Tag: tagging for relevance

It’s ok to watch the same clip over and over

Real Social Skills

I’ve seen a lot of parents express concern about their kid watching the same clips over and over on YouTube, or watching shows they’ve seen before over and over, or similar.

I think that a lot of people are under the impression that watching the same videos repeatedly is an inherently meaningless activity. It’s not.

Here are some purposes repeated video watching can serve:

Getting oriented:

  • Sometimes the world is very confusing
  • Going back to something familiar can make the world less confusing
  • It can also remind you of feelings that it is possible to have and ways that it is possible to express them
  • For some people, all of this is really important

Focusing or averting overload:

  • Noise can be really overloading or distracting for some people
  • So can silence
  • So can new things
  • Having a familiar video on can be a really effective way for some people to avert overload and/or stay focused
  • This is meaningful and important. It’s important to be able to be comfortable and think clearly.

Noticing new things

  • The video is the same every time, but the person watching it isn’t
  • When you watch it over and over, you see new things
  • It can be conceptual things like coming to interpret the story in a new way
  • Or sensory things like noticing sounds and colors that you never noticed before
  • This kind of repetition and examination is meaningful, and can be a great joy

Receptive and expressive language:

  • People who communicate by repeating words and phrases can get more words and phrases, and more meaning out of the phrases they have, by watching the same video over and over
  • Watching the same video over and over can also be really good for receptive language
  • It can be practice listening to things
  • The meaning stays the same, and watching it over and over can be a way, over time, come to understand the words in it better
  • This is also true of body language – in a video, you can watch the body language over and over and come to understand it
  • There’s also far less pressure to already understand. In interactions with people, you upset them if you don’t get it. Videos don’t need you to understand them – you can try as many times as you need to and take as much time as you need without anything bad happening.

Short version: It’s not cause for concern if a kid watches the same videos over and over. Adults do it too, and it serves a purpose. Watching the same things over and over can be valuable and important.

Autism is a disability

Real Social Skills

A reader asked:

You know, I follow this blog because I think it’s cool and although I don’t really read your advice posts, I can see they’re very respectful and well thought out. That aside, I want to ask: how do you feel about labeling autism as a disability?

realsocialskills said:

I feel very strongly that it is important to refer to autism as a disability. It’s not just a difference; it’s a particular kind of difference, and that kind of difference is called disability.

There are all kinds of things that most people take for granted that autistic people can’t do, or struggle with, or can only do intermittently. Autistic people face ableist discrimination in response to not being able to do those things, or being perceived as not being able to do those things.

We have all of that in common with people with any other kind of disability. Acknowledging that allows us to learn from and collaborate with one another. Denying that we’re disabled just isolates us.

I think that every single thing I’ve written about autism has been reblogged by someone with another kind of disability saying “I can relate to this too”. As a result, my writing has become increasingly cross-disability. We have a lot in common.

If we try to separate ourselves from other disabled people, we lose a lot. Overlapping disability communities have a lot in common, and a lot of built up tools for dealing with disability, dealing with discrimination, and supporting one another. If we admit that we’re disabled, we can be part of that. If we don’t, everything gets a lot harder.

Short version: I think that autism is a disability and that admitting that makes life a lot better for autistic people.

Stress makes everything harder

Real Social Skills

Autistic people are autistic all the time. Sometimes some difficulties fade into the background, then come back out again when someone is particularly stressed out. This is true across the board for sensory issues, communication issues, movement, and all kinds of other things. (This is also true for people with any other kind of disability).

The intermittent nature of some apparent difficulties can sometimes lead to them being misinterpreted as psychosomatic. They’re not. Everyone, autistic or not, has more trouble doing things that are hard for them when they’re experiencing significant stress. Some things are particularly hard for autistic people, and those things also get harder with stress.

This is how it actually works:

  • Doing the thing always takes a lot of effort
  • Putting in all that effort has become second nature
  • When you’re not exceptionally stressed, you might not notice the effort it takes consciously
  • When you *are* really stressed, you don’t have energy to do the thing in the ways you normally can
  • So you end up having more trouble than usual, and probably looking a lot more conspicuously disabled than usual

For instance, with motor issues:

  • For those of us with motor difficulties, moving smoothly and accurately takes more effort than it does for most people
  • This can become second nature, to the point that we don’t consciously notice how difficult it is
  • But it’s still there
  • And when you’re really stressed or overwhelmed, you may not have the energy to make yourself move accurately
  • So things you can normally do (eg: handwriting, not walking into walls, picking up objects, pouring water) might become awkward or impossible
  • That doesn’t mean you’re faking or somehow doing it on purpose
  • It just means that things are harder when you’re stressed

Or with sensory issues:

  • Living with sensory sensitivities means that a lot of things hurt
  • For the sake of doing things anyway, a lot of us build up a high pain tolerance
  • To the point that we may no longer consciously process things as pain even though they hurt
  • Ignoring pain takes a lot of energy
  • When we’re really stressed, we may not have the energy to ignore pain
  • And things we normally tolerate can be experienced as overloading or intolerably painful
  • That doesn’t mean we’re faking the pain to avoid something stressful, or that we’re somehow bringing it on ourselves.
  • It just means that everything is harder under stress, including tolerating pain

Or with communication:

  • Communication can be hard for a lot of us in varying ways
  • For some of us, being able to speak requires juggling a lot of things that are automatic for most people
  • Or being able to use words at all, including typing
  • For some of us, that’s true of understanding people when they talk to us
  • Or of knowing what words are at all
  • If someone can’t talk, understand or use words under stress, it doesn’t mean that they’re somehow faking it to avoid a difficult situation
  • It means that communication is hard, and stress makes everything harder

Short version: Stress makes everything harder. For people with disabilities, that includes disability-related things, including things that we don’t normally seem to have trouble with. Sometimes we’re wrongly assumed to be doing on purpose or faking to avoid a difficult situation; it should actually be seen as an involuntary, normal, and expected physiological response to stress.

“Attention seeking behaviors”

Real Social Skills

Autistic people and other people with cognitive disabilities are often interpreted as doing things for attention, whether or not that explanation is plausible.

For example:

  • Alice is autistic. She flaps her hands.
  • Hand flapping is part of Alice’s body language. She moves her hands to express a large range of thoughts and feelings, just like some people move their facial muscles to express a broad range of thoughts and feelings
  • Alice also sometimes flaps her hands to calm down when she is overloaded
  • Bernice is a behaviorist. She is distressed about the fact that Alice flaps her hands.
  • Whenever Alice flaps her hands, Bernice stares at her, and pays intense attention to the fact that she is flapping her hands
  • Bernice notices that every time Alice flaps her hands, Bernice pays attention to her
  • Bernice concludes that her attention is reinforcing Alice’s flapping behavior
  • Bernice concludes that Alice’s hand flapping is an attention-seeking behavior
  • Bernice puts Alice on a behavior plan based on ignoring her whenever she flaps her hands

Behaviorists and others make this mistake a lot. They very, very frequently assume that the fact that they are paying attention to something means that it is being done to get their attention. It doesn’t. It just means they’re paying attention.

Starting at someone whenever they do something doesn’t mean that they’re doing it because they like being stared at. It just means that you’re staring at them.

Short version: Stop calling everything attention seeking behavior. The fact that you’re paying attention to something doesn’t mean that someone is doing it because they want your attention. Not everything a person who has a developmental disability does is about you.

Why I oppose ABA as a method of instruction

Real Social Skills

Content warning: This is a post about ABA.

The primary reason I think ABA is irredeemable: ABA uses behavior modification as a primary method of instruction. I think that is inherently demeaning, counterproductive and dangerous.

ABA therapy relies on continuous extrinsic motivation, which means conditioning the person it’s being done to to comply with a lot of things that they’re actively unwilling to do for several hours a week over and over. It means making them do things that make no sense to them, over and over for many hours a week. That’s dangerous. It’s especially dangerous for people with disabilities who have complex communication needs.

It’s dangerous to make a kid do things that make no sense to them over and over and over while relying on extrinsic reinforcement. That teaches them that people in positions of power can do whatever they want to them, and that they have no right to protest or understand or influence things. ABA leaves people subject to it very, very vulnerable to abuse. Extreme conditioned obedience is dangerous, and it’s the most persistently reinforced behavior in ABA therapy. It’s generalized to other environments, and does not go away once therapy ends.

There’s also a few secondary problems with ABA, which are deeply embedded in the culture of the BACB:

The goals of therapy are often bad in themselves. Eg:

  • Teaching a kid not to stim
  • getting them to say a few words by rote
  • insisting on eye contact
  • making a kid spend hours and hours on facial expression flash cards at the expense of age appropriate academics

(For some good discussion of the issue of bad goals, see “Would You Accept this Behavior Towards a Non-Autistic Child?“ by an SLP specializing in AAC.)

The reinforcers are often unethical even when the goals have merit.

  • ABA depends on extrinsic motivation in order to make people subject to it cooperate.
  • This used to routinely involve pain and food deprivation, and sometimes still does.
  • (Neither is actually prohibited by the ethical guidelines of the BACB, although they do mildly discourage it).

Aversives have fallen somewhat out of favor in recent years, partly due to public outcry over them. That does not solve the problem, and a lot of common reinforcers are not much of an improvement.

ABA therapists talk about using things like bubbles, tickles and praise – but those things are not, in the long term, reliably sufficient to get anyone to comply with many hours a week of boring therapy.

What does work is taking everything a child (or adult) cares about, and making their access to it contingent on compliance in therapy. That’s an awful thing to do to someone, and it can seriously impair their ability to care about anything or communicate about anything. If you know that showing interest in something means it will be taken away, it’s going to be hard to show interest.

I think that’s inherent to this kind of therapy – ultimately, you have to either get intrinsic motivation or use really invasive extrinsic motivation. But even if that problem was solvable, I’d still be opposed to ABA as an educational method, because of the primary problem that behavior motivation is not defensible as a primary educational approach. Educational approaches should be about teaching, not about behavior modification.

Backup communication methods

Real Social Skills

A reader asked:

I find it very difficult to communicate myself verbally sometimes, to the point where I get frustrated and actually cry. It’s like, I can’t find the right words quick enough and it all comes out in jumbles. How can I improve my social skills when it comes to speaking?

realsocialskills said:

I think I’m going to write a few posts about this, because there are a lot of things that can help. But in this post, I’m going to talk about backup methods of communication:

For many people for whom speech is unreliable, having another method of communication to fall back on is gamechanging:

  • Speech isn’t the most important thing
  • Knowing that you will be able to communicate is the important thing
  • If fear and frustration is a reason that speech becomes difficult for you, knowing that you will definitely be able to communicate might in itself improve your ability to speak

Having a backup method doesn’t mean you have to use it all the time:

  • You might get stuck at one point in a conversation, type a bit, then resume speaking

Some possible backups:

Pen and paper:

  • If handwriting is reliable for you, it might help to carry around a pen and paper
  • That can allow you to write instead of speaking
  • Or to write a few words to unstick yourself
  • The advantages of this is that it’s cheap, low-tech, and readily available
  • (And most people have used paper to pass notes in a situation where they didn’t want to speak, eg: in a class, so it might not even look that odd)
  • You can also use this to draw diagrams or drawings illustrating a point. (even if it’s not a point that’s usually illustrated that way.) Having a non-words-based way of explaining things can help a lot.

An iPad (even without any special apps):

  • If you have an iPad, it might be worth making a point of carrying it with you all the time
  • You can take an iPad out relatively quickly and type on it just in the Notes app
  • (I do this)
  • You can even do text-to-speech this way. If you go to the general settings, then accessibility options, you can turn on text to speech. There are voices for a lot of languages; not just English.

You can also use iPads, paper, and computers as a stealth form of communication support:

  • If you pretend you’re taking notes, people generally won’t question it
  • You can then type out many of your responses before you say them
  • That can separate the process of figuring out what to say from the physical act of saying it
  • That can make speech far more possible for some people
  • (I do this more or less constantly in classes, seminars, discussion groups and certain kinds of meetings).

An iPad with decided communication apps:

  • There are a lot of dedicated communication apps for iPads (most of the good ones are expensive).
  • If part of your problem is that you lose words or forget the kinds of things that it’s possible to say, a communication app might help
  • Proloquo2Go has a lot of flexibility and good symbol support. If you have trouble with words and need symbols to remind you, it might be  a good option.
  • You can make dedicated pages for situation in which you tend to have trouble communicating.
  • Making the pages also might in itself help you to map out things you can say in various situations, even if you aren’t able to use them directly.
  • Speak4Yourself isn’t very flexible at all, but it has icons arranged in a way that’s well thought-out. It’s designed to work with muscle memory, having the words in the same place all the time so that your hands remember where you are. If you sometimes need help even with simple words and don’t need specialized pages, it might be a very cognitively user-friendly option.
  • Proloquo4Text is a text-based AAC app. It can store phrases in categories to access quickly, and has very high-quality word prediction. You can also make the display text very large if you’d rather show your screen than use a computer voice.

Short version: If you have trouble with speech and get overloaded, it’s a good idea to have a backup communication method. Scroll up for some concrete suggestions.

Red flags vs fear of new things

Real Social Skills

I don’t know a solution to this, but this is a problem I think it’s worth discussing: It can be hard to identify red flags when you have a general fear of change and trying new things.

For some of us, anticipating change always or usually feels bad, regardless of whether there’s anything actually wrong. For instance, I hate all new TV shows until I’ve watched them with someone else at least three times. To use more weighty examples: for a lot of people, moving to a new apartment, taking a new job, starting school, getting close to another person, exploring a new hobby, eating new foods, or anything that involves change, will at first invoke an unreasonable sense of dread whether or not anything is actually wrong.

For most people who have routine fear of new things, it can sometimes be important to override that dread and do some new things anyway. Because sometimes change is necessary, or an improvement. But overriding and ignoring dread all the time causes a serious problem.

The problem is – sometimes the feelings of dread are because you’re noticing red flags. Sometimes the problem isn’t that you’re generally averse to change; sometimes the problem is that you’re noticing something that’s actually wrong.

I’m not sure what the solution is. Most people get told that the best way to avoid walking into trouble is to always trust your gut. That’s not necessarily viable for people whose guts tend to dread all change. Trusting all of those instincts would mean never trying anything new, and also never walking away from bad situations (since that would have to involve change). But disregarding your gut all the time doesn’t work well either, because sometimes it’s the only thing alerting you to trouble.

I think the best approach might be: listen to your gut, but don’t necessarily obey it. I think it’s a good idea to think, in as concrete terms as possible, what your gut feeling might be about. Some examples of questions that some people find helpful in that regard (not exhaustive, and not all the questions on this list are helpful for everyone with this problem):

  • Is the dread you are feeling the same way you always feel when you’re doing something new, or does this feel different?
  • (If it feels like a different feeling, it’s very likely something you should be taking seriously)
  • Are you afraid of a particular person?
  • Do you know why you’re afraid of them? Is it that they’re unfamiliar, or something in particular about them?
  • Are you afraid of a particular risk?
  • Does something seem physically unsafe?
  • Are there other available options that would be safer?
  • Do people seem to be treating you respectfully?
  • Is someone being mean to you, or to other people, in a way that’s making the new thing seem inadvisable?
  • Are people assuming that you can do things that you can’t?
  • Is anyone treating you like a child?
  • Is someone taking your private decisions weirdly personally?
  • Are you being pressured into spending money you can’t afford to spend?

I don’t think that there is a general answer to this. I think that deciding whether to go with your gut feeling, or whether to assume that you’re just fearing change, is something that you have to decide on a case by case basis. Either option involves risks; it’s ok to decide which risk you’d rather take in a certain situation. Sometimes that will mean you do the new thing (and risk ignoring a red flag); sometimes it will mean you don’t do the new thing (and risk avoiding a necessary or beneficial change for irrational reasons). Sometimes that will mean doing the new thing, but cautiously. Sometimes that will mean modifying the new thing. All are legitimate approaches; you’re the only one who can decide.

It’s ok to decide that something real is going on and that you’re not going to do the thing (even though it’s possible that you’re afraid for no good reason). It’s ok to decide that you’re going to risk doing the thing (even though it’s possible that you’re ignoring a red flag.) Both have risks. There’s no generalized answer to every situation; it’s a decision you have to make for each situation.

Short version: If you’re generally averse to change, it can be really hard to tell whether your apprehension about a new situation is irrational fear of change, or a red flag you’re picking up on. It can help to evaluate in concrete terms what you think you might be noticing.