Natalie is a Speech and Language Therapist, based in the UK, with over 12 years of experience. She has kindly agreed to share her personal reflections, having worked with a wide range of autistic people and their families. We spoke about diagnosis, disclosure, and how to handle communication and socialising. This is the second of two articles covering that conversation. Here is a link to the first.
Through our recent surveys (sign up for the newsletter at the bottom of this page if you want to receive links!), we've been getting requests for new topics. Most of those relate to communication, disclosure, and reasons for late diagnosis. Enter... Natalie! I am so grateful to her for sharing her expertise and hope it will be useful for you too.
This is the second of two articles covering our conversation. Here, we'll talk about socialising and communication. The first article was about diagnosis and disclosure, and includes more of an introduction to Natalie.
What would you expect to look "different" in how autistic family members communicate with each other?
Communication around feelings and emotions is likely to be more challenging. This is often due to hyper-empathy i.e. getting overwhelmed by each other’s emotions, by feeling them very strongly.
On the positive side, those family members are probably quite clear with each other about things like expectations and plans, which will help!
Routines are probably pretty consistent too. If you’ve got an autistic parent who’s naturally put in place a structure or sense of predictability, that will help their kid who might struggle in a less structured environment.
What challenges might there be with communication between autistic and non-autistic folk? What advice would you give to help with that?
There's likely to be confusion around abstract language, humour, and sarcasm. This can lead to a lot of misunderstanding. Especially if texting, where there is less context. Sometimes a phone call or even a voice note can be a bit easier.
Non-autistic folk also need to be very clear about expectations and intentions. It might help to state things that they think would be obvious about plans or instructions, because, to an autistic person, they might not be obvious.
I have an autistic friend who I know will always just ask to clarify things where she thinks she (or someone else) may have misunderstood, or if she is not sure how something has been interpreted. Over-communication can help to remove a lot of anxiety in those situations!
What things do your service users find helpful for supporting their social skills?
A lot of the support I focus on at the moment is around understanding autism. Noticing what your triggers are, and noticing signs of mild distress to then be able to intervene and avoid getting to the point of a meltdown.
Once you get some of that in place you have more space freed up to deal with social situations. If you can manage your anxiety, you are more able to attempt social situations and tolerate the stresses that come with it.
If a social situation was coming up, I'd usually advise controlling as much as you can (e.g. planning somewhere familiar, with timings that suit you). And allowing time afterwards for relaxation and recovery and stimming, i.e. strategies that help you "come back down" if it has been stressful.
And what about during social situations?
Having a bank of small talk starter questions can sometimes be helpful. Ideally, they should be personalised for the person you're speaking to and what is going on in their life, so you're not always asking the same question over and over, or focusing only on your own interests. Sometimes just getting over that initial hurdle helps settle into a situation, and the rest flows a bit more easily.
Or, better still... find people with similar interests to talk to! You could go to social events where you have a common interest or purpose so you always have something common to talk about. The website/app Meetup is a great source of groups with specific interests.
One thing that can be difficult is picking up if someone doesn’t want to talk about something, or just doesn't want to speak anymore. On the one hand, you could try and learn lots of social cues, but... that feels like putting neurotypical expectations onto a neurodivergent brain, and is a bit of a recipe for burnout!
So, finding people you don’t have to "try" so hard with is a more sustainable solution. That's where finding folk with similar interests can be really helpful.
And, like I said earlier, handling your overall day-to-day anxiety levels means you can attempt these situations more often. Rather than feeding a vicious cycle where one situation knocks you back for ages and stops you leaving the house, for example.
I've heard the terms "social stories" and "social scripts" for supporting autistic children - how do these work, and do you find them helpful?
Social stories and scripts are helpful to prepare for new or unfamiliar situations. Particularly situations where social rules aren’t so obvious.
A script is something that explains step-by-step how a situation might happen e.g. your first trip to the dentist.
A social story is more specific, aimed at addressing a behaviour e.g. when or how to say sorry. One that I wrote recently was "we line up when the bell rings to go back inside". Some children won't pick up on the social cue to join in with everyone else lining up, if no one has explained to them what this means before.
Parents learning how to write social stories for their children is really helpful, because often they’re quite specific, and little things might come up day-to-day.
A social story always has a statement similar to “I will try to…” at the end. They are teaching a very specific social skill tailored to the situation.
Whereas a script might just say “I’m going to the dentist, I will go to this place, I will say hello to receptionist, I will sit in the waiting room…” and so on. Those are more about managing expectations.
But you need to know the person, and the situation. You need a lot of information to be able to write a good one.
Comic strip conversations can also be helpful after a situation has happened. They were developed by Carol Grey, who also developed social stories. The idea is that, after a socially complex situation, you sit down and draw out a comic strip about what happened. It will have speech bubbles and thought bubbles, perhaps different colours for different emotions, to help someone understand what happened or what went wrong. E.g. “he said X but was actually thinking Y”.
Any other helpful hints you can share that people might be unaware of?
The biggest thing for me is visuals.
Visual timetables to plan routines. This doesn’t have to be pictures, it can be written. It's an extension of things everyone uses e.g. calendars on a phone. They can help plan and give you more predictability. I've seen people use whiteboards, paper, or an app on their phone.
Visuals around feelings are great. An emoji poster, colour coding, traffic light colours, numbers for "how I’m feeling today" or "my energy levels today". Even just to notice this in yourself is helpful, it doesn't need to be shared. But it's also great if everyone in the household does it (e.g. parents modelling it for children).
You can also use visuals to help with daily tasks. E.g. a whiteboard by the door of everything you need to take when you go out, or a box by the door with everything you might need inside it (visual reminders can be objects as well as words or pictures!)
Another handy thing can be a notebook or Dictaphone beside the bed at night. To get things out of your head so you know you won’t lose them, but they are also not distracting you from doing what you need to do at that moment: sleep!
One final thing - the Right Click programme by Scottish autism is a great resource that I often recommend.
If you'd like to read the first part of this, where we cover diagnosis and disclosure, you can find it here.
Thanks so much for sharing your expertise with us, Natalie!
Note, in case you are wondering: Natalie has an active base of service users in her local authority, so has chosen not to include a real photo of herself. We hope you can understand, and please forgive the generic image :)
Lauren x