Friday, May 17, 2013

Answering the Caller

Going back to the radio show on Tuesday I did on WWKI I had a caller call in with a question regarding her son and the ability to talk to the doctor one-on-one and the inability to socialize in a school setting. I gave an answer, but I don't think I gave the perfect answer so I'm going to take this blog post and give a proper answer.

First, this is something that I have struggled with as well. If anyone ever gets me into a one-on-one conversation I usually am rather able at having the conversation without issues. Should another person join the conversation the issues will mount as I have a harder time being able to process all that is going on. Should yet another person join I will become almost unable to chime in with any of my thoughts and anything more than three people in a conversation and I will have a hard time uttering a single word. Since this is true a one-on-one conversation with a doctor is easy where as anything in the school setting would be much trickier.

Also, speaking to a doctor is a much narrow range of communication. What I mean by that is that a conversation with a doctor is usually going to be just heavy in facts. On top of that, after a while, the conversations can become a routine. A doctor may ask the same questions so it becomes almost scripted. In a school/group setting this is harder to achieve with the range of conversation being much greater and a routine much harder to achieve.

Yet another aspect is timing. This is one thing I still struggle with and timing is so critical. What timing is, by my definition, is the timing of when to speak. When talking to a doctor the doctor will speak, ask a question, and wait for a response. The doctor may also give ample time for processing. Others though, especially in a group setting, will have a much more fluid and ever changing conversation. To speak, one must be somewhat aggressive in getting their words out much like trying to navigate a busy four-way stop situation where drivers aren't really obeying the protocols. I will wait for that right moment when no one is speaking, but each time I get ready to speak someone else beats me to it.

All in all these issues can be rather confusing for a doctor because, should the doctor only get the story from what they are seeing in front of them right then and there, it may be hard for the doctor to get the complete picture. Let's take myself at a young age; I could talk to the doctor just fine. I could talk about the weather, or body temperature, and I was ahead of my years. Why would the doctor think there was anything wrong? This is a rather common story! I'm not sure what future book I have this in, but I do call it a "problem with Kansas" as, if a person only sees us in Kansas then it will be practically impossible for that person to think of us as having any challenges at all.

I hope I answered this better than I did on the air. Perhaps my answer was decent on the air, but I feel this is a much better painter picture than what I gave on Tuesday.


  1. I would think that an aspect of successful conversations in a public setting is whether the people involved know that you are on the Autism Spectrum or not. The doctor knows and can adjust himself to what makes you comfortable. I would assume that many kids, especially older, junior high or high school, would not be comfortable telling any but their closest friends that they might be different from them in any way. This is, of course, an observation from the outside, but even those not on the Spectrum sometimes have trouble in larger, group settings, while others can't handle a one on one situation. I was curious though, you say you can do your large presentations with no nervousness. Are you able to see the audience as a single entity or do you focus on something else besides the large number of people in the audience?

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  3. I have dealt with a few situations like that in my career right now. There are moments that I deal with that surprisingly well for an autistic person.

    I will give you an example. A few weeks ago, three occupational therapists I knew as well as one other person that I didn't (it was one of the three occupational therapists' girlfriend) went out for an evening. We first went to an alumni reception, where two of the occupational therapists' alma mater for OT school. We then went to a Mexican restaurant and we had a good time, which we planned to do this again next year when we see each other. I socialized a fair bit that night. Most of the time it was the other three occupational therapists doing the talking and picking the conversation topics. So, I blended right in when the others asked questions and wanted my response. There were times I also jumped in with my own questions.

    I met the three occupational therapists the previous year, but we didn't really have a meaningful conversation with each other then, since the setting didn't allow us to do so. Nonetheless, we connected through Facebook soon after and eventually arranged this dinner the next time we saw each other, which was a few weeks ago.

    All in all, it IS possible for us autistic people to hold our own in such social situations. Observe, aware, analyze, and prepare, practice, and reflect are my six keys to success in such situations.

    Observe- Since I am usually the quiet one (or one of the quieter ones), I always observe for what is appropriate/inappropriate in such situations. In this situation, I knew the two female occupational therapists probably would be the ones who would drive the conversations. So, I would just sit back and let them take the lead. I would just pop up an occasional question or two when appropriate.

    Aware- I am always aware of who I am with and what are my social expectations. In this case, I was aware that I was with three occupational therapists and someone who is a non-occupational therapist. I am also aware that my social expectations was to chip in and provide a good experience to these folks. Hence, I can't just surf the Internet on my phone or watch sports on TV at that restaurant the whole time. Plus, if I do that, I know they probably won't want to hang out with me again next year.

    Analyze- Because I know who I am with, I can't go all out on OT topics even though occupational therapists were the majority (since there were four occupational therapists in the setting, me included)

    Prepare & Practice- In my OT experiences, I had numerous opportunities where I had to be with multiple people at a setting and had to function and social well. I knew that the only way I could have more confidence in such situations is to practice the right way. Hence, I joined in when appropriate. Slowly but surely, I gained the confidence.

    Reflect- This is important for me because I know these are settings I have to deal with regularly. Coupled with my peers' perception of me were pretty good, I know it is that much more important to NOT have a social blow up. (I forgot to put the "NOT" in my initial reply.)

    If I were to answer the question that you answered on that radio show, I would have a much different response, "It's understandable that we have anxieties and fears in social situations that we might not be comfortable in. That said, we can utilize our strengths and interests to navigate through such weaknesses. In addition, it's important for us to understand what is expected of us socially. Sometimes we can figure it out through our previous experiences, knowledge of situation, and/or observation of others. But if we can't, we need people to fill us in and prepare us. From my experiences, the more that are expected of us socially, the more we have to know what we need to do so that we can perform the best we can."

  4. Frankly Bill, those six socialization skills could benefit a large majority of today's population, especially the AWARE part of it. I know it's joked about that you can see six people at dinner these days and every one of them will be staring at their phone screen rather than talking and interacting with the others around them. We have built a bubble of technology around ourselves that we need to break if we're goig to be a more communicative society.

    Funny how people with Autism are struggling to cope with being in social situations while those not on the spectrum voluntarily seclude themselves, even in the most crowded of situations.

    1. In that social situation, interestingly enough. Some of us might have glanced at the basketball game on TV at the time, but nobody had their phones out on the table aside from the moments where we wanted to take pictures of each other.

      There were some factors here-

      1. It was the only time of year (for a few days) where me and the three other occupational therapists got to see each year. Moreover, we knew each other's time were valuable during those few days.

      2. Phone use in that conversation is a general no-no unless it's for one of these (since anything outside of this is considered rude).
      - Taking a picture
      - Uploading the picture you just took on social media
      - Someone in the group asking you to look up something
      - You are looking up something that might contribute to a conversation or create a new conversation topic.

      With coping with conversations, there is a really diverse range in terms of autistic people's abilities. Some people might have little trouble. Some people might have lots of trouble. And there are those who are somewhere in between. That said, one thing that will help autistic people in this department is to have people who understand them and encourage them to participate at a level that is just right for them. Moreover, as they participate, they are not afraid to give autistic people feedback on how they did- indirectly or directly.

      I won't say social skills is easy for autistic people. But if autistic people have the opportunity to be with some people with great social skills socialize with them while providing them a great time, learn from that. I had the opportunity to learn from at least half a dozen examples in the last 4 years and I am proud to say that I have put what I learned to use and have done a good job of it. Sure, there will be times where our quirks show up in social situations, and that's OK as long as they don't ruin the other person's social experience with us.

      For me, whenever people tell me that I have given them a great time, each praise represent a "vote of confidence". For us autistic people, positive reinforcements on social skills are huge. After all, an indirect benefit is that I know I either gained a person I can trust or enhanced an already great relationship with someone.