Say What You Mean and Mean What You Say
Say what you mean and mean what you say.
This is probably one of the most important things you need to remember when giving instructions to someone with autism.
One of the characteristics of autism – especially for those who have been diagnosed with Aspergers – is literal thinking. Tony Attwood, a well-known author on Aspergers identifies this as a theory of mind trait. They may not understand sarcasm and have a difficulty understanding how to tell a joke, or getting the punch line of one.
Both Sabrina and I have experienced this on many occasions with our children. In fact just this weekend we had a great example I’d like to share. We bought MJ some new female “super-hero” underwear. She was very excited about this underwear but we quickly realized she didn’t actually understand the concept of what a super hero was.
Her underwear sported Bat Girl, Super Woman and Wonder Woman and as she tore open the package she said “Mommy, I am going to be Bat Girl! You can be Bat Mom and dad can be Bat Dad! And we’ll be a bat family that saves bats from extinction and teaches people not to be scared about bats, cause that’s what a bat superhero does right? Mom, what does Wonder Woman do? Ask questions about things she wonders about? ”
I suppressed a giggle (because laughing at her in these situations understandably upsets her deeply) and sat her down and tried to explain about each of the super heroes. This sweet and innocent example of literal thinking is not the only one we have.
Language is a powerful tool, but the English language with our homonyms and figurative expressions is extremely difficult to grasp. Let’s think for a moment about abstract and concrete terms.
Abstract refers to an idea, thought or feeling, it’s not tangible to the senses. Concrete refers to something that is physical, available to the senses like an object.
If you stop and think for just a moment about those two statements and relate them back to the hundreds of sentences you speak each day, the instructions you give your spouse, coworker or child, how much of what you say is concrete? Likely not much.
For the longest time every morning and night we had daily meltdowns over getting dressed for the day or night. Part of it we know is related to an intense dislike of change that MJ has – she simply didn’t like the concept of having to change her clothes regardless of whether it was into or out of pajamas. But as we got to understand our daughter’s diagnosis more and identify areas that were challenges for her, we began to see a common thread – she would have a meltdown every time we gave her a vague set of instructions. Now to you and I, these instructions or concepts may not sound vague, we get the innuendo behind them, but to a child with autism they are confusing and meaningless.
Let’s look at what we would tell her. In the morning we’d say, “ok time to get dressed,” and at night we might use the same phrase, or say, “it’s time to get ready for bed.” What do those statements really mean? What the heck does “get dressed” mean to someone who thinks in pictures and is very literal?
Well one day, MJ showed me – after a battle she came out of her room in a dress and said, “OK, I put on a dress.” It was that moment when the light bulb went off in my head. I asked her what she thought I meant when I asked her to go get dressed. She replied with, “That I am supposed to go get a dress on, isn’t that what get dressed means?”
I hadn’t thought of it that way, I’ve been getting “dressed” for thirty-something years now, I understand the vagueness of the concept, it means that I should find something appropriate in my closet to wear for the weather or occasion and put on all of the assorted items that would be appropriate for the day. It’s ingrained in my brain from years of practice. That is not what it means to my daughter.
We took this to heart and immediately did three things.
1. Created a visual diagram of all of the steps of of getting “dressed” depending on the time of the day. For the morning we had pictures of pants + shirts + underwear + socks or a dress + tights and for the nightime, the pictures were of pajamas – but only after showing pictures of clothes (from above) being put in the laundry basket.
2. We created a weather chart (look for a separate post on this coming up soon to discuss season changes) that she could change on a daily basis showing the temperature and expected forecast for the day.
3. We listed our our instructions in more concrete form: “OK, please go into your room, look in your dresser or closet and choose a pair of pants and a shirt, or a dress with some tights. Then, please choose some underwear and some socks if you are going to wear pants. The weather today is… so please choose something that has (long/short sleeves). Then, please take off your pajamas and put on the clothes you picked out.”
We went from twice-daily meltdowns to practically none overnight. I will say, at first we had to also list out the order of which clothes to put on first, because we did have a few occurrences of forgotten underwear, or underwear over the pants… but practice makes perfect and after a few months of this “routine” we rarely need to remind her of this step now.
We have found this approach to be extremely useful in other areas of life too – from setting the table for dinner to getting ready to leave the house. Any time we start to see signs of a meltdown approach, we try our best to take a step back and ask ourselves: what is it we are asking her to do in this moment and are the instructions clear and concrete? If the answer is no, then as long we’re not past the point of no return, we can often stop a meltdown that is brewing in its tracks simply by changing how we communicate what we are asking.
Have a great day, err, Have a day full of smiles and laughter,