Friday, February 4, 2011

More Book Excerpts: Autism and Social Skills

Admittedly, this section is out of context. It is from a long chapter I am still editing and revising, but I think this section of the text can encourage some discussion.

Relationship Constraints
All relationships exist within boundaries. In some cases the boundaries are cultural, physical, or in other ways external to us. There are constraints that are personal. Sometimes we can learn to expand this constraints; sometimes we learn to adapt to them. The coming pages are going to explore four groups of constraints that affect the relationships of people with autism: 
• Social Skills: ability to read and adjust to people, avoid confusing for “passing” as normal
• Tolerances: both emotional and sensory tolerances that can affect relationships
• Desires: “best case” wishes for relationships, from acquaintances to friendships to lovers 
• Needs: what works for us, helps us, and ideally traits close to what we desire
Sometimes we need to remind ourselves that our social skills, tolerances, desires, and needs are not universals. Your relationships aren’t like mine and my relationships aren’t like yours. People with ASDs can have trouble remembering that their experiences are unique. While we do have empathy, it can be a challenge to “think like someone else” — and that includes those with whom we form social connections and meaningful relationships.
You must have realistic expectations. If you are an autistic individual, you have to realize and accept that there are limits we each reach. There are, quite simply, constraints on our relationships. I don’t like knowing I have limits, but I definitely have them. I will always be sensitive to some stimuli. I will always have language cognition issues. And it is okay to have limits. If you are the parent, friend, or educator of an autistic person, you have to be patient. You also have to realize there might be temporary or permanent limitations. 
Knowing limitations is part of relationships. My family and friends have to know my limits. Sometimes, that is difficult because it means we cannot do some things together. I have to know my limits so I can communicate them to people effectively. The impulse still exists to cover my ears, close my eyes, and panic in some situations, which is not the most effective communication. And if I end up struggling verbally in a stressful situation, it is important that those around me not panic and make a difficult moment even more challenging.
 Relationships are about trust. It isn’t always easy to discuss our weaknesses or to tell someone else about his or her weaknesses. I hope this book helps people begin some difficult conversations.
Social Skills
Any discussion of relationships, from familial connections to marriages, and the challenges of autism must frankly address social skills impairments. With severe impairments, families must deal with an inherent lack of social skills development. This of us with some social abilities must also be understood by our families while we attempt to master some skills. This section addresses the following aspects of social skills development: 
• Social skills are necessary to entering and maintaining “intentional” relationships
• Family, friends, and educators must offer frank social skills advice to individuals with ASDs
• Situations (and even careers) emphasize different social skills and styles
• Some skills are “essential” while others are good to develop as much as possible
Intentional Relationships
There are various types and depths of relationships, but most can be categorized as either customary or intentional. A customary relationship is one that is expected or mandated by cultural expectations. For example, a parent-child relationship is customary in our culture. Likewise, teacher-student and doctor-patient relationships are customary relationships, meaning there’s a minimal amount of choice involved. For some autistic individuals, the customary relationships are their primary relationships — they might or might not develop intentional relationships.
“Intentional” relationships are those we intend to form. We focus our minds on trying to understand the person with whom we want to bond. While I admittedly am oversimplifying the concept, the key to intention is that you consciously choose to focus on “the other.” Many people can remember when they saw someone they wanted to meet. They can recall making a choice to approach the stranger and engage in a conversation. That approach is an intentional moment, during which plans were made, quickly and instinctively for many people, about how to handle the anticipated interactions. 
Intentional relationships require maintenance, which can make them an exhausting effort for some individuals with ASDs. That is because most people seem to anticipate and adapt during interactions with friends and colleagues. There is little conscious effort after the initial moments of an encounter. For me, every interaction is an ongoing, conscious effort to analyze the other person or people involved. Because I must think about every movement, expression, and word spoken, I respond slowly or awkwardly. I can only maintain a few intentional relationships, not only because it tires me, but because many people cannot accept my awkwardness. 
Helping with Honesty
Family, friends, and teachers have learned to tell me when my social skills are lacking. Sometimes, I simply get confused in situations or misunderstand someone. At other times, my reactions are “inappropriate” to the situation. Parents and friends can teach and guide a person with autism in social situations. Correcting someone, politely but clearly, can help reinforce social norms. My social skills are still improving, year after year.  
My wife knows she can and should correct me quickly, but politely in social settings. Quickly correcting or guiding me allows me a chance to apologize for any confusion my quirks might cause. I’m not bothered by making mistakes — I make many of them. Students and adults with Asperger’s Syndrome tell me that they feel “guilty” or “bad” after making a social skills error in public, especially when they wanted to make a new friend. I realize it is easy to tell someone not to feel bad, but that is the best advice I can offer. It’s okay to make social skills mistakes. Everyone commits an etiquette faux pas at some point. 
The fact that I don’t care can make it a challenge to remember and avoid repeating mistakes. Students have told me that learning to use that sense of guilt helps them overcome it. The sinking feeling of a mistake becomes a passing sensation that doesn’t linger for days once you train yourself to understand that emotion as a reminder that a “life lesson” just occurred. It seems like a reasonable approach, at least based on the experiences of students and adults with ASDs.
Some autistic people never develop social skills for a variety of neurological and physical reasons. In these instances, being honest about skills means recognizing the limitations of the autistic individual. It also means helping that person deal with an often unforgiving world of social interactions. Maybe you have to tell a clerk or waiter than the autistic person didn’t mean to seem rude. Maybe you have to help explain why an autistic person has to leave a crowded, noisy gathering. You can be honest without revealing private information, and I suggest that’s often the best approach. 
Situations and Social Skills
Relationships can be strained by an autistic individual’s inability to understand social context. Social skills are specific to situations, which is a difficult concept for some of us with ASDs. When we end up having to leave a social event or, worse, have meltdown in public, the stress on friends and family undeniably affect our relationships with those people. Parents tell me that the frustration builds with each “public failure” associated with autism. They don’t mean to blame their autistic child, but they also feel the glares of uninformed strangers and extended family members. 
It would be nice if one set of social skills and rules applied to all social situations. It’s perfectly acceptable to cheer a high note at a blues concert, but you shouldn’t applaud in the middle of an opera. I learned that the hard way. Every setting seems to have its own rules, and the social skills required change accordingly. It is frustrating for me, since any new situation means I have to guess the rules by mimicking other people. 
Even situations that seem similar to parents and educators are different in the minds of many people ASDs. As an example, “church” is not a single set of behaviors or norms. I’ve been asked why a child will sit quietly and “behave” (not the correct term in my view) in one church, while the child has a meltdown in another. Only when I learned that one church as a traditional Lutheran service and the second was a modern Baptist service did I have the answer for the parent: these are not the same.
One church was orderly and followed a set pattern week after week. The sermon was delivered like a lecture from a professor, in quiet tones. The other church was more spontaneous, and certainly louder. The parents had assumed asking for “church behavior” was enough to indicate their expectations. Maybe their expectations were the same, but the social situations were quite different. The church communities themselves were likely different, too. 
I have found that settings are not easily categorized: work, church, school, doctor’s office, and grocers do not describe settings enough for a child or adult with autism. Different workplaces, churches, classrooms, doctors, and even stores have different social norms. They are also different environments, with unique sounds, smells, and sights. 
Before going to a social setting, including those encountered on a regular basis, it helps to consider what will be experienced. My wife reminds me every time what a particular restaurant will be like once we arrive. I often forget how much trouble a setting is for me. When I want Mexican food, I might remember that the food is great at a restaurant without recalling the tile floors and wooden ceiling form an echo chamber. If you are the parent of an autistic person, you might also want to remind your child of a setting and the rules before arriving. 
Parents and teachers ask me why a student with autism can’t remember that one teacher and classroom wants students to work together in groups while another wants silence. I don’t know why it is, but I had the same problem remembering classroom rules from day to day. As explain later, I learned to cope by preparing lists of what to expect from each setting I encountered. 
Family gatherings are more difficult for some autistic people than church, school, or even the doctor’s office. Friends and family don’t always appreciate that “gatherings” from birthdays to holidays are particularly challenging because the expectations encroach on the things most trying for some autistics. I don’t like to shake hands, be hugged, or receive kisses. I need my space. Imagine being an autistic child. Yes, Grandma or Aunt Jane might want a hug or kiss, but that risks a meltdown. You can prepare me for gatherings, but sometimes people cross lines. 
Gatherings at holidays are accompanied by everything from costumes (I include fancy clothes as costumes) to decorations. Unusual menus, especially unfamiliar foods, are annoying to me. Again, imagine being a child unable to express frustration with the once-a-year meal that isn’t part of a routine. The entire family gathering experience is one huge over-stimulation. 
Parents and friends can prepare an autistic individual for only so much of what will be experienced in a social setting. This goes back to preparing not only the individual with autism, but others attending a social event whenever possible. 
I will address workplaces in a coming chapter. They are definitely social settings with changing norms. If an autistic child learns to adapt to different teachers and different public spaces, the child is preparing for workplaces. You can never start learning too early, including learning that social “norms” are anything but standardized. 

1 comment:

  1. The best bit was probably Social skills and situations in which it was shown why things can be hard.

    I can imagine being that child with the once-a-year meal. Temple Grandin wrote about that really well in the first chapter of Emergence when her aunt embraced her and had perfume and everything.

    This segues into social skills; desires; tolerance and needs. "Sometimes we learn to expand our constraints; sometimes we adapt to them".

    I also understood that settings were not easily categorised, especially the church situation. That was a good example.

    And the "public failure". Apologies are good.

    Interesting distinction between customary and intentional relationships.

    It was also interesting about how you mentioned that some of your students use their sense of guilt. Guilt, for me, is one of the ultimate social emotions, and one I try to use in social situations. When I use it on myself...And how it becomes a passing sensation.

    Asking for church behaviour is like asking for "quiet hands", "quiet voice", "quiet feet".

    Fancy clothes as costumes: I'd never have picked that up!

    Good point to prepare others. They may need guidance that it's good to think like the other: in this case, an autistic person.

    The Mexican food example? Like colour to the blind is full of these. Donna and Ian waited for the world to adjust itself after 25+ years of misunderstanding/malabsorption!

    I would like to ask a bit more about choice in customary relationships? Is it that the choice is made by the dominant partner/the choosing partner? Can the person influence the relationship? How?

    Adapting seems to be more useful to external constraints; expanding to personal. Or I think it's both of them.

    A good book on preparation was Smiling at Shadows.

    I thought about the concept of anticipation when I was watching tennis. There was one young player who seemed to read the play and anticipate the ball and her opponent.

    And it's good that you don't tell people to unfeel the stares and develop a thick skin! That is a limitation, too, and probably not a social norm!

    ReplyDelete

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