Wednesday, 21 February 2018

Autism: Why won't my child clean their teeth?

"Why won't my autistic child brush their teeth?"  It's a question a lot of parents ask.  Some autistic individuals are of course very happy to brush their teeth.  Others, less so...

So, what's stopping them?  It could be one of a large range of things.

Autistic brains take in too much sensory information.  From scans, it appears that this causes literal overheating, as too many of the brain's electric circuits are used at once.  Then, we need downtime to let the brain temperature cool off.  If we don't let it cool, we could go into a painful/scary shutdown (7 out of 10 of us) or meltdown (3 out of 10 of us). Both are brain events, not a way to get out of doing stuff.

Firstly, what's going on around them at the time?  Are they expected to also shower/bath, change clothes, etc?  All of those are big sensory 'asks' for many children.  Are they expected to be in an area of a lot of noisy chatting from siblings and family at the same time?  Have they recently come in from a big noisy, sensory-challenging event, e.g. after-school clubs, supermarket visit?  They may need downtime between those kinds of things, and teeth-cleaning.
Let's now look at what teeth-cleaning involves for a good number of us:

Firstly, we need to understand the task.  Not many of us have a very good sense of where our bodies are.  Being able to feel their own teeth, and see them in a mirror, is a good first skill.

Then, noticing if teeth need cleaning.   It may help to watch another person clean their teeth, or it may not.  Some learn by watching, others mostly by learning to do the task themselves.
A social story can help, with pictures showing the steps.  Various ones of these can be found online.

Then, having skills to hold the toothbrush and clean something without dropping it.  It can be useful to practise cleaning other things with a small brush first, for example. Not the actual toothbrush - you probably don't want to teach them to clean the house with their own toothbrush...(yikes).   Try to get a brush that has an easy handle to grip, without ridges and bumps all over it.  It's possible to get 'easy grip' toothbrushes.  Look for a brush that has bristles all the same length, to start with, and very very soft, with a small brush head.

Make the room as quiet as possible.  Get rid of endless unnecessary smells in there, too.  The more relaxing it is, the more chance of success.

Let them choose a toothpaste they like.  There are all sorts of different flavours and smells.  It can take a lot of courage to sniff and taste even tiny bits of something new.  Especially if it's ones with different colours and different textures as part of it.  A tiny bit of toothpaste, or just water, might be a good first step.

Once they are used to the feel of the brush in their hand, they can practise putting it in their mouth and cleaning a few teeth.  This is very noisy, and (for us) often very painful on gums, cheeks and tongue, as well as hugely sensory-overloading ,with the toothpaste smell and taste.  They need to be sure that they can handle it. 

 Let them have a think about it and a relax at that point.  Quiet praise.  When they are confident, they can have another go.  Teach them about not swallowing all the toothpaste, and how much to use.

This way, they are keeping their brain at a good operating temperature.  It's not having to face a barrage of noise. It's not having to face overwhelming pain from texture and pressure.  It's not having to cope with undoable levels of smell.   Teeth cleaning is still a scary thing for me as an adult, even though it's something I have to do twice a day.  I can truly understand why an autistic child may think that we're torturing them.

It may take them a while to feel confident in balancing that brain temperature. 

Once they are confident, they can perhaps learn to time it by counting, or with a countdown-timer.  Then, they know how much time they have to do this for...and can work out how much downtime they need before and afterwards to keep that brain temperature correct.

If you are worried about tooth cleaning in the meantime, your dentists can help.  Find one that understanding autism, and can advise you on using alternatives.

Some people are now using assistance dogs to help children learn about teeth cleaning and other daily skills, and to help keep children calm and focused.  It is worth contacting good respected charities such as Dogs for Good, to talk to them about pet dogs (PAWS scheme) or assistance dogs, and see what might help your family.

The photo is of three toothbrushes in different colours.


Tuesday, 20 February 2018

"Complete human beings, made in the image of God" The decision of the Church of England

In February, the Church of England's 'Government' met.  It's called General Synod, and meets in London/York twice a year.

One of the talks was about people with Down's Syndome.  We were told, 

"People with Down's Syndrome are complete human beings, made in the image of God, deserving full inclusion in both Church and society.  It is imperative that every step is taken to ensure that they are welcomed, celebrated and treated with dignity and respect."

People were asked to vote on this statement:  "...affirm the dignity and full humanity of people born with Down's Syndrome...a real welcome for all."  They all agreed.

The debate was indeed about Down's Syndrome.

But, I sense that we cannot help but apply it also to every other disabled and neurodiverse person.  Including autistic people. All two million of us in the country.


Treated with dignity
Treated with respect

What is it like to be celebrated?  

It's about understanding what is important for that person.
It's about honouring.

It's about seeing that-of-God within them.
It's about moving away from notions of speed, power, IQ, qualifications, medals, awards, qualifications, perfect health.
It's about enabling and including as equals before God.
It's about love.
It's about friendship.
It's about allowing the person to be a disciple, to lead, to encourage, to teach.

It's about learning from that person, with respect.  
It's about meeting them 'half way' - communicating together, not insisting on them matching your own communication.

It's about getting over egos and fears.
It's about meeting people and sharing life with them.
It's about considering what 'safe' looks like to someone who isn't you.

It's about including them in discussions about them.
It's about including them in writings about them.
By 'including', I mean leading.  I mean attending.  I mean being the ones with the expertise on our lives.
It's about a lack of pity, a lack of praying-for-their 'cure' -whether-they-want-that-or-not.

It's about realising that you don't have the whole picture, or all the answers.

And it's about realising that disabled and neurodiverse people have as many answers as you do.  But...people need to be humble enough to learn them.

The moment people have decided we are not worth it...
Too much bother...
Too much cost...
Too much effort...

That's the moment they decided we're not welcomed.  That we are not celebrated.  That we are not to be treated with dignity.  That we are not to be treated with respect.

And that we are not disciples alongside them, all walking in the footsteps of our dear Lord Jesus.

So, do we affirm the Synod vote?  

Walk with us, friends.  In love.

The picture is floor tiles. Some are patterned and coloured, and, in the light from the window, formed a beautiful cross.

Saturday, 10 February 2018

How To Pretend That Autistic People Are Nasty

Occasionally, we see articles claiming that autistic individuals are more  deliberately 'aggressive' than other people. 

As an autistic autism professional, this has often intrigued me.  It would be fair to say that in 20 years, I've not seen an instance of this, other than when someone has been pushed into a brain event akin to an epilepsy situation. In my lifetime, I've not been violent to anyone other than in self defence against a bully one day who was attacking me regularly.  That's quite an achievement, if all the hundreds of autistic people in my life are more likely to be some sort of nasty threat to me.   I've thought long and hard about all of my autistic family members and, still no idea what this is about.

Yet, we get these studies claiming that they have researched it and found that parents have reported high instances of aggression for a large number of their children.  Fascinating.  I wondered what the researchers meant.

I looked at a lot of studies.  Let us consider one finding.  The studies often make mention of the 'Child Behavior Checklist', which lists out over 100 questions.  It has an 'aggressive behaviour' set of questions.  I'm going to tell you what those say, so you can marvel at this with me:

Is loud.
Appears rude
Mood can vary suddenly
Is suspicious
Teases people
Asks for attention
Disobeys commands, at home, or at school.
Is mean 
Experiences meltdowns or tantrums
Destroys some things - at home, or at school
'Gets into fights'
Threatens someone
Attacks people

For each of these, score 1 for 'sometimes' and 2 for 'often'.  The more you score, the more 'aggressive' your child is.  

So, if you have a loud child who...
Appears rude and sulky (because their body language doesn't match expectations and they cannot hear voice loudness)
Doesn't hear commands (because of sensory overload) or cannot process them, so doesn't know to obey them
Experiences autistic meltdowns from being put in situations that cause these physical brain events, ( which may result in them pushing others away or lashing out in extreme pain and fear)
Asks for assistance more than other children because they cannot see or hear well enough in the sensory chaos.
Is wary of what on earth people are going to do to them next
And screams in distress

.... you have an 'aggressive child', see?

Do you?

Or have a lot of people made a science (and, in some instances, a lot of money) out of characterising autistic children and adults as deliberately 'aggressive', when they are no such thing?

The picture shows a shocked older woman.  It represents the sort of shocked face people tend to have when told that we are likely to be 'aggressive'.  In reality, most of us are victims of aggression repeatedly over a lifetime, by non-autistic people.  Many of us are the kindest, gentlest, nicest people you'll ever meet.  A few are nasty characters, in the same way that a few people with size nine feet are nasty, and a few men and a few women and a few people who do knitting.  Doing knitting doesn't make them nasty.  Being autistic doesn't make us nasty.  Thank you for listening.

Wednesday, 7 February 2018

Applied Behaviour Analysis - Personal Reflections

As an autistic autism professional, my work has involved a very large number of different groups and settings.  I have had the honour of working with the Houses of Parliament, Teachers, Psychologists, Psychiatrists, Social Workers and therapists of all kinds.  In each setting, we work collaboratively, respecting one another as fellow professionals and trainers.  I and my team are asked to advise on a wide variety of scenarios and situations, whether it involves children, young people, young adults or adults of other ages.  We assess care home settings, train fellow professionals on the modern understanding of autism, and act as consultants.  It's fantastic work, and brings me into contact with many hundreds of autistic people.  Researchers, fellow professionals, parents, employers and employees, and a huge range of others working from home or not currently working.
I have done this for 20 years now, part time, including being a Trustee of an autism charity, a Governor in an autism-specific school and Vice Chair of Governors with responsibility for SEND in a large and very mixed Primary School setting for many years, where our young autistic people thrived.   I am also Managing Director of a Professional Practice covering most of the country and handling vast amounts of money and responsibility, as well as employing a team.
There has been only one group of people who have generally refused to engage with me.  Specialists in Applied Behaviour Analysis ("ABA").  I will say from the outset that there have been two exceptions to this, over the last years.  Two individuals who were respectful, thoughtful and valued my input.
I shall not name names or organisations in what follows, because those are not important.  What is important is the pattern of it, for me as a professional.  These are just some examples.
Situation 1:  Working in an ABA specialist charity for two years.  We were expected to cope with the sensory environment.  My fellow autistic professionals were sometimes rendered so ill by it that they had to go home.  The leader of the charity would not speak to me.  They stated that in their view, there was no need to consult with autistic people, as it took too long.  We would be taken to events where the sensory environment was terrible, the format was unknown, and an autistic person would be paraded at the front as a 'zoo exhibit', told to say nice things about the charity.  Then we would all applaud them.  No-one would speak to the other autistic people - we were irrelevant.  I took another fellow professional along.  Also autistic.  They were utterly ignored.
Situation 2. Working in a formal advisory group for six years, at a high level.  I was Vice Chair of that, brought in to provide specialist autism advice.  In it, representatives from an ABA charity.  I can safely say that in those six years, they did not speak to me even once, let alone ask my advice on anything.  This is quite an achievement.
Situation 3.  A powerful ABA-supporting parent, in charge of allowing access to buildings for me.  They made sure I was disadvantaged, time after time.  My access was taken away and I was made to go through the most extraordinary procedures that I simply could not access.  Meantime, the meetings in that building were filled with ABA supporters, and the senior figures would be sent endless letters from ABA supporter parents, telling them that ABA was the only way for autistic children.  That it should be in every school.  Every setting.  That the children would be unable to function with it.  I know this to be untrue.  It is simply nonsense.  Some children may benefit from some aspects of ABA, but ABA for autism is something that many professionals are deeply concerned about. There are many ways to teach a child good skills.
Situation 4.  ABA charities online.  I would attempt to engage with them, politely and respectfully, asking questions about their work.  I would be blocked on their social media.  Repeatedly.  None of their parents and teams were allowed to hear from me.   They also blocked other fellow autistic enquirers, asking equally polite questions.
Situation 5.  An anecdote from a fellow autistic professional, who had two ABA trainers in their training session.   The ABA trainers undermined the training session repeatedly, and were entirely dismissive of the autistic professional. 
Situation 6.  The training materials.  I got the industry-standard ABA training materials.  Endless pages of how to control autistic people.  One brief mention of sensory needs, in passing.  A rather alarming example?  Paraphrased - " We asked the parents what they wanted their child to be like.  They said they wanted their child to go to parties like the other children. We explained that yes, we can deliver that for them, no problem at all."  I've watched training happening in real life.  I've watched videos of it.  I've watched YouTube about it.  I have spent two years trying to understand why ABA is seen as a good thing.  Nope.
Situation 7.  I went into a care home, to do an assessment, as an autism professional.  An ABA trainer was there.  They undermined me, spoke over me, and barged into the discussion on every solution and every suggestion, to say their way was the only way.  They even had business cards to hand to people to say they were the only person to be contacted.  My fellow professional confided in me that they had tried ABA with some of their people, and it had been a disaster.
Situation 8.  A fellow professional confided in me that they were hired by an ABA charity to lie to the parents.  If they were worried that their child was responding badly, and wanted to remove them, they were told to tell the parents it would damage the child.  Even though that was a lie.  I have no direct proof of this, but the person had no reason to lie to me.  They also note that the charity hired zero autistic trainers or managers.  Everything was done by non-autistic people.  Offers to assist with those functions, from autistic people, were turned down.  Autistic people were allowed to be volunteers, nothing more.
Situation 9.  I and fellow autistic people have been asking online whether there are some happy ex-ABA-adults who can tell us what's good about it.  Silence.  Nothing.  Well, apart from the ones who are under an Ambassador contract with the charities.
Situation 10.  I went to a consultation event.  There, an autistic adult who had been put through ABA.  We chatted.  All through the chat, he was making direct eye contact with me, with no clue what it meant, and attempting to smile throughout...which was a problem, because he was actually really sad and was crying.  His life had fallen apart once he got to university, he said.  ABA hadn't given him the skills he needed for real life.  He knew to stare and smile, and wear a business suit, and say Polite Professional Things - but his quality of life, as an person, was now so bad that he couldn't cope.  He couldn't be 'non-autistic' any more.
I'd like to put in some positive examples now, but I've not been able to find any from autistic specialists or adults.
Now, this is all quite strange, isn't it.  After all, if this is an ordinary, everyday good therapy for children, then of course one would talk to one's fellow professionals about it.  Of course you would engage with them, and collaborate on how to bring good things to the lives of children, together.  One would hire in autistic professionals to showcase what we can do, what we can bring.  One would use autistic experts, autistic managers, autistic leaders, autistic trainers.... 
ABA practitioners don't want autistic professionals within a mile of them, it seems.
People ask me whether I like ABA.  I do not.  I have attempted to give it 'the benefit of the doubt', but frankly, as an industry, it is the exact opposite of being respectful of autistic individuals. 
It worries me tremendously that an industry that alleges to want to teach autistic children to speak then seems to spend its time silencing ,or refusing to hear, the autistic adults.
The two exceptions have been a blessing.  They are nice people, genuinely trying to offer something to autism.  I am sure there are more nice people out there.  It's not about individuals.  It's about whether this is a respectful, responsible approach, given that there are so many other methods available that seem to be more respectful.   I have too many questions that need answering about the methods used.
We are starting to see research happening, showing that ABA may be causing harm to some.  A recent paper by Henny around possible links to PTSD, for example.  It is an emerging set of concerns, and clearly more work needs to happen around this.  I, and many others, look forward to clarification on the short, medium and long term outcomes. 
Children need to be safe and have a good future, allowing them to flourish.  In terms of their own agency, their confidence, their sense of being able to solve problems and learn skills collaboratively.  In terms of their moral and spiritual awareness.  In terms of their intellectual curiosity and opportunity. In terms of being able to say 'no' to things that cause pain and fear, unless there are really good medical reasons for those.   In terms of seeing really good adult role models and having that opportunity to challenge, to think for themselves.  
Are they enabling all of this, with ABA?  A serious, open question.
The picture shows a young boy with dark hair, wearing a blue and white striped top and blue trousers.  He is staring and smiling, but it looks false. 

Tuesday, 6 February 2018

Autism and Spoon Theory

The picture shows 12 spoons.
Christine Miserandino was the first person to write about 'Spoon Theory', in 2003.  Her original article can be found at:

Since then, a large number of people from the disability and neurodiversity groups have used this as a basis for explaining our own situations.

I am sometimes asked about how 'spoon theory' relates to autism.  I shall explain it from my own perspective, in this blog.

Firstly, a reminder of the principles of 'spoon theory'.  Let us say that an average person wakes up in the morning with (say) 12 units of energy to 'spend' on the daily activities.  Once all that energy is used up, they can do no more and must rest. 

Christine illustrated it by imagining the units of energy as something physical - and the first thing she found was 12 spoons in a cutlery drawer.  So those became the example. 

Each spoon represented a 'unit' of energy for that person.  She then explained how much energy each daily task, each social event, took to complete for her, as someone with a long-term health condition.    Each missing unit of energy meant that she had one fewer 'spoon' for the day.  If she had overspent the amount of energy, maybe she could borrow a 'spoon' of energy from tomorrow....but then, tomorrow, she would have fewer units of energy to complete that day.  It is a helpful example of how much of a challenge life can be, for people placed in situations which require huge energy to complete. Autism is not a health condition, but if we are put into inappropriate social and sensory situations, we can run out of ability to keep our brain operating.  When that happens, we go into meltdown or shutdown.

What is it like for me?  I'll take tomorrow as an example.

Let us say that I wake up with those 12 units of energy, represented by the 12 spoons.
I can do at most 12 things, before they're gone.
Some of the things need more than one unit of energy to complete.

For me, a possible list would be:

Showering, including drying and any lotions or deodorants etc.
Cleaning teeth.
Washing and drying hair.
Getting dressed.
Dealing with the morning tasks for the house, family and animals.
Driving a long distance.
Giving a talk to an audience.
Carrying out work for the business or charities.
Visiting a shop to buy ingredients for dinner.
Preparing dinner for the family and sorting out evening tasks for the house, family and animals.
Meeting a friend in the evening.
Getting ready for bed.

That's 12 things.  But do I have enough 'spoons'?

Showering, including drying and any lotions or deodorants etc. - 2 spoons.
Cleaning teeth - 1 spoon.
Washing and drying hair - 2 spoons.
Getting dressed - 1 spoon.
Dealing with the morning tasks for the house, family and animals. 1 spoon.
Driving a long distance. 2 spoons.
Giving a talk to an audience. 1 spoon.
Carrying out work for the business or charities. 1 spoon.
Visiting a shop to buy ingredients for dinner. 2 spoons if it's a small shop, maybe 3 or 4 if it is a sensory nightmare.
Preparing dinner for the family and sorting out evening tasks for the house, family and animals. 2 spoons.
Meeting a friend in the evening. Maybe 1 spoons, maybe 4 spoons.  Depends if they are autistic or not.  If not, I have to work extra hard to communicate. I want to. I love being with people, but I can't do it for long without running out of 'spoons'.
Getting ready for bed  1 spoon.

Total possible 'spoons' of energy?  22.
I don't have 22 'spoons' of energy.  I have 12.  12 and then I'm out of energy and unable to do more.  The sensory and social load would be too much.

So, each day, I have to plan how to use that energy.

Showering, including drying and any lotions or deodorants etc. - 2 spoons.
Cleaning teeth - 1 spoon.
Washing and drying hair - 2 spoons. [Maybe only do this every second day, so call it 1 spoon]
Getting dressed - 1 spoon.
Dealing with the morning tasks for the house, family and animals. 1 spoon.
Driving a long distance. 2 spoons.
Giving a talk to an audience. 1 spoon.
Carrying out work for the business or charities. 1 spoon.
Visiting a shop to buy ingredients for dinner.  Nope. Not today.
Preparing dinner for the family and sorting out evening tasks for the house, family and animals. 2 spoons.
Meeting a friend in the evening. Nope.  Not today.
Getting ready for bed  1 spoon.

13 spoons.  OK, I'll 'borrow' one from what should be a quiet day on Thursday, and hope it really is a quiet day. If it isn't, it is going to be a problem.

That's how I have to plan my life, as an autistic person asked to live in a world that is not designed for me.  Too bright, too loud, too many social demands from people who expect social skills that match theirs...until they learn to 'speak autistic' and take the pressure off me.

If something unexpected happens, I may need to expend even more energy.
Angry person - for me, 5 spoons gone at once.
Unexpected change of venue from a doable one to one that is a sensory nightmare - 3 spoons gone, maybe more.

Then, I'm in trouble.
If I can't rest for long enough, to recover, after that kind of emergency 'spoon drop', I'm in shutdown. I cannot speak, or move much.  Overwhelming, pain, exhaustion.  And every 'spoon' I have is then gone, probably for tomorrow too.

This, my friends, is why autistic people plan so carefully, and are so concerned about knowing what is ahead. 

Important to know about 'spoon theory'.  Important to realise that small changes for you may be huge changes for your autistic friends and colleagues.  Important to realise that if we ask for information, we need it to be around those social and sensory energy-loss-points.  Help us know whether we can do the thing.  It makes such a difference.

So many autistic people have to live lives just about making it through each day.
So many are pushed into negative energy every day, for no good reason.

We want to be a full part of society, and  - if we are allowed to communicate, socialise and contribute in doable ways, we can do just that.  As friends, colleagues, specialists, carers and so many other things. 

Thank you for listening.


Saturday, 27 January 2018

Church. Autism. Trans. Safeguarding. Love.

The Church of England is deep in debate about Trans lives.  Their 'Parliament', General Synod, had asked that the church consider services for Trans individuals.  That was voted for by a huge majority of the Synod members.  

We now learn that a small group of Bishops has decided that will not happen, without reference to any of the Trans Priests and advocates involved.  A mystery indeed. This may be helpful as a commentary. 

Why is this anything to do with autism?  Because...

There are two million autistic parishioners in the country.
Autistic people are as likely to be Christians, and want to go to church, as anyone else.  Many already do.  Some are our leaders now.  Or in our choirs, our pastoral teams, our musical groups, our PCCs, our Synod.
Autistic people are more than seven times as likely to be Trans as other people.
A full 30%+ of autistic people in the country are part of the LGBTQ communities.  That is some 600,000 people. No, really.

Why is it anything to do with safeguarding?
Autistic people are amongst the most marginalised and 'at risk' groups in the country.  Autistic individuals die, on average, 16 years early, because of the horrific lives many are forced to live.  Little access to healthcare.  Little access to social opportunity.  Little access to love, to friendship, to fellowship, to being able to share their gifts and humanity with others.
Autistic people are nine times as likely to take their own lives, because of how bad a quality of life they endure.

8 out of 10 autistic people endure extremes of bullying and poverty, often because of myths and misinformation, trying to link all autistic people to a tiny number of 'shock headlines'.
Most autistic people struggle to identify who is a friend and who is a predator.
It becomes a safeguarding matter when those battered and bruised - spiritually, emotionally, physically, sexually - stagger to the door of church, and find it shut in their faces.  With the people inside saying, "You're nothing to do with us".  Or... make it inside to find a barrage of hate, othering and ostracism.    That final straw...and such a missed opportunity for the congregation and leadership to find a new friend, a new prayer partner, a new pair of hands to help share all the load within the church.

Why it is anything to do with Jesus?

Because Jesus, it appears, had an autistic friend, Nicodemus.  Approaching Jesus in the quiet of night, misunderstanding metaphor.  Jesus helped him to understand.  He didn't tell him to go away.  He didn't tell him it was too much bother, too much cost.  There was Nicodemus, reaching for a rule book to try to solve a tricky social dilemma and danger for Jesus.  Staggering up a hill with an imponderable and socially-awkward amount of herbs and spices, to Jesus's tomb.  We cannot 'diagnose' people no longer alive, but we can affirm the autistic-like nature of Nicodemus.  Still as autistic at the end, still a friend of Jesus.

We know we're made by God.  Part of the Body of Christ.  Loved as the honest, dedicated and justice-seeking people we are.

We know that many of our number are gay, lesbian, bisexual, trans, non-binary...and many other identifiers.  A rainbow of diversity.  Each bringing a piece of that-which-God-has-created.  Each, a vital part of the picture of humanity.

We, as a church, need to do better than to shut the door in the faces of the Trans autistic people.  Or any other Trans or autistic person, of course.  In fact, anyone at all.  We need to do better than to condemn them to a life outside of the church walls, a life apart from God.  

We need to do better than to leave some of the most vulnerable outside, as too much bother, too much cost, too 'scary'?  Did Jesus not say that the good shepherd goes in search  of the lost sheep?  

As one of the country's leading autism experts, my life has been so blessed with meeting autistic people of every kind, every gender identity and sexuality, every faith and of no faith.  Each loved by God. Goodness me these are fantastic people.  I'm autistic and part of that same community.  Such depth of faith in God, such depth of love for others.

I look forward to the day when all share in the one banquet, share in the one love, sheltering in the safety of the presence of God.  Each and every one, safely in the fold.

The picture is of a Cross in a church.

Monday, 22 January 2018

"But you can speak on the phone sometimes"

(This is a picture of a woman wearing a pink dress, talking on a telephone).
"But you can speak on the phone sometimes!"
I get that a lot, when I explain that I can find speaking on the phone very difficult.  Most autistic people do.
Some days I am partly or completely non-verbal for part of the day, and I simply cannot speak at all.  That's rare, but it can happen.
The rest of the time, I'm relying on 'stock phrases' when I pick up the phone.
"Good morning, this is Company X, how can I help you?"
"Yes, I'm fine thank you.  What about you?"

"Of course.  I'll put you through."
I can do that.  Not a problem.
But, listening to complex instructions for a long time over a phone line is really, really difficult for me.  Some autistic people can do that.  Me, I'm worried that I will miss intonation that turns out to be really important, for example.  Let me give you an example of voice tone, and how it changes the context:
"I SAID you must move the money".
"I said YOU must move the money"
"I said you MUST move the money"
"I said you must MOVE the money"
"I said you must move the MONEY"
I have put the emphasis on different words in the sentence.  All those mean something different.  But if you can't hear voice tone, that becomes tricky. To me, if spoken, they all sound the same. 

That's just one sentence.  By the time people have used voice tone for nearly every sentence they speak, it can get mighty confusing.  And exhausting.  And I get in big trouble if I fail to get stuff right afterwards.   If it's business-critical stuff, I can't afford to rely on interpreting voice tone and bizarre expressions.  What do I mean by bizarre expressions?  "We shall completely mesh the emerging systems, and holistically explore the boundaries, whilst pushing the envelope on timescales".  I think someone actually said that to me, last week.
Here's a picture of me pushing an envelope...

Written instructions tend to be easier.  Certainly easier to query.

If it's a casual phone conversations on a topic I know really well, I can do that.
If it's a totally new topic, with people I don't know well, that's a big ask for me.

So, I work in writing where I can, as a personal preference.  Or I ask to meet in person with others of my team who can be additional listeners.  

Each autistic person has their own best way of communicating.  We need to respect it as much as we would a Blind person asking for audio, or a Deaf person asking for things in writing.  It's not a joke, it's not a way to annoy organisations.  It's vital to ensure that there is meaningful and accurate communication.

Is this a 'deficit'?  Let me ask you a question.  If you went to lawyer to write a Will for you, would you hope that they wrote something vague?  Something that could be misconstrued?  Gave you a quick chat and nothing in writing?  How about if you were doing your tax accounts and went to an Accountant who did the figures in a vague way that could mean almost anything, with you just taking notes and hoping for the best?  Suppose you went to a Doctor, and they gave you a set of vague instructions for your medication, scribbled on the back of an envelope?  Some things require accuracy.  We're the accuracy.  There are endless autistic professionals whose brains are simply superb at making sure words say what they mean.  That's what my Professional Practice does.  It's done it accurately, for £billions in properties, for 18 years and counting.  That's a benefit. It's a business advantage.  It's what keeps clients of all kinds safe and well looked after.

Find out what autistic people do differently, and why it's sometimes a lot better than others can do.  Then, make use of us.  But respect that we need communication to be clear.
Thank you for listening.