Join Dr. Regan for the final episode of the series "Talking About Autism." This episode focuses on how talk to others when you see autistic characteristics in them. New Course for Clinicians - Interventions in Autism: Helping Clients Stay Centered, Connect with Others, and Engage in Life New Course for Clinicians: ASD Differential Diagnoses and Associated Characteristics Dr. Regan's Resources Book: Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website Resources for Clinicians Read the transcript: 00:00:02,540 -- 00:00:06,380 Hello everyone. 3 00:00:06,390 -- 00:00:13,200 This is Dr Theresa Regan and you are joining me for this episode of autism in the adult podcast. 4 00:00:13,210 -- 00:00:15,620 I am a neuropsychologist, 5 00:00:15,630 -- 00:00:23,730 the parent of a teen on the spectrum and I'm the director of a diagnostic autism clinic for adolescents, 6 00:00:23,730 -- 00:00:26,960 adults and aging adults in central Illinois. 7 00:00:27,540 -- 00:00:33,220 And we are in the third uh segment here of the series that we're calling, 8 00:00:33,220 -- 00:00:34,890 talking about autism, 9 00:00:34,900 -- 00:00:43,350 which has been a listener requested series and a really great topic to review together and discuss. 10 00:00:43,930 -- 00:00:54,260 The first episode was about personal journeys towards getting a diagnosis or receiving a diagnosis and how to communicate with others about that. 11 00:00:54,740 -- 00:01:01,570 The second episode was about navigating emotional atmospheres when talking about autism. 12 00:01:01,570 -- 00:01:02,950 For some reason, 13 00:01:02,970 -- 00:01:21,150 the topic can be very emotionally charged and it can be unexpected at times and intense and thinking about how to navigate all those emotions can help if you're wanting to talk more about the topic with other people. 14 00:01:22,040 -- 00:01:30,930 Uh and this episode is about talking about autism to others when its characteristics in them that you identify, 15 00:01:30,930 -- 00:01:41,060 that you wonder if they might be on the spectrum and you're wanting to bring up the topic and just kind of um suggest that to them or see if they've thought about it. 16 00:01:43,640 -- 00:01:55,060 What I'm going to do first is a segment where I'm going to lay the foundation for how I explain autism to other people. 17 00:01:55,540 -- 00:02:02,610 I think this Foundation may at times be something that you need a way of verbalizing. 18 00:02:02,610 -- 00:02:04,960 If you're going to bring up the topic to others. 19 00:02:05,250 -- 00:02:06,650 This may help some of you. 20 00:02:06,650 -- 00:02:09,100 It may be old hat for some of you. 21 00:02:09,540 -- 00:02:16,530 Um But it'll be after we review that foundational kind of information that I talk about. 22 00:02:16,530 -- 00:02:24,360 Some ways to approach people and ways to talk about the topic or introduced the topic. 23 00:02:26,640 -- 00:02:30,060 So when we talk about autism, 24 00:02:30,640 -- 00:02:53,660 you may be talking to someone who has less knowledge than you do about what it is and at some point in the conversation you may be wanting to clarify what it is so that they can consider the information um in a really accurate way. 25 00:02:55,840 -- 00:03:03,850 What autism is is a neuro behavioral developmental condition that's neurologic. 26 00:03:04,340 -- 00:03:09,800 Uh So what it means is that the brain, 27 00:03:09,810 -- 00:03:17,060 because it's in charge of our thinking skills are academic skills are motor coordination, 28 00:03:17,070 -- 00:03:18,980 our emotions, 29 00:03:18,980 -- 00:03:21,110 our personality structure, 30 00:03:21,120 -- 00:03:22,950 our behavioral patterns. 31 00:03:23,340 -- 00:03:40,450 Um Sometimes the brain has kind of an atypical wiring from birth that whereas one individual may be born with some atypical bone structure or an atypical heart valve. 32 00:03:40,460 -- 00:03:48,150 Um Others are born with an unusual pattern of neurological wiring and that's what this is. 33 00:03:48,430 -- 00:03:57,710 So it's a physical state and research at this point shows us that it's largely driven by the genetic code, 34 00:03:57,710 -- 00:04:20,750 which is not surprising in the sense that we now know it's not the result of poor parenting or um other things that decades ago people were talking about but that it's really um kind of this condition of how the code was revealed during development and how the body developed. 35 00:04:22,440 -- 00:04:27,360 Sometimes for the individuals with developmental differences, 36 00:04:27,370 -- 00:04:32,280 They have a few um atypical areas in their body. 37 00:04:32,280 -- 00:04:37,530 So one person might have a heart valve problem from birth. 38 00:04:37,530 -- 00:04:41,610 That's a congenital difference and may have autism. 39 00:04:41,610 -- 00:04:54,890 And in fact That is um true in the research that I think it's about 30% or so of kids with certain cardiac differences that are congenital, 40 00:04:54,890 -- 00:04:58,500 they're born with them are also on the autism spectrum. 41 00:04:58,500 -- 00:05:11,660 And the reason for that is just that this is a reflection of biology of how the person developed and came together before birth, 42 00:05:13,190 -- 00:05:31,090 neuro behavioral refers to the fact that the diagnosis only describes behavioral patterns and in that as a neuropsychologist behavior is interpreted perhaps more widely than than you might interpret it. 43 00:05:31,090 -- 00:05:31,740 So for me, 44 00:05:31,740 -- 00:05:44,530 behavior has to do with communication and the establishment of relationships and repetitious behavioral patterns and um reacting to the sensory environment. 45 00:05:44,530 -- 00:05:48,260 So all of those are neuro behavioral characteristics. 46 00:05:49,640 -- 00:06:04,170 One thing to understand that might make it easier to think about autism or to explain it to other people is that the brain is an organ that is organized. 47 00:06:04,180 -- 00:06:11,330 It's really organized by pattern and pathway and nuclei and location where, 48 00:06:11,340 -- 00:06:11,780 you know, 49 00:06:11,780 -- 00:06:22,620 you probably know that there are some things that the left side of the brain typically does and some things that the right side is in charge of and the same for the inside versus the outside. 50 00:06:22,630 -- 00:06:41,660 And there are some general patterns about how the brain is organized when a neurologist does a checkup for someone in the emergency room because they've had vision changes and they have weakness on part of their body. 51 00:06:41,670 -- 00:06:46,190 They will check all these kinds of things that the brain is in charge of. 52 00:06:46,190 -- 00:06:48,500 So they'll check the person's vision, 53 00:06:48,500 -- 00:06:50,750 they'll check the person's speech, 54 00:06:50,950 -- 00:06:53,630 their ability to find words that they want to say. 55 00:06:53,630 -- 00:06:56,750 They'll check the person's comprehension of speech. 56 00:06:57,140 -- 00:06:59,130 They'll watch the person walk, 57 00:06:59,140 -- 00:07:01,680 they'll check their strength and their reflexes. 58 00:07:01,750 -- 00:07:11,060 And the reason they do this is that it tells them something about what part of the brain might be struggling. 59 00:07:11,440 -- 00:07:13,920 Because we know for example, 60 00:07:14,040 -- 00:07:17,540 that in general the right side of the body is, 61 00:07:17,550 -- 00:07:21,780 is controlled uh in strength, 62 00:07:21,790 -- 00:07:23,410 in that muscle strength, 63 00:07:23,420 -- 00:07:26,010 by the left side of the brain. 64 00:07:26,020 -- 00:07:31,380 And so if the person's presenting with right sided weakness, 65 00:07:31,410 -- 00:07:34,150 there may be a left side of the brain issue, 66 00:07:34,160 -- 00:07:39,860 But it gives you this sense that when we see clinical signs, 67 00:07:40,440 -- 00:07:46,080 we can make conclusions about pathways and locations in the brain. 68 00:07:47,330 -- 00:07:52,420 The same is true when we look at neuro behavioral patterns. 69 00:07:53,110 -- 00:08:00,700 The reason I bring this up is that I think it gives meaning and cohesion to this concept of autism. 70 00:08:00,700 -- 00:08:22,910 That the reason these characteristics hang together in the same person is that they tend to hang together in certain pathways and connections in the brain and that to me gives this a kind of meaningful picture that oh there, 71 00:08:22,920 -- 00:08:36,160 there are particular freeways in the brain and stops along the way that hang out together anatomically and the expression of differences in that wiring hangs together behaviorally. 72 00:08:37,340 -- 00:08:41,450 So that concept of the anatomy, 73 00:08:41,840 -- 00:08:49,600 the wiring being reflected in the cohesion of these behavioral differences. 74 00:08:49,610 -- 00:08:50,220 To me, 75 00:08:50,220 -- 00:08:51,560 that adds meaning to it. 76 00:08:53,440 -- 00:09:19,030 The next part of neurology that I want to explain is that we realized as a scientific community that these kind of characteristics hang together In about 2% of the population and that they're really important to pay attention to like these have implications and there are things we should understand. 77 00:09:19,040 -- 00:09:30,000 So let's have a name for this so that we can communicate in an efficient way about these pathways that seem to be wired differently. 78 00:09:30,640 -- 00:09:47,350 So we currently use the words autism spectrum and that helps us communicate and study something and learn about it and kind of take a snapshot of someone's needs or how they might process the world. 79 00:09:49,630 -- 00:09:55,850 Now this gets to be complex because we then have to say, 80 00:09:55,850 -- 00:09:56,400 well, 81 00:09:56,400 -- 00:09:59,360 when are we going to call it autism? 82 00:10:00,240 -- 00:10:10,330 Because there will be these um characteristics here and there um that are noticeable. 83 00:10:10,340 -- 00:10:13,560 But when do we actually give it that whole name? 84 00:10:14,540 -- 00:10:20,560 So this is the same process that the scientific community goes through with? 85 00:10:20,570 -- 00:10:22,960 When do we call something dyslexia? 86 00:10:23,840 -- 00:10:26,450 Or when do we call something dementia? 87 00:10:27,140 -- 00:10:29,150 When do we call this? 88 00:10:29,160 -- 00:10:32,400 Alzheimer's dementia versus Lewy body dementia. 89 00:10:32,420 -- 00:10:39,380 So there are these distinctions that we're trying to make that are difficult to say, 90 00:10:39,390 -- 00:10:39,700 oh, 91 00:10:39,700 -- 00:10:39,900 well, 92 00:10:39,900 -- 00:10:46,620 let's say there have to be two characteristics in this area and three characteristics in this area. 93 00:10:46,630 -- 00:10:48,460 And then we're gonna call it this. 94 00:10:49,540 -- 00:10:50,160 Well, 95 00:10:50,540 -- 00:10:59,950 that's helpful in the sense that we add definition to the concept of autism or dementia or whatever we're talking about. 96 00:10:59,960 -- 00:11:03,580 But it is somewhat arbitrary. 97 00:11:03,580 -- 00:11:05,760 Like at some point you have to, 98 00:11:06,440 -- 00:11:08,580 if you're going about this process, 99 00:11:08,750 -- 00:11:11,750 you have to make some type of demarcation. 100 00:11:12,240 -- 00:11:12,900 You know, 101 00:11:12,940 -- 00:11:15,330 this is when we're going to call it this. 102 00:11:16,340 -- 00:11:20,360 An analogy might be um you know, 103 00:11:21,340 -- 00:11:22,800 if we're going to say, 104 00:11:22,800 -- 00:11:24,990 when do we call something purple? 105 00:11:25,940 -- 00:11:26,540 Well, 106 00:11:26,540 -- 00:11:30,210 there are colors that we would all agree are purple. 107 00:11:30,220 -- 00:11:31,110 There are colors, 108 00:11:31,110 -- 00:11:33,190 we would all agree aren't purple. 109 00:11:33,200 -- 00:11:35,620 And then there's kind of this, 110 00:11:35,630 -- 00:11:36,210 you know, 111 00:11:36,210 -- 00:11:40,370 middle progression of Hughes where somebody might say, 112 00:11:40,370 -- 00:11:41,050 well, 113 00:11:41,060 -- 00:11:44,360 I'd call that more red than purple and someone else would say. 114 00:11:44,940 -- 00:11:45,690 Uh well, 115 00:11:45,700 -- 00:11:48,060 I I think it's more purple than red. 116 00:11:48,540 -- 00:12:00,550 Um So there is this area of Hugh that is not captured in the way the diagnosis is currently defined. 117 00:12:00,560 -- 00:12:01,650 In addition, 118 00:12:01,660 -- 00:12:09,620 there are many associated characteristics of autism that are not part of the diagnostic criteria, 119 00:12:09,810 -- 00:12:16,010 but research has shown that they they very frequently occur. 120 00:12:16,640 -- 00:12:17,200 So, 121 00:12:17,210 -- 00:12:18,510 for example, 122 00:12:18,520 -- 00:12:26,330 it's very common for people on the autism spectrum to have sleep disturbance that's not part of the diagnostic criteria, 123 00:12:26,340 -- 00:12:35,160 but it is a very common co occurring um brain characteristic because the brain is in charge of sleep. 124 00:12:36,240 -- 00:12:47,010 Um Also there are people that feel like um atypical motor coordination should be part of the diagnosis because many, 125 00:12:47,010 -- 00:12:53,620 many people on the spectrum have a history of having some difficulty with motor coordination, 126 00:12:53,620 -- 00:12:54,850 not everybody. 127 00:12:54,860 -- 00:13:03,460 But it's common enough that some people feel like it should be one of the diagnostic features that can present. 128 00:13:05,640 -- 00:13:07,600 So in talking about this, 129 00:13:07,690 -- 00:13:12,450 I hope you get the picture that neurology is complicated. 130 00:13:12,940 -- 00:13:21,960 And when we're trying to realize that certain things hang together in a person and are valuable enough that we should be talking about them, 131 00:13:22,740 -- 00:13:28,330 we have to go about some process of defining what we call what. 132 00:13:28,390 -- 00:13:30,200 And the same is true as I said, 133 00:13:30,200 -- 00:13:31,120 for dyslexia. 134 00:13:31,120 -- 00:13:34,560 Like what do we call a reading problem? 135 00:13:34,570 -- 00:13:37,060 Is that when there's a phonetic problem, 136 00:13:37,070 -- 00:13:38,760 a sight reading problem, 137 00:13:38,770 -- 00:13:45,830 a reading comprehension for paragraphs problem and then how how big does the problem have to be like, 138 00:13:45,840 -- 00:13:48,090 is it that they're one grade behind? 139 00:13:48,100 -- 00:13:48,470 You know, 140 00:13:48,470 -- 00:13:57,390 So they're just gets to be this um discussion in scientific communities about what do we call it? 141 00:13:57,390 -- 00:13:58,250 And when do we call it? 142 00:13:58,250 -- 00:14:04,260 That that is true for this diagnostic process? 143 00:14:06,160 -- 00:14:27,250 Some people will end up having what we call sub threshold autism characteristics and that can still be good to understand in the sense that there's a point at which understanding that a behavioral pattern or a reaction to the environment has a neurologic base that can still be helpful, 144 00:14:27,640 -- 00:14:31,670 even if there's not the full picture there, 145 00:14:31,680 -- 00:14:43,150 it may help us understand the person or help the person understand themselves to know that there's kind of this neurologic foundation there for that particular characteristic. 146 00:14:45,040 -- 00:14:48,120 And this happens in families as well. 147 00:14:48,120 -- 00:14:56,630 We talked about the genetic contribution and what may happen in families is that certain people have no characteristics, 148 00:14:56,640 -- 00:15:11,060 certain people have some characteristics and perhaps a few people in the family meet threshold for a full diagnosis as we talked about, 149 00:15:11,070 -- 00:15:14,440 because the diagnosis is neuro behavioral, 150 00:15:14,450 -- 00:15:21,960 it's really important that people understand that thinking skills does not come into this picture at all. 151 00:15:22,440 -- 00:15:27,010 There is no diagnostic criteria for autism that has to do with intellect, 152 00:15:27,020 -- 00:15:30,280 which is good because it doesn't have to do with intellect. 153 00:15:30,290 -- 00:15:33,920 It can co occur with intellectual difficulty, 154 00:15:33,920 -- 00:15:41,060 it can co occur with average thinking skills and it can co occur for those who have giftedness. 155 00:15:41,340 -- 00:15:47,100 So there's no implication when we have this diagnosis, 156 00:15:47,940 -- 00:15:48,500 um, 157 00:15:48,510 -- 00:15:54,690 that intellect will look a certain way or that the future of the individual will look a certain way. 158 00:15:54,700 -- 00:15:59,890 We're just talking about an unusual neurologic level of, 159 00:15:59,900 -- 00:16:07,160 of connection within a certain pathway and these kinds of characteristics tend to hang together in certain people. 160 00:16:09,440 -- 00:16:14,080 So let's switch gears now that we have kind of a foundation about neurology, 161 00:16:14,090 -- 00:16:15,280 what it looks like, 162 00:16:15,280 -- 00:16:17,360 how the diagnosis is created. 163 00:16:18,640 -- 00:16:32,760 Let's go to this topic about how might you approach someone if you want to share with them that you think maybe they're on the spectrum or they have some characteristics that are neurologic or autistic. 164 00:16:33,140 -- 00:16:48,270 Um I'm gonna start by just saying at the beginning that as you may um realize I talked to a lot of people about this topic and sometimes I am invited to talk about it and that gives me permission to talk about it. 165 00:16:48,640 -- 00:16:51,560 Um Other times I bring it up out of the blue, 166 00:16:51,560 -- 00:16:53,770 like we're kind of talking about today, 167 00:16:54,140 -- 00:16:57,540 some of that may be out of the blue in a professional context, 168 00:16:57,540 -- 00:17:11,660 some of it may be uh with people in my general environment and I want you to know that I do not talk to everyone about my thoughts, 169 00:17:12,340 -- 00:17:13,170 um, 170 00:17:14,640 -- 00:17:21,870 indiscriminately so I am not of the opinion that if we notice this pattern and someone else, 171 00:17:21,880 -- 00:17:26,560 we automatically are obliged to talk to them. 172 00:17:27,730 -- 00:17:28,450 Now, 173 00:17:29,440 -- 00:17:49,170 that is because there are some people that I can think of in my life and in my experience in my communities that I know that they have autistic characteristics or I suspect that they would be on the spectrum if they had an assessment, 174 00:17:49,540 -- 00:17:59,960 but I do not have the type of relationship with them where it would be okay for me to bring that up, 175 00:18:01,130 -- 00:18:02,740 for example. 176 00:18:02,750 -- 00:18:04,350 Um you know, 177 00:18:04,350 -- 00:18:09,540 this may be a person that I've had really tough interactions within the past, 178 00:18:09,550 -- 00:18:18,060 or we've had a really difficult relationship and we just don't have the kind of relationship where I have permission to speak into their life. 179 00:18:18,740 -- 00:18:19,270 Um, 180 00:18:19,280 -- 00:18:23,450 I may hope that other people get the opportunity to talk to them about it. 181 00:18:24,140 -- 00:18:24,500 Um, 182 00:18:24,510 -- 00:18:37,570 but I may conclude that anything that I say is probably going to be filtered through this tough relationship that we've had and might even make things worse that now. 183 00:18:37,570 -- 00:18:44,660 I'm less inclined to think about it because I really don't like you talking into my life. 184 00:18:46,140 -- 00:18:46,590 Um, 185 00:18:46,600 -- 00:18:55,950 there may also be contexts in which I think it would be inappropriate to raise it at that place and at that time, 186 00:18:56,440 -- 00:19:00,010 so I'm unlikely to raise it at a funeral. 187 00:19:00,010 -- 00:19:01,060 I may not, 188 00:19:01,540 -- 00:19:02,420 you know, 189 00:19:02,430 -- 00:19:03,170 um, 190 00:19:03,180 -- 00:19:10,580 I feel like I'm going to bring that up to a superior of mine at a professional convention or something like that. 191 00:19:10,580 -- 00:19:11,050 So, 192 00:19:11,440 -- 00:19:11,860 um, 193 00:19:11,870 -- 00:19:20,770 I do pick and choose when I think it would be wise to approach someone and say something. 194 00:19:20,960 -- 00:19:23,140 Now there are exceptions to that. 195 00:19:23,140 -- 00:19:32,380 So let's say this person that I've had kind of a tough relationship with in my life is really in a dire spot, 196 00:19:32,390 -- 00:19:36,720 like they are struggling significantly and they can't figure out why. 197 00:19:36,730 -- 00:19:46,960 And really I believe it's related to things that would be eased if they knew this conceptualization of autism. 198 00:19:48,140 -- 00:19:48,530 Um, 199 00:19:48,540 -- 00:19:49,530 in that situation, 200 00:19:49,530 -- 00:19:55,750 I probably would decide to go ahead and approach them because of their high level of need. 201 00:19:55,760 -- 00:19:58,130 So in that situation, 202 00:19:58,140 -- 00:20:04,760 the context would override the relationship concerns that I have. 203 00:20:05,240 -- 00:20:10,850 So I always kind of make that judgment based on the relationship I have with the person, 204 00:20:11,340 -- 00:20:15,060 the context that we're in and and maybe the time, 205 00:20:15,070 -- 00:20:16,950 like is this the time to do it? 206 00:20:18,040 -- 00:20:27,100 And then I would make exceptions based on just what I think would be wise at that time based on their need based on where they're at. 207 00:20:27,110 -- 00:20:27,490 Um, 208 00:20:27,490 -- 00:20:33,470 and based on what I could contribute in cases where we do decide, 209 00:20:33,720 -- 00:20:33,990 you know, 210 00:20:33,990 -- 00:20:36,260 I think I'm going to at least bring it up. 211 00:20:36,740 -- 00:20:57,860 One thing that I find helpful is to think about this image of putting our toe in the water that we don't have to bring up the topic in all its glory and detail and kind of get down to the nitty gritty and convince someone that this is correct. 212 00:20:57,870 -- 00:21:02,290 We can kind of test the waters so to speak. 213 00:21:02,290 -- 00:21:11,230 So we could bring it up something gently or bring up something in a non direct way. 214 00:21:11,240 -- 00:21:11,920 Um, 215 00:21:11,920 -- 00:21:14,330 and kind of test the waters to see, 216 00:21:14,340 -- 00:21:20,040 does this person have a strong negative reaction to the topic, 217 00:21:20,050 -- 00:21:24,040 do they jump on board and seem really interested to talk about it? 218 00:21:24,050 -- 00:21:26,670 Do you think there's an opening to go deeper? 219 00:21:27,040 -- 00:21:31,640 So if there's some opening and you feel like there's some receptiveness, 220 00:21:31,640 -- 00:21:35,430 you can always share more or provide more information. 221 00:21:35,440 -- 00:21:38,150 So that's one thing that I keep in mind too, 222 00:21:38,150 -- 00:21:40,840 like putting feelers out, 223 00:21:40,850 -- 00:21:47,060 how how comfortable is this person with introducing this new topic, 224 00:21:47,070 -- 00:21:57,420 How open might they be when you decide you are going to share something or bring up the topic, 225 00:21:57,430 -- 00:22:00,040 you could do this in a variety of ways. 226 00:22:00,050 -- 00:22:14,730 So one way might be to share a personal story that kind of gives us an in in the sense that um I have a reason for bringing this up because I've experienced it and this is my experience. 227 00:22:14,730 -- 00:22:25,540 So if you're a person who's been diagnosed and you found that helpful or if you're a parent of a child or young adult who's been diagnosed, 228 00:22:25,550 -- 00:22:28,670 sometimes that just gives you, 229 00:22:29,340 -- 00:22:36,830 um it creates a context for the person to hear your wisdom based on your experience. 230 00:22:36,840 -- 00:22:37,600 So, 231 00:22:37,610 -- 00:22:38,040 oh, 232 00:22:38,040 -- 00:22:40,400 you've had this personal experience, 233 00:22:40,410 -- 00:22:43,350 I would like to hear what you have to say. 234 00:22:44,140 -- 00:22:52,770 So sometimes approaching it in that way I'm bringing it up because what you're experiencing reminds me of myself. 235 00:22:55,640 -- 00:23:00,900 Sometimes you can bring it up in the context of new learning that you've had. 236 00:23:00,910 -- 00:23:05,430 So maybe you're not a person who has experienced that yourself, 237 00:23:05,440 -- 00:23:19,120 but maybe you have recently heard a lecture or read a book or listen to a podcast and the light bulb just went off about various things maybe about yourself and about, 238 00:23:19,130 -- 00:23:19,720 you know, 239 00:23:19,720 -- 00:23:22,660 how neurology impacts people in general, 240 00:23:22,670 -- 00:23:32,350 like this has opened up a curiosity in you and you've really been thinking about that for yourself and you're thinking about it for this other person. 241 00:23:34,240 -- 00:23:35,600 And in that context, 242 00:23:35,600 -- 00:23:50,260 if you do lead with I learned about this and I've been thinking about it regarding myself and I realized that I tend to do this and this is really neurologically based. 243 00:23:50,260 -- 00:23:51,780 It's so interesting to me, 244 00:23:51,780 -- 00:23:57,460 it's helped me so much when we do lead with a personal experience. 245 00:23:57,470 -- 00:23:59,670 Even if it's not a diagnosis, 246 00:23:59,690 -- 00:24:00,340 you know, 247 00:24:00,340 -- 00:24:13,950 I have this personal experience where I've learned this about myself and then introducing the other person to think about themselves may be just a nice flow to the conversation. 248 00:24:16,940 -- 00:24:17,270 Mm hmm. 249 00:24:17,840 -- 00:24:23,980 Another way to approach it is to have a wondering or a curious tone. 250 00:24:23,990 -- 00:24:38,080 I think what we want to avoid is to have any kind of lecturing tone or that we are going to argue our point and that they must agree with us by the end of the conversation. 251 00:24:38,080 -- 00:24:47,380 I think what's likely to happen in that sense is that they can feel backed into a corner and they can push back really just to have more space. 252 00:24:47,840 -- 00:24:52,010 And so if we approach it more as a wondering, 253 00:24:52,540 -- 00:24:53,110 you know, 254 00:24:53,110 -- 00:24:54,250 I've been wondering, 255 00:24:54,250 -- 00:25:04,400 I've noticed this or that and I've been wondering if autism would be a way to understand what's been happening and kind of open up possibilities. 256 00:25:04,410 -- 00:25:08,360 What do you think or what's your thought about that? 257 00:25:10,050 -- 00:25:17,050 That gives the person's space to react and to think and they don't feel rushed or pushed. 258 00:25:17,640 -- 00:25:18,450 Um, 259 00:25:18,940 -- 00:25:22,360 and that freedom to explore the thought, 260 00:25:22,840 -- 00:25:23,340 um, 261 00:25:23,340 -- 00:25:27,570 with you or on their own can really bring about some fruit, 262 00:25:27,580 -- 00:25:28,270 I think, 263 00:25:28,740 -- 00:25:29,690 um, 264 00:25:29,700 -- 00:25:41,560 that can encourage people to learn more and give people space to get their in their own time now as a professional. 265 00:25:41,740 -- 00:25:57,190 I also have contexts where I am with a patient and I'm talking to them about this kind of based on my own clinical expertise and they've come in as a patient and I use the word patient because I work in a hospital, 266 00:25:57,200 -- 00:26:01,490 but you could say client or whatever kind of fits the situation. 267 00:26:01,490 -- 00:26:03,190 If you work in a school, 268 00:26:03,200 -- 00:26:04,560 there would be students, 269 00:26:04,560 -- 00:26:05,260 et cetera, 270 00:26:05,940 -- 00:26:08,360 and they have come in for some reason. 271 00:26:08,360 -- 00:26:13,900 And sometimes it has to do with an autism diagnosis and sometimes it does not. 272 00:26:13,910 -- 00:26:17,120 I work with patients who have all kinds of different backgrounds, 273 00:26:17,120 -- 00:26:25,670 someone may have had a head injury and be coming in for that or a stroke or an assessment for dementia. 274 00:26:26,040 -- 00:26:29,780 And I just realized in the midst of that, 275 00:26:29,790 -- 00:26:32,860 that there's an undiagnosed autism spectrum. 276 00:26:32,870 -- 00:26:35,800 So sometimes I'm bringing it up cold, 277 00:26:35,810 -- 00:26:36,310 um, 278 00:26:36,310 -- 00:26:38,910 where there's no context and they're not expecting it. 279 00:26:38,920 -- 00:26:42,860 And other times I'm bringing it up or they are expecting it. 280 00:26:44,640 -- 00:26:45,360 Um, 281 00:26:46,140 -- 00:26:48,880 I think it's pretty straightforward when they're expecting it. 282 00:26:48,880 -- 00:26:50,630 So I'm not going to cover that. 283 00:26:50,630 -- 00:26:53,880 I think what I said at the beginning of the episode, 284 00:26:53,890 -- 00:26:58,460 does summarize how I how I explain autism to people, 285 00:26:58,840 -- 00:27:00,800 but if they're not expecting it, 286 00:27:00,810 -- 00:27:08,170 what I find helpful is to summarize to them what they have said to me, 287 00:27:08,640 -- 00:27:12,060 so that I make sure I understood it correctly. 288 00:27:12,940 -- 00:27:15,660 But I'll take that summary and I'll say, 289 00:27:15,780 -- 00:27:16,090 you know, 290 00:27:16,090 -- 00:27:20,050 it sounds like you're a person who uh, 291 00:27:20,060 -- 00:27:23,440 really gets revived by alone time. 292 00:27:23,440 -- 00:27:32,870 And sometimes the drama of female relationships just actually feels overwhelming that you would be more content with your, 293 00:27:32,880 -- 00:27:34,660 your cat in a good book. 294 00:27:34,660 -- 00:27:39,380 And sometimes people at work seem to think you're standoffish or whatever. 295 00:27:39,380 -- 00:27:48,750 And so I go through the social part and then I'll say it also seems like when you're interested in something you are all in, 296 00:27:48,750 -- 00:27:49,100 like, 297 00:27:49,110 -- 00:27:50,950 you love that thing. 298 00:27:51,340 -- 00:27:51,780 Uh, 299 00:27:51,790 -- 00:27:56,770 and so I'll go through each of the criteria just saying that. 300 00:27:57,540 -- 00:28:00,090 So I'm not bringing up the word autism, 301 00:28:00,280 -- 00:28:06,010 I'm just showing them that I've heard their description of themselves. 302 00:28:07,640 -- 00:28:10,400 And I in my own mind, 303 00:28:11,340 -- 00:28:18,360 I'm saying it back because I know that these things represent some of those criteria, 304 00:28:20,940 -- 00:28:22,910 then I will say, 305 00:28:22,920 -- 00:28:23,630 you know, 306 00:28:23,640 -- 00:28:31,010 when these kinds of things happen and they're expressed in the same person. 307 00:28:31,440 -- 00:28:34,000 One of the things I think about is neurology, 308 00:28:34,000 -- 00:28:37,000 because these patterns of neurology, 309 00:28:37,000 -- 00:28:39,500 these freeways or highways in the brain, 310 00:28:40,470 -- 00:28:40,840 you know, 311 00:28:40,840 -- 00:28:46,500 there are patterns that contain these characteristics and when they happen together, 312 00:28:46,500 -- 00:28:49,520 often it's because of a neurologic, 313 00:28:49,530 -- 00:28:50,660 um, 314 00:28:50,670 -- 00:28:59,540 space in there that has some different kinds of wiring that people are noticing and when we see that in the same person, 315 00:28:59,550 -- 00:29:03,850 we have a name for that and what we call that is autism. 316 00:29:05,040 -- 00:29:10,060 And then I'll just kind of let them process or react. 317 00:29:10,640 -- 00:29:12,770 Now I have to say that I am, 318 00:29:13,140 -- 00:29:17,050 I am very surprised um, 319 00:29:17,060 -- 00:29:20,070 at how many times somebody in the room, 320 00:29:20,070 -- 00:29:24,600 whether it's a family member or themselves will say I thought so, 321 00:29:24,610 -- 00:29:29,030 but I didn't want to bring it up and maybe there's a group of three of them, 322 00:29:29,030 -- 00:29:29,360 right? 323 00:29:29,360 -- 00:29:31,360 Like the client and family members, 324 00:29:31,360 -- 00:29:33,970 but they've never talked to each other about it. 325 00:29:33,980 -- 00:29:35,520 They've just been wondering, 326 00:29:35,520 -- 00:29:38,910 but they don't feel like it's okay to bring the topic up. 327 00:29:38,920 -- 00:29:40,960 Kind of like we talked about before. 328 00:29:40,980 -- 00:29:42,990 Like is this okay to mention, 329 00:29:43,000 -- 00:29:44,450 is this okay to think about? 330 00:29:44,840 -- 00:29:46,890 And so we'll go from there. 331 00:29:49,220 -- 00:29:59,080 Sometimes this is something that they have never considered and they are surprised and kind of pause and have to take that in. 332 00:29:59,090 -- 00:30:01,950 And I might kind of ask them, 333 00:30:01,950 -- 00:30:03,560 what are your thoughts about that. 334 00:30:04,340 -- 00:30:05,170 Um, 335 00:30:06,340 -- 00:30:08,110 if there is, 336 00:30:08,120 -- 00:30:09,190 uh, 337 00:30:09,200 -- 00:30:14,790 a misunderstanding or they just don't know much about autism or they're thinking of it in a different way. 338 00:30:14,800 -- 00:30:17,350 I just try to give that education, 339 00:30:18,440 -- 00:30:24,530 if the person seems to be stressed by that or to be upset, 340 00:30:24,540 -- 00:30:27,670 I just try to figure out what the barrier is. 341 00:30:28,140 -- 00:30:33,680 So if it's not an information gap that I fill in with education, 342 00:30:33,680 -- 00:30:38,550 it may be an emotional reaction like we talked about last time, 343 00:30:40,540 -- 00:30:45,640 um I may say it sounds like maybe you feel like this is a criticism, 344 00:30:45,650 -- 00:30:46,090 you know, 345 00:30:46,090 -- 00:30:48,410 this isn't a criticism to me, 346 00:30:48,420 -- 00:31:01,210 it's really just the self revelation that can help you so much understand yourself and what you need and um really just feel better in your own skin. 347 00:31:01,210 -- 00:31:03,360 There are lots of things we can recommend. 348 00:31:05,640 -- 00:31:19,960 One of the things I try to do if the person is not really feeling open to the diagnosis or the discussion at that time is just to try to leave the door open. 349 00:31:20,540 -- 00:31:22,600 So I might say, 350 00:31:22,610 -- 00:31:23,170 well, 351 00:31:23,170 -- 00:31:27,150 if you ever want to talk more about that topic, 352 00:31:27,160 -- 00:31:29,960 let me know because I'd be happy to do that. 353 00:31:30,540 -- 00:31:32,640 Um but in my mind, 354 00:31:32,640 -- 00:31:34,620 I also know that I just, 355 00:31:34,690 -- 00:31:40,210 I may just want to plant the seed and let them go and not push the topic, 356 00:31:40,250 -- 00:31:42,460 but now that I've introduced it, 357 00:31:42,840 -- 00:31:45,440 they may process that over time. 358 00:31:45,460 -- 00:31:48,460 Someone else may bring it up to them in the future. 359 00:31:48,470 -- 00:31:51,180 It may all fall together to them, 360 00:31:51,180 -- 00:31:52,660 but at a different time. 361 00:31:52,670 -- 00:31:55,950 So planting a seed is okay as well. 362 00:31:58,400 -- 00:31:59,590 I may also say, 363 00:31:59,590 -- 00:32:00,060 you know, 364 00:32:00,710 -- 00:32:04,960 at some point it doesn't matter if we call it that, 365 00:32:04,970 -- 00:32:10,190 but I do think there's some neurology behind it and because of that, 366 00:32:10,190 -- 00:32:13,270 I have some things that I think would really be helpful for you. 367 00:32:13,740 -- 00:32:18,920 So sometimes the person may be able to consider that there is some neurology there, 368 00:32:18,940 -- 00:32:21,770 but not wanting to call it a particular thing? 369 00:32:22,140 -- 00:32:23,510 Uh and other times, 370 00:32:23,520 -- 00:32:23,880 you know, 371 00:32:23,880 -- 00:32:31,950 I just try to focus on what I think would be helpful regardless of whether the person wants to call it a specific thing. 372 00:32:34,340 -- 00:32:39,580 Other times I just let it be, 373 00:32:39,580 -- 00:32:46,680 I don't bring up the topic or maybe I have and it's been shut down and I just, 374 00:32:46,740 -- 00:32:53,130 in my own mind think of the person through that lens when it's helpful. 375 00:32:53,130 -- 00:32:59,770 So maybe there is a behavior or a communication that otherwise I would feel a bit perplexed about. 376 00:33:00,440 -- 00:33:11,950 Um but because I can remind myself that there neurology maybe um autistic in nature that that can help me understand. 377 00:33:11,960 -- 00:33:17,310 So it could help me um when I interact with the individual, 378 00:33:17,320 -- 00:33:23,760 even if we're not kind of overtly calling ah the characteristics by any particular name. 379 00:33:25,440 -- 00:33:33,410 Those are a summary of my thoughts when it comes to describing autism and autistic characteristics to others, 380 00:33:33,420 -- 00:33:44,560 introducing that topic kind of feeling out how they think about it and planting a seed for someone to process that information over time. 381 00:33:45,840 -- 00:33:49,760 I'm really glad you joined me for this last episode of the series, 382 00:33:49,760 -- 00:34:02,960 talking about autism and next time we are going to begin a new series that has to do with the experience and expression of autistic characteristics across the lifespan. 383 00:34:03,840 -- 00:34:08,850 I'm going to be talking about topics such as the developing nervous system. 384 00:34:08,850 -- 00:34:13,420 So the brain doesn't fully develop until about 21 years of age. 385 00:34:13,420 -- 00:34:21,260 So how can that impact the evolution of autistic characteristics through childhood and adolescence? 386 00:34:21,440 -- 00:34:27,600 We're going to talk about hormonal shifts and how that can impact these things puberty, 387 00:34:27,600 -- 00:34:28,630 menstrual cycles, 388 00:34:28,630 -- 00:34:29,540 pregnancy, 389 00:34:29,550 -- 00:34:31,100 menopause aging, 390 00:34:31,740 -- 00:34:38,620 and we're also going to talk about other things related to aging on the autism spectrum, 391 00:34:38,630 -- 00:34:46,260 such as the experience of shifts and how the characteristics our felt or expressed. 392 00:34:47,440 -- 00:34:48,460 Until then, 393 00:34:48,570 -- 00:34:51,690 I hope you have good talks about autism with each other.

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“What did the council decide on item 42?” — answered with the speaker and the moment.

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