Autism in the Adult

This episode of the podcast explores the idea of expanding special interests in various areas of life. It offers advice on turning interests into personal goals, acquiring new skills through online courses, and finding free opportunities to showcase work. The podcast also discusses leveraging online platforms and community events to further passions and take steps towards goals.

Do you want to live with more intention to achieve your goals? In this 5th episode in a series on Intentional Living, Dr. Regan identifies ways to improve household interactions by attending to the needs of the group and establishing traditions and structured activities.    Dr. Regan's Resources Book: Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians   Read the transcript here: 1 00:00:06,139 --> 00:00:06,480 Hi, 2 00:00:06,489 --> 00:00:07,110 everyone. 3 00:00:07,119 --> 00:00:12,170 This is Doctor Regan joining you for an episode of Autism in the Adult podcast. 4 00:00:12,489 --> 00:00:14,970 I'm the mom of a teen on the spectrum. 5 00:00:14,979 --> 00:00:17,500 I have a doctorate in neuropsychology. 6 00:00:17,700 --> 00:00:20,790 It's the field of brain behavior relationships. 7 00:00:20,909 --> 00:00:25,649 And I'm the director of an autism diagnostic clinic for adolescents, 8 00:00:25,659 --> 00:00:29,149 adults and aging adults in Central Illinois. 9 00:00:30,010 --> 00:00:30,459 Today, 10 00:00:30,469 --> 00:00:38,180 you're joining me for the fifth episode in a series about living with intention making goals, 11 00:00:38,189 --> 00:00:43,500 shifting in areas of life to get you closer to where you would like to be. 12 00:00:44,240 --> 00:00:55,540 So there were two episodes about how to choose an area of life to target and how to approach change with some specific goals and strategies. 13 00:00:56,009 --> 00:01:02,369 We had episodes about improving regulation and about communicating and connecting. 14 00:01:02,979 --> 00:01:09,629 So today we have an episode focused on household living and the culture of the household. 15 00:01:10,400 --> 00:01:10,690 Now, 16 00:01:10,699 --> 00:01:13,250 before we dive into the topic for today, 17 00:01:13,260 --> 00:01:20,519 I want to invite you to check out the resources on my website at adult in geriatric autism dot com. 18 00:01:20,959 --> 00:01:28,410 There are posts and videos for many different types of listeners and learners including clinicians. 19 00:01:29,019 --> 00:01:29,529 Also, 20 00:01:29,540 --> 00:01:31,610 you may find one of my books helpful, 21 00:01:31,620 --> 00:01:32,580 many of you know, 22 00:01:32,589 --> 00:01:39,069 that my first book called Understanding Autism in Adults and Aging Adults is in the second edition. 23 00:01:39,500 --> 00:01:40,589 And if you don't know, 24 00:01:40,599 --> 00:01:44,550 I have a second book called Understanding Autistic Behaviors, 25 00:01:44,559 --> 00:01:47,250 which is more of a workbook format. 26 00:01:47,540 --> 00:01:55,809 So it explains the neurology ... kind of the neurologic-why of some of the behavioral patterns. 27 00:01:55,819 --> 00:02:02,110 And it outlines ways to work toward increased well-being if someone's in a season of struggle. 28 00:02:04,419 --> 00:02:07,430 So let's focus on household living. 29 00:02:07,470 --> 00:02:16,449 So I want to highlight this topic because many people talk to me about the complexities of living in a household with other people. 30 00:02:16,949 --> 00:02:22,330 Most often this has to do with spouses or partners or with couples who have Children. 31 00:02:22,690 --> 00:02:27,350 Not only is the individual trying to increase their own self awareness. 32 00:02:27,360 --> 00:02:27,559 You know, 33 00:02:27,570 --> 00:02:29,050 this is how I'm wired, 34 00:02:29,059 --> 00:02:30,529 this is what makes me tick, 35 00:02:30,539 --> 00:02:31,770 this is what I need. 36 00:02:32,059 --> 00:02:33,830 But in a household, 37 00:02:33,860 --> 00:02:41,160 this is really next level awareness because there's now this demand to be aware of yourself, 38 00:02:41,169 --> 00:02:46,289 multiple other people and the interplay between all of the people. 39 00:02:46,500 --> 00:02:47,630 And on top of that, 40 00:02:47,639 --> 00:02:52,100 the needs and interplay change from day to day and from life, 41 00:02:52,110 --> 00:02:53,770 season to life season. 42 00:02:54,789 --> 00:03:00,240 It's so so easy to default to this kind of household interaction. 43 00:03:00,449 --> 00:03:02,039 Stop doing that. 44 00:03:02,050 --> 00:03:03,440 Why are you doing that? 45 00:03:03,449 --> 00:03:08,440 I've told you 100 times to X Y Z. 46 00:03:08,860 --> 00:03:09,800 Oh my gosh, 47 00:03:09,809 --> 00:03:12,440 you are so loud, 48 00:03:12,449 --> 00:03:21,630 messy clingy and guess what this focus on telling people to be different every day is just not that effective. 49 00:03:21,960 --> 00:03:27,679 And that's why we find ourselves saying the same things every day over and over. 50 00:03:27,690 --> 00:03:28,770 And not only that, 51 00:03:28,910 --> 00:03:35,339 but these repetitive interactions cause a strain on the relationships in the household. 52 00:03:35,369 --> 00:03:40,940 And they create this kind of adversarial connection rather than a partnering connection. 53 00:03:41,330 --> 00:03:50,050 So the big message is I want you to be different now rather than I want to partner with you to make things better, 54 00:03:50,110 --> 00:03:51,339 better for you, 55 00:03:51,350 --> 00:03:53,839 better for me and better for the household. 56 00:03:54,520 --> 00:04:01,009 So let's talk about some specific areas of focus and strategy that might help. 57 00:04:01,820 --> 00:04:05,509 The first thing we're gonna talk about is focus on the other. 58 00:04:05,889 --> 00:04:06,199 Now, 59 00:04:06,210 --> 00:04:07,690 during the previous episode, 60 00:04:07,699 --> 00:04:14,910 we talked about the importance of expanding our awareness from only what do I need right now, 61 00:04:14,919 --> 00:04:22,100 which actually can be difficult to figure out to what does the other person need right now. 62 00:04:22,399 --> 00:04:24,170 And when we add that element, 63 00:04:24,420 --> 00:04:28,109 we can get away from this push and pull of, 64 00:04:28,119 --> 00:04:31,769 stop doing that to oh, 65 00:04:31,779 --> 00:04:35,309 things might be able to go smoother in this area. 66 00:04:35,660 --> 00:04:42,910 I wonder what the need is that's connected with that behavior and how could I support change? 67 00:04:43,250 --> 00:04:46,109 So as we're talking about households, 68 00:04:46,119 --> 00:05:00,899 this concept of focus on the other then becomes expanded and that makes things a little more complex but also much more important and potentially really helpful, 69 00:05:00,950 --> 00:05:04,730 especially if this becomes the culture of the household, 70 00:05:04,760 --> 00:05:09,079 meaning that this is how we do things it becomes more automatic. 71 00:05:09,089 --> 00:05:13,880 It becomes something that everyone's focusing on as best they can. 72 00:05:14,980 --> 00:05:28,660 Let's imagine that a gentleman who's on the autism spectrum is also a dad and a husband and he's coming home from work after what's been a really draining and complex day, 73 00:05:29,059 --> 00:05:36,130 he's had work demands but also lots of other layers of unexpected changes in his schedule, 74 00:05:36,140 --> 00:05:38,230 detours on the route home. 75 00:05:38,600 --> 00:05:43,970 There were lots of sensory overload moments and a disagreement with a work colleague. 76 00:05:44,750 --> 00:05:51,579 So he comes home and mom who is home with three kids is not on the spectrum, 77 00:05:51,589 --> 00:05:55,070 but she does have sensory processing sensitivities, 78 00:05:55,200 --> 00:05:56,220 stickiness, 79 00:05:56,230 --> 00:05:58,529 and kids hanging on her and noise. 80 00:05:58,540 --> 00:06:02,600 And she's getting to the point that that has been really overwhelming today. 81 00:06:03,359 --> 00:06:05,149 She is home with three kids. 82 00:06:05,160 --> 00:06:21,200 A daughter who is eight has been home from school with the stomach flu but is feeling better and is now running around the house in her tutu singing and spinning and waving her magic wand around an autistic son who is 11, 83 00:06:22,160 --> 00:06:25,049 is melting down while doing his math homework. 84 00:06:25,070 --> 00:06:32,630 And another son is 15 and is playing loud music in his room with the door shut. 85 00:06:34,019 --> 00:06:35,790 So the first approach, 86 00:06:35,799 --> 00:06:41,040 the one that is our most typical go to may look like this. 87 00:06:41,549 --> 00:06:42,899 Dad walks in. 88 00:06:43,059 --> 00:06:46,480 Mom is yelling at her two youngest kids to be quiet. 89 00:06:46,660 --> 00:06:51,549 She's juggling hot food in the kitchen while trying to get food ready for dinner. 90 00:06:52,700 --> 00:06:58,130 The youngest daughter runs up to dad and wants to show off her tutu and her magic wand. 91 00:06:58,540 --> 00:07:03,549 And dad hears the loud music coming from upstairs and mom is thinking, 92 00:07:03,559 --> 00:07:06,059 thank goodness he is home. 93 00:07:06,220 --> 00:07:07,549 I need some help. 94 00:07:07,559 --> 00:07:14,130 I need some relief and dad is thinking I can't wait to get out of here and go for my bike ride. 95 00:07:16,299 --> 00:07:23,519 So mom and dad get in a fight about how he comes home and goes off by himself and she's been there all day, 96 00:07:23,529 --> 00:07:24,309 et cetera. 97 00:07:25,209 --> 00:07:28,279 So dad feels the pressure to make things right. 98 00:07:28,510 --> 00:07:30,950 He yells at his oldest son saying, 99 00:07:30,959 --> 00:07:34,070 why don't you turn off your music and come down and help your mother. 100 00:07:34,390 --> 00:07:40,850 And he yells at the middle son and says that math really isn't that hard and he should stop crying. 101 00:07:42,920 --> 00:07:55,970 We all get that right like we are at the end of our rope and we just want to make the chaos stop and calm down and we want other people to do their part. 102 00:07:58,119 --> 00:08:00,250 Let's think about a second approach. 103 00:08:01,019 --> 00:08:17,299 This is increased awareness that all of these people have really legitimate needs and a realization that there needs to be a way to figure out what they are and then to try to work together to do something. 104 00:08:19,170 --> 00:08:22,100 Mom is overwhelmed with sensory inputs. 105 00:08:22,109 --> 00:08:26,929 She's drained from the whole day of being the only adult at home, 106 00:08:27,079 --> 00:08:33,700 which means that she has been the go to person for everyone's needs in the household. 107 00:08:34,559 --> 00:08:37,588 So she needs quiet alone time. 108 00:08:37,838 --> 00:08:39,598 She needs compliments, 109 00:08:39,609 --> 00:08:41,059 she needs support. 110 00:08:41,900 --> 00:08:44,830 The youngest daughter suddenly feeling better. 111 00:08:45,239 --> 00:08:54,210 She needs to run off some of her nonsick energy and be recognized as someone who's beautiful and magical with her wand. 112 00:08:55,409 --> 00:08:59,330 The middle son has also been very drained from the day. 113 00:08:59,669 --> 00:09:06,080 He gets overwhelmed with the social and sensory environment at school and he has a math learning disability. 114 00:09:06,719 --> 00:09:17,369 So he has gone from a draining environment to a draining environment and he's doing a task that he just knows he can't have success with. 115 00:09:18,260 --> 00:09:21,840 He's unable to get his bearings to calm, 116 00:09:22,059 --> 00:09:23,469 to reenter, 117 00:09:23,479 --> 00:09:25,869 he needs some regulation help. 118 00:09:27,960 --> 00:09:39,880 The oldest son is feeling the angst of being a teen and this comes with easy irritation thinking his parents don't know anything and the loud music releases some of his irritability. 119 00:09:40,000 --> 00:09:43,450 It establishes his identity as his own person. 120 00:09:43,619 --> 00:09:46,969 So that is a lot. 121 00:09:49,590 --> 00:09:51,229 In this case, 122 00:09:51,900 --> 00:10:07,090 it often helps to have some type of planned huddle uh between the couple or with the family about what is the status right now and what do you need? 123 00:10:09,809 --> 00:10:18,659 The huddle is just a coming together to talk briefly about what are we gonna do next? 124 00:10:18,900 --> 00:10:20,820 What's going on and what are we gonna do? 125 00:10:21,979 --> 00:10:26,710 The status is really high chaos for everyone in this family right now. 126 00:10:27,979 --> 00:10:35,590 And sometimes families make up kind of humorous labels for levels of chaos or crisis. 127 00:10:35,880 --> 00:10:50,049 One family might use a color code where a code red is the most chaos or sometimes a movie related code where the most chaos is the Lord of the Rings scene where the orcs come. 128 00:10:51,070 --> 00:10:54,030 The status could also be a factual description. 129 00:10:54,190 --> 00:10:55,340 Bad day at work, 130 00:10:55,349 --> 00:10:57,619 really drained or bad day at home, 131 00:10:57,630 --> 00:10:58,539 really drained. 132 00:10:58,710 --> 00:11:02,919 And I'm at my breaking point at the highest level of chaos. 133 00:11:02,929 --> 00:11:05,309 Both mom and dad really need alone time. 134 00:11:05,669 --> 00:11:06,280 Now, 135 00:11:06,289 --> 00:11:07,820 what do the kids need? 136 00:11:08,450 --> 00:11:08,929 Well, 137 00:11:08,940 --> 00:11:11,000 you may have a quick family huddle, 138 00:11:11,320 --> 00:11:12,780 what do you need? 139 00:11:13,210 --> 00:11:21,960 Or the parents may have a sense already of what the kids would probably need to regulate and regroup. 140 00:11:22,349 --> 00:11:27,219 One helpful thing in this scenario might look like the following. 141 00:11:27,840 --> 00:11:36,130 Dad could go on his bike ride but also take the 11 year old son who's on the autism spectrum on the ride as well. 142 00:11:37,150 --> 00:11:42,070 They both really feel better after they get some pressure input, 143 00:11:42,080 --> 00:11:45,929 that's proprioceptive input and movement input, 144 00:11:45,940 --> 00:11:47,330 vestibular input. 145 00:11:47,669 --> 00:11:53,450 You can see our episode about sensory inputs for regulation. 146 00:11:54,070 --> 00:11:57,539 And this is why the bike ride is so important. 147 00:11:57,760 --> 00:12:03,200 If we tell dad not to go on the bike ride because the house is in chaos, 148 00:12:03,599 --> 00:12:07,409 he's not going to be able to regulate himself. 149 00:12:07,590 --> 00:12:09,849 So we want a dad who comes back, 150 00:12:09,859 --> 00:12:12,979 regulated centered calm. 151 00:12:13,239 --> 00:12:14,640 Um not at, 152 00:12:14,650 --> 00:12:15,890 at the breaking point. 153 00:12:16,539 --> 00:12:30,619 This bike ride also gives time for their mind to settle and it's a kind of together activity where they actually don't have to talk So it's the thing they like to do and we're together, 154 00:12:30,630 --> 00:12:36,780 but we don't have to say anything and that's very calming and regulating for them. 155 00:12:38,750 --> 00:12:40,349 Perhaps in this scenario, 156 00:12:40,359 --> 00:12:51,559 mom chooses a bubble bath with headphones and music and gives the 15 year old a task to keep him busy and to acknowledge his independence. 157 00:12:52,200 --> 00:13:01,650 So there's a small corner store about three blocks away and she gives him $15 to walk to the corner store and to take the eight year old, 158 00:13:03,049 --> 00:13:11,119 the eight year old can spin and sing and walk with her wand and he gets to choose whatever he wants for, 159 00:13:11,130 --> 00:13:13,539 quote dessert for the family. 160 00:13:14,460 --> 00:13:18,489 He chooses lots of movie candy like now and laters, 161 00:13:18,500 --> 00:13:21,059 Mike and Ike and Swedish fish. 162 00:13:21,070 --> 00:13:25,109 And he lets his sister pick out a Princess Pez dispenser. 163 00:13:25,700 --> 00:13:27,390 Then they walk home, 164 00:13:27,400 --> 00:13:29,330 mom's done with their bath. 165 00:13:29,340 --> 00:13:38,270 Dad and son are home and this is a regrouping time that acknowledges as many people's needs as possible. 166 00:13:38,609 --> 00:13:44,409 And then there can be a huddle at that point about how the rest of the night might go. 167 00:13:46,419 --> 00:13:54,750 But we at least want to problem solve when as many people as possible are more centered and less close to the breaking point. 168 00:13:57,289 --> 00:14:06,520 So this focus and strategy is uh really pinpointing what other people need people in the household. 169 00:14:06,869 --> 00:14:12,479 And it uses the huddle concept to come together and make a plan. 170 00:14:12,849 --> 00:14:14,979 So it's a quick coming together. 171 00:14:14,989 --> 00:14:16,690 It's not like a family meeting, 172 00:14:16,700 --> 00:14:18,739 where we talk through things, 173 00:14:18,859 --> 00:14:21,580 it's what's going on and what do we need to do. 174 00:14:23,190 --> 00:14:23,679 Now, 175 00:14:23,690 --> 00:14:26,760 we all know that this doesn't make everything easy, 176 00:14:26,780 --> 00:14:35,969 but it often makes things better and it creates partnerships within the household rather than really strained relationships. 177 00:14:40,070 --> 00:14:44,280 Let's look at another approach to household culture. 178 00:14:44,419 --> 00:14:51,020 So the second one is focusing on tradition and structure in order to interact, 179 00:14:52,859 --> 00:14:55,090 individuals with autistic neurology, 180 00:14:55,099 --> 00:15:04,099 often prefer structured topic based activities rather than hanging out or sharing about their day or sharing about feelings. 181 00:15:04,510 --> 00:15:10,869 These are typically more enjoyable to them than just unstructured together time. 182 00:15:12,219 --> 00:15:16,950 It might involve harnessing their knowledge about something that they love. 183 00:15:19,450 --> 00:15:25,099 And once you know who in the family really likes this kind of interaction. 184 00:15:25,109 --> 00:15:26,320 And you can say, 185 00:15:26,479 --> 00:15:29,049 I know this is what we enjoy best. 186 00:15:29,380 --> 00:15:35,059 This awareness can help increase the number of nice family memories or interactions. 187 00:15:35,380 --> 00:15:37,239 So for example, 188 00:15:37,250 --> 00:15:46,159 let's take a family um who likes to socially connect at the dinner table by sharing about their day, 189 00:15:46,380 --> 00:15:47,929 how the practice went, 190 00:15:47,940 --> 00:15:49,409 how their soccer game? 191 00:15:49,419 --> 00:15:53,669 Did uh did your friend feel good about their science project? 192 00:15:53,679 --> 00:15:56,809 How is your boss's husband doing since his surgery, 193 00:15:56,820 --> 00:15:57,510 et cetera? 194 00:15:58,900 --> 00:16:02,880 In contrast to another family with neurodiversity, 195 00:16:02,890 --> 00:16:03,359 now, 196 00:16:03,369 --> 00:16:10,299 they may prefer something more structured and less about how people felt or responded, 197 00:16:10,780 --> 00:16:14,119 less open ended or broad questions about the day. 198 00:16:14,340 --> 00:16:15,919 So what might that look like? 199 00:16:17,909 --> 00:16:25,080 This family might start a tradition at the dinner table where they each share an interesting fact that they learned that day. 200 00:16:25,159 --> 00:16:30,159 So perhaps the eight year old learned that most fish don't have eyelids. 201 00:16:30,580 --> 00:16:33,000 The 15 year old learned that on average, 202 00:16:33,010 --> 00:16:36,739 every person on earth owns 86 Lego Bricks. 203 00:16:40,210 --> 00:16:42,320 Let's look at another example. 204 00:16:42,330 --> 00:16:44,059 Let's take a spouse. 205 00:16:44,400 --> 00:16:56,059 We're looking at a woman who feels dissatisfied because her husband doesn't engage in conversations during times like car rides or while at a restaurant and waiting on their meal. 206 00:16:56,739 --> 00:17:03,609 She's realized though that they can have a really good social interaction if it's structured about a topic. 207 00:17:04,250 --> 00:17:12,939 She's also noticed that they have a good time interacting if they take online quizzes or play trivia together during these times. 208 00:17:13,660 --> 00:17:22,630 So the passenger in the car can ask the driver trivia questions and then they can switch and she notices that they really end up laughing, 209 00:17:22,640 --> 00:17:24,089 they learn new things. 210 00:17:24,099 --> 00:17:25,530 It works out well. 211 00:17:25,540 --> 00:17:28,380 It's actually a really connecting time, 212 00:17:28,689 --> 00:17:34,829 uh much better than the silence of sitting together without interacting. 213 00:17:37,680 --> 00:17:39,530 Let's take a third family. 214 00:17:39,619 --> 00:17:53,829 This family has teens and it's been struggling because the kids are a bit more moody than they were as youngsters and they're too old for some of the things that they used to do as a family when they were younger. 215 00:17:54,099 --> 00:17:54,380 You know, 216 00:17:54,390 --> 00:17:57,170 they don't like going to the zoo anymore. 217 00:17:58,119 --> 00:18:05,349 This family realized that structuring some traditions for activities has worked better than small talk. 218 00:18:05,359 --> 00:18:13,849 Like how with school they might have a Friday night tradition of board games and pizza or they might rotate, 219 00:18:13,859 --> 00:18:16,530 who gets to pick the Friday night activity. 220 00:18:16,979 --> 00:18:21,810 One teen may pick a movie and chooses the snacks next week, 221 00:18:21,819 --> 00:18:26,089 another chooses a board game and challenges kids against parents. 222 00:18:26,579 --> 00:18:31,229 And the next week mom chooses a Lock Drew mystery for the family to solve together. 223 00:18:32,780 --> 00:18:43,729 So this approach harnesses the fact that individuals with autistic neurology may really enjoy each other within the context of some structure, 224 00:18:43,739 --> 00:18:53,310 topic and activity rather than these loose connecting moments or open ended questions like how is your day and what's going on in your life. 225 00:18:56,209 --> 00:19:00,420 There's so much that goes into the culture of a household. 226 00:19:00,790 --> 00:19:18,670 But these two tips of helping people get their needs met and coming together with structure and topic focused activities can be part of what helps shift things in a good direction for many families and it really protects those partnering kinds of relationships. 227 00:19:19,989 --> 00:19:24,660 Thank you for joining me today to talk about households and families, 228 00:19:24,819 --> 00:19:27,060 protecting the wellness of our family. 229 00:19:27,069 --> 00:19:32,709 Connections can help us feel more supported and resilient overall. 230 00:19:33,530 --> 00:19:42,430 And next time we will round out this series by focusing on adding meaning and growth to areas of special interest. 231 00:19:42,619 --> 00:19:44,219 I hope you can join me then.  

The podcast discusses the importance of effective communication and connection, understanding needs in communication, connecting with others through genuine interest, and provides strategies and resources for enhancing communication and connection.

In this podcast, Dr. Regan discusses intentional living and improving resilience. She explores the use of sensory inputs, such as pressure and movement, for regulating the nervous system. The importance of vestibular input and finding the right sensory inputs for each individual is emphasized. Dr. Regan provides practical tips for using sensory inputs to improve regulation and well-being.

Dr. Regan discusses intentional living and how to make goals and achieve them. She explores different areas of personal growth, setting achievable goals, strategies for success, and adapting strategies when circumstances change.

In this episode, the podcast explores topics related to intentional living for individuals with autism. They discuss self-awareness in goal setting, health and wellness, challenges in communication and daily tasks, and intentional living categories such as navigating the community and setting goals.

Join Dr. Regan for this episode on the neurodiversity movement, autism affirming services, and the importance of allowing for complexity in our understanding of autism.    Dr. Regan's online presentations with Zur Institute March, 2023: Is my Client on the Spectrum? Dispelling Myths About Autism Diagnoses Autism Assessment: The Seven Diagnostic Criteria Brought to Life Dr. Regan's Resources Course for Clinicians - Interventions in Autism: Helping Clients Stay Centered, Connect with Others, and Engage in Life Course for Clinicians: ASD Differential Diagnoses and Associated Characteristics Book: Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians   Read the transcript here:   1 00:00:07,050 --> 00:00:10,400 Welcome to the podcast Autism in the Adult. 2 00:00:10,540 --> 00:00:12,310 I'm Dr Theresa Regan, 3 00:00:12,320 --> 00:00:14,060 a neuropsychologist, 4 00:00:14,100 --> 00:00:16,150 the mother of a teen on the spectrum, 5 00:00:16,160 --> 00:00:22,680 and the founder and director of an autism diagnostic clinic in Central Illinois for adolescents, 6 00:00:22,690 --> 00:00:24,720 adults and aging adults. 7 00:00:26,490 --> 00:00:32,300 Sometimes I get emails from people asking if I perform autism assessments for adults. 8 00:00:32,310 --> 00:00:33,080 And indeed, 9 00:00:33,080 --> 00:00:35,030 that's my full time job. 10 00:00:35,040 --> 00:00:36,850 So I go to work every day. 11 00:00:36,850 --> 00:00:42,730 I see patients and clients in a medical setting for evaluations and recommendations. 12 00:00:44,260 --> 00:00:58,920 Then I also have other things that I've chosen to do in the topic area of autism because I'm passionate about the people impacted and the positive things that can happen when we understand more about the autistic neurology. 13 00:01:00,000 --> 00:01:12,240 I do have a few online presentations coming up through Zur Institute which is a continuing education program for professionals. 14 00:01:12,250 --> 00:01:20,970 I'll include a link in the podcast show notes to these programs so you can look at the descriptions and registration links. 15 00:01:21,340 --> 00:01:26,440 And the first one is Tuesday March 7th 2023. 16 00:01:26,440 --> 00:01:27,740 For one hour. 17 00:01:27,760 --> 00:01:34,100 The presentation covers information about the basic foundational rules of the autism. 18 00:01:34,100 --> 00:01:45,750 Diagnostic criteria Will be dispelling myths about the foundations and requirements that may prevent people from being referred for assessment appropriately. 19 00:01:45,870 --> 00:01:48,740 And the second presentation is on Saturday, 20 00:01:48,750 --> 00:01:50,210 March 25, 21 00:01:50,220 --> 00:02:02,410 that's for two hours and this presentation will highlight the seven diagnostic criteria what they mean and also what they look like in a clinical case of a young adult female, 22 00:02:02,410 --> 00:02:05,580 just to illustrate some of the concepts. 23 00:02:05,900 --> 00:02:08,860 So if you are a clinician or you know, 24 00:02:08,870 --> 00:02:13,420 of professionals in your area who are wanting to learn more about autism, 25 00:02:13,430 --> 00:02:16,420 this may be a good resource opportunity. 26 00:02:16,940 --> 00:02:22,020 The topic of the podcast today is actually not the topic that I had been working on. 27 00:02:22,030 --> 00:02:23,860 Uh to record, 28 00:02:23,870 --> 00:02:29,120 I've had multiple interactions about a different topic over the last few weeks. 29 00:02:29,120 --> 00:02:35,460 And it really struck me as perhaps something that would be timely to talk about or helpful to process. 30 00:02:35,470 --> 00:02:37,090 And so in this episode, 31 00:02:37,090 --> 00:02:47,760 I wanted to talk about neurodiversity and autism affirming approaches to serving those on the spectrum. 32 00:02:47,770 --> 00:02:54,790 I'm gonna talk about three things within the context of this episode. 33 00:02:54,790 --> 00:02:57,480 One is just what are we talking about? 34 00:02:57,480 --> 00:03:01,050 What's the definition when we talk about neuro diversity? 35 00:03:01,060 --> 00:03:11,630 The second is what kinds of conditions or characteristics might we want to include under the umbrella of neuro diversity? 36 00:03:11,640 --> 00:03:30,220 And the third has to do with a viewpoint that some put forward that says that only individuals who have diagnoses of neuro divergence should be offering services to those on the spectrum. 37 00:03:30,230 --> 00:03:32,820 When we talk about neuro diversity, 38 00:03:32,830 --> 00:03:40,800 we're basically talking about the idea that people experience and interact with the world around them in many different ways. 39 00:03:40,810 --> 00:03:44,570 And this concept of course, 40 00:03:44,570 --> 00:03:47,450 neuro being neurology and diversity, 41 00:03:47,460 --> 00:03:48,760 meaning diversity. 42 00:03:48,760 --> 00:03:58,080 So we all have variations in our neurologic wiring and there's no one quote right way of thinking, 43 00:03:58,090 --> 00:04:05,700 learning and behaving and that all neurologic differences should be appreciated as part of natural variation. 44 00:04:06,370 --> 00:04:10,350 And I explain those concepts, 45 00:04:10,360 --> 00:04:16,990 knowing and wanting to communicate that people will defined neuro diversity differently. 46 00:04:16,990 --> 00:04:23,630 And so I'm trying to use phrases that are commonly used um in describing what that means, 47 00:04:23,640 --> 00:04:25,750 one person can say that, 48 00:04:25,760 --> 00:04:26,230 you know, 49 00:04:26,230 --> 00:04:31,060 that isn't really what it means to me and that's completely fine. 50 00:04:31,070 --> 00:04:39,020 It's such a complex topic that getting it right as everyone would define it is difficult. 51 00:04:39,020 --> 00:04:40,260 But basically, 52 00:04:40,270 --> 00:05:06,220 it is this understanding that there's variations on our wiring and there's this emphasis that there's not one right way to be connected neurologically um at its best when we're talking about neuro diversity as a concept and autism affirmation as a concept. 53 00:05:06,230 --> 00:05:29,960 It really helps ward against an approach to intervention that may focus on correcting or fixing behaviors in the neuro diverse individual only because the behaviors are unusual or atypical. When a therapist is neuro diversity affirming or autism affirming, 54 00:05:29,970 --> 00:05:44,310 this is often used to emphasize that they understand that neuro divergence itself is not a flaw or an illness that needs to be fixed or corrected. 55 00:05:44,640 --> 00:05:47,820 And we're gonna talk about this a little bit more later. 56 00:05:47,820 --> 00:05:52,640 But neuro divergence often refers to autism, 57 00:05:52,640 --> 00:05:56,030 but it is a much larger umbrella right now. 58 00:05:56,030 --> 00:05:58,020 And so we'll talk about that as well. 59 00:05:58,800 --> 00:06:02,940 However, 60 00:06:04,180 --> 00:06:05,410 at the same time, 61 00:06:05,410 --> 00:06:23,080 we hope that the autism affirming therapist can also acknowledge some parts of autism that really may create a lot of difficulty or pain for the person that's presenting for care. 62 00:06:23,090 --> 00:06:25,230 So at its best, 63 00:06:25,230 --> 00:06:39,420 we really hope there's this balance of understanding of the gifts and strengths in the autistic experience in the struggles and difficulties that someone may really inherently experience, 64 00:06:39,430 --> 00:06:43,960 not because of the attitudes of society or, 65 00:06:43,970 --> 00:06:44,690 or anything, 66 00:06:44,690 --> 00:06:51,640 but because this neurologic piece is really giving them difficulty. At it's extreme, 67 00:06:52,260 --> 00:07:24,600 there may be some in the autism affirming community or the neuro divergence community that really emphasize that the autistic experience is very positive in its essence that the diverse experience should always be emphasized as strength and the variation doesn't involve any inherent struggle. 68 00:07:25,560 --> 00:07:28,740 I think that when 69 00:07:28,740 --> 00:07:32,970 we get to that categorical kind of description, 70 00:07:32,980 --> 00:07:39,740 whether someone is talking about the autistic experience is all bad... or all good, 71 00:07:40,010 --> 00:07:40,430 you know, 72 00:07:40,430 --> 00:07:49,340 I think we're missing the complexity of the human experience and specifically here, 73 00:07:49,340 --> 00:07:51,210 the autistic experience. 74 00:07:51,220 --> 00:08:05,430 So what I would say about the movement and the concept of neuro diversity is it's really best when we're able to stay centered in the complexity... in the center, 75 00:08:05,430 --> 00:08:07,550 not those two extreme categories, 76 00:08:07,550 --> 00:08:18,990 but in the center of this mix of good and difficult where most often the truth lies in that center in that complexity. 77 00:08:19,990 --> 00:08:24,140 Let me explain what the DSM 5, 78 00:08:24,140 --> 00:08:32,620 that's the diagnostic manual for many of the conditions that people refer to as neurodivergent... 79 00:08:32,630 --> 00:08:39,240 I want to talk about the criteria they use for when something is called a diagnosis. 80 00:08:39,240 --> 00:08:41,880 So this is not specific to autism. 81 00:08:41,890 --> 00:08:46,040 This could include learning disability, 82 00:08:46,050 --> 00:08:47,250 autism, 83 00:08:47,260 --> 00:08:48,360 psychosis, 84 00:08:48,360 --> 00:08:49,400 depression, 85 00:08:49,410 --> 00:08:50,960 lots of different things. 86 00:08:50,960 --> 00:09:01,810 And there are two things that they really focus on as being present in order for a diagnosis to be relevant. 87 00:09:01,810 --> 00:09:04,760 And so one is that the condition, 88 00:09:04,770 --> 00:09:19,440 the constellation of characteristics, is statistically atypical ... that it's not the most common constellation that we see in the daily human experience. 89 00:09:19,450 --> 00:09:23,410 It's not the most common state. 90 00:09:24,060 --> 00:09:24,340 Now, 91 00:09:24,340 --> 00:09:33,970 the second thing though is that the atypical constellation of characteristics must cause some form of difficulty for the individual, 92 00:09:33,980 --> 00:09:34,490 you know, 93 00:09:34,490 --> 00:09:36,500 does it work against their physical health? 94 00:09:36,500 --> 00:09:39,580 Does it reduce their safety in some situations? 95 00:09:39,590 --> 00:09:43,320 Is it associated with internal distress, 96 00:09:43,320 --> 00:09:46,810 does it prevent the person from reaching goals for daily living, 97 00:09:46,810 --> 00:09:48,290 like maintaining work? 98 00:09:48,550 --> 00:09:51,660 Is it associated with pain and relationships? 99 00:09:51,660 --> 00:10:01,860 So it has to have some functional impact that has worked against the well being of this individual. 100 00:10:01,870 --> 00:10:02,490 So, 101 00:10:02,490 --> 00:10:08,070 both things according to the diagnostic manual must be present for a diagnosis. 102 00:10:08,080 --> 00:10:11,530 There has to be this atypical constellation, 103 00:10:11,530 --> 00:10:20,590 but there also has to be ... that this atypical constellation has been the root of some functional struggle. 104 00:10:21,450 --> 00:10:31,440 So if there are individuals who have the autistic neurology and it has never been a source of functional difficulty, 105 00:10:31,450 --> 00:10:36,950 they actually don't meet the criteria for a diagnosis as defined in the in the manual. 106 00:10:36,960 --> 00:10:40,710 So when we're talking about having an official diagnosis, 107 00:10:40,720 --> 00:10:42,010 that would be part of it, 108 00:10:42,010 --> 00:10:43,540 that in some season, 109 00:10:43,540 --> 00:10:44,700 in some way, 110 00:10:44,710 --> 00:10:50,130 there's really been a struggle associated with those neurologic characteristics. 111 00:10:50,790 --> 00:10:51,680 And this is why, 112 00:10:51,680 --> 00:10:52,560 for example, 113 00:10:52,560 --> 00:10:57,680 depression is a diagnosis as well. It's not rare, 114 00:10:57,690 --> 00:11:00,650 but ... it's not the most typical mood state. 115 00:11:00,650 --> 00:11:04,600 And when people get stuck in that atypical mood state, 116 00:11:04,610 --> 00:11:08,230 it causes these functional areas of difficulty. 117 00:11:08,230 --> 00:11:09,330 It's hard to get up, 118 00:11:09,330 --> 00:11:10,470 it's hard to go to work, 119 00:11:10,470 --> 00:11:12,660 it's hard to maintain relationships. 120 00:11:12,850 --> 00:11:22,610 And so that's where we shift from saying something is diverse to something that 121 00:11:22,620 --> 00:11:29,740 we're calling a diagnosis... that rather than just being mood-diversity where gosh, 122 00:11:29,740 --> 00:11:31,410 I've had a bad day, 123 00:11:31,930 --> 00:11:37,590 but it's really not impacted functionally how I'm doing across time... 124 00:11:37,600 --> 00:11:48,460 but when I get stuck in this mood state and it's really interfering with wellness in my daily life, 125 00:11:48,460 --> 00:11:50,440 that's when it's a diagnosis. 126 00:11:51,270 --> 00:11:51,660 Now, 127 00:11:51,660 --> 00:12:01,130 autism as a diagnosis does require that difficulty at some point in your life that you've really had the autistic neurology, 128 00:12:01,140 --> 00:12:07,590 making it hard to function in a way that's comfortable where you're achieving your goals. 129 00:12:08,030 --> 00:12:08,440 Now, 130 00:12:08,440 --> 00:12:13,360 autism as a diagnosis occurs in 2% of individuals, 131 00:12:13,370 --> 00:12:15,290 they would meet the full criteria. 132 00:12:15,300 --> 00:12:27,890 The neurologic characteristics hang together in those individuals because they hang together anatomically and they have also impacted the individual's well being their goals, 133 00:12:27,890 --> 00:12:29,390 their functional life. 134 00:12:29,910 --> 00:12:30,170 Now, 135 00:12:30,170 --> 00:12:36,400 does this mean that the neurology of autism causes pain or distress in every way? 136 00:12:36,410 --> 00:12:37,870 Absolutely not. 137 00:12:37,880 --> 00:12:43,160 Does it mean that the difficulty is constant throughout the whole lifespan? 138 00:12:43,580 --> 00:12:44,440 No. 139 00:12:44,450 --> 00:12:46,100 So in my viewpoint, 140 00:12:46,110 --> 00:12:52,160 all humans have characteristics that work for them in some ways and against them in some ways. 141 00:12:52,170 --> 00:12:54,870 And this is true in autism as well. 142 00:12:54,880 --> 00:12:55,870 For example, 143 00:12:55,870 --> 00:13:00,570 the attention to detail can be a great strength in some work projects. 144 00:13:00,570 --> 00:13:08,360 Whereas it can really create difficulty when the ultimate goal is speed and generalization rather than detail. 145 00:13:09,070 --> 00:13:22,980 So much of the benefit for the autistic individual and those who love them is this increased awareness of how their characteristics may work for them or against them in different contexts or across life seasons? 146 00:13:23,510 --> 00:13:23,790 Now, 147 00:13:23,790 --> 00:13:25,180 having said that again, 148 00:13:25,180 --> 00:13:40,460 remember that individuals who meet that full criteria by definition have had a level of neurologic difference that really increases the risk of difficulty and a lot of these functional areas compared with someone with a different neurology, 149 00:13:41,100 --> 00:13:45,930 we know that every human will have this mix of gifts and weaknesses, 150 00:13:45,930 --> 00:13:47,270 strengths and struggles, 151 00:13:47,280 --> 00:13:49,510 abilities and limitations. 152 00:13:49,520 --> 00:13:51,510 And for one person, 153 00:13:51,520 --> 00:13:52,070 you know, 154 00:13:52,070 --> 00:13:57,780 he may excel in athletics but struggle to read at functional levels. 155 00:13:57,790 --> 00:14:05,040 So he can't read a contract or release or a medical form without struggling and getting taken advantage of, 156 00:14:05,040 --> 00:14:09,390 that's a neurologic difference in that reading comprehension. 157 00:14:09,790 --> 00:14:18,050 Another person may be able to produce wonderful needlework that requires really good fine motor skills appreciation of color 158 00:14:18,050 --> 00:14:18,770 palettes, 159 00:14:18,770 --> 00:14:20,660 creativity and design. 160 00:14:20,670 --> 00:14:21,450 However, 161 00:14:21,450 --> 00:14:30,420 they might struggle to keep blood sugar levels even and their pancreas just isn't helping them with this task as much as we would wish. 162 00:14:30,430 --> 00:14:33,810 And maybe they take insulin shots because of this. 163 00:14:34,400 --> 00:14:39,960 I bring these examples up just to say that in our human form, 164 00:14:39,970 --> 00:14:48,650 we all have gifts and strengths and triumphs and skill sets. 165 00:14:48,660 --> 00:14:59,580 And we also will have some form of limitation or struggle at some part in our life and my struggle, 166 00:14:59,580 --> 00:15:03,850 my limitation in my human form may be different than yours. 167 00:15:04,100 --> 00:15:12,010 But I know that the commonality of the human experience is that you also will have some strength, 168 00:15:12,010 --> 00:15:16,520 some gift in your human form and some limitation, 169 00:15:16,520 --> 00:15:19,500 some struggle in that human form. 170 00:15:19,510 --> 00:15:27,980 And for some their area of gift and struggle may involve aspects of this autistic neurology. 171 00:15:29,200 --> 00:15:34,380 I think we do best for each other when we appreciate all sides of our humanity, 172 00:15:34,420 --> 00:15:36,550 that these are my strengths, 173 00:15:36,550 --> 00:15:38,030 these are my limitations, 174 00:15:38,030 --> 00:15:39,710 this is my humanity, 175 00:15:39,870 --> 00:15:43,840 this mix of good and difficult and strong and weak. 176 00:15:43,850 --> 00:15:55,770 And I'll always have a mix of this and this is what it is to be human and to truly show honor and respect and appreciation to the personhood of each individual. 177 00:15:55,780 --> 00:16:00,960 We allow all those things in the mix to be viewed and discussed. 178 00:16:01,030 --> 00:16:04,340 There's no reason to only talk about easy things, 179 00:16:04,340 --> 00:16:05,120 bright things, 180 00:16:05,120 --> 00:16:06,220 successful things. 181 00:16:06,220 --> 00:16:13,630 We can talk about all the messiness of each of our humanity and still affirm that every single person, 182 00:16:13,640 --> 00:16:15,420 no matter their age, 183 00:16:15,430 --> 00:16:16,030 culture, 184 00:16:16,030 --> 00:16:17,340 health abilities, 185 00:16:17,340 --> 00:16:18,580 spirituality, 186 00:16:18,590 --> 00:16:19,340 gender, 187 00:16:19,340 --> 00:16:20,880 any of these things, 188 00:16:20,890 --> 00:16:38,020 every single person is filled with inherent value and is deserving of honor and respect because that is inherent to their personhood and having a gift does not make them any more valued in having limitations. 189 00:16:38,020 --> 00:16:41,120 Does not take away any of their value. 190 00:16:41,550 --> 00:16:44,140 When someone is celebrating and rejoicing, 191 00:16:44,140 --> 00:16:47,220 we can come alongside and celebrate too. 192 00:16:47,420 --> 00:16:49,440 And when someone is grieving, 193 00:16:49,450 --> 00:16:54,530 when someone is struggling with something or coming across their own limitations, 194 00:16:54,530 --> 00:16:58,540 we also come alongside them in this as well. 195 00:16:58,550 --> 00:17:00,860 We can acknowledge the struggle, 196 00:17:00,870 --> 00:17:03,640 we can offer community assistance, 197 00:17:03,650 --> 00:17:10,640 anything that we can bring to the table in this moment of of humanity and coming together. 198 00:17:10,650 --> 00:17:13,890 So let's talk about the second topic, 199 00:17:13,890 --> 00:17:25,000 which is What kinds of diagnoses or characteristics do we want to consider as under that neuro diversity umbrella. 200 00:17:25,010 --> 00:17:38,640 So the neuro diversity movement began in the 90s as a way of talking about autism and sometimes attention deficit and the real benefit of it was that it, 201 00:17:38,650 --> 00:17:56,780 it championed the humanity of everyone with neuro diverse characteristics and made sure that they weren't being looked at as less than or somehow not as valued in society. 202 00:17:57,410 --> 00:18:07,690 Examples of conditions that are currently considered under the neuro diversity umbrella often include in addition to autism and attention deficit, 203 00:18:07,700 --> 00:18:10,370 things like obsessive compulsive disorder, 204 00:18:10,370 --> 00:18:11,680 bipolar disorder, 205 00:18:11,680 --> 00:18:13,020 dyslexia, 206 00:18:13,030 --> 00:18:14,800 and dyspraxia. 207 00:18:15,870 --> 00:18:16,950 But now, 208 00:18:16,960 --> 00:18:18,640 even though in the beginning, 209 00:18:18,640 --> 00:18:26,350 we often would talk about autism or attention deficit as being a large part of neuro diversity. 210 00:18:26,360 --> 00:18:27,010 Now, 211 00:18:27,010 --> 00:18:43,020 there's a much bigger umbrella that people um talk about as involving these kinds of conditions and it's kind of growing all the time and there's not an inherent  difficulty with that, 212 00:18:43,020 --> 00:19:02,280 but there are some challenges with having the umbrella be very narrow or having it be really um inclusive because neuro diversity at its most inclusive is anything that has diverse neurology as part of its definition. 213 00:19:02,290 --> 00:19:03,510 So, 214 00:19:03,710 --> 00:19:08,910 if we're going to expand it beyond autism and attention deficit, 215 00:19:08,910 --> 00:19:18,120 that we're really going to um be expanding it to include everything with diverse neurology. 216 00:19:18,120 --> 00:19:23,850 And so that's going to include things like spinal cord injury, 217 00:19:23,860 --> 00:19:24,710 stroke, 218 00:19:24,720 --> 00:19:25,970 cerebral palsy, 219 00:19:25,970 --> 00:19:28,150 parkinson's traumatic brain injury, 220 00:19:28,150 --> 00:19:29,230 encephalitis, 221 00:19:29,240 --> 00:19:30,430 brain tumor, 222 00:19:30,430 --> 00:19:31,750 multiple sclerosis, 223 00:19:31,750 --> 00:19:32,820 hydrocephalus, 224 00:19:32,830 --> 00:19:34,020 Alzheimer's disease, 225 00:19:34,020 --> 00:19:35,920 and all other forms of dementia, 226 00:19:35,930 --> 00:19:37,980 all learning difficulties, 227 00:19:37,990 --> 00:19:40,880 intellectual disability and so on. 228 00:19:41,500 --> 00:19:46,300 If we're going to use the umbrella to be all inclusive of neurologic diversity, 229 00:19:46,310 --> 00:19:51,090 we are essentially going to be talking about all neurologic conditions. 230 00:19:51,340 --> 00:19:52,170 In which case, 231 00:19:52,170 --> 00:19:56,240 we really kind of lost the meaning of the term itself. 232 00:19:56,250 --> 00:20:01,010 So I'm not sure that it's as powerful a term or meaningful a term. 233 00:20:01,800 --> 00:20:04,120 But if that's what we prefer, 234 00:20:04,120 --> 00:20:05,900 we certainly can do this. 235 00:20:05,910 --> 00:20:07,620 I just think at some point, 236 00:20:07,620 --> 00:20:15,560 we'll need to decide what meaning do we want the term to include and to be specific, 237 00:20:15,560 --> 00:20:28,640 knowing that there are a lot of neuro diverse conditions that would have to be under the umbrella if we're going to be all inclusive for neuro diverse conditions. 238 00:20:29,480 --> 00:20:29,910 So, 239 00:20:29,910 --> 00:20:30,620 in summary, 240 00:20:30,620 --> 00:20:31,600 so far, 241 00:20:31,610 --> 00:20:38,470 I would suggest that we think about what kind of meaning we want the term to have as far as neurology. 242 00:20:38,470 --> 00:20:48,170 And then also are we able to approach autism in a way that acknowledges all the strengths and the struggles that each individual presents with? 243 00:20:48,180 --> 00:20:51,240 Always understanding that in all of this mix, 244 00:20:51,250 --> 00:21:06,870 every person is filled with inherent value and you are important and your importance is never defined by strengths or limitations and you will always have a mix of both because you are human. 245 00:21:07,660 --> 00:21:08,000 Now, 246 00:21:08,000 --> 00:21:23,280 in this final section will be addressing an opinion that some have put forth that states that it's really not okay for individuals without an autism diagnosis or some form of neurodivergent diagnosis. 247 00:21:23,290 --> 00:21:23,700 Again, 248 00:21:23,700 --> 00:21:25,270 this is ill defined, 249 00:21:25,460 --> 00:21:34,370 but it's not all right for these individuals to provide services or input to autistic individuals essentially, 250 00:21:34,370 --> 00:21:38,750 only autistic providers should serve those on the spectrum. 251 00:21:38,760 --> 00:21:40,780 Uh For example, 252 00:21:40,780 --> 00:21:51,550 there are some workplaces that serve neurodivergent clients and only hire those with neurodivergent diagnoses. 253 00:21:52,110 --> 00:21:57,940 I think my response to this is similar to my response to the topics that we've covered so far, 254 00:21:57,940 --> 00:22:12,740 which is basically that I think the truth and the life and the best outcomes are often found in the center rather than um at either categorical opinion. 255 00:22:13,020 --> 00:22:17,950 So anytime we're tempted to go for that uh kind of simple, 256 00:22:17,950 --> 00:22:18,870 straightforward, 257 00:22:18,880 --> 00:22:21,550 only this and never that kind of thought process, 258 00:22:21,550 --> 00:22:28,380 we're really limiting the truth and limiting the good that we'll find in the complex middle. 259 00:22:29,030 --> 00:22:30,200 And in this case, 260 00:22:30,200 --> 00:22:44,190 I think the wonderful thing about this approach is it does emphasize uh welcoming all kinds of diverse inputs to discussion services and program development as far as they do go, 261 00:22:44,200 --> 00:22:51,260 which is neuro diversity that we bring together the neuro diverse to serve the neuro diverse. 262 00:22:52,500 --> 00:22:53,030 Now, 263 00:22:53,030 --> 00:22:55,620 I love to hear people's stories, 264 00:22:55,630 --> 00:22:56,580 their opinions, 265 00:22:56,580 --> 00:23:01,170 their perspectives and whether those are from the autistic individual, 266 00:23:01,170 --> 00:23:01,940 their friends, 267 00:23:01,940 --> 00:23:03,320 their family members, 268 00:23:03,330 --> 00:23:07,320 whether those are from individuals and a helping profession, 269 00:23:07,320 --> 00:23:08,550 anyone, 270 00:23:08,560 --> 00:23:12,350 it enriches me over and over and over again. 271 00:23:13,700 --> 00:23:14,390 However, 272 00:23:14,390 --> 00:23:24,700 I think saying that only autistic providers should come alongside the autistic to provide input is limiting in a way that would work against the greatest good. 273 00:23:24,710 --> 00:23:31,330 Not because the autistic providers viewpoint is not valid or in some way less than others viewpoint. 274 00:23:31,340 --> 00:23:44,400 But because the breadth of specialization and experience that benefits individuals is so huge that no one group of individuals can ever cover all of that information. 275 00:23:44,410 --> 00:23:54,020 And I think if we tap into our diverse knowledge and experience that we will have the richest information to share. 276 00:23:54,030 --> 00:23:59,240 So having occupational therapists and neurologists and neuropsychologist, 277 00:23:59,250 --> 00:24:02,290 experts in academic learning and nutrition, 278 00:24:02,300 --> 00:24:05,200 all of these things are so beneficial, 279 00:24:05,210 --> 00:24:13,150 such richness of knowledge and experience that it's the exchange here that brings the blessing. 280 00:24:13,160 --> 00:24:18,030 It's increasing the diversity of input that brings the blessing. 281 00:24:18,490 --> 00:24:27,720 And some of these individuals in their specialization will be on the spectrum and some will not in other examples. 282 00:24:27,730 --> 00:24:28,200 You know, 283 00:24:28,200 --> 00:24:36,470 if I had multiple sclerosis and I would only receive care from a neurologist who had the same diagnosis. 284 00:24:36,480 --> 00:24:41,670 I would be limiting some of my um options. 285 00:24:41,670 --> 00:24:43,740 There may not be someone available. 286 00:24:43,750 --> 00:24:47,690 Uh This person may not be as experienced as someone else. 287 00:24:47,700 --> 00:24:52,030 Um I may be limiting where I could have a whole team of people. 288 00:24:52,030 --> 00:24:53,090 Maybe I'm saying no, 289 00:24:53,090 --> 00:24:54,870 I just want this one person. 290 00:24:55,300 --> 00:24:59,490 It would get even more difficult if I had two conditions, 291 00:24:59,490 --> 00:24:59,930 right? 292 00:24:59,930 --> 00:25:04,870 That I have multiple sclerosis and congestive heart failure. 293 00:25:04,880 --> 00:25:05,390 Now, 294 00:25:05,390 --> 00:25:12,550 do I have to find a provider that has both or I can see a heart provider that also has congestive heart failure? 295 00:25:13,230 --> 00:25:22,290 It's not that there's not value in getting input from others who share characteristics about your life and have walked in your shoes and get it. 296 00:25:22,300 --> 00:25:25,220 I think that's really valuable. 297 00:25:25,700 --> 00:25:32,230 But there's also value in getting input from those who don't share the same characteristics, 298 00:25:32,230 --> 00:25:40,150 but they have areas of expertise that they can offer some input that you wouldn't get in other places. 299 00:25:40,250 --> 00:25:41,190 Essentially, 300 00:25:41,190 --> 00:25:46,240 we're talking about the benefits of diversity and getting diverse input. 301 00:25:46,240 --> 00:25:50,810 When you have some struggles or limitations in any form of your life, 302 00:25:51,140 --> 00:25:57,930 then you get to take in the perspectives of all those other people and you decide what's helpful to you. 303 00:25:57,940 --> 00:26:03,160 But you have a lot of diverse input and rather than limiting the input, 304 00:26:03,160 --> 00:26:04,140 you're getting, 305 00:26:04,150 --> 00:26:11,020 you get to take in this information process it and say this has really helped me. 306 00:26:11,030 --> 00:26:17,290 This is not helpful to me and you get to be the filter for what you take into your own life. 307 00:26:17,810 --> 00:26:20,720 This is a really complex topic. 308 00:26:20,730 --> 00:26:23,220 There's a lot of emotions involved. 309 00:26:23,230 --> 00:26:24,410 I think in the end, 310 00:26:24,410 --> 00:26:38,470 what I'm saying is just that being able to be in the center of complexity helps me the most to understand the good and the difficult, 311 00:26:38,480 --> 00:26:43,220 the strength and the struggle of all kinds of human experience. 312 00:26:43,230 --> 00:26:54,750 And I would emphasize that the inherent value of the person is in their personhood and that never changes. 313 00:26:54,760 --> 00:27:02,820 So whether we're working with someone on something that they're celebrating or something that they're grieving, 314 00:27:02,830 --> 00:27:07,200 we can come along either way and say you are important, 315 00:27:07,580 --> 00:27:09,110 your personhood, 316 00:27:09,120 --> 00:27:11,300 you have this inherent value. 317 00:27:11,310 --> 00:27:13,600 I value that you've come, 318 00:27:13,610 --> 00:27:21,320 I value your story and your input and let me come alongside you and add what I can to your journey. 319 00:27:22,070 --> 00:27:31,790 I'm glad that you joined me today and that you're part of this podcast community and I hope you join me next time for another great topic.  

Join Dr. Regan for this episode on the quest for balance on the autism spectrum. Whether it's emotional regulation, attention, sleep, social interactions, task initiation, finances and more, finding the "just right" state is difficult for many on the spectrum. Book: The Science of Making Friends   Dr. Regan's Resources Course for Clinicians - Interventions in Autism: Helping Clients Stay Centered, Connect with Others, and Engage in Life Course for Clinicians: ASD Differential Diagnoses and Associated Characteristics Book: Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians Read the Transcript Here:    1 00:00:07,240 --> 00:00:11,610 Hello and welcome back to the podcast Autism in the Adult. 2 00:00:11,620 --> 00:00:12,730 I am your host, 3 00:00:12,730 --> 00:00:14,390 Dr Theresa Regan, 4 00:00:14,400 --> 00:00:16,120 a neuropsychologist, 5 00:00:16,130 --> 00:00:18,470 a certified autism specialist. 6 00:00:18,480 --> 00:00:23,930 The director of an autism diagnostic clinic for adolescents, 7 00:00:23,940 --> 00:00:29,590 adults and aging adults in central Illinois and the mother of a teen on the spectrum. 8 00:00:30,660 --> 00:00:48,140 I'm glad you're joining me today for this episode that I'm going to call autism and "just right."  This is actually a great topic that was suggested by a listener from Finland and I hope that I am pronouncing the name correctly. 9 00:00:48,140 --> 00:01:07,680 I think it's Maya ... Maya wrote about questions and struggles within the topic of balance in life when you have that autistic neurology, 10 00:01:07,690 --> 00:01:09,270 Maya wrote this. 11 00:01:09,670 --> 00:01:23,030 I would so much love to hear what you have to say about autistic people and the struggle we have with striking a balance in situations where we have to create an appropriate view on or understanding of things? 12 00:01:23,040 --> 00:01:29,350 I am convinced that this is the major autistic difficulty that I personally struggle with. 13 00:01:30,110 --> 00:01:34,570 It shows up in different forms for me and on many levels. 14 00:01:35,700 --> 00:01:39,890 I could take a few examples so that you understand what I mean? 15 00:01:39,900 --> 00:01:44,520 Because most often this is not linked to intelligence, 16 00:01:44,530 --> 00:01:46,350 for example, 17 00:01:46,350 --> 00:01:47,490 is this person, 18 00:01:47,500 --> 00:01:50,100 a friend who respects me or not, 19 00:01:50,740 --> 00:01:53,230 am I too skinny or even to fat? 20 00:01:53,240 --> 00:01:58,050 Should I contact a doctor because of this thing that I'm feeling right now. 21 00:01:58,570 --> 00:02:01,470 How far should I stand by this person's side? 22 00:02:01,660 --> 00:02:04,500 How much should I help him or her? 23 00:02:05,210 --> 00:02:10,820 Exactly how well should I perform in this university course in order to pass. 24 00:02:11,910 --> 00:02:15,030 I want to thank Maya for writing about that. 25 00:02:15,040 --> 00:02:29,300 Um this is something I've thought about as well and I think it's one of those really great ways to conceptualize autism aside from specific details. 26 00:02:29,310 --> 00:02:34,510 So sometimes to get the most meaning out of what you're feeling, 27 00:02:34,510 --> 00:02:47,890 it can help to step back and say how is it that all these little pieces of the autistic experience hang together in some ways it can feel so granular, 28 00:02:47,900 --> 00:02:51,500 like so many things are impacted. 29 00:02:51,510 --> 00:02:59,120 Why do these things happen at the same time and when we have ways of conceptualizing it? 30 00:02:59,480 --> 00:03:02,450 Um I think it brings meaning. 31 00:03:02,460 --> 00:03:10,290 It helps these little pieces come together as why do I have trouble with these 12 things? 32 00:03:10,300 --> 00:03:11,380 Well, 33 00:03:11,390 --> 00:03:19,090 these 12 things have a thread that go through and when we can step back and see that thread that joins things, 34 00:03:19,100 --> 00:03:23,020 I think it really makes things more meaningful. 35 00:03:23,030 --> 00:03:26,210 Um and so that's what I want to do with this topic. 36 00:03:26,210 --> 00:03:32,870 Today I call this the just right state. 37 00:03:32,880 --> 00:03:35,570 So she was talking about balance. 38 00:03:35,570 --> 00:03:38,230 That's another great way to term it. 39 00:03:38,240 --> 00:03:43,950 Um A lot of times with the neurology that we're talking about, 40 00:03:43,950 --> 00:03:55,770 somebody will have difficulty finding that just right spot of balance where whatever they're attempting is not too much or too little. 41 00:03:56,130 --> 00:04:24,560 And ideally our neurology should help us flow in these areas that we can flow and adjust and we have this innate sense of where we should land to be just right for this context for this person for this topic and we can shift because just right will look different in one setting that it will in another setting or across time. 42 00:04:25,100 --> 00:04:30,320 So there's a lot of innit nous and flow in this ability to find just right. 43 00:04:31,650 --> 00:04:35,920 We've talked about difficulty with regulation in a very broad sense. 44 00:04:35,920 --> 00:04:47,530 We did a series on regulation issues having to do with alertness and attention and emotions and getting to that just rate state in those areas. 45 00:04:47,540 --> 00:04:59,270 But I think what Maya is pointing out is that regulation and balance and just right is a thread that goes through a lot of other areas with autism as well. 46 00:04:59,280 --> 00:05:04,170 So let's take a few areas and see how this just right. 47 00:05:04,400 --> 00:05:08,330 Uh this quest for just right is difficult. 48 00:05:08,950 --> 00:05:10,990 Let's take the social area. 49 00:05:11,590 --> 00:05:19,020 So some things that were struggling with that would capture this difficulty with just right would be, 50 00:05:19,030 --> 00:05:22,400 how much should I be speaking right now to this person? 51 00:05:22,410 --> 00:05:24,690 How much detail should I be giving? 52 00:05:24,700 --> 00:05:27,830 How much personal information should I share? 53 00:05:27,840 --> 00:05:34,660 What is the just right intensity and level of excitement for this context or person? 54 00:05:35,020 --> 00:05:41,240 What is just right as I'm interacting with a boss versus an acquaintance? 55 00:05:41,250 --> 00:05:43,090 How much eye contact? 56 00:05:43,100 --> 00:05:44,700 Too much or too little? 57 00:05:44,710 --> 00:05:55,420 How much emotional expression should I be using without looking false or like I'm putting on a show or that I don't care at all. 58 00:05:56,380 --> 00:05:57,410 For example, 59 00:05:57,420 --> 00:06:01,380 opening gifts without looking just flat or board, 60 00:06:01,390 --> 00:06:07,660 but without looking like an actor that's pretending to be happy with a gift. 61 00:06:08,690 --> 00:06:11,720 How much should I give this person? 62 00:06:12,830 --> 00:06:15,130 How long should I stand by them? 63 00:06:15,140 --> 00:06:17,200 How much money should I loan them? 64 00:06:17,210 --> 00:06:20,490 How many times should I give them a ride or a lift? 65 00:06:20,500 --> 00:06:24,040 How much leeway should I give in a relationship? 66 00:06:24,050 --> 00:06:25,270 For example, 67 00:06:25,280 --> 00:06:31,540 I know people are complex and I can be friends with people who do things that I don't agree with. 68 00:06:31,550 --> 00:06:34,120 But at what point do I say? 69 00:06:34,120 --> 00:06:34,420 Yeah, 70 00:06:34,420 --> 00:06:37,970 this is really not a healthy relationship for me. 71 00:06:37,970 --> 00:06:40,130 I need to end this relationship. 72 00:06:41,290 --> 00:06:44,200 How close should I make this relationship? 73 00:06:44,210 --> 00:06:52,470 And how soon what is the just right closeness and the timing of a relationship? 74 00:06:52,480 --> 00:07:03,690 So some people on the spectrum struggle because they really want some definition to the relationship quickly because this in between state, 75 00:07:03,690 --> 00:07:06,770 this undefined state feels really uncomfortable. 76 00:07:07,600 --> 00:07:08,600 So they might say, 77 00:07:08,600 --> 00:07:20,770 well let's just get married right away because we know we're right for each other and in essence defining and structuring the relationship feels better than this. 78 00:07:20,770 --> 00:07:21,300 Huh? 79 00:07:21,310 --> 00:07:23,600 I don't know what's gonna happen with this relationship. 80 00:07:23,610 --> 00:07:27,070 It feels safer and more defined and more predictable. 81 00:07:28,080 --> 00:07:36,130 Others will break up a relationship because they don't want to be in that undefined spot that in between place. 82 00:07:36,140 --> 00:07:42,420 Um So how much is just right as far as closeness in a relationship. 83 00:07:43,810 --> 00:07:52,850 What is the just right number of times to text or phone someone if they don't call you back or to extend an invitation to someone. 84 00:07:52,860 --> 00:07:58,530 Now sometimes there are rules of thumb for something like that. 85 00:07:58,540 --> 00:08:06,670 There's a nice book that I like called the Science of Making Friends that I'll link in the show notes that talks about, 86 00:08:06,680 --> 00:08:06,970 you know, 87 00:08:06,970 --> 00:08:14,120 you don't text or call again once you've done so twice without a return text or call. 88 00:08:17,250 --> 00:08:28,880 I once worked with a couple and we were trying to really increase his ability to bring some nurturance and emotional content to the relationship. 89 00:08:28,890 --> 00:08:38,330 And I worked with him on being aware that one way to show his wife love is to compliment her. 90 00:08:38,340 --> 00:08:40,960 So we kind of worked on that as a goal, 91 00:08:40,960 --> 00:08:41,780 practiced it, 92 00:08:41,780 --> 00:08:45,090 role played it and he put it into action. 93 00:08:45,820 --> 00:08:48,310 The problem was then his wife said, 94 00:08:48,310 --> 00:08:50,820 well now he's complimenting me too much. 95 00:08:53,000 --> 00:08:54,570 It is the difficulty, 96 00:08:54,570 --> 00:08:55,820 isn't it? 97 00:08:55,870 --> 00:08:58,880 Like I can learn a strategy, 98 00:08:58,890 --> 00:09:02,390 I can apply new knowledge, 99 00:09:03,300 --> 00:09:08,690 but the getting the just right amount, 100 00:09:08,690 --> 00:09:09,880 the just right moment, 101 00:09:09,880 --> 00:09:11,970 the just right compliment boy. 102 00:09:11,970 --> 00:09:13,510 That's really difficult. 103 00:09:13,520 --> 00:09:15,260 It's difficult for anyone. 104 00:09:15,270 --> 00:09:16,010 Uh, 105 00:09:16,010 --> 00:09:18,580 and even more so on the spectrum, 106 00:09:20,830 --> 00:09:24,280 let's look at finances for that just right state. 107 00:09:25,130 --> 00:09:39,340 It seems common for individuals on the spectrum to either lean toward spending too much perhaps on their special interests or other things that cut their eye or to spend too little. 108 00:09:40,490 --> 00:09:41,090 Um, 109 00:09:41,100 --> 00:09:56,050 there are people that have lots of money in a savings account or other type of account but they don't want to withdraw anything to fix the roof or to buy an updated phone. 110 00:09:57,660 --> 00:10:01,970 What is the amount of spending that is just right. 111 00:10:02,830 --> 00:10:12,100 There are guides for budgeting but it can still feel really elusive to get just right in specific personal situations. 112 00:10:12,110 --> 00:10:13,490 So yeah, 113 00:10:13,490 --> 00:10:14,840 this is the principle, 114 00:10:14,840 --> 00:10:16,080 this is the guideline, 115 00:10:16,080 --> 00:10:17,750 this is the percentage, 116 00:10:17,760 --> 00:10:25,380 but it is hard to have to look that framework up and not have a sense, 117 00:10:25,380 --> 00:10:29,070 an innate sense like yeah, 118 00:10:29,070 --> 00:10:33,180 I really need to get this roof repaired some will say, 119 00:10:33,190 --> 00:10:33,730 yeah, 120 00:10:33,730 --> 00:10:35,960 I know that I can ask for advice, 121 00:10:35,960 --> 00:10:41,950 I know that I can use this budget but I wish I had this innate sense of yeah, 122 00:10:41,950 --> 00:10:46,440 I really need to update this in my home or boy, 123 00:10:46,440 --> 00:10:51,570 I've spent too much on this area and not enough on this other area. 124 00:10:53,460 --> 00:10:54,240 They'll say, 125 00:10:54,240 --> 00:10:54,540 you know, 126 00:10:54,540 --> 00:11:02,840 it's difficult to have a feel for it instead of having to stick to some type of formula and maybe feeling like, 127 00:11:02,850 --> 00:11:09,360 well what would that rule of thumb look like in this situation and how would it apply to this other case. 128 00:11:11,270 --> 00:11:16,490 Let's look at just right as it relates to task completion on the spectrum. 129 00:11:17,020 --> 00:11:22,400 What is the just right amount of completion for some people on the spectrum, 130 00:11:22,410 --> 00:11:30,960 completion is very important but when is something complete and what is the just right amount of accuracy and detail? 131 00:11:30,970 --> 00:11:44,080 Some may feel like I need to finish one task before I start another task or I can't go to bed until I read all of these pages assigned from the class of the previous day. 132 00:11:45,060 --> 00:11:49,120 What is the right amount of detail? 133 00:11:49,130 --> 00:11:51,290 What is the right amount of speed? 134 00:11:53,480 --> 00:11:57,100 Have I done enough that this assignment is complete, 135 00:11:57,140 --> 00:12:03,440 especially when we get to adulthood tasks don't have a clear cut off. 136 00:12:04,510 --> 00:12:16,370 It's not like there are five math problems and we finish each one and we know the task is complete and maybe that we have a research paper or we have a software project. 137 00:12:16,380 --> 00:12:16,830 Well, 138 00:12:16,840 --> 00:12:18,040 when is it complete? 139 00:12:18,040 --> 00:12:19,620 When is it good enough? 140 00:12:23,130 --> 00:12:25,020 That difficulty knowing? 141 00:12:25,020 --> 00:12:25,480 Hey, 142 00:12:25,480 --> 00:12:29,120 I haven't attended a task B at all, 143 00:12:29,120 --> 00:12:33,420 but I've overworked on task A and how do I balance that? 144 00:12:33,420 --> 00:12:35,030 When do I know that? 145 00:12:35,030 --> 00:12:36,560 That's the difficulty. 146 00:12:38,750 --> 00:12:50,450 One person I worked with said I've always had the strong feeling that a newspaper needs to be read completely from cover to cover from every page that there, 147 00:12:50,460 --> 00:12:53,030 there is a completion that's important. 148 00:12:53,840 --> 00:12:56,700 You can't just read an article here and there. 149 00:12:56,750 --> 00:12:58,630 That's just not right. 150 00:12:59,420 --> 00:13:06,680 Another person may feel I have to finish this test completely before I start this other project. 151 00:13:07,650 --> 00:13:18,980 Even though the first task was something a coworker asked me about and this next one I have to complete is something my boss asked me to work on. 152 00:13:22,510 --> 00:13:32,520 It's difficult sometimes for the individual with that autistic neurology to understand that all details do not have the same importance. 153 00:13:33,110 --> 00:13:38,970 Um There are people um on the spectrum who feel like, 154 00:13:38,980 --> 00:13:48,350 well every detail is going to be important so it has to be included and the neurology there just isn't helping the person know like Yeah, 155 00:13:48,350 --> 00:13:54,010 but in this instance this part is not as important as this part, 156 00:13:56,290 --> 00:14:06,880 it can be really hard to get the neurology to shift uh to adjust if a task needs to be done quickly but does not need to be as accurate. 157 00:14:07,390 --> 00:14:12,510 So meeting deadlines might really be difficult if your boss says to you, 158 00:14:12,510 --> 00:14:15,910 hey this project needs to be done quickly. 159 00:14:15,920 --> 00:14:21,720 It doesn't really need to be detailed but I have to have it ready for a meeting tomorrow at noon. 160 00:14:21,730 --> 00:14:24,990 I just want to give a broad overview. 161 00:14:25,000 --> 00:14:29,830 Details are not important that can feel actually very stressful. 162 00:14:29,840 --> 00:14:32,990 Well what does a broad overview look like? 163 00:14:33,000 --> 00:14:34,600 And will, 164 00:14:34,610 --> 00:14:41,230 will I feel okay stopping when there are other details available. 165 00:14:43,910 --> 00:14:49,200 This is also related to the topic that maya brought up about working on a course, 166 00:14:49,210 --> 00:14:50,780 a university class. 167 00:14:50,790 --> 00:14:57,460 How much work do I need to do in order to do a good job? 168 00:14:57,470 --> 00:15:00,290 What if I could have done more? 169 00:15:00,300 --> 00:15:01,820 Could have done better. 170 00:15:03,090 --> 00:15:06,500 How many a's do I need to get to be a good student? 171 00:15:06,500 --> 00:15:11,730 How can I hit the mark of balance with accuracy and speed? 172 00:15:12,910 --> 00:15:14,800 How can I balance that? 173 00:15:14,800 --> 00:15:18,460 Everything doesn't have the same importance at the same time, 174 00:15:20,530 --> 00:15:26,400 something may be able to go undone while something else cannot wait another minute. 175 00:15:26,400 --> 00:15:27,490 So triaging, 176 00:15:27,490 --> 00:15:32,400 how do I triage quickly based on importance? 177 00:15:33,210 --> 00:15:36,360 How thorough do I need to be on this project? 178 00:15:36,870 --> 00:15:41,420 If the professor said I need to cite 10 sources, 179 00:15:42,200 --> 00:15:44,070 Can my brain let go? 180 00:15:44,070 --> 00:15:52,440 The other 25 sources I might be able to get and how can I just innately have a feel for? 181 00:15:52,450 --> 00:15:53,360 Okay, 182 00:15:53,370 --> 00:15:54,250 this is done, 183 00:15:54,260 --> 00:15:58,120 this is this project is finished and it's good to go. 184 00:15:59,020 --> 00:16:11,500 Maya also noted in her email that sometimes the approach to dealing with this difficulty is to get input from others about what might be just right in a situation, 185 00:16:12,310 --> 00:16:15,570 but that approach doesn't always feel practical. 186 00:16:15,580 --> 00:16:23,180 Like who could I ask or there's a deadline and people aren't around this just isn't practical. 187 00:16:23,190 --> 00:16:25,520 It also takes a lot of energy. 188 00:16:25,530 --> 00:16:32,760 And do I always bother the same person or how many times do I ask for input and who do I ask? 189 00:16:34,050 --> 00:16:35,610 So first of all, 190 00:16:35,620 --> 00:16:40,850 let's talk about that difficulty finding the just right state. 191 00:16:41,510 --> 00:16:46,470 So this could be within alertness and behavioral activation, 192 00:16:46,480 --> 00:16:49,310 it can be within attention. 193 00:16:49,320 --> 00:16:52,790 Like what is the just right amount of attention. 194 00:16:52,800 --> 00:16:56,210 It's somewhere between distractible and hyper focus. 195 00:16:56,220 --> 00:17:08,840 What is the just right space for our emotions while it's to be psychologically present and um clearheaded and calm. 196 00:17:09,520 --> 00:17:12,010 What is just right for test completion, 197 00:17:12,010 --> 00:17:15,280 finances working out nutrition, 198 00:17:15,280 --> 00:17:17,130 dieting all of these things. 199 00:17:18,280 --> 00:17:26,470 Let me give you an example for my own life that has to do with another physical just rate dilemma. 200 00:17:27,400 --> 00:17:35,250 So one of the things that I think about that I think also highlights this is that personally, 201 00:17:35,260 --> 00:17:42,950 it's kind of a joke in my family that I have really bad depth perception and again, 202 00:17:42,950 --> 00:17:51,470 it's kind of a joke because at some point you just have to laugh and luckily I always think I have less room. 203 00:17:51,480 --> 00:17:55,770 So it's not that I go around hitting things with the car, 204 00:17:56,070 --> 00:17:57,870 but you know, 205 00:17:57,880 --> 00:18:01,350 there's lots of room left and it does get kind of funny, 206 00:18:02,960 --> 00:18:12,470 I wish so in the back of my mind that I could learn to compensate for that because I do get tired of laughing at myself and having to be a good sport about this, 207 00:18:12,490 --> 00:18:18,620 just silly thing that I've parked so far away from where I could have parked, 208 00:18:20,790 --> 00:18:29,250 I realized that I always leave two ft from where I could have pulled up. 209 00:18:29,780 --> 00:18:37,640 So there's this remarkable consistency for me in that area that I can't tell what's just right, 210 00:18:37,650 --> 00:18:42,600 but somehow I'm always two ft from where I probably should be. 211 00:18:42,600 --> 00:18:43,650 So I thought, 212 00:18:43,660 --> 00:18:45,100 okay, 213 00:18:45,110 --> 00:18:57,570 well I will compensate for this difficulty with just right by going an extra two ft because I actually think I can Gauge what two ft would be. 214 00:18:59,020 --> 00:19:06,830 So I started to do that and lo and behold I that just does not work. 215 00:19:06,840 --> 00:19:16,110 I cannot compensate to get to intellectually get to the where the just right status. 216 00:19:16,120 --> 00:19:31,770 So as you can imagine I'm either to end up touching the wall or the um edge of the parking space with my car or I end up still being well below where I could be. 217 00:19:33,350 --> 00:19:48,420 So for me that's just another example that if my eyes in my brain are not able to show me the just rate state, 218 00:19:50,120 --> 00:19:54,700 there's not much I can do about that unfortunately. 219 00:19:55,990 --> 00:20:02,700 Um And even though I intellectually think of a strategy to compensate, 220 00:20:02,710 --> 00:20:06,940 it still doesn't mean that I can hit the just right spot. 221 00:20:06,950 --> 00:20:08,680 Well I should do this more, 222 00:20:08,680 --> 00:20:10,140 I should do this less. 223 00:20:10,150 --> 00:20:29,430 Um So I actually believe and in my experience with clients I think that ability that flow for that feel for the just rate state is something that is very difficult to compensate for. 224 00:20:29,440 --> 00:20:33,770 And I'm not sure that there are great ways to do that. 225 00:20:34,900 --> 00:20:46,350 I think what we typically do is we suggest intellectual compensations kind of like what I tried to do for my uh driving and parking. 226 00:20:46,360 --> 00:21:15,230 Um And I think those things are helpful in some ways but there's still this gap between where we would want to be as far as having a flow and an efficiency a feel for that would be so great rather than having to try to gauge to hit that spot a little bit better. 227 00:21:17,430 --> 00:21:23,400 Some of the compensations that are helpful would be, 228 00:21:23,410 --> 00:21:24,330 um, 229 00:21:24,340 --> 00:21:28,280 I think having the self awareness is helpful. 230 00:21:28,290 --> 00:21:29,750 So for example, 231 00:21:29,760 --> 00:21:33,660 I know that I have this difficulty, 232 00:21:33,660 --> 00:21:36,480 so if I have a passenger in the car and they're like, 233 00:21:36,480 --> 00:21:37,040 you know, 234 00:21:37,050 --> 00:21:42,450 you can pull up some more because I have that self awareness. 235 00:21:42,460 --> 00:21:45,850 I have a place for that to integrate that comment. 236 00:21:45,850 --> 00:21:47,070 And I can say, 237 00:21:47,800 --> 00:21:49,080 oh yeah, 238 00:21:49,080 --> 00:21:50,320 I probably can, 239 00:21:50,330 --> 00:21:51,520 I can't really tell you, 240 00:21:51,520 --> 00:21:52,840 tell me when to stop. 241 00:21:53,470 --> 00:21:54,000 Um, 242 00:21:54,010 --> 00:21:57,510 so I'm able to say yes to that comment. 243 00:21:57,520 --> 00:21:58,060 Like, 244 00:21:58,070 --> 00:21:58,480 oh yeah, 245 00:21:58,480 --> 00:21:59,640 I have a place for that. 246 00:21:59,640 --> 00:22:00,680 That makes sense. 247 00:22:00,690 --> 00:22:01,900 I have that awareness. 248 00:22:01,900 --> 00:22:05,930 I have that understanding of myself and I can't compensate myself. 249 00:22:05,940 --> 00:22:09,010 But if you're here and you're willing to help, 250 00:22:09,010 --> 00:22:09,940 let's do that. 251 00:22:11,310 --> 00:22:14,460 So having a place to put comments like, 252 00:22:14,470 --> 00:22:15,650 um, 253 00:22:15,660 --> 00:22:16,350 you know, 254 00:22:16,350 --> 00:22:25,390 you don't have to call me so many times or um I really don't think that person is mad at you. 255 00:22:25,400 --> 00:22:25,840 You know, 256 00:22:25,840 --> 00:22:27,590 when we get feedback like that, 257 00:22:27,590 --> 00:22:30,950 it it does help us to have a place where we say, 258 00:22:30,960 --> 00:22:31,650 oh, 259 00:22:32,250 --> 00:22:33,400 I didn't realize that, 260 00:22:33,400 --> 00:22:39,570 but I do know I can make errors in that in that area sometimes. 261 00:22:40,420 --> 00:22:41,170 Um, 262 00:22:41,810 --> 00:22:47,440 I also think that the awareness can be about what we lean toward. 263 00:22:47,450 --> 00:22:50,780 So if we have trouble finding the just right spot, 264 00:22:50,780 --> 00:23:03,780 sometimes we lean toward going toward too much or too little and in my case I lean toward uh leaving too much room or thinking I don't have enough room. 265 00:23:03,780 --> 00:23:05,790 So I lean in the same direction. 266 00:23:07,100 --> 00:23:07,800 Um, 267 00:23:07,810 --> 00:23:17,440 in the case of autism and the categories that we've talked about sometimes that's true for individuals in those categories as well. 268 00:23:17,450 --> 00:23:28,640 So I have clients that always lean toward thinking that they haven't done enough or they always lean toward thinking, 269 00:23:28,900 --> 00:23:29,500 um, 270 00:23:29,510 --> 00:23:36,160 someone's mad at them or thinking that they shouldn't spend money on something. 271 00:23:36,170 --> 00:23:40,680 So they have a way that they lean so they can say to themselves, 272 00:23:40,690 --> 00:23:46,090 I realize about myself that when I am off of just right, 273 00:23:46,090 --> 00:23:48,780 I'm usually in this direction in this category. 274 00:23:50,230 --> 00:23:51,840 That's also helpful. 275 00:23:51,850 --> 00:23:52,600 Um, 276 00:23:52,610 --> 00:23:54,780 because I do think again, 277 00:23:54,780 --> 00:23:56,510 it gives us a place to put things. 278 00:23:56,510 --> 00:24:06,800 So let's say that someone is working on a university project and there's nobody there to guide them through and they're thinking, 279 00:24:08,050 --> 00:24:14,600 I've checked all these specific boxes that the professor asked for, 280 00:24:14,610 --> 00:24:17,390 but I just have this feeling that I should do more. 281 00:24:17,390 --> 00:24:19,290 I know I could do more, 282 00:24:19,300 --> 00:24:21,910 at least they're able to say to themselves, 283 00:24:21,910 --> 00:24:22,590 you know, 284 00:24:22,600 --> 00:24:26,720 when I'm uncertain about whether I've done enough, 285 00:24:26,720 --> 00:24:29,410 usually I've already done too much. 286 00:24:29,420 --> 00:24:30,060 Um, 287 00:24:30,060 --> 00:24:34,730 so that can be a guide for them of sorts where they could say, 288 00:24:34,730 --> 00:24:35,150 okay, 289 00:24:35,150 --> 00:24:36,170 I'm gonna, 290 00:24:36,180 --> 00:24:38,730 I'm gonna complete this task, 291 00:24:38,730 --> 00:24:42,370 I'm gonna call it completed because um, 292 00:24:43,210 --> 00:24:47,890 I know I lean in that direction and I feel like I've ticked the basic boxes. 293 00:24:52,170 --> 00:24:58,140 Another thing that can be helpful then is to have some way to communicate. 294 00:24:58,150 --> 00:25:06,210 Maybe some uh sentences or phrases or ways of putting things that you've practiced ahead of time, 295 00:25:06,890 --> 00:25:13,520 that communicate to others about your difficulty finding just right in a specific area. 296 00:25:15,040 --> 00:25:17,880 So let's take some examples. 297 00:25:17,890 --> 00:25:26,920 And this could be communication beforehand or uh in the midst or after something has happened, 298 00:25:27,960 --> 00:25:29,720 an example would be, 299 00:25:29,730 --> 00:25:42,750 let's say someone is starting a new romantic relationship and they have the self awareness that sometimes when they come home from work, 300 00:25:42,750 --> 00:25:48,130 they are really shut down psychologically and they're in their own head, 301 00:25:48,140 --> 00:25:48,780 you know, 302 00:25:48,780 --> 00:25:53,590 that they don't talk a lot to their partners, 303 00:25:53,590 --> 00:25:59,110 they don't interact much and sometimes partners need something that they aren't, 304 00:25:59,120 --> 00:26:00,180 aren't giving. 305 00:26:00,190 --> 00:26:02,410 So with that awareness, 306 00:26:02,420 --> 00:26:06,300 they could say to the partner ahead of time, 307 00:26:06,930 --> 00:26:07,640 hey, 308 00:26:07,640 --> 00:26:17,420 I'm I've been learning about myself uh and one of the things I've learned is that I guess I tend to be shut down after work when I come home. 309 00:26:17,430 --> 00:26:20,940 So if you need help with something, 310 00:26:20,950 --> 00:26:23,620 if you um you know, 311 00:26:23,620 --> 00:26:27,580 want to tell me a specific story or something that's happened, 312 00:26:27,580 --> 00:26:39,820 you might really just have to um have me look you in the eye and tell me exactly what you need because I might not read the situation very well on my own. 313 00:26:40,550 --> 00:26:43,360 So that would be a case where, 314 00:26:43,370 --> 00:26:44,020 you know, 315 00:26:44,020 --> 00:26:45,950 you have difficulty finding just right, 316 00:26:45,950 --> 00:26:49,600 you're not going to be able to compensate after work, 317 00:26:49,600 --> 00:26:52,210 you're already kind of offline, 318 00:26:52,220 --> 00:27:02,410 but you could explain a bit of the context even though you can't compensate yourself or shift that you could give some context. 319 00:27:03,990 --> 00:27:08,890 I think the value of that is not only giving the person that information, 320 00:27:08,890 --> 00:27:15,040 but I think telling people that you're trying to learn more about yourself, 321 00:27:15,050 --> 00:27:19,350 I think is just a really good thing to communicate. 322 00:27:19,360 --> 00:27:32,340 People value that we all know we're imperfect humans and we're learning about ourselves and we're growing and that we're open to feedback. 323 00:27:32,350 --> 00:27:33,350 So, 324 00:27:33,360 --> 00:27:33,830 you know, 325 00:27:33,830 --> 00:27:36,280 if feel free to give me feedback, 326 00:27:36,280 --> 00:27:49,630 if I'm if I'm offline and and I can try to adjust an example of communicating after the fact or maybe in the midst of a fact. 327 00:27:49,640 --> 00:27:52,540 So let's take a different example. 328 00:27:52,540 --> 00:28:06,350 We're going to take the example of being at work and there is a project that you've been put in charge of and you miss the deadline and your boss is gonna do coaching with you about that. 329 00:28:07,400 --> 00:28:15,290 Um So you get feedback from your boss who is frustrated that the deadline was missed. 330 00:28:15,860 --> 00:28:16,890 That you know, 331 00:28:16,890 --> 00:28:25,660 he he really needs to be able to count on someone that can meet deadlines because these are very important to the bottom line of their department. 332 00:28:25,670 --> 00:28:30,540 And if you can't be a team player and get those deadlines done, 333 00:28:30,540 --> 00:28:34,670 then the whole team suffers again. 334 00:28:34,670 --> 00:28:39,980 This would be an opportunity for you to say in your head, 335 00:28:39,990 --> 00:28:40,380 you know, 336 00:28:40,380 --> 00:28:43,970 to think uh here here, 337 00:28:43,970 --> 00:28:44,860 this comes up. 338 00:28:44,860 --> 00:28:53,530 I know that I do tend to focus on accuracy more than speed and I didn't realize it, 339 00:28:53,530 --> 00:28:58,300 but uh that's come into play here and so out loud to your boss, 340 00:28:58,310 --> 00:29:01,140 you could say a similar thing, 341 00:29:01,140 --> 00:29:02,330 you could say, 342 00:29:03,230 --> 00:29:04,700 you know, 343 00:29:04,710 --> 00:29:07,410 I'm really sorry that that happened, 344 00:29:07,420 --> 00:29:31,260 I've been learning about myself that I really do tend toward getting into the detail and sometimes I sacrifice speed without really meaning to and what I realize helps me is and then you can give a specific thing that you would like. 345 00:29:31,270 --> 00:29:36,870 Um so one of the things an employee might ask for would be, 346 00:29:36,880 --> 00:29:55,720 it would help me if I could set uh deadlines for parts of the project rather than the completion so that I really stay on pace and what I'd like to do for this next project you've given me is break it into six parts and I'm going to, 347 00:29:55,730 --> 00:29:56,390 you know, 348 00:29:56,390 --> 00:30:04,290 give you dates for my deadlines for each of these parts and you can tell me if the deadlines need to be adjusted. 349 00:30:04,800 --> 00:30:11,090 Um so what you're doing is saying I have this self awareness and I'm growing in this area, 350 00:30:11,630 --> 00:30:19,600 you're showing that you're open to feedback and then you're also showing that you're going to try a new strategy. 351 00:30:20,650 --> 00:30:31,310 So sometimes there can be ways of trying to um navigate this difficulty with just right, 352 00:30:31,320 --> 00:30:38,760 we talked before about how another navigation tool might might be rules of thumb or general principles. 353 00:30:38,760 --> 00:30:40,900 So here's my budget, 354 00:30:40,900 --> 00:30:50,230 this is what I'm supposed to spend or not spend or um rules of thumb for completing a university course. 355 00:30:51,540 --> 00:31:10,790 But I think the truth of that struggle of not having that innate feel for just right really is something core in the autism neurology that I haven't found um a way to shift. 356 00:31:10,790 --> 00:31:20,690 I think that's really a core neurologic piece that I'm either too much or too little and if I hit just right, 357 00:31:20,700 --> 00:31:21,590 that's great. 358 00:31:21,590 --> 00:31:23,760 But I have such a hard time staying there. 359 00:31:25,490 --> 00:31:39,900 I want to thank my again for that insight and um I think even when there aren't answers to correct a challenge or to kind of make it easier over time, 360 00:31:39,910 --> 00:31:46,180 I think that awareness that conceptualization that oh why do I do this? 361 00:31:46,180 --> 00:31:48,650 Why am I really good at detail? 362 00:31:48,650 --> 00:31:50,590 But I really struggle with deadlines. 363 00:31:50,600 --> 00:31:54,390 Well this all hangs together neurologically, 364 00:31:54,390 --> 00:32:05,120 it's part of that difficulty finding just right and I do think that that conceptualization that self awareness is important in and of itself. 365 00:32:05,130 --> 00:32:10,960 Um and I do think the understanding that that crosses over categories, 366 00:32:10,970 --> 00:32:21,170 social and task completion and sleep and attention and all of these other things that are really difficult to balance. 367 00:32:22,410 --> 00:32:26,960 Thank you Maya and I hope you all join me for our next episode     

Join Dr. Regan for this episode on neurodiversity and holiday celebrations. Sometimes the most memorable moments come from holding tightly to our foundations and releasing other things that don't fit our season of life or individual needs.  Planning a Merry Holiday on the Autism Spectrum, podcast episode 2020   Dr. Regan's Resources Course for Clinicians - Interventions in Autism: Helping Clients Stay Centered, Connect with Others, and Engage in Life Course for Clinicians: ASD Differential Diagnoses and Associated Characteristics Book: Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians   Read the transcript here: 1 00:00:03,870 --> 00:00:09,800 Hello and I'm glad you're joining me today for this episode of Autism in the Adult podcast. 2 00:00:09,810 --> 00:00:12,790 I am your podcast host, 3 00:00:12,800 --> 00:00:14,430 Dr Theresa Regan, 4 00:00:14,440 --> 00:00:16,530 a neuropsychologist. 5 00:00:16,540 --> 00:00:25,010 I am the founder and director of an autism diagnostic clinic in central Illinois for adolescents, 6 00:00:25,020 --> 00:00:27,830 adults and geriatric patients. 7 00:00:27,840 --> 00:00:32,780 I'm a certified autism specialist and the mother of a teen on the spectrum. 8 00:00:33,790 --> 00:00:37,770 Today we are going to talk about the holiday season. 9 00:00:37,780 --> 00:00:41,460 If you are listening to this shortly after its release, 10 00:00:41,470 --> 00:00:45,980 you may be within a holiday season as well. 11 00:00:45,990 --> 00:01:01,120 There are many different meaningful celebrations going on at this time of year across the world and those look different across families and countries and backgrounds and faith experiences. 12 00:01:01,470 --> 00:01:07,150 But many of us are celebrating a yearly, 13 00:01:07,160 --> 00:01:09,310 meaningful 14 00:01:09,320 --> 00:01:12,910 moment in our lives and that can get hectic. 15 00:01:12,920 --> 00:01:24,980 It can get exciting ... and we're going to talk about how to do that with intention and meaning and hopefully a bit more peace, 16 00:01:24,990 --> 00:01:33,490 particularly in light of the neuro diversity that may be within your home or your extended family. 17 00:01:34,960 --> 00:01:49,930 I published one other holiday episode two years ago and re ran that last year. I will link that in the show notes in case you're wanting even more ideas or information about holiday seasons. 18 00:01:51,580 --> 00:02:00,770 What I wanted to talk to you about today is really something that impacts everyone regardless of generation, 19 00:02:00,770 --> 00:02:06,720 regardless of region that you're from or what you're celebrating. 20 00:02:07,260 --> 00:02:26,270 It impacts those on the autism spectrum and impacts neurotypicals...  it's something that also is not specific to holidays that really these are concepts I want to talk about related to anything that we celebrate and re celebrate, 21 00:02:26,270 --> 00:02:33,050 that we have some kind of tradition for ... this meaningful moment or life season. 22 00:02:33,510 --> 00:02:40,420 And this could pertain to how we celebrate birthdays or the birth of a child, 23 00:02:40,430 --> 00:02:42,290 the death of a family member, 24 00:02:42,300 --> 00:02:43,320 a wedding, 25 00:02:43,320 --> 00:02:44,570 a graduation. 26 00:02:44,580 --> 00:02:47,570 You know that in addition to holidays, 27 00:02:47,570 --> 00:02:52,450 these are events that often have some tradition to them. 28 00:02:52,450 --> 00:02:55,880 Like this is how we  29 00:02:55,890 --> 00:02:57,510 remember this person. 30 00:02:57,510 --> 00:02:59,590 This is how we celebrate this event. 31 00:02:59,600 --> 00:03:02,190 This is this is our tradition. 32 00:03:02,190 --> 00:03:10,420 And what happens in these moments is that we have reproducible  33 00:03:10,430 --> 00:03:13,290 items to how we approach this season. 34 00:03:13,290 --> 00:03:17,340 So we reproduce the birthday celebration. 35 00:03:17,340 --> 00:03:22,740 We reproduce the holiday celebration... that this is what we do every year. 36 00:03:22,740 --> 00:03:24,050 This is our tradition. 37 00:03:24,050 --> 00:03:35,950 This is our expression of joy or meaning or sorrow in the celebration in addition to having a lot of reproduced elements. 38 00:03:35,960 --> 00:03:47,990 These are also times with heightened emotion and intensity and whether those emotions are joyous or sorrowful or complicated, 39 00:03:48,000 --> 00:03:53,010 they are there and particularly for the holiday season, 40 00:03:53,020 --> 00:03:57,700 I think a lot of times there's this feeling of "This year, 41 00:03:57,700 --> 00:03:59,920 we're going to heighten that excitement. 42 00:03:59,930 --> 00:04:05,240 We're going to heighten the anticipation and it will be the best holiday ever!" 43 00:04:05,250 --> 00:04:14,580 And whether we're doing that for ourselves or for kiddos in our household or why we're doing it ... a lot of times. 44 00:04:14,580 --> 00:04:23,330 there's this quest to reproduce and one-up the last time we celebrated these things. 45 00:04:25,050 --> 00:04:39,440 It's important to understand that the same adrenaline that feels exciting to many people during these events can also feel overwhelming. 46 00:04:39,450 --> 00:04:48,360 Adrenaline can feel like anxiety to someone particularly with a sensitive nervous system. 47 00:04:48,360 --> 00:04:53,940 So someone on the autism spectrum may experience that anticipation, 48 00:04:53,940 --> 00:04:54,890 the unknown, 49 00:04:54,890 --> 00:04:56,580 the surprises... 51 00:04:57,670 --> 00:05:03,690 and this heightened emotion and intense schedule as pretty overwhelming. 52 00:05:03,690 --> 00:05:05,190 Whereas someone else might say, 53 00:05:05,200 --> 00:05:05,700 oh, 54 00:05:05,710 --> 00:05:06,590 I love it. 55 00:05:06,600 --> 00:05:09,910 It's this anticipation, 56 00:05:09,920 --> 00:05:11,440 the emotion in the air, 57 00:05:11,440 --> 00:05:14,720 all the memories... I dive in. 58 00:05:14,730 --> 00:05:16,840 It's one of my favorite things. 59 00:05:16,850 --> 00:05:27,540 So here we see that different nervous systems are going to process these moments and celebrations and meaningful events differently. 60 00:05:27,550 --> 00:05:31,050 And that's one of the things we'll talk about today. 61 00:05:34,130 --> 00:05:36,330 I'm going to talk about some things that 62 00:05:36,340 --> 00:05:56,420 I'll invite you to try this holiday season ... or next birthday or next graduation celebration. And one is that I'd really like to invite you to pause and become really psychologically present. 63 00:05:56,930 --> 00:06:04,280 I think one thing that can happen particularly with the holidays that there is this momentum that comes, 64 00:06:04,290 --> 00:06:18,100 it's almost like a tidal wave or a tsunami of events and all of a sudden you are kind of just automatically riding this wave of things that are coming at you. 65 00:06:18,640 --> 00:06:20,080 Again, 66 00:06:20,080 --> 00:06:21,500 they may be fun things. 67 00:06:21,500 --> 00:06:22,820 They may be exciting things, 68 00:06:22,820 --> 00:06:26,230 but often there's really no moment to say, 69 00:06:26,240 --> 00:06:26,800 okay, 70 00:06:26,800 --> 00:06:31,240 let's pause and think about what's going on, 71 00:06:31,250 --> 00:06:32,300 what we need, 72 00:06:32,300 --> 00:06:33,570 what we'd like to do. 73 00:06:33,580 --> 00:06:34,110 Um, 74 00:06:34,120 --> 00:06:39,040 It's just kind of seeing what's coming at us next and riding the wave... 76 00:06:40,000 --> 00:06:46,120 So I do want to invite us to pause and realize, 77 00:06:46,130 --> 00:06:48,130 kind of what season we're in, 78 00:06:48,340 --> 00:06:51,030 what our celebration is about. 79 00:06:51,040 --> 00:06:53,830 And as we're pausing, 80 00:06:53,830 --> 00:06:57,430 I would like you to think about ... 81 00:06:58,350 --> 00:07:02,230 what the season is this year. 82 00:07:02,240 --> 00:07:24,080 One of the best things that I learned at a time in my life that I guess I needed to hear it was that it's okay for every holiday season to be different ... because it will be we reproduce these events and that's fine. 83 00:07:24,080 --> 00:07:26,550 But everything won't be reproducible. 84 00:07:26,560 --> 00:07:37,680 And so one person or family may have a different holiday season this year because they've lost a family member or they've gained family members. 85 00:07:37,690 --> 00:07:42,510 It may be different for health reasons or financial reasons. 86 00:07:42,520 --> 00:07:47,280 And sometimes it's not even an individual difference. 87 00:07:47,290 --> 00:07:47,840 It's 89 00:07:48,450 --> 00:07:50,290 throughout the whole world, 90 00:07:50,290 --> 00:07:50,640 you know... 92 00:07:51,020 --> 00:07:58,370 when we were in the midst of covid and that really just impacted  93 00:07:58,380 --> 00:07:59,190 everyone. 94 00:07:59,200 --> 00:08:28,990 And so we have this ability to then pause and become a bit more self aware of what is happening this season that may be a bit different ... and to realize that it's okay to give space to that and to think about how we might want to engage a bit differently this year given these circumstances. 96 00:08:30,690 --> 00:08:48,590 I think that the intense desire to reproduce and to one-up the greatness and happiness of past holiday seasons can again be the only driving force. 97 00:08:48,600 --> 00:08:51,770 So if we take a moment and pause and think, 98 00:08:51,770 --> 00:08:55,660 what is this holiday season going to be like? 99 00:08:55,660 --> 00:08:59,260 What's what's the reality like in my household, 100 00:08:59,270 --> 00:09:00,450 in my personal life, 101 00:09:00,450 --> 00:09:03,180 my work life, in our region, 102 00:09:03,190 --> 00:09:07,350 in my faith system, in the country... 103 00:09:07,360 --> 00:09:11,320 And let me become aware of that for a moment. 105 00:09:15,230 --> 00:09:27,680 in addition to noticing that the seasons of life change... and that there may be different ways that we want to engage in the holiday season. 106 00:09:27,690 --> 00:09:28,200 (again, 107 00:09:28,210 --> 00:09:29,510 other birthdays, 108 00:09:29,510 --> 00:09:30,310 anniversaries, 109 00:09:30,310 --> 00:09:31,160 etcetera) 110 00:09:31,810 --> 00:09:45,270 there are also differences in people... that one person in your household is going to need something different than another person. 111 00:09:45,620 --> 00:09:49,470 And pausing and thinking about that can be really helpful. 112 00:09:49,470 --> 00:09:49,850 Again, 113 00:09:49,850 --> 00:09:59,700 the drive to reproduce all of these elements the same way the same year for all people around you... 114 00:09:59,700 --> 00:10:01,460 That's really difficult. 115 00:10:01,470 --> 00:10:05,630 And it often doesn't make this season as meaningful. 116 00:10:06,830 --> 00:10:09,180 So for example, 117 00:10:09,180 --> 00:10:10,650 one person, 118 00:10:10,660 --> 00:10:19,480 like we said in the beginning may love surprises and that may be the best part of the holiday season, 119 00:10:19,480 --> 00:10:25,670 that there are all these little surprises and gifts and wow moments like, 120 00:10:25,680 --> 00:10:29,610 oh look at this recipe that this person made, 121 00:10:29,610 --> 00:10:31,010 how new, 122 00:10:31,010 --> 00:10:32,000 how interesting, 123 00:10:32,000 --> 00:10:43,750 how exciting ...another person may really want peace and maybe internal introspection or alone time. 124 00:10:43,750 --> 00:10:51,110 And maybe they want the "silent night" of the Christmas carol ... or  125 00:10:51,120 --> 00:10:57,320 they want to know ahead of time what will happen because they enjoy the experience 126 00:10:57,330 --> 00:11:01,080 but they don't like the excitement or the surprise, 127 00:11:01,090 --> 00:11:05,720 They want to calm down that intensity and that's where the autism piece comes in, 128 00:11:05,980 --> 00:11:17,910 that someone with a heightened neurology or a different neurology may have different desires and needs and to reproduce everything the same year and  129 00:11:17,920 --> 00:11:20,200 for every different person, 130 00:11:20,210 --> 00:11:26,970 I think that takes away some of the real meaning and good memories that we could have. 131 00:11:29,070 --> 00:11:36,290 What I'd like to invite you to do is to think about what your reality is this year. 132 00:11:36,300 --> 00:11:39,710 What has gone on this year in your personal life, 133 00:11:39,710 --> 00:11:40,680 your family life, 134 00:11:40,680 --> 00:11:44,070 what's the reality for people in your home? 135 00:11:45,080 --> 00:11:53,630 And I'd also like you to take a personal inventory and to check in with the people that you're closest with, 136 00:11:53,640 --> 00:12:08,910 that you will be doing the holidays with, and see where they're at and what they need and to take this intentional pause and to ask for everybody's individual needs. 137 00:12:08,920 --> 00:12:18,740 ... I think really helps the holiday season run more smoothly and helps for better connection and more meaning. 138 00:12:21,910 --> 00:12:34,120 Part of the way that an individual is going to respond will be based on their neurologic makeup and part will be based on their own life story this year, 139 00:12:35,900 --> 00:12:45,790 invite people to pick 1, 2, ... 3 things that really are the most meaningful for them during a holiday season. 140 00:12:45,800 --> 00:12:55,390 So you could conceptualize it as what do you want to hold tightly to and what could you hold loosely, 141 00:12:56,140 --> 00:13:02,900 what do you want to be your foundational holiday experience like ...this is meaningful, 142 00:13:02,900 --> 00:13:03,840 I love this. 143 00:13:03,840 --> 00:13:07,400 I look forward to this every year... and what could be, 144 00:13:07,410 --> 00:13:08,420 you know, 145 00:13:08,420 --> 00:13:10,580 something you enjoy and you've done, 146 00:13:10,580 --> 00:13:13,040 but you could hold loosely to it... 147 00:13:13,050 --> 00:13:26,770 you could release it this year and still feel OK. And when everyone has those one or two things and is able to come together, 148 00:13:26,930 --> 00:13:41,160 I would invite you to share that together and see what kinds of things come up that are most meaningful and important to people in this framework. 149 00:13:41,670 --> 00:14:05,400 There is a need to be able to release some things and I think if we are holding on to every reproducible piece of every holiday season tightly because we don't want to miss out or we don't want the kids to miss out or it wouldn't be Christmas without everything going on or Hanukkah, 150 00:14:05,410 --> 00:14:10,540 ... it wouldn't be a birthday if we didn't do this again, 151 00:14:10,540 --> 00:14:21,880 I'd invite you to pause and think about whether we're doing all of those things out of fear that people will miss out on something. 152 00:14:22,460 --> 00:14:31,100 And if so maybe we could release that this year and maybe we could pause and make a few more meaningful choices. 153 00:14:32,500 --> 00:14:45,060 I cannot tell you the number of times I've talked to families in crisis who have a neuro diverse family ... and they're in crisis because you know, 154 00:14:45,070 --> 00:14:51,190 one or more of them is really having a lot more meltdowns and anxiety. And yet when they leave, 155 00:14:51,190 --> 00:14:52,170 they talk about 156 00:14:52,180 --> 00:14:57,900 "oh and we're going to this concert and we're going out of state to visit this relative and we're..."  157 00:14:57,910 --> 00:15:00,090 and I kind of think, 158 00:15:00,850 --> 00:15:01,690 you know, 159 00:15:01,690 --> 00:15:06,660 I think that's an example of where we don't even kind of stop to think like, 160 00:15:06,660 --> 00:15:11,850 does that match where we're at this year in this family unit? 161 00:15:11,850 --> 00:15:17,190 And does it match the nervous system for people who are in the family? 162 00:15:21,510 --> 00:15:33,510 I want to give you an example of a family that went on this journey just to make it come alive and give you some ideas and encouragement to  163 00:15:33,520 --> 00:15:39,350 focus on this pause and intentionality this year in some way, 164 00:15:40,730 --> 00:15:46,320 This is a family with a couple who have been married 20 plus years. 165 00:15:46,330 --> 00:15:48,610 They are now empty nesters. 166 00:15:48,610 --> 00:15:58,570 They have three young adult Children and one of their adults kids is not going to be home for the holidays this year, 167 00:15:58,570 --> 00:15:59,430 which is different. 168 00:15:59,430 --> 00:16:03,450 So that's a piece of their life that is in transition. 169 00:16:03,460 --> 00:16:05,780 What is this holiday to them? 170 00:16:05,780 --> 00:16:05,980 Well, 171 00:16:05,980 --> 00:16:08,470 one of their loved ones won't be there... 173 00:16:09,740 --> 00:16:14,770 the gentleman in this couple lost his mother this year, 174 00:16:14,770 --> 00:16:16,110 she passed away. 175 00:16:16,700 --> 00:16:17,240 Um, 176 00:16:17,250 --> 00:16:24,110 they each work and they each have had some personal struggles and challenges at work. 177 00:16:24,120 --> 00:16:26,530 They've had some financial changes. 178 00:16:26,540 --> 00:16:28,190 Um, 179 00:16:28,200 --> 00:16:41,030 one of the two kids who is going to be home for the holiday season is doing really well and another of their adult kids whose coming home is struggling, 180 00:16:42,110 --> 00:16:44,320 their family is neuro diverse. 181 00:16:44,330 --> 00:17:08,970 And the gentleman in the couple has been diagnosed on the spectrum for a couple of years and the one individual who is actually doing well and really in a good place is also on the spectrum and they have extended family members that they suspect to have qualities or perhaps undiagnosed autism. 182 00:17:10,490 --> 00:17:21,770 So one of the things that they were invited to do as a couple that started off with the couple kind of focusing on the holiday season, 183 00:17:21,780 --> 00:17:28,340 They were invited to have this pause and awareness of what's going on in the family. 184 00:17:29,000 --> 00:17:35,860 What's the context for this year's holiday season and to become more aware of that. 185 00:17:35,870 --> 00:17:43,100 And they were invited to do this within the context of counseling because they really had had just um, 186 00:17:43,110 --> 00:17:48,100 about a rough year and a half of relationship issues. 187 00:17:48,110 --> 00:17:49,290 Um, 188 00:17:49,300 --> 00:17:50,590 it was complex, 189 00:17:50,590 --> 00:17:55,640 some of it had to do with empty nest issues and, 190 00:17:55,650 --> 00:17:58,370 and now that they didn't have the kids there, 191 00:17:58,370 --> 00:18:03,270 they wanted to rely on each other more for emotional support and companionship. 192 00:18:03,270 --> 00:18:04,340 And uh, 193 00:18:04,350 --> 00:18:06,730 there were some rough spots there, 194 00:18:06,740 --> 00:18:09,520 they had each had their own stressors. 195 00:18:09,520 --> 00:18:13,060 And so that impacted their ability to connect as well. 196 00:18:14,260 --> 00:18:22,730 So they were really hurting in their relationship and that was why they went to counseling and that is why the counselor brought up, 197 00:18:22,740 --> 00:18:32,950 what is this holiday season for you guys where you at in your life and how might the holiday season connect with all of this complexity. 198 00:18:33,680 --> 00:18:38,010 And that ended up being a really good pause for them. 199 00:18:38,020 --> 00:18:39,170 Um, 200 00:18:39,180 --> 00:18:51,340 and they were able to review all of these life events and to think about this concept of whether everything needed to be reproduced um, 201 00:18:51,350 --> 00:18:54,590 in their life this year again for the holidays. 202 00:18:54,590 --> 00:18:57,260 They were very active people. 203 00:18:57,270 --> 00:19:00,070 They both worked full time. 204 00:19:00,080 --> 00:19:04,900 They there were various volunteer things they did over the holiday season. 205 00:19:04,910 --> 00:19:14,780 They also hosted more than one holiday gathering at their home for extended family and also for a community organization. 206 00:19:15,260 --> 00:19:16,000 Uh, 207 00:19:16,010 --> 00:19:16,800 they just, 208 00:19:16,810 --> 00:19:18,170 they were busy people. 209 00:19:18,170 --> 00:19:19,850 They decorated their house. 210 00:19:19,860 --> 00:19:23,780 So kind of a lot of the normal stuff in there. 211 00:19:23,790 --> 00:19:24,460 Um, 212 00:19:24,470 --> 00:19:32,390 geographic region they participated in when they became more self aware, 213 00:19:32,390 --> 00:19:41,120 they tried to go through this process of what do I want to hold tightly to and what can I hold loosely? 214 00:19:41,130 --> 00:19:43,790 And they did have this initial reaction like, 215 00:19:43,800 --> 00:19:44,060 oh, 216 00:19:44,060 --> 00:19:46,120 I don't want to give this part up. 217 00:19:46,130 --> 00:19:46,790 Um, 218 00:19:46,790 --> 00:20:04,090 and they felt increased pressure to make it the best holiday ever because they were struggling that that almost made it more dire for them to make this wonderful. 219 00:20:04,280 --> 00:20:11,730 And there was the voice in the back of their head that felt like if we can't even make the holidays work. 220 00:20:11,740 --> 00:20:12,920 Uh, 221 00:20:12,930 --> 00:20:13,400 you know, 222 00:20:13,400 --> 00:20:15,450 is there hope for our relationship, 223 00:20:15,450 --> 00:20:20,830 Can we make other things work if we can't do this kind of very reproducible, 224 00:20:20,830 --> 00:20:22,760 happy kind of celebration. 225 00:20:23,780 --> 00:20:26,270 So they thought about that for a while. 226 00:20:26,280 --> 00:20:33,140 Um and they had a whole list of things they didn't feel like they could release, 227 00:20:33,660 --> 00:20:36,360 but then you know, 228 00:20:36,360 --> 00:20:37,670 with a bit more pause, 229 00:20:37,670 --> 00:20:40,300 they decided that this year they would try it, 230 00:20:40,310 --> 00:20:45,660 they would try to see and if next year they wanted to do the whole shebang, 231 00:20:45,660 --> 00:20:47,180 they really could do that. 232 00:20:49,930 --> 00:20:58,360 An interesting thing for them as a couple to was that they had recently had a really nice personal moments. 233 00:20:58,370 --> 00:21:05,840 Um they lived in a warm climate and they had this kind of slider um, 234 00:21:05,850 --> 00:21:07,790 it's kind of like a porch swing, 235 00:21:07,790 --> 00:21:31,150 but I guess it was on a slider kind of mechanism and they would be in the backyard in that slider swing kind of thing and they've had some nice conversations out there and that was not always the case for them in the season of their life and they both said those were moments recently that were really good. 236 00:21:32,400 --> 00:21:48,570 Now interestingly the therapist in working with them could see that the gentleman on the spectrum really sought a lot of the stimulator input and that is movement input and that was calming and regulating to his nervous system. 237 00:21:48,580 --> 00:21:52,210 He was an avid long distance cycler. 238 00:21:52,220 --> 00:22:17,880 Um he had done other things like downhill skiing and he was really drawn toward movement to feel centered and this was a way that he could get some gentle rocking input while having a conversation that had the potential to have kind of an emotional elevation or difficulty. 239 00:22:18,810 --> 00:22:35,870 Another thing that the therapist notice that probably made that swing a nice place for them to talk and connect was that there is not a social expectation that you're going to face each other and have this long extended eye contact. 240 00:22:35,880 --> 00:22:39,260 So when you're in this kind of swing mechanism, 241 00:22:39,270 --> 00:22:50,950 it's expected that you'll sit side to side and for him that was enough to reduce some of the intensity of the experience to a point where he felt more regulated. 242 00:22:50,960 --> 00:22:54,140 So this was actually a good place for them. 243 00:22:54,140 --> 00:23:01,120 And even though there's no reason they can't have a conversation in the house getting away from the house, 244 00:23:01,120 --> 00:23:08,740 psychologically felt like they were kind of leaving behind and and coming away together. 245 00:23:08,940 --> 00:23:09,760 Um, 246 00:23:09,770 --> 00:23:16,520 so that felt like a separating a part that was good for them to have those conversations. 247 00:23:16,530 --> 00:23:30,180 They also had a pagoda type set up in the backyard with comfy chairs and that was also just a nice place of respite for them both individually and as a couple. 248 00:23:31,380 --> 00:23:42,380 So in talking through what was going on in their life and what was most meaningful to them that they wanted to hold onto during the holiday season. 249 00:23:42,390 --> 00:23:43,020 Uh, 250 00:23:43,030 --> 00:23:54,510 the wife said that lights were really part of the holiday that brought her the most joy and she wouldn't want to not have lights in the house or christmas, 251 00:23:54,510 --> 00:24:02,530 lights in in what they were doing and so what they decided to do was not to decorate the whole house, 252 00:24:02,540 --> 00:24:07,570 they decided to put white lights all over the pagoda, 253 00:24:07,580 --> 00:24:23,360 all over the um swing mechanism chair and to have a little festive area in the back that they could retreat to and kind of connect in that space. 254 00:24:23,370 --> 00:24:27,270 And that ended up being um, 255 00:24:28,000 --> 00:24:32,650 both a really nice celebration of the holiday. 256 00:24:32,660 --> 00:24:35,150 It ended up bringing them together. 257 00:24:35,160 --> 00:24:45,610 So they worked together to create this space that was meaningful and pleasant and they were able to protect that space where they could communicate. 258 00:24:45,620 --> 00:24:51,560 And so that felt like a good exchange that a lot of the decorations were released, 259 00:24:51,570 --> 00:24:57,510 but they did focus on this nice space and on the lights that were important to her. 260 00:24:59,590 --> 00:25:12,090 Now the husband said that one of the things that was most important to him about the holidays that he wouldn't want to release is he had a whole list of dishes. 261 00:25:12,100 --> 00:25:16,840 Uh he liked to cook and she was never the cook in the home. 262 00:25:16,840 --> 00:25:17,330 He, 263 00:25:17,340 --> 00:25:26,920 he was always the cook and he really liked to reproduce uh family dishes and traditional dishes during the holiday season. 264 00:25:27,250 --> 00:25:35,700 The difficult thing about that though is that oftentimes because of the way the holiday schedule works. 265 00:25:35,710 --> 00:25:36,350 You know, 266 00:25:36,350 --> 00:25:42,080 you end up having to produce all this food in a very short period of time. 267 00:25:42,090 --> 00:25:43,490 You're having guests, 268 00:25:43,490 --> 00:25:46,780 you're having a celebration on a particular day. 269 00:25:47,300 --> 00:25:53,030 So what he held onto were 10 of those dishes? 270 00:25:53,550 --> 00:26:03,580 Uh he let some go and then he also released having to have these nice meals on a particular day. 271 00:26:03,590 --> 00:26:09,450 So what they did is they took Multiple weeks out of the season. 272 00:26:09,450 --> 00:26:21,730 So prior to their thanksgiving that they were celebrating through the Christmas season through the new year and they made 1-2 of those important dishes every week. 273 00:26:22,380 --> 00:26:25,810 And what they did was they also made them together. 274 00:26:25,820 --> 00:26:27,720 So now that the kids were gone, 275 00:26:27,720 --> 00:26:34,160 she actually was interested in learning not to cook mundane meals, 276 00:26:34,160 --> 00:26:34,680 but she, 277 00:26:34,690 --> 00:26:38,700 she kind of really did want to get in there and learn some fun stuff. 278 00:26:38,710 --> 00:26:42,330 So this became a good um, 279 00:26:42,340 --> 00:26:52,140 couples moment as well and they also had a nice time just having a calm meal together, 280 00:26:52,350 --> 00:27:00,550 having some of these fun traditional dishes and it offered them the opportunity to reminisce as well. 281 00:27:00,560 --> 00:27:05,360 And so he could tell his stories again about childhood and this is grandma, 282 00:27:05,360 --> 00:27:05,630 so, 283 00:27:05,630 --> 00:27:08,550 and so's recipe and um, 284 00:27:08,560 --> 00:27:09,800 some of these facts, 285 00:27:09,800 --> 00:27:14,350 she knew before and some were new and that felt like a meaningful, 286 00:27:14,350 --> 00:27:17,380 enjoyable thing that they did. 287 00:27:17,380 --> 00:27:19,640 And for some of these dishes, 288 00:27:19,650 --> 00:27:22,020 um their kids were home, 289 00:27:22,020 --> 00:27:26,670 the two kids and they were able to kind of have that family moment as well. 290 00:27:28,380 --> 00:27:33,680 So there were other things that they did things that each of their kids wanted or needed. 291 00:27:33,690 --> 00:27:40,800 But this story I think highlights the potential of a couple of things. 292 00:27:40,800 --> 00:27:44,090 One is realizing what the, 293 00:27:44,100 --> 00:27:50,320 the life season is for you during a particular birthday season, 294 00:27:50,320 --> 00:27:51,840 holiday season. 295 00:27:51,850 --> 00:27:53,990 What is your life season? 296 00:27:53,990 --> 00:28:14,390 How does that connect also who are the individuals that are in the celebration or this meaningful, reproduced event and what are their specific needs ... and that may be related to their age, 297 00:28:14,390 --> 00:28:16,050 to their neurology. 298 00:28:16,060 --> 00:28:20,550 Um lots of different things can impact what a person needs. 299 00:28:21,710 --> 00:28:27,340 Having this self awareness and pause of those two elements, 300 00:28:27,350 --> 00:28:31,910 the life season and the individuals that's really helpful. 301 00:28:33,440 --> 00:28:41,190 It also teaches us to have increased self awareness a lot of times. 302 00:28:41,190 --> 00:28:41,800 As I said, 303 00:28:41,800 --> 00:28:46,280 there's this tidal wave about this is what the season is, 304 00:28:46,280 --> 00:28:51,040 regardless and it it teaches us to be more aware of what we need. 305 00:28:51,050 --> 00:28:58,500 It encourages people around us to be aware of what they need and to communicate that that's huge. 306 00:28:58,500 --> 00:29:00,130 We can use that every day. 307 00:29:00,330 --> 00:29:03,290 This is a household where people have different needs, 308 00:29:03,300 --> 00:29:15,600 what do you need and let me tell you what I need and how can we bring together a moment and a celebration and a season that is life giving for the people in this home. 309 00:29:17,300 --> 00:29:29,330 It does require us to hold fast and strong to some foundational things and to release things and the releasing can feel hard, 310 00:29:29,340 --> 00:29:36,850 but I challenge you to do that this season and to see if there's joy and peace that comes from this. 311 00:29:36,860 --> 00:29:39,280 Um in a meaningful way. 312 00:29:39,900 --> 00:29:42,030 Every season can be different. 313 00:29:42,040 --> 00:29:44,600 You can go back to the whole shebang, 314 00:29:44,610 --> 00:29:53,900 You can pick different things next season but never feel that you have to go along with the tidal wave just because it's there. 315 00:29:55,120 --> 00:30:15,520 I hope you have a blessed and meaningful holiday season if you are in the midst of one and that all of your life moments that you celebrate and you pause to add meaning to that these come together to really be a calm and peaceful place in relationship building. 316 00:30:16,420 --> 00:30:23,700 I'm going to take the rest of the holiday season off and I will see you again for the next episode in january.    

In this podcast episode, Dr. Regan discusses how anxiety-related conditions can lead to misdiagnosis of autism. She explores the prevalence and misinterpretation of anxiety in autism, highlighting the different anxiety-related challenges faced by individuals with autism. Dr. Regan also talks about the risks, misdiagnoses, and OCD associated with autism, and emphasizes the importance of including autism in assessments and differential diagnosis.