Friday, 3 August 2018

Stairs and Autism

A picture showing a flight of wooden stairs. It is difficult to tell where the edges are.

"Why are stairs a problem for some autistic people?"  We get that question a lot from trainee Occupational Therapists and Social Care assessors, amongst others.    A logical question to ask, because autism doesn't appear to be a mobility difficulty.

It's about sensory processing.

The picture at the top shows a flight of wooden stairs.  Did you know that was what it was?  My brain doesn't see wooden stairs.  It sees some vague stripes.  How would I know that was stairs?  How do I know where to put my feet?  I'm having to guess.  Not good.

Stairs are also an exercise in balance, and the sense of balance is another difficulty for many autistic people.  We may not know exactly where our body is, in relation to the things around us, also.  Thus, navigating a flight of near-invisible stairs, up and down, becomes epic.  I can manage to nearly fall down stairs on a weekly basis.  Only a lifetime of knowing to pace myself, grab the rail, brace against the opposite wall, or otherwise find a 'third point of contact' works.  In the holiday accommodation we're in at the moment, the stairs are steep, with narrow treads and uneven heights, some going into a semi-spiral at the top.  I've nearly fallen three times so far.

On a bad day, stairs are unclimbable for me.  Yet people will look and think, "There's nothing physically wrong with you, so you must be exaggerating".  If only we were.

So, when assessing autistic needs, be aware of the Stair Perils.  Ask about how often the person loses their balance on stairs, or worries about climbing or descending stairs.  Ask what helps them at the moment.  Consider whether accommodation can be provided that helps with this.  Maybe hand rails both sides.  Maybe no stairs at all.

Thank you for listening.