Neuroaffirming Practice | Bryden Carlson-Giving & Katherine McGinley | TEDxAlmansorParkLive

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began my work as an occupational

therapist five years ago working to

support autistic children and youth and

their ability to learn and grow

as someone who prioritized research and

form strategies I was surprised to learn

that I was using techniques that were

not only unhelpful but actually quite

harmful to the autistic community and

some examples of these techniques were

conducting reinforcement token economies

improving a child's sensory processing

patterns and promoting neurotypical

social skills

autistic voices were missing from my

education my training the research and I

had no idea how the autistic Community

felt about the methods I was using let

alone the harm I was causing

I was a very ableist practicing

therapist and I was absolutely failing

my autistic clients

it wasn't until I witnessed a child

demonstrating excitement by flapping

their hands and seeing another therapist

attempting to stop that child from

stimming that I began to not only

question what the stimming meant for the

child but began to explore autistic ways

of living

now as a neurodivergent OT Catherine and

I look forward to discussing how you can

avoid making the same mistakes that I

made and reflect on how you work with or

view autistic individuals

it can be an extremely arduous process

but it's what are autistic clients and

friends deserve and is the only way that

we can support to make the world more

validating off autistic ways of living

some is a culture that needs to be

recognized and celebrated

and that is why during this talk we

intentionally say autistic person rather

than person with autism

the autistic Community has asked that we

make this shift away from person first

language and towards identity first

language

this shift recognizes autism as an

essential part of an individual's

identity

just as we recognize gender and

sexuality as core parts of an

individual's identity it is important to

recognize disability as it changes the

way we move throughout the world

autism is a core part of many

individuals identities and that is why

instead of person with autism we say

autistic person

throughout this talk you will hear us

use the term neurodiversity

neurodiversity is described as the idea

that people experience and interact with

the world around them in many different

ways and these different ways are valid

forms of living there is no one right

way of thinking and learning and

differences are not viewed as deficits

it's about switching The Narrative

changing the story and empowering

as practitioners caregivers and teachers

we can shift our thinking away from a

deficit-based approach and Empower

autistic individuals validate their

identity and incorporate their interests

into our treatment

this process is called being strengths

based

when we incorporate principles of

strengths-based practice goals and

treatment looks more like a partnership

between the autistic individual

practitioner and family some common

traits of a strengths-based approach are

including environmental supports and

accommodations in line with an

individual's learning differences and

preferences

authentic collaboration with the

autistic individual

incorporating interest in meaningful

ways rather than as reinforcers

moving away from compliance and

presuming competence

and moving away from a deficit model

and redefining deficits as differences

such as sensory processing experiences

when it comes to strengths-based

practice our focus is less on changing

the individual and more on partnering

with the autistic individual and their

family to validate their autistic

identity

so what does applying this

strengths-based practice actually look

like well today we want to introduce you

to Kai Kai is not a real child but

rather a compilation of many children we

have worked with and their stories

during this talk we are going to use

them to demonstrate concrete examples of

how to move away from traditional models

of thinking and viewing autistic

individuals and towards ways that

amplify and empower the autistic

Community we'll start with language

language is important and Powerful by

simply switching our terminology to

being more affirming and less deficit

focused we are promoting a world that is

more validating for all sorts of

individuals two examples of how language

can shape the way we practice our

attention seeking and functioning labels

when referring to Children it is very

common to use the term attention seeking

this is usually seen as a negative thing

however attention is a need we all have

as human beings when someone is trying

to get your attention they are trying to

connect with you and be validated that

they are there and that they are seen by

simply replacing attention seeking with

connection seeking we can reframe

so-called bad behavior to a child

seeking a vital human need

language is powerful and this simple

change can help us take a step towards

understanding where the child is coming

from and honoring their perspective

many autistic individuals dislike the

terms high and low functioning

describing someone is low functioning is

a heavily reductionist way to categorize

someone and gives no semblance of what

the individual can do

in contrast high functioning is often

used as a way to demonstrate

neurotypicality or someone who doesn't

require many supports which is often

untrue

instead we can describe the specific

supports someone might require the

amount of support and their strengths

for example Kai benefits from

substantial support such as a visual cue

to participate in unstructured recess

and Kai benefits from minimal support

such as a verbal cue to participate and

advocate for self-regulatory breaks now

we are not saying simply modifying your

language or all that is needed to be

more neurodiversity affirming to be

neurodiversity affirming requires

continuous self-reflection of what you

think you know active listening to the

communities of individuals you are

attempting to serve increasing your

comfort and being wrong and receiving

feedback to better your practice

it is a process and not a single event

after modifying your language to reflect

the needs and wants of the community you

are working with the next step towards

being strengths based is for you to

learn how to regulate yourself

regulation is an encompassing term for

how our mind and body are feeling such

as emotions or having energy

as the saying goes you can't pour from

an empty cup and if we are dysregulated

such as feeling mad you're unwell there

is no way we will be the support

Partners our clients need in order to

assist others it is important to take

time to learn about your own sensory and

regulation needs once you are regulated

we then determine if the learner is well

regulated if the individual is not

regulated no meaningful learning or

participation can occur

when they are not regulated one

strength-based approach to support the

regulation is demonstrating encouraging

or even exploring the learner's favorite

methods of stimming at

facial therapy practitioners we are

experts in occupations which are the

things we do every day that give our

life meaning and purpose such as your

role as a student in school getting

ready for the day or coping with life's

challenges

we Advocate that autistic behaviors are

occupations with stimming being an

intentional Reclamation posed by

autistic individuals and is attempting

to be normalized within our society

as mentioned earlier we all need to be

regulated and stimming helps many

individuals do just that

as partners to autistic individuals we

can help them to co-regulate

all people need assistance co-regulating

however some may need more assistance

than others

Kai does a great job using

self-regulatory strategies they Rock

when they need movement and they flap

their hands when they're excited

however sometimes the environment is too

much for Kai to regulate on their own

when this happens as support Partners we

can assist to collaborate and

co-regulate

Kai finds movement incredibly soothing

the trampoline and deep pressure have

been regulating for Kai in the past

so as partners we can offer these to Kai

perhaps by using them ourselves or by

placing an object related to the task

within their View

if the learner is not well regulated no

meaningful learning or participation can

occur and that is why it is essential

that we consider not only our own

regulation but the individual's

regulation as well

as we talked about earlier we live in a

society that emphasizes autistic

people's deficits so the next step is to

consider the strengths of being autistic

all autistic individuals have skills

abilities and strengths some common

examples of autistic strengths are the

ability to hyper Focus honesty their

technical abilities high amounts of

energy their loyalty artistic talents

passionate risk taker and pattern finder

for example Kai needed support in

learning how to self-advocate for their

needs when becoming overwhelmed

traditional terminology for describing

feelings such as mad frustrated happy

calm the they're very abstract for Kai

and they provided no functional support

in learning how feelings are expressed

within them self and for communicating

their needs

I learned right away Kai is a dinosaur

wizard Kai knows absolutely everything

about dinosaurs and by partnering with

Kai's interests of dinosaurs we utilized

a visual guide of various dinosaurs and

their energy levels and they got to be

the teacher and teach their family what

the support means here is the energy

meter already created by the Fantastic

advocacy organization autism level up by

creating a meaningful language using

their interests Kai was far more

successful in self-advocating how they

were feeling and Kai's family was more

able to connect with them by honing in

on and cultivating their passion for

dinosaurs there are plenty of times

where an individual may need to work on

developing skills such as using an

Adaptive pencil for academic tasks

using environmental supports or

advocating for self-regulatory breaks

however we need to ensure that the task

is not only meaningful to the client and

their family but that adequate

environmental supports are in place and

that we are considering the individual's

learning style strengths and preferences

after identifying an individual

strengths we can begin to think about

our goals within my goals I often

include that unrestricted access to a

support or accommodation is necessary

prior to measuring the individual's

performance to ensure that that support

is there

the goals do become longer but in a way

it protects the learner and it makes

sure that they have what they need so

switching our goals from deficit to

strengths-based will require a lot of

unlearning and that's okay I mean think

about it we are constantly reminded of

and influenced by society's dominant

perspective that autism is comprised of

deficits and that these deficits need

fixing additionally Health Care Services

often are administered without the

knowledge of what the community

prioritizes so to also continue to

support amplifying autistic voices I

make sure that my goals Target what many

within the autistic Community have

identified

as their health and well-being

priorities including the learner's

self-esteem their self-advocacy skills

positive mental health social

participation on their terms and their

quality of life

so some examples of strength-based goals

with Kai are when provided with

unrestricted access to environmental

supports Kai will self-advocate for a

regulatory strategy during a challenging

task or Kai's family will demonstrate

competency in embracing Kai's play style

and Report satisfaction with their

ability to connect with Kai and play

these goals really highlight how they

empower the learner and Advocate to

others how they can better understand

and embrace Kai's differences

we need to think about

it include environmental supports and

a condividual's learning differences and

preferences

I like to think about how I can adjust

the environment to support the

individual can I dim the lights or

remove background noise if I can't

change the environment can I add support

instead can I advocate for the

individual to have headphones or

movement breaks

instead of changing the individual to

fit the environment we get to change the

environment to fit the individual

once we have created an environment that

supports the child and we have offered

adequate accommodations we get to do our

favorite part incorporating interests

autistic people often have incredibly

intense interests historically rather

than incorporating these interests and

respecting them we have decided that

these interests are too intense and that

they need to be redirected or expanded

because they're often described as being

harmful or meaningless

participation in Passionate interests

have been shown to reducing anxiety

enhanced activities social bonding

higher reported autistic well-being and

quality of life so instead with this

approach we get to learn and enjoy these

incredibly intense interests rather than

removing something that the autistic

person loves

when incorporating interest it is

important to consider why the autistic

person is so excited about this topic or

item and it will most likely vary for

different autistic people

one autistic individual might be excited

about Sesame Street because of the way

Elmo's voice sounds to their ears

another may enjoy the consistency of

characters and learning facts about each

one

once I identify why an interest is so

important to the individual I get to

find ways to authentically engage it if

Kai loves Sesame Street I am not putting

Sesame Street characters on a worksheet

so that Kai works on their handwriting

that is not incorporating interest

instead I may help Kai look up facts

about each Sesame Street character and

suggest they write it down so they can

take it home later

in both examples Kai is working on

writing however one expects Kai to get

excited about writing because of

pictures on a worksheet and the other

authentically engages Kai's interests

and helps them achieve their goal well

also happening to work on handwriting as

we mentioned earlier an essential part

of being neurodiversity affirming is

letting go of compliance in favor of

presuming competence and empowering

as previously mentioned by an incredible

researcher we look up to Dr Amy Lauren

we need to stop focusing on controlling

behaviors or behavior management that

should never be the goal presuming

competence means to assume an autistic

person has the capacity to think learn

and understand it's assuming that they

are not inherently incapable and that

they just need the right supports and

systems to help them succeed by making

this shift from attempting to make

autistic individuals indistinguishable

from their peers to forming partnership

and supporting positive autistic

identity and well-being we acknowledge

and we empower

so what does strengths-based practice

actually look like it looks like making

sure that you are well regulated before

attempting to support the learner it

looks like focusing on areas of

strengths rather than focusing on areas

of deficits it also looks like changing

our goals so they focus on changing the

environment rather than focusing on

changing the individual it looks like

incorporating interests presuming

competence and it looks like changing

our language so we are reframing our

mindset

when we think about of autism often we

think of horrible disease that needs to

be cured through hundreds of hours of

therapy or we think of Rain Man and we

call it a superpower

but autistic people have been asking us

for years to think of them not as a

deficit or as a superhuman but as people

with different brains not better not

worse just different

autism can be both a valid form of human

diversity while acknowledging the need

for support

so let's let go of neurotypical norms an

autistic person will never be

neurotypical and that's okay we

challenge you to join us

and consider and discover how

strengths-based practice can not only

improve the relationship between you and

the autistic people in your own life

but make a better world for the autistic

community