Sunday, January 28, 2018

Autistic female critiques Spectrum News article "Girls with autism need help honing social skills in realistic settings"

Recently, Spectrum news  (a website that publishes news regarding the latest research on autism spectrum disorders) published this article written by Rene Jamison who runs a social skills program for young women on the autism spectrum called "Girls Night Out."  In this article, Jamison stresses that autistic girls need help navigating social rules in more real world settings. As an autistic female who's had some form of a social skills intervention similar to the program being discussed, I find Jamison's article and her underlying argument  very problematic and ableist.  I do agree with the title of autistic people needing more real world experiences to practice social skills.  It is  her solutions that I disagree with.  She proposes the age old idea that autistic females need to learn to socialize like their NT female peers in order to have successful lives.  I find this very destructive on a psychological level because it indirectly tells autistic people that the way they socialize is the problem instead of the rigid social expectations and categorizations put forth by a neurotypical society.   In this post, I am going to explain why I find Jamison's position problematic from an autistic's perspective.

The problem with a lot of the current social skills interventions especially  the ones built for autistic females is that there tends to be a push of "gender" or "age" appropriate interests.   Upon further research of the curriculum of the "Girls Night Out" program that is proposed  in this article, one of the topics covered is  "fashion" and "makeup" which are both stereotypically feminine activities.    When I was an adolescent, my behaviorist and I along with one other girl on the spectrum did outings to the mall to female clothing stores and other activities  which is a considered to be a "real life setting" in learning teen culture.  This  exposure  made me temporarily traded my interests of Hello kitty and Disney Princess for  fashion and designer clothing so I can fit in with my female peers.    Looking back as a young adult, it was a painful process of letting those interests go during high school and it contributed to long term feelings of anxiety, inadequacy and low self esteem.  To this day, I am still dealing with these negative emotions surrounding my love of "little girl" characters such as Frozen, Hello Kitty etc.  Neurotypical teens aren't told what to like or are given didactic teaching lessons on fashion and makeup.  In fact not all NT girls are into fashion and makeup.   This is the point that I think is missed in Jamison's article.

Another issue that I have with Jamison's intervention and others like it is the need to get autistics to feel comfortable socializing in a group or what is known as a "peer group."  As an autistic female who is more introverted and has sensory processing issues, the idea of being in a unstructured social group was a hellhole for me.  In high school, I was made to join clubs as well as sit with a group of same aged peers. I felt so overwhelmed with the numerous conversations that were going on at the same time that I didn't know when to join in.  I also feel that in groups, you don't get to know people on a more intimate level as well as them not getting to know me.  This is why I preferred one-to-one social situations as opposed to group settings because aside from getting to know people on a more intimate level, you get the individual attention and it's a lot easier to socially manage from a sensory perspective.  To sum this paragraph, some people on the spectrum (just like in the general population) are  introverts, and they shouldn't be forced to socialize in a group setting if they don't feel comfortable.

Perhaps, the biggest problematic element of Jamison's article, is that I felt she used the article to promote her "Girls Night Out" program.  In that sense, I feel there is a personal bias as well as self interest from the author in writing this article.    I always get suspicious (as well as cringe) whenever a clinician writes an article on a website/platform that highlights our "deficits" in order to promote their program or therapy.  The underlying theme of these articles is that autistic people won't have a good future unless they participate in the program or therapy.    It is this very message that is very damaging as an autistic person.  She also contradicts herself towards the end of the article  by stating that the long term effects of her social skills program is unknown.  On the plus side, at least she admitted this shortcoming of her program.  As an adult autistic advocate who's been through social skills training, I can provide my insight that these interventions are part of the reason of long term issues with anxiety and insecurity.  It is bad science that a research based website such as spectrum would allow a clinician to promote her program on their site.

In sum,  I feel that Jamison's article though well meaning,  is reiterating (in a different way) the viewpoint that autistic people are the ones that need to conform to a NT level and that we need "peer coaches" to help us learn teenage trends.  It overlooks the fact that a lot of autistic females spend most of their young lives trying to emulate their typical peers to the point of exhaustion.  This is the reason for the high levels of anxiety and depression in autistic females.  As I stated at the beginning of this article, I do agree with Jamison that  autistic people of both genders need more real world experiences to practice their social skills.  This is why I hired a social companion/mentor to go on outings in the community to get that real world experience in practicing my social skills.  However unlike traditional social skills groups, this type of intervention is relationship based  on respect and there is no pressure to like things that are gender or age appropriate.  In fact my mentor is working with me on my self confidence about being comfortable with my unconventional interests.   Having a companion to do social outings was what worked for me but Jamison's intervention could work for some girls on the spectrum.  Autistic girls are not monolithic in which one type of intervention would be effective for all of them.  They are complex human beings with varying interests, challenges, goals and talents etc. just like typical girls.  If we truly want to come up with more effective interventions that actually help autistic people, researchers need to consult with autistic people as well as individualizing supports for people on the spectrum.

7 comments:

  1. As a friend said to me, you will not spend the rest of your life socialising with teenagers.

    And mentors like yours are important, Christine.

    "However unlike traditional social skills groups, this type of intervention is relationship based on respect and there is no pressure to like things that are gender or age appropriate. In fact my mentor is working with me on my self confidence about being comfortable with my unconventional interests."

    Does she share some unconventional interests as well?

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  2. Unfortunately not, but she is respectful and accepting of my interests. She is very direct which is important to me as an autistic person since we need to be told the “why” and have things clearly explained to us. I feel that more individualized approaches work for autistic people.

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  3. I've been recommending an article (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5286449/) on how NT peers are less willing to interact with autistic peers based on immediate superficial ("thin slice") judgments. There's an interesting program, PEERS (http://www2.semel.ucla.edu/peers), based on work led by Elizabeth Laugeson, to teach social skills. I'm autistic as well, and I'm quickly exhausted in unstructured social settings. I found I was happier when I didn't expect peers to like or have any special point of view towards what I like. I tried to mainstream for a year and stopped reading, but it made me depressed. On the other hand, I believe in imitating people. I don't have to agree with them or like them to imitate - I can stay neutral (maybe it helps that my parents are Swiss, Switzerland is a neutral country). To me, when I don't stick out, I'm actually exerting control, because I'm choosing not to stick out. I work on listening and imitating, and over time I got good at it. It takes work and it doesn't work for long, I tire out. But it does work at times. People who know me know how I'm special. People who don't know me don't have to know anything special.

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  4. As a mother who homeschooled all of her children, being unique and not "the norm" was our norm. Now as a educator, that works with autistic students, I will take your suggestions seriously and watch these students grow! Thanks so much!

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    1. I am glad you found my suggestions helpful to you as an educator. It makes feel good that professionals like you want to learn from people like me.

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  5. Well said, thanks. As a mom of an autistic tween girl, I really appreciate your feedback and it helps me to relax and let my daughter to be herself. I don't need to stress out over her individual interests but embrace her differences and encourage my daughter to embrace her unique self in spite of the negative feedback she receives from her 'peer group'. I love your direct and honest approach. Thank you. Please keep writing.

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    1. Exactly! If your daughter expresses an interest in trying something stereotypically "girly" like makeup then by all means assist her to find something she will get on with (I'm autistic myself and dislike the feeling of foundations on my skin, even mineral ones feel too heavy) but if she doesn't seem to want to bother, let her not bother. :)
      I wish my mother had supported my differences more than she did and not tried to push me to be more "normal" because it caused me a great deal of stress, anxiety and worsened my self esteem and really didn't help with depression (I also have bipolar disorder). Granted she didn't know I was autistic then (I only found out this year aged 30) but that's no excuse as one shouldn't be knocking down their child regardless of their neurotype.

      Thank you for taking on board what other autistic people have to say on this and for supporting your daughter like this! If she ever feels down because of difficulties connecting with her peer group, do let her know that in time she will find people she will connect with with greater ease. They may well end up being on the spectrum themselves. My teens were hellish and it wasn't until many years later that I found out that some of the people I wished were my friends actually considered themselves to be so, its just that there was a lot of confusion in how we communicated. I find it next to impossible to tell if someone actually likes me. I literally have to have it said, often repeatedly at intervals to be sure. I don't know if your daughter is similar, but perhaps if she is it might be worth explaining (if you can) how people who are not autistic communicate that they like you. And maybe work with her to find a way to ask if she's unsure without coming across as if she's doubting them. I'm not quite sure how to do that myself, but if you can help her if needs be that would be so awesome. :)

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