Tuesday, 30 November 2021

Useful New Autism Info for Care Settings

 

This is a list of useful research papers and Commissioned documents that have changed how we think about autistic people, and how we respond to their distress, co-occurring conditions and their brain events.

https://www.ndti.org.uk/resources/publication/its-not-rocket-science  is a commissioned report by young autistic people, on easy ways to make wards and care settings into sensory-friendly spaces.  Lots of useful new information on the sensory needs of autistic people, and the social communication needs.

https://www.local.gov.uk/our-support/sector-support-offer/care-and-health-improvement/autistic-and-learning-disabilities/autistic/considering-and-meeting-sensory-needs-autistic-people-housing is a commissioned paper from the Local Government Association on how to ensure really good housing for autistic people.  

https://www.waterstones.com/book/avoiding-anxiety-in-autistic-children/luke-beardon/9781529394764  is an example of an excellent up to date and accessible book about how to avoid anxiety for autistic children.  Dr Luke Beardon has written other books for different age groups and situations, equally recommended.  Other booksellers are available.

https://onlinelibrary.wiley.com/doi/full/10.1002/aur.2306 is a new paper looking at the huge number of autistic people who experience diagnosable trauma from 'traditional' and other events, including bullying.  It changes how we think about 'behaviour'.

https://www.peacepathway.org/ Potentially useful information about autistic people and difficulties with food/eating.


https://www.jpma.org.pk/PdfDownload/10585 The newer research into autism and hypermobility/EDS, suggesting more than half of autistic people may have one of the forms of hypermobility, which can lead to or include exhaustion, movement difficulties, POTS (potentially causing collapse), and pain.

Saturday, 20 November 2021

Strengths-Based Approaches for Autistic Individuals

 

A picture of a person wearing headphones.  They have dark hair and are smiling.  The background is rainbow-coloured.

For many years, people assumed quality of life for autistic people only happened when we were 'normalised' from an early age.  This 'Early Behaviour Intervention' usually focused on improving our allegedly weak areas, and enforcing this improvement for many hours a week.

An informal Twitter poll asking autistic people if being made to use eye contact has improved their lives.  Most said a clear 'no'.

There is very little evidence of this approach leading to a better quality of life.  The informal poll shown above is a clue.  Hundreds of votes.  Did all that 'you must make eye contact' training lead to a better quality of life for them?  Hardly anyone said yes.
Below, another informal poll, again with hundreds of votes.  What about wider social skills training for us?  Did it improve our quality of life?  Hardly anyone said yes.

It's useful to ask people if something helps, isn't it.

Another informal Twitter poll asking if it helped quality of life to have our social skills normalised.  Most people said a clear no.



There is growing evidence of weakness-based approaches such as ABA leading to poor self esteem and sometimes catastrophic outcomes. Other of my blogs discuss these. This isn't difficult to understand.  In the same way, if you were described as a list of problems that had to be solved, every day of your life, you might feel depressed, anxious and exhausted.


A strengths-based approach, building on things we are good at, has an increasing fan base, amongst Professionals as well as autistic people.

There are a lot of good research papers that may help with our thinking.

Here are a few of them:






It is an important discussion for all of us to have.

How is a team going to build on my fantastic young person's strengths, as well as supporting them in any area where they need that support?

How can their hobbies and interests be a source of relaxation and joy to them, not a thing used by teams to enforce normalisation?

How can we appreciate diversity, and work collaboratively with autistic people to understand autistic culture and communication?

There are so many useful things to keep exploring, and so many more positive outcomes to be discovered.

I am grateful, as ever, for teams who are promoting this strengths-based, positive approach, and who refuse to use the negative, 'deficit and disorder' thinking of the past.

I would like every autistic individual to be safe to live their best, authentic lives, able to thrive as themselves, not as a copy of someone else.  That's a Human Rights approach, and a caring approach.  I commend it to all.

Wednesday, 20 October 2021

What is autism? A modern understanding for 2021

A photo of a woman with blonde hair. She is wearing a grey jacket and white top. Above her head are question marks.  She looks quizzical.
What is autism?

We get asked this a lot.

There's been quite a battle going on.  I will generalise:

Group one... fans of two men who thought they'd invented it in the 1940s, and who were completely convinced that autistic people were broken versions of other people.  Young boys with strange behaviour...maybe an occasional young girl.  No empathy, repetitive meaningless behaviour, resistance to change, no interest in other people.

It didn't matter that autism was well described by a woman, years beforehand.  The men got the acclaim for this supposed discovery.

It was important to put autistic people into 'mental hospitals', describing them in entirely negative language like deficit, disorder, obsessive, etc.  It was important to stop their 'behaviour' by enforcing normalisation, because this was believed to be better for us.

We were too-often experimented upon as if we lacked opinions, feelings, insight, pain responses or human rights. 

No progress was made.  But they just had to keep on doing these things, convinced that at any moment, they were going to prove that there was some fix, some cure, some pill, potion, lotion, electric shock, operation or genetic wizadry that would remove autism.

Nothing worked.  Well, some autistic people were forced to do repetitive things, and others were forced to sit really still and be really quiet.  This was called a success.  Mmm.

Group two... the autistic researchers, academics, specialists and our allies.  The rise of the neurodiversity movement. 

We want human rights for all autistic people.

We want every autistic person to thrive as their own best version of themselves, not a fake copy of someone else.

We appreciate autistic communication as a genuinely different way to socialise with one another.  No, really.  See research links below.

We appreciate the deep focus that autistic people have for their specialist interests, their hobbies and perhaps future careers.

We see autism as a largely sensory condition, in which our brains take in too much information in busy, noisy places.  Too much from flickering light and loud sound.  Too much from odours and rough textures.  Too much from noisy chattering.  So we respect those who need quieter, better spaces.

We want every autistic person to have excellent support, whatever their level of support needs.  Truly person-centred.

We want every autistic person to have excellent healthcare, whatever their communication needs.  That worryingly low average age of death has to change.

We want all families to feel supported and valued also.

We want to leave negative language about us in the past, where it belongs.  Stigmatising language has done such damage. None of it is necessary. Not for alleged 'treatment' or for anything else.

In line with the National Autistic Society and the Parliamentary Reports, we want autistic people to be freed from inappropriate hospital placements and given proper, safe community homes where they can belong.  Where they can thrive.  Where they can flourish as themselves, amongst those they choose and whom they trust.

We know that so many autistic people are still to be discovered, thanks to those old myths about it.  Autistic females, Black individuals, Asian individuals, older individuals.  So many different groups who were left out of diagnosis, denied diagnosis. 

So many who have found better self-understanding through realising they are autistic.  Better chances of finding places that suit their needs, now they understand those needs.  Better chances of finding good relationships, now they understand how they communicate and how they can thrive.

A diagnosis should never be a pathway to a locked door, normalisation-enforcement and a daily list of negative words and low expectations.

A diagnosis should be a pathway to thriving and to meaningful access to everyday things, in the same way as others expect.

Time to leave the past where it belongs, and gather round our autistic loved ones with new appreciation, and new hope for the future.

Thank you for reading.




Want more info and  research on the above?  Sure - go to 

http://annsautism.blogspot.com/2019/01/autism-some-vital-research-links.html as a good starting point.  Using that as your starting point, lLook up the best respected autistic academics and our allies, and read what they write.  Get the books by Dr Luke Beardon, for example. Look at the outputs from the autistic-led research conferences that happen regularly through the year.  Ask us.



 

Saturday, 25 September 2021

Autism is not a look or a behaviour. About enforcing 'Masking'.

 

A drawing of a boy who is smiling. He has brown hair and a yellow shirt
In the press, news that a team have found a way to give fewer diagnoses to autistic children.

"Autism therapy aimed at infants may reduce likelihood of later diagnosis: Study suggests tailored therapy could help some children develop social skills before school age", reads the headline in the Guardian newspaper for example (20 September 2021).

The alleged therapy appears to be based on ignoring a young child if they behave autistically, or giving them a 'time out' for doing so.  Parents are taught to reward any behaviour that matches non-autistic social skills, such as eye contact, waving when someone else waves, etc.  The end result is to deliver to the parent one child who appears normal and can make eye contact.  Like the picture at the top.

"This is the first worldwide evidence that a pre-emptive intervention can reduce autism behaviours and the likelihood of a later diagnosis,” said Prof Jonathan Green at the University of Manchester, breathless with excitement.  OK, I may have added the 'breathless with excitement' bit.  But that's the general tone of the Press - that if we can 'reduce autism behaviours' we can stop the autistic children getting a diagnosis, and isn't that fantastic!

OK.  Reality check.  I asked autistic people if they had stopped being autistic, once they learned to do eye contact, waving, etc.


An informal Twitter poll as described in the text

That's odd, isn't it.  There's over 1000 votes.  Hardly more than a handful thought that doing those things means they're now cured of autism.  No, they'd still be autistic.

So what on earth is going on?  Other Press articles suggest that perhaps they wouldn't develop 'full blown autism' if they learned to hide being autistic.  What? Is that even supposed to make sense?  There's not even a diagnostic category of 'full blown autism'.  We're either autistic, or we're not.

There are so many problems with this allegedly exciting new research, I and other professionals barely know where to begin.

Autism is not a 'look'.  It is not a 'behaviour'.  It is a different neurology and we are born with it, from all the evidence to hand.

Training autistic children to appear nonautistic is called training them to 'mask' or 'camouflage' their natural and normal behaviour, and replace it with inauthentic, exhausting mimicking of others, all day, every day.  

The end result of that is not happiness.   It is misery.  Misery to such a degree that we now know from research that there are links to suicide. Reference and so many more modern research papers can be found in http://annsautism.blogspot.com/2019/01/autism-some-vital-research-links.html

Brand new research details the narratives around how 'masking' leads to autistic burnout and other mental health crises. Here's the link to the article, which also discusses the other awful outcomes of enforced normalisation:  Autistic burnout

So, our triumph is to stop autistic children being diagnosed, is it?  Getting help and support, finding their peers, learning who they are?  That's good, is it?
Because autism is some terrible thing that needs hiding, is it?
Who says so?

For sure some autistic people have a tough life, with multiple difficulties. A life that needs a lot of support. A life that may need medical assistance for actual medical situations such as epilepsy, or pain/mobility conditions such as Ehlers Danlos (both of which can co-exist in autistic people).  But in what way is preventing a diagnosis a fantastic idea?  So we can fail to support them?  So we can make them exhausted from masking as well as struggling?

This is recklessness, not triumph.  It's wrecking children's lives.

And it has no place in a modern society.

The Medical Professions are tasked to do no harm.  To put the rights of the child at the forefront of their thinking.  To uphold Human Rights legislation such as the Convention on the Rights of Persons with Disabilities (CRPD) which says that autistic children have the right to their autistic identity.  I'm not sure people even read that document, let alone uphold the very principles our Country signed up to.

Condemning young children to a life of poor outcomes, so others can be pleased that they 'look normal' or don't have 'full blown autism' (the sort where we are visibly autistic, shock!)  is an act of terrible cruelty, and I suggest that we never, ever do it again.

Thank you for reading.







Thursday, 2 September 2021

Autistic people and phone calls

 


A picture of a mobile phone being held in someone's hand


There's a lot of misunderstanding about autistic people, and phone calls.

Many autistic people are not always able to speak, or may not be able to speak at all.

Unfortunately, not a lot of people know this.  So there can be major difficulties with people misunderstanding what's happening.

A poll result from Twitter, asking autistic people if they can speak.  A large number said 'not always'. Some said 'no'.


Equally unfortunately, people expect us to use phones reliably.

I can sometimes use phones.  It depends if I'm in a good enough state to speak.  It depends if I have rested enough to prepare for a known phone call.  It depends if I know and trust the person who is calling me.  It depends if I can calculate how long it will take for the call, since my ability to speak is time-limited, much of the time.  A short call may be OK.  A long call, holding on for a call centre, completely terrifying and impossible a lot of the time.

Lots of autistic people can only sometimes use phones.  It's a major barrier to healthcare, to job success, to getting basic services and basic human rights.  It's great when companies and organisations know the law, want to work with us, and create different ways to interact.  Text.  Email.  Webchat.  Timed called with a known person.  Anything that works for us as individuals.   

But, too often, what we get is a sort of a 'gotcha!' from people who don't understand.  "Ha, you could phone yesterday - you're a liar!".  Same principle as the ones who follow wheelchair users round a store to see if they can stand for a while (most can...the chair is to save energy, extend the range of where people can go. and help with balance, for many health conditions including heart situations, connective tissue conditions and joint problems). If they're seen standing or taking a couple of steps, some arguably unwell or ignorant people get a thrill out of saying that 'gotcha!'

Disabled people have to work very very hard to get the same things as everyone else.  And explain, endlessly, to everyone around us.  Exhausting.  Hour after hour.  Day after day.

Even if we pay for services ourselves, we're often expected to put up with shoddy service and appalling treatment.  Even if it could lead to injury or other danger for us.

And, if we complain, we're accused of Taking Services Away From People That Really Need Them.

It's just extraordinary.

Let's do better, together.  Be knowledgeable about how many autistic people may struggle to speak, sometimes or always.  Be aware how many will struggle with phone calls, and being able to say what we need during them.  Be willing to help make changes so that we can survive, and thrive, the same as other people.

Thank you for reading.





Monday, 23 August 2021

The new ABA textbook, and why there are serious concerns

A book with the heading Applied Behavior Analysis - Third Edition

For many years, funders and parents have been informed that there is only one approach that works, for autistic people.  Applied Behaviour Analysis, usually shortened to just ABA.

I and thousands of other autistic people in academia and other areas have raised grave concerns about this approach, and the behaviour of some of its followers.

Quite often, we are told that ABA is different now.  Better.  Kinder.  We're told that it works.

I've done Blogs already on the research showing that it doesn't 'work'.  Not even when allegedly stopping problematic behaviours.  My general reading list around autistic research is kept at http://annsautism.blogspot.com/2019/01/autism-some-vital-research-links.html  and details some of them.

This post is going to be about a particular book, which ABA enthusiasts term 'the white bible' because of its pale cover.  We may wish to quietly consider why else they refer to it in religious terms, rather than scientific ones, but I'll leave you to be baffled about that for the moment.

OK, so what are we hoping to find in a book about how to improve children's lives?
Modern research into child psychology by the great name of modern history, perhaps?
Research into relationship, trust, respect, thriving?
Basic teaching principles, showing the difference between enforced rote repetition and actual learning?
Discussion of Human Rights, autonomy, ethics, & how to avoid adverse effects and long term harms when conducting research into new teaching methods?
Discussion of how to ensure disabled and neurodivergent children can rest, play and otherwise enjoy leisure time, without exhaustion.
The voices of children throughout, written with caring and respect, being careful to obtain their assent wherever possible, respecting their dignity and privacy?

Those are pretty standard things, after all.

So, what do we find in this 'white bible'? Published in 2020, so this is new and by a very famous team.  These are just a few of my concerns.

No discussion of Human Rights, in particular the rights of disabled children to find an identity of their own (rather than have their own identity erased), & the rights for them to enjoy their needed possessions which help them cope and thrive. Yes, those are in the international Human Rights protocols.

No discussion of autonomy.  Autonomy is about having the right to be your own person and make your own safe choices wherever possible, including the right to choose who is able to use physical contact with you. (Bodily autonomy).  One should note from wider research that ABA enthusiasts will use physical contact or force to force a child to comply, including use of unconsented hugs.

No discussion of consent or assent (depending on age) from a child or young person.  Any consent is sought from a parent/carer. http://www.crae.org.uk/media/26645/Teenage-booklet-final.pdf is a useful guide for young people on their rights, which you may wish to consider, here.  Whilst of course parents should offer consent to appropriate care and treatment, it has to be informed consent. Are parents informed of the serious concerns that most autistic people have about ABA, before consenting to it, I wonder?

The book describes 'Planned Ignoring'.  If an autistic child becomes distressed, crying, during an experiment on them, ABA enthusiasts are told to ignore them completely.  Eventually they will give up trying to make their needs known, it explains (paraphrased).

I'd like us to stop there for a moment, and let that sink in.  Yes, this is the new book on ABA, the 'white bible'.  Yes, it's telling its people to ignore a child in distress.  Have you heard of 'learned helplessness'? https://www.verywellmind.com/learned-helplessness-in-children-1066762 is a useful short article on how it can lead to anxiety, depression, complete compliance because there's no point in refusing to do an awful thing, because there is no escape.

Onwards... "Terminating specific reinforcer contact".  If the child doesn't comply with something on command, take their stuff away until they do.  On a closely related matter, look at this:

A Twitter poll result. Autistic people were asked how they would feel if someone took their most needed possessions away, to enforce them behaving normally.  Most said 'traumatised'


Above is an informal poll I did on Twitter, which received nearly a thousand votes.  Note that most of those responding said that they would be traumatised to have their much needed items used in this way.  Now, we can perhaps either say, "So what?  Who cares how they feel - the only thing that's important is getting their compliance".  Or we can think, "Wait, what? They're doing what?  Do they know nothing about how autistic people use personal possessions to focus, to balance, for comfort, as items of spiritual and cultural significance?"

There's more.  Let's keep going. 

Page 395 tells people to put a child in a windowless space with nothing to look at or do, if they fail to comply.  Sooner or later, they are desperate to get out of there and will do as they are told.  Basically, imprison them in solitary confinement, as an autistic child?  Is that right?  I'm asking that as a question.

Turning to wider ABA materials, we're informed by the highly regarded research teams including papers led by Dawson, Fletcher-Watson,  Bottema-Beutel & Rodgers, for example.  https://journals.sagepub.com/doi/10.1177/13623613211031403 is a good starting point for reading.  I'll put a snip here. I've marked some of it with bold print.

"The literature on nonpharmacological early autism interventions has profoundly influenced how autistics are regarded and treated. It underlies the widespread promotion of early interventions as having large and lasting effects on the lives of autistic people. But do these effects include short- and long-term harms? Bottema-Beutel et al. (2020a) investigated this rarely asked question by examining 150 early autism intervention group designs. Attention to adverse outcomes was absent in almost all studies and inadequate in the remaining few: 139 (93%) did not even mention or allude to this possibility, 11 (7%) had cursory statements, and none indicated that adverse events were monitored, much less how. Scrutiny of the poorly reported reasons for participant withdrawal and of effect sizes for reported outcomes yielded evidence that harms had occurred, yet were never interpreted as such. Bottema-Beutel et al. follow Rodgers et al. (2020), whose systematic review of early intensive applied behavior analysis (ABA)–based autism interventions also found a pervasive failure to consider harms. Nowhere in this highly influential literature was there any reported effort to monitor or collect data on adverse outcomes."

So, does this 'white bible' mention adverse effects or long term harms from ABA research?

I can't find a discussion of this anywhere in the book, which stretches to more than 900 pages in total. 

Does it even talk about what autism is?  Do the authors mention working with autistic specialists?

Do the authors talk about neurodiversity, or about the vital work on Double Empathy, Monotropism and other key theories that are revolutionising our understanding of this developmental difference?  What about the ground-breaking research of Crompton & team into autistic social communication being effective, but simply different?

No, not that I can find in it.   

I'm not joking.

How did this industry manage to convince funders and parents that ABA was the best, the only way, for some of our most vulnerable children and young people?

I'll leave you pondering that, whilst modern researchers, teachers and parents continue to make excellent progress by treating autistic individuals of all ages as fellow human beings, worthy of their full rights, and worthy of courtesy, safety, respect and (where possible) collaborative working.

Thank you for reading.

PS - wanting good alternatives to ABA?  Contact groups led by autistic people alongside our allies.  They can help direct you to what actually supports autistic individuals, including those with higher support needs (sometimes called 'severe' by some).  A good Occupational Therapist and Speech & Language Therapist can help.  So can really good modern training on autism as a mainly sensory condition, so that parents understand it's distress behaviour or a brain event, not anger.  http://www.thinkingautismguide.com/2019/05/behaviour-analysis-autistic-way.html may also be helpful.








Saturday, 24 July 2021

Appropriate Descriptions around Autistic People

 

A crowd of diverse people, facing the camera

The photograph above shows a typical group of Autistic people.

We're one sentence into this blog and I expect a number of people are already shocked.  

1) The group doesn't look anything like a group of young white males with 'rigid, repetitive' behaviour who 'lack empathy' and are a Deficit & Disorder.

2) I used the term Autistic people rather than People With Autism or People with Autism Spectrum Disorder.

As regular readers will know, I'm a Professional in this field, working nationally & internationally with Autistic people and their families, with healthcare professionals, and with a range of other groups.  I'm also delighted to be trekking through year 4 of Post Graduate academic study.  Well, I say 'delighted', but the delight is balanced with concern about the number of times I am told I am a Rigid Repetitive Disordered Deficit in any one day.  Yes, I'm Autistic.

So is our lovely son.

So are most of our lovely friends and colleagues, contacts and fellow Professionals/advisers.

Back to that photo.  Autistic people are in every walk of life.  Every one of them of full worth, whether in paid employment or not. I want to start by making that clear.  I also want to make clear that some have a really tough time in life and need excellent support around them, as well as excellent support for their families.  

The reality is that if you travel through a city for a couple of hours, you'll pass by Autistic older people.  Autistic parents.  Autistic grandparents.  Autistic Accountants.  Autistic Doctors.  Autistic Faith Leaders. Autistic Teachers. Autistic Artists and Musicians.  Autistic people of all kinds, all ethnicities, all IQs.

You'll notice that I'm often putting a capital letter in the word Autistic.  Same as we do with the Deaf community by capitalising the D.

As the Royal College of Psychiatrists wrote in their report (2020), we have found very few of the autistic adults.  Why is this?  Well...because who on earth would go forward for a diagnosis if the end result was that they were going to be called a Deficient Disordered Burden at the end of it?  Even those with a diagnosis are forced into hiding, a lot of the time, thanks to that narrative. Who would recognise that they're autistic, if all the descriptions are white boys who are biting someone (!) or solving equations whilst playing with a train?

Excellent support never starts by calling a fellow human being a deficient disordered empathy-lacking burden. 

Yet that's what we do.

It's written in the manuals that these are the 'correct terms', and so we use those terms.

The terms do damage.  Here's a useful Twitter thread linking to the healthcare papers discussing how stigmatising language gets in the way of support, care and treatment.  Thread by an Occupational Therapist

What terms are preferred instead, by the autistic communities?  This is a generalisation from research.  Always ask for individual preferences.

Old term:  Autism Spectrum Disorder.              New term:  Autistic.

Old term:  "Has autism"                                    New term:  "Is Autistic"

Old way of describing us: Rigid, repetitive behaviour with outbursts of anger. Obsessive interests.

New way of describing us:  Autistic people may be concerned about sudden change, as we are protecting our brain's ability to function. Sudden sensory and social change can overwhelm our brains and force us into an unwanted and deeply exhausting brain event.  This is either a shutdown where we go still and quiet, or, for some, a meltdown in which we are unable to prevent some wild-looking behaviour.  It is linked to epileptiform brain spikes, in recent research.  Many of us benefit from the flow of routine, or a passionate interest in a subject, in which we often then specialise as a career or volunteering choice.

Old way of describing us:  High Functioning, Low Functioning.  Mild.  Severe.

New way of describing us:  Some Autistic people are good at 'masking'.  Basically, pretending not to be autistic.  It's exhausting, demoralising, inauthentic, and leads to autistic burnout, mental health conditions and potentially suicide.  This can be mistaken for a 'mild' form of autism.  Others cannot mask or do not choose to mask, and they are then described as 'low functioning'.  This isn't good. A better way is to describe us as having lower support needs, or  higher support needs, but being aware that this isn't static for life.  It varies with illness, age or other demands placed on us.

Old way of describing us:  Lacking in empathy.

New way of describing us:  Autistic people are often very caring, deeply focused on social justice. As Autistic people have a different social communication system, and often experience a delay in processing emotions, this has been mistaken as a 'lack of empathy'.  In reality, nonautistic people are every bit as bad at guessing what we're thinking and feeling, by looking and hearing.  This is called 'Double Empathy Theory', and both neurotypes need to learn to speak one another's language.  Research on this - see bottom of this blog.

Old way of describing us:  Antisocial, a loner, 'in their own world'.

New way of describing us:  Autistic people have the same range of personalities as everyone else.  Some are more extravert. Others are more introvert.  Most of us will struggle to be in a busy, noisy place for long because of sensory and social overload pushing us into brain events (see above).  We also don't use eye contact or facing people to signal love, interest or listening.  Our signalling is different, and often involves minimising eye contact, and sitting parallel, not facing.  Often we make good friendships with a small number of other autistic people, with whom we share deep interests.

Old way of describing us: Lacking in creativity, using rigid and inappropriate methods of play.

New way of describing us:  Autistic people learn differently, and will focus on specialising on one subject first, before generalising that to others.  Many will use objects as part of a needed flow, ritual or relaxation technique, in the same way as some cultures use ceremonies to relax and destress.  This may look like lining things up, or using the same movement with a toy over and over.  Other people may not detect the slight differences we're tested, or understand why.

Old way of describing us:  Stereotyped body movements.  Stereotypy.

New way of describing us:  Autistic stimming is often vital for most Autistic people as a way of regulating our brain's processing.  It is calming, centring, enables us to find where our body is in three dimensions (proprioception) and leads to a feeling of joy.  We may rock, flap, wiggle toes, make a repetitive sound, or (if deep in masking) keep those movements and repetitions so small that others are completely unaware of them).  Some use repetitive movement to mark time, or to communicate, or to judge distance.  Being clear that if a repetitive movement is actually causing physical harm, of course it must be redirected to a safer alternative.  Autistic people generally learn better when allowed to stim.

This is just a small selection of different terms, and different ways we now understand autism.

If you are hoping for the academic references, make your way to 
http://annsautism.blogspot.com/2019/01/autism-some-vital-research-links.html

If you want to see what thousands of autistic people have been voting for, in informal polls and some surveys, make your way to 
https://annsautism.blogspot.com/2020/09/so-what-might-autistic-people-think.html

If you and your team want fabulous, cheery training that truly understands the needs of your organisation, there are so many good groups now offering this.  I mention some from time to time, including NDTi, AT-Autism, and the teams working with the Anna Freud Centre.  All are used by NHS Professionals for CPD training or other bespoke training, and I'm delighted to work with those groups from time to time.  Many other excellent ones exist.

Thank you for reading this starting point.