you’re allowed to watch TV.

It’s more like:

  • Not being allowed to go to the weekly meeting of the science club unless you’ve refrained from complaining about the difficulty of your English homework for the past week

Or, even further:

  • Not being allowed to join after school clubs because you’re required to have daily after school sessions of behavior therapy during that time
  • In those sessions, you’re required to practice making eye contact
  • And also required to practice talking about socially expected topics of conversation for people of your age and gender, so that you will fit in and make friends
  • You’re not allowed to talk about science or anything else you’re actually interested in
  • You earn tokens for complying with the therapy
  • If you earn enough tokens, you can occasionally cash them in for a science book
  • That’s the only way you ever get access to science books

Or even further:

Being a 15 year old interested in writing and:

  • Being in self-contained special ed on the grounds that you’re autistic, your speech is atypical, and you were physically aggressive when you were eleven
  • Having “readiness for inclusion” as a justification for your behavior plan
  • Having general education English class being used as a reinforcer for your behavior plan
  • Not being allowed to go to English class in the afternoon unless you’ve ~met your behavior targets~ in the morning
  • Not being allowed to write in the afternoon if you haven’t “earned” the “privilege” of going to class
  • eg: if you ask questions too often in the morning, you’re “talking out of turn” and not allowed to go to class or write in the afternoon
  • or if you move too much, you’re “having behaviors that interfere with inclusion”, and not allowed to go to class or write
  • or if you mention writing during your social skills lesson, you’re “perseverating” and not allowed to go to class or write

Or like: being four years old and not being allowed to have your teddy bear at bedtime unless you’ve earned 50 tokens and not lost them, and:

  • The only way to earn tokens is by playing in socially expected ways that are extremely dull to you, like:
  • Making pretend food in the play kitchen and offering it to adults with a smile, even though you have zero interest in doing so
  • You gain tokens for complying with adult instructions to hug them, touch your nose, or say arbitrary words within three seconds; you lose two for refusing or not doing so fast enough
  • You lose tokens for flapping your hands or lining up toys
  • You lose tokens for talking about your teddy bear or asking for it when you haven’t “earned” it
  • You lose tokens for looking upset or bored

Or, things like being two, and loving books, and:

  • Only having access to books during therapy sessions; never being allowed unscripted access to books
  • Adults read to you only when you’re complying with therapy instructions
  • They only read when you’ve pointed to a picture of a book to request it
  • You’re required to sit in a specific position during reading sessions. If you move out of it; the adult stops reading
  • If you rock back and forth; they stop reading
  • If you stop looking at the page; they stop reading
  • If you look at your hand; they stop reading
  • Adults interrupt the story to tell you to do arbitrary things like touch a picture or repeat a particular word. If you don’t; they close the book and stop reading.

Here are a few posts that show examples of the kind of thing I’m talking about:

Short version: Intense behavior therapy has some things in common with methods that are used with typically developing kids, but it’s not actually the same. Intense behavior therapy involves violation and a degree of control that is not considered legitimate with typically developing children.

A behavior modification aftermath

Real Social Skills

Content note: This post is written with parents and professionals in mind. It’s about a common way that rewards-based behavior modification hurts people, and the importance of being aware of that effect in work with people who might be ABA survivors.

I’ve seen a lot of well-meaning people who are trying to fix special education and adult disability services say things like “you have to find out what they’re interested in and incorporate it.”

This can be good advice. It’s also important to realize that this is loaded, and that not all disabled people are going to be willing or able to show you what they’re interested in.

For people with disabilities, “what do you like?” can be a deeply intimate personal question. It can be very dangerous to let people know what you are interested in.

Autistic people (and others with intellectual and developmental disabilities) are often subjected to intense behavior modification. This is often aimed at silencing them, getting them to pretend to be non-autistic, or otherwise change in ways that deny fundamental things about who they are.

You have to take some pretty extreme methods to get someone to comply with that kind of behavior program. One traditional way is to use painful punishment like starvation and electric shock. These days, that’s considered distasteful, and most therapists prefer to use positive methods.

In practice, what that often means is that anything a disabled person expresses interest in will be taken away and used as a reinforcer for a behavior plan. The more they care about something, the more their access to it will be contingent with compliance with what powerful people in their life want.

Even if the thing they care about is something like math. Or books. Or access to fresh air. Or their teddy bear.

People subjected to this kind of thing learn quickly that when they express interest in something, it will probably be taken away.

And beyond that, they learn that when people know what you care about, they will use it to manipulate you into doing awful things to yourself. In many cases, this includes being manipulated into maintaining a grateful affect and praising the therapist.

When people have experienced this type of violation, sharing their interests with anyone is a big risk. Particularly if that person has power over them. Particularly if that person is a member of a professional culture that largely approves of what was done to them. (And if you’re a teacher, therapist, direct support professional, or similar, you have power over them and your professional culture approves of misusing it.)

It’s important to keep in mind that people you work with have every reason to believe that it is dangerous to tell you what they care about. They don’t know what you will do with that information, and have every reason to believe that you will use it against them. (Or that information they give you will get back to people who will do so.) It might take a long time before some people are willing to share their interests. Some people may never trust you. The way you teach and offer support needs to take this into account.

Short version: It’s important to be aware of the loaded nature of asking disabled people to express interest in things. It’s important to make space to incorporate interests; it’s also important to allow people to keep their interests private.

Finding things you can fix when things are really wrong

Real Social Skills

ischemgeek asked:

Advice on expressing sympathy and lending emotional support to a family member whose child may be facing a serious illness? Both for the “dunno for sure” phase and for the “know for sure either way” phase. Comforting is not my strong suit and halp plz because this can’t be fixed so soothing is only way to be helpful.

realsocialskills said:

This is the second part of my answer to this question. The first part was about emotional support. This part is about practical support.

I think that there are probably some things you can fix in this situation.

The problem of possible illness can’t be fixed. Secondary problems surrounding the situation *can* be fixed.

When a child is facing a serious illness, all kinds of practical things get complicated. Diagnosing and treating illness involves a lot of medical appointments, tests, insurance wrangling, and other complications. And it happens with no warning, when people are already busy with other things. They’re probably both physically and emotionally exhausted. They probably could use a lot of help.

Some possible problems that might be solveable:

Childcare:

  • If you live nearby and are comfortable babysitting, offering to watch their kids some could be really helpful
  • If they have other kids, someone has to watch them while they’re at medical appointments with the possibly-sick kid
  • Suddenly needing more childcare than you expected to need is a logistical nightmare, and it is very likely that they don’t have as much help as they need
  • Even if they only have the one child, more childcare would probably be helpful
  • The obligations of life don’t go away when a child gets sick, and there are likely many things they’re behind on that are hard to catch up on while caring for a child

Helping kids with homework:

  • If their kids go to school, they likely have a lot of weekly homework that they need adult support with
  • This can get very complicated if parents are suddenly very busy and emotionally exhausted
  • Even if you don’t live nearby, if you can be available for some homework help over email or Skype, that could take a *lot* of pressure off of the family.

Communicating and running interference:

  • When a kid gets sick, a lot of people want constant updates
  • This is generally exhausting and burdensome to the kid and the parents
  • Sometimes it helps to have a point person for updates and boundary-assertion
  • Or someone to run a CaringBridge page so they don’t have to
  • I don’t know if they’d want this or if you’d want to do this; some people find this helpful but I don’t know what they want or what your relationship with them is like

Helping them with the insurance company and other bureaucracy:

  • If they are in the US, an insurance company is probably being awful to them and refusing to pay for things
  • Or making things needlessly complicated and confusing
  • They also might need to apply for government or charitable assistance at some point
  • Which is hard to do when you’re overwhelmed and exhausted and have never done so before
  • If you’re good at navigating that kind of thing, you might be able to help them
  • Or you might be able to do research and find out things that can help them
  • Again, I don’t know if they’d want this kind of support from you or not. Some people do; some don’t

Money:

  • Illness is expensive no matter where you live, even under ideal circumstances
  • And unexpected major expenses make life really hard
  • If you are in a position to help them financially, it would probably make some things significantly easier for them
  • Money can’t fix the biggest problem, but it can go a long way towards fixing the secondary problems

Other general life logistics: There are a lot of things that get hard when there’s a crisis, that they might welcome help with:

  • Keeping their house clean
  • Cooking some food (or ordering them the occasional pizza)
  • Mowing the lawn if they have one
  • Getting groceries and supplies
  • Picking up prescriptions
  • Getting kids to and from school
  • Keeping their computers and network in good working order
  • Making sure bills get paid on time

These are the things I can think of offhand. I don’t know which, if any, it makes sense for you to do. I don’t know the extent to which your relationship with them makes help appropriate. I think it is likely that there are things that you could do to be materially helpful — and also important to realize that you don’t have to do all of them (and probably shouldn’t).

Short version: When someone’s facing a major life problem that you can’t solve, they’re generally also facing secondary problems that it’s possible to help them with. Scroll up for some specific suggestions.