Issue link: https://www.massageandbodyworkdigital.com/i/1439667
mechanisms can be developed and applied over time with some success—and with a lot of support from the person's environment. If the reaction is criticized, condemned, or mocked, it will simply intensify the reaction. Criticism of something one cannot change any more than one's eye color becomes perceived as a threat. Nevertheless, the pain, dysfunction, and neuropathologies accompanying EDS/HSD will often require physical therapeutic intervention, so awareness and sensitivity to autistic needs is particularly significant in this context. WHAT TO WATCH FOR AND HOW TO HANDLE IT Before you read on, a caveat: Not all autistic people display all these behaviors; some may tell you they have a diagnosis yet exhibit none of them. They may make consistent eye contact, communicate perfectly, and not demonstrate any traits described here. Never, ever say to these people "but you don't look autistic." If they have a diagnosis, they are autistic, and it is outside your scope of practice to make this call. Someone may have very intense invisible traits, but be very good at masking, or their traits may assert themselves in different circumstances. Telling someone they "don't look autistic" is saying you don't believe them, and it also suggests that "not looking autistic" is a good thing, forcing that mask more firmly on and confirming to the autistic person that they will never be socially accepted without masking. Both of these make a bad situation worse for your client, and more importantly, you will never gain their trust. If on the other hand they exhibit some obvious traits, such as visible stimming (self-stimulating behaviors), or speech or body language quirks, don't comment on these either. It's as hurtful as commenting on someone's visible disability. Also never say "we're all a little autistic." No, we're not. Autism stems from neurological differences that are hardwired into the body. Some of the physical and behavioral challenges can be mitigated with careful, holistic approaches, but navigating everyday life built for a different kind of neurology is full of challenges, threats, and sometimes actual physical pain for autistic people. Being quirky, or introverted, or off beat, or super-creative is not the same thing, and does not give anyone the right to assume they know what navigating the world with autism is like. Try to imagine saying the same thing ("we're all a little . . .") to someone with a different skin color, ethnic background, or gender identity. You wouldn't. Don't say it to an autistic person either. SELF-DIAGNOSIS, FORMAL DIAGNOSIS, AND THE AUTISTIC CLOSET Getting formally diagnosed with autism in adulthood is difficult, sometimes costly, and fraught with the difficulties that come with navigating complex health systems. Autistic advocacy on social media has helped raise awareness, but it has also led to a lot of people "identifying" as autistic when they are not by taking an oversimplified, checklist approach, and this has damaged the actual needs of the autistic community. Adults with diagnosed autistic children or adults with particular educational specializations may well self-diagnose accurately, but it is outside your scope of practice to judge this. Someone seeing you for a bad knee with a superficial "Tik-Tok" style self- diagnosis is unlikely to bring up autism because they won't see a need to. Someone who really is autistic—formal diagnosis or not—is already very self-conscious about the difficulties they're facing, and they may tell you about it to excuse or explain certain quirks you're bound to observe in the therapeutic encounter. And some autistic people who mask well (or think they do) fear the stigma too much to tell you at all—they may try to "act normal" and focus on the physical complaint. If, in your assessment, you observe traits and physical correlations that make you suspect they are on the spectrum, wait to establish a good, trusting relationship before considering UNUSUAL RESPONSES TO SENSORY STIMULI AMONG AUTISTIC INDIVIDUALS ARE WELL- DOCUMENTED, WHEREBY THE TEX TURE OF A FABRIC MAY BE SO DISTURBING THEY CANNOT EVEN LOOK AT IT, OR CERTAIN SOUNDS, SCENTS, OR FOOD TEX TURES MAY BE EQUALLY UPSET TING.