Neurobehavioral Patterns in Autism

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.