Good social work is good social work. Why do I need to do anything differently for autism?
Committed to non-discriminatory practice, it is not surprising that this is a common social work view. There was a time when similar views were espoused around ethnicity and culture. A child is a child and good parenting is good parenting, so it shouldn’t matter whether a child is placed with a family from the same background and culture. Gradually social work theory and practice developed to recognise that doing things the same way for everyone does not avoid discrimination – it actually promotes it. Now it is autism’s turn.
Modern understandings of autism increasingly recognise that the autistic view of the world is a fundamentally different one. Not automatically or necessarily wrong or deficient, but distinctly different. Just as it is possible for well-meaning professionals to inadvertently discriminate against minority ethnic or cultural groups through lack of knowledge of a range of cultures, similarly there is a constant risk for professionals of doing more harm than good by wading into the lives of autistic clients without sufficient understanding and awareness of neurodiverse ways of seeing the world.
- Seeking to comfort and reassure, a gentle touch on the hand or shoulder will help
- The client who turns away and says “No” is choosing not to engage with you
- Someone who speaks fluently and has a good vocabulary is capable of telling me their needs and views
- He spends so much time alone and rarely goes out, so he is lonely and needs support to go to groups and make friends
- She keeps saying that she wants to clear up all this clutter but it never happens, so she doesn’t really want to do it. I need to motivate and persuade her.
- He can tell me all the reasons why that behaviour would be dangerous, so he understands the risks.
- The psychology report says her global IQ score is below 50, so of course she doesn’t have capacity to decide which is the most appropriate placement for her
- He won’t look at me so he isn’t engaging with what I am saying and doesn’t understand
None of these are safe conclusions where a client is autistic. Touch may cause pain and distress. Lack of eye contact doesn’t mean an autistic person isn’t listening and isn’t a reliable guide to comprehension. Verbal utterances may be scripted or echolalic and not entirely voluntary. Those with fluent speech can have profound difficulties communicating effectively and actually achieving mutual understanding of words and concepts. This can often include the ability to recite learned information (such as why something is dangerous) without actually understanding how the information might apply in a range of circumstances. Some autistics find social interaction distressing and far prefer to be alone. Many autistic people struggle with executive function and are unable to initiate or sustain tasks despite being motivated to do so. Global IQ is woefully meaningless in autism because autistic individuals invariably have a ‘spiky profile’ and can be highly able in some areas, whilst being profoundly disabled in other areas.
I could go on. And on. And on.
Do social workers need to become experts in autism? Not generally. But just as with cultural awareness, it is vital to gain sufficient knowledge and understanding of a fundamentally different way of being, to be able to avoid doing harm through ignorance.