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With the Association for Child And Adolescent Mental Health (ACAMH)’s logo looming large behind the stage in Sheffield, and serving as a reminder that today was about improving understanding of mental health issues, Professor Tony Atwood was faced with a challenge at the talk: ‘Tony Attwood – What you need to know about Autism’, on May fifteenth, 2019. (Photo of Professor Attwood by ACMAH).

Would Professor Attwood, a seasoned speaker, continue the rhetoric that has included the disparagement of autistic individuals, in order to get a laugh from delegates predominately consisting of clinicians and parents of autistic children?

Or, would he develop a 250 strong community of inclusion and understanding whose delegates went away enlightened? The answer is – both.

Let’s look at the positives of Professor Tony Attwood’s autism presentation, of which there were many.

A side on image of a white female used to illustrate autism article(1)Professor Attwood spoke of the increased awareness of the prominence of autistic girls and females. He detailed the ‘fake it till you make it’ practice of ‘camouflaging’ among young female autists, and indicated the risk of predatory male characters towards young female autists [the word ‘autists’ being the author of this blog’s preferred short-hand term for ‘autistic individuals’ – it isn’t a term that Professor Atwood used]. He explained that female autistics may lack a ‘social identity’.

(2)He spoke at length about autists’ ability to empathise (debunking out of date theories to the contrary). “They [autistics] just didn’t read the signals; it’s not that they don’t care.” [Yes, the ‘they’ language was prevalent!] Professor Attwood described ‘empathetic attunement’ in autists; a sixth sense of knowing what a third party feels, or their mood, which was a breath of fresh air, when many professional clinicians consider autists not to have empathy. (However, live on Professor Attwood’s website is the dated statement: ‘Someone with Asperger’s syndrome… has limited social understanding and empathy.’ Perhaps it is time to update the website?!)

(3)Professor Attwood changed his anecdotal content a little, when he took an anecdote he’s used before, when describing ‘the apple doesn’t fall far from the tree’ concept; specifically when parents of an autistic child are present for their child’s diagnosis with Tony, and the father is seemingly also autistic. Instead of ‘taking the mickey’ out of the father’s voice and imitating the man as if he were a robot, this time there was no robotic voice.

(4)He acknowledged that autistic individuals may have a fantastic sense of humour, and often excel in wordplay, and puns.

(5)Professor Attwood did stress that his goal “Is [autistic] self acceptance, not to cure [autism]”, in the context of psychotherapy; e.g. non-pathologising.

(6)He waxed lyrical about the benefits of music and art therapy as therapeutic treatments to explore trauma, after an event.

(7)Professor Atwood spoke positively about adapting Cognitive Behavioural Therapy (CBT) with components of yoga, mindfulness and music therapy, to help tackle depression.

Three girls are shown to illustrate that echolalia can be an early sign of autism.He also gave specific adaptions based on the autistic individual’s learning profile, and gave recommendations regarding how to adapt the therapy, e.g. using visual clues and experiential tasks (e.g learning through experience, and reflecting).

He later advised that therapists using CBT with autists should definitely have experience of autism, and detailed the concept of giving parents CBT skills.

(8)Professor Attwood showcased some useful emotion games for autistic children, to improve their social skills and help reduce their anxiety, if they feel they ‘don’t fit in’. (Although the narrative didn’t also stress the importance of teaching neurotypical or non-autistic individuals (NTs) to accept autists’ differences!)

(9)He neatly turned his disparagement humour on NTs, saying that, “You have to feel sorry for them; they’re fragile flowers that wilt and die , if not hugged regularly”, when discussing autistics’ propensity to avoid excessive hugging.

(10)Professor Attwood also suggested that lyrics, music playlists, poetry, writing and art are forms of eloquent expression, in terms of researching how to tackle depression in autists. A nice, forward-thinking attitude!

(11)He suggested some very useful therapeutic strategies such as using a favourite TV show or film scene to help an autist describe their feelings, emphasising the importance of recognising one’s own feelings, to help promote good mental health.

(12)Professor Attwood did acknowledge the benefits of using technology to communicate from a social point of view, saying, “They [e.g. autistic individuals] can disclose their inner self through typing, not talking.’

(13)He mentioned the brilliant concept of using a Fitbit watch to check an autist’s heart rate, which increases under anxiety or stress, e.g. as a self-monitoring device. (And a tool for parents to monitor WHEN there’s a heart rate peak, e.g. to use as valuable data to prove the eminence of a child’s anxiety, and the locality or environment when the levels peaked).

(14)Professor Attwood did promote mentoring and advice from ‘actually autistic’ individuals, saying, “The repository of autism is there, with the knowledge,” when describing how autists had helped and given tips in response to his online ‘Ask Dr Tony’ series.
Woman with eyes closed _ to illustrate article on communication between NTs and autisticsHe also said psychotherapy for autists should ideally be designed and delivered by autistic individuals, citing four autistic psychologists that he personally knew.

(15)He did detail the concept of the ‘autistic energy account’, although mentioning the spoons theory, which autists tend to use, would have been a nice way to engage with the autistic community.

(16)With the narrative among some people in the UK that home-schooling may be a bad thing, Tony praised the concept of home-schooling young autists (with options or conditions), explaining that home-schooling had ‘saved his sister in law’s life’, in her teens.

(17)He did acknowledge the importance of sensory input as a trigger for anxiety, e.g. “In your bedroom [as an autist], your difficulties dissolve; you can manage your sensory input.”

(18)Although it wasn’t presented due to over-running timewise, there were some really excellent slides at the end (supplied to delegates), which referenced the ‘Self-affirmation Pledge’, ‘I am not defective, I am different’), and detailed a plan for dealing with a ‘Depression Attack’, that included removal from triggering environments and situations.

However, whilst the autistic individuals in the audience relished all of the above content, there was an issue with some of the LANGUAGE used. Here are some of the more negative elements of the event:

(1)The ‘othering’ language was prevalent, with Professor Attwood literally using ‘us and them’ language. (Also using identity first language e.g. ‘person with autism’, which many autists tend not to use.) Incidentally, the ‘othering’ narrative was also picked up by the mother of an autistic teen who had joined her at the conference.
Two females talking _ to illustrate communication between NTs and autistics: ASC ASDThe Mum was mortified at the ‘them and us’ language, and obviously distressed by it.

(2)There were many examples of ‘presenting banter’ to get a laugh. Described by a fan of Tony’s presenting style as ‘sardonic’, they’re as follows:

*The anecdote of the male aspie who when asked whether a female looked fat in a dress, replied, “No, you look obese’. Cue audience laughter.

*When describing the aspie chid, who suggests to a neighbour that she wears a hat to cover up her big ears. (Sourced from a Judge Judy book on teaching social skills). Cue laughter.

*When describing an autistic child whose mother is upset, and who isn’t clear on what comfort to offer. To the audience: “If YOU don’t know what’s missing [in the scenario], YOU may need a diagnostic assessment”. Cue laughter.

*When recalling a man from Tony’s clinic, who began complimenting his wife once in possession of Tony’s ‘compliment guide’ [used to help clinicians teach social skills]; but stopped the wife’s compliments, once the guide was lost. Cue laughter.

*The tongue in cheek comment that ‘Cats are autistic dogs’ (cue laughter). While there’s a book called ‘All cats have Asperger Syndrome’ by Kathy Hoopman, whose books are reportedly loved by autistic children, this is the kind of joke that sounds wrong from a non-autistic person.

*Using the ‘we and them’ narrative to describe a child who had assaulted a teacher by poking her with a pencil. “WE (NTs) THINK it – we don’t DO it.” This language would undoubtedly leave the autistic delegates feeling ‘othered’.

(3)There were copious references to Professor’ autistic son Will, whose autism was missed in childhood:

“He goes on and on, and just doesn’t get to the point!”
(When describing his son’s prison sentence). “[At least] we got respite care when he was in prison, and knew where he was.” (Cue laughter). This narrative felt uncomfortable, to a degree.

(4)There were also a number of sweeping generalisations, e.g:

“People with autism interrupt all the time.”
“If you make a mistake, the first person to correct you has autism.”
(The irony of this constructively critical article ‘correcting’ Tony isn’t lost on us!)
A wince-inducing reference to autists being like Dr Jeckyl and Mr Hyde, when describing autistic masking.
The statement that “Autism occurs when you [e.g. the autist] walk out of the room”, meaning that when an autist retreats to their bedroom for solitude, their challenges are reduced. True, but a poor over-simplification, suggesting that socialisation is always the main issue, or stressor.

(5)The statement that parents of autistic adolescents should “Provide a plan or schedule [after the child has left school], as they may not leave their castle [e.g. their room is their safe place, or castle], or may fill their time with Minecraft, or solitude.”
Professor Attwood had already stated that young autists need solitude ‘to feel better’, so it was a shame to suggest that parents need to provide social plans to prevent the aloneness that the teenage autist would actually need, in order to recalibrate. A good point explored further by Tony in the Q&As, but over-simplified in the above sentence.

(6)The (presumably) tongue in cheek generalisation that adolescent female autists may choose either: “Promiscuity, as at least I will be popular – or drugs, as at least I will be happy”, when describing teenage autistic girls as “Either puritanical, or using their sexuality to be popular.” There was for example a teenage autistic delegate in the room, who understandably may have felt downbeat about this impending life forecast.

(7)Using the wrong pro-nouns to describe a transgender woman.

(8)Alluding to the frustrating ‘We are all a little bit autistic’ narrative, when stating: “Autistic characterisations are like a jigsaw of 100 pieces [e.g. 100 autistic traits] – I have never met a person with less than 20 pieces, and never met someone with autism with 100.” (Although carefully noted, this may not be absolutely verbatim; so alluding to neurotypicals as people, rather than autists as people too, was hopefully not the intention here; although another delegate did also pick up on the specific language used here.)

(9)Professor Attwood didn’t specifically mention autistic stimming at all, and made a comment along the lines of, “I don’t like the American stim comment; you [eg. as an autistic individual] do it as its soothing”, seemingly disliking the phrase itself, but not acknowledging stimming’s links to environment, sensory regulation etc. (See below).

Autistic stimming, or ‘self stimulating’ behaviour – calming, satisfying and recalibrating

(10)A brief mention of the ‘Who falls in love with an aspie?’ narrative, and the observance that many wives of autistics are nurses. (This is apparently true in Tony’s clinical experience, but lends kudos to the autist thinking that they will only be loved by someone who wants to repair or nurse them.)

So there we have it – more positive than negatives – a success, surely?

With a general feeling among the #actuallyautistic advocates present that Professor Attwood had toned down the disparagement humour (compared to previous events), the day finished on a good note, when Sarah Jane Harvey of Agony Autie proposed to Tony that he join her, on one of her Vlogs.

Explaining that she didn’t always like his rhetoric towards autistics, Professor Attwood wholeheartedly agreed to the proposal, saying that if autistic individuals wanted to correct him he’d welcome their input. When writer Kate Fox commented on his reduced use of disparagement humour on the day, Professor Attwood explained that “I promised I would, and I did”. We’re not sure to whom he promised, but it is definitely a step in the right direction!

Respectful language

In balance, there was a lot of useful information at the conference presented for parents and clinicians, and plenty of encouraging concepts concerning managing stress and anxiety. The criticisms from #actuallyautistic individuals mainly concern language. (After all, other minorities such as ethnic groups now have more respectful language. This website details the concept of respectful language very well, advising: ‘Be sure to avoid language that stereotypes or patronises’.)

The simple change from the word ‘they’ to either ‘autistics’ or ‘autistic individuals’ would go a long way to aid inclusion, and avoid ‘othering’.

The host organisation (ACAMH) was quick to respond to questions fielded ahead of the event (which was very professionally run), and perhaps were the advocates of Tony using less disparagement humour?! The venue had quiet rooms, roomy seats, plenty of breaks and the sound system was very good – the Q&As were well managed by the hosts, and the live-streaming audience were catered to well. So, on balance? A generally good experience, with a simple request to use more respectful language moving forward, as #autisticsdeservebetter.

NB – edited update – a reader has questioned whether an objection to the word ‘they’ is because it’s a gender neutral pronoun for autistic people, as opposed to ‘he’ or ‘she’. Just to be clear, that isn’t the issue at all, the reference to ‘they’ and ‘them’ is not gender-related, but related to autistic and non-autistic (neurotypical). So, to clarify, ‘they’ meaning autistic, and ‘we’ or ‘us’ meaning NT. 

A little disclaimer – here at we don’t claim to be experts about Autism Spectrum Disorders / Conditions; the information we post here is based purely on our own exposure and experiences. We’d also love your feedback on our posts!

Also published on Medium.