Thread by @thinkingautism

Autistic PT Iris @warchall had SO much great advice about supporting autistic people with EDS chronic pain, injuries, dysautonomia, pelvic health issues, & other neurologic issues etc. that we're putting the highlights in a thread. Full interview here:
thinkingautismguide.com/2022/08/autist… 1/

@warchall "Each individual PT or OT has their own specialized area of practice and specific skill set. If you need support for a particular issue, it’s best to seek out a PT or OT who specializes in providing that particular support." 2/

@warchall "I want to help my patients discover what strategies they as individuals can use […] and I think I’m more likely to be open to supporting my patients in using “atypical” strategies. I’m less likely to suggest goals that are trying to fit a patient to a “reference norm." 3/

@warchall "I tend to consider my patients’ executive functioning and sensory processing needs to a greater degree than most physical therapists." 4/

@warchall "PT’s generally learn a bit about [sensory and EF issues) as part of our entry level training, but not enough, and there’s a lack of education for PT’s about what accommodations or supports autistic adults might need, and how to recognize and accommodate those needs." 5/

@warchall "My [autistic] communication style can be a better fit for some neurodivergent patients, and I’m tending to look out for whether I need to modify my communication style to fit that person’s processing style." 6/

@warchall "Additionally, [as an autistic physical therapist] I am able to empathize with neurodivergent patients who have had developmental differences in motor, sensory, or executive functioning." 7/

@warchall "Since I work with a lot of people with chronic pain or other conditions that are very affected by a person’s overall systemic stress level, I teach a lot about stress management, which most physical therapists wind up doing to one degree or another." 8/

@warchall "But I do think I’m more aware of the fact that ppl can potentially have a broad range of sensory, communication & executive functioning needs that are unknown & unmet.

"I work with my patients to explore what they as individuals need in order to minimize stress & feel good." 9/

@warchall "Do they need help reducing sensory overload? More sensory input of some kind? Would this person benefit from exploring these issues with an OT? Do they need executive functioning supports to minimize stress at work or at home?" #neurodiversity 10/

@warchall "Does it seem like this person may be experiencing stress associated with masking neurodivergent traits, and would they benefit from a referral to a neurodiversity-affirming mental health professional to explore this?" 11/

@warchall "We know a large number of autistic people who have currently reached adulthood are undiagnosed/misdiagnosed. It sometimes happens that I’ll have a patient with a formal autism diagnosis, but it’s likely that a reasonable % of the patients I see are autistic and undiagnosed." 12/

@warchall "If we extrapolate from some of the recent literature on [autism] prevalence in females (which is much, much higher than historically clinicians have thought), it is likely that up to about 1 in 20 people in the world are autistic."

Citation: ncbi.nlm.nih.gov/pmc/articles/P…

13/

@warchall "I work with a lot of people who are dealing with chronic pain, hypermobility spectrum conditions & pelvic health issues—which are all more common in autistic adults. So if someone walks into my clinic, they are more likely to be autistic than that rough estimate of 1 in 20." 14/

@warchall "I approach all my patients in the same way: by assuming I should be on the lookout for whether they need modifications to my default way of providing care in order to accommodate their individual executive functioning, sensory, motor developmental, or communication needs." 15/

@warchall "I’d also like to pause for a moment to point out that we’re talking about autism in this conversation, but other forms of neurodivergence, both developmental and acquired, are common as well and almost always benefit from accommodations of one kind or another." 16/

@warchall "I am somewhat more likely to find myself masking my autistic traits when working with an allistic patient if I sense it will make that person more comfortable. Not all allistic people need this to be comfortable, but some do." 17/

@warchall "Of course, it’s impossible to completely mask my autistic traits, & there are often situations in which I won’t be able to give the best care when putting energy into masking, so over time I’ve learned to give simple explanations for my differences when working with people." 18/

@warchall "There’s a huge lack of understanding in our society about what autism actually is, so instead of explaining that I am autistic, and getting into a long discussion about what autism is, I give explanations for the specific traits of mine that my patients might find unusual." 19/

@warchall "Prior to my child being identified as autistic, I had already over time accepted that I needed to do things differently than most people in order to function well." 20/

@warchall "I had realized I needed to pace my activities, have a consistent routine, engage with my special interests, and manage my social relationships differently in order to avoid burnout." 21/

@warchall "I had realized that I needed quiet transition time to recover after working, and I had found a position at a clinic where I could work one-on-one with my patients in a quiet room without harsh lighting." 22/

@warchall "t had taken a lot of trial and error, talk therapy, and self-discovery work to get to the point where I had even started to understand these things about myself." 23/

@warchall "I consider myself immensely privileged to have had the ability to access the resources to begin to understand my [autistic] needs, and yet […] I still had a lot of questions, uncertainties, and self-doubt about why I needed to arrange my life differently from most people. 24/