For all parents considering/doing autism therapy for child

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A curious mind wonders, would you hire an ABA/play therapist who has the following characteristics in an interview:

- A lot of knowledge on the subject of ASD and evidence-based interventions as well as enthusiasm about it

- Clearly exhibits some ASD traits in the interview situation, such as atypical patterns of eye contact, a stilted manner of speaking, obliviousness to some social cues and
an inability to form a social-emotional dynamic with you

- Has the educational prerequisites, relevant job experience with excellent work references, and/or training in the approach

- Discloses ASD in the interview in a confident and appropriate manner

- Takes more of a neurodiversity approach: believes that the child needs to learn different skills and strategies to be able to be financially and functionally independent as
much as possible, but would tailor the kinds of skills taught and how they're taught to the unique processing style of the child (e.g. if child exhibits disruptive behaviour
at a restaurant because of noise sensitivity, give child tools like earplugs/headphones to block out noise instead of conditioning "appropriate behaviour"). Also, incorporates
a focus on identity and acceptance into therapy, and does not necessarily follow what is "developmentally appropriate" but instead follows the child's lead and patterns.

- Demonstrates strong emotional understanding/empathy and is willing to learn and be flexible in teaching

Instead of a candidate who has the experience/education but is not on the spectrum and may not be as sensitive to the child's individuality and needs?

I would appreciate it if you elaborated on your response below, especially if you said No or Maybe

I suspect you would see a wide range of responses correlating to how new the idea of autism is to the family doing the hiring. For people brand new, meaning until their toddler was diagnosed, to autism, they are going to have a lot of misconceptions and preconceived notions that would prevent them from hiring someone who displays autistic traits. However, to someone who none of this is new to, either because the kid was diagnosed before, or because another child or a close family member or friend has a diagnosis, the therapist having autism may be a positive factor.

There will also be a difference between families who are primed to take a neurodiverse approach themselves and the more "warrior mother" type approach. If you are asking this question as it pertains to whether or not you should pursue this, if you do, please don't even think about "converting" a "warrior mother." It will cause you great deals of unnecessary stress. I know this from experience. Just smile politely as soon as someone reveals their true nature and do not take the case.

I know of therapists and social workers who have autism or other related conditions and work with people on the spectrum with a great deal of success. I am hoping to find someone to pair my daughter up with in middle school and high school because I can already tell she is going to have a really hard time navigating the social waters. She will need help from someone who understands it from the inside out.

NO. In Psychology, there is such a thing as professional boundaries; self-disclosure of ASD, especially in an intake interview, gives me the impression this person has poor professionalism, and it makes me question his/her treatment skills. Understand, there is no way to - as you said - disclose ASD in a confident and appropriate manner during someone else's therapy session: that is inappropriate for a professional.

It is similar to a therapist disclosing a history of depression when seeing a client with depressive symptoms, or a therapist admitting to a drug history when seeing a patient for a substance abuse problem: disclosing that information removes a layer of professional detachment. The therapists's personal medical history is irrelevant in the context of a psychologist/client relationship. Even a therapist self-disclosing a diagnosis of ADD is inappropriate.

Now, if the therapist showed signs of ASD (eye contact issues, odd speech patterns, and so on), but did not self-disclose, I would be fine with my child seeing that person; it's the self-disclosure I have an issue with.

I would definitely hire a therapist with asd as I've always found adults with asd have given me the best strategies and information to help my son.
I think disclosing it is entirely relevant. If you were working for an organisation that didn't allow this then it would be unprofessional but if you are working for yourself as a private therapist it's entirely up to you. And I think more parents would hire you if they knew you were coming at it from a first person perspective as we can educate ourselves but that is something we can't ever have.

Wow! After asking some professionals in the field in the past, including job coaches at an employment program I was part of two years ago, nobody said it was inappropriate to disclose when working for a family in a private home setting! That's even when I learned how to disclose appropriately in an interview! I have a prof who is a psychologist working in the LGBT field and she is LGBT herself; perhaps I should ask her if she discloses this with her clients.

I wouldn't think this is inappropriate because I am NOT asking for special treatment and/or support with my condition when I disclose in the interview. The reason why I would disclose is to make the parent(s) aware that there is a reason for why I interact with people in a certain way and I don't convey any social messages on purpose. It is really to make the relationship more comfortable for the parent(s) and also for me. If I know for sure that the other person knows that I have ASD, I become a lot less anxious and can show my true abilities better.

I'll have to ask around about this and see what people say. Thanks for letting me know that this is a possibility!

So, if the therapist discloses, do you see that person as a therapist, or as someone with ASD? Do you then see the therapist, who has both ASD and a successful career, as a proxy for your child? Essentially, the therapist has ASD but learned coping skills/strategies, so my child should be able to as well?

I think the self-disclosure issue really depends on the situation and the way that it is done. There are different schools of thought on this in psychology: The traditional view, which comes from Freudian psychoanalysis is that the psychologist is supposed to be completely closed off, so that the client is free to project their own issues onto them. Issues that may arise are thus treated as a product of transference and countertransference. Even though that's the origin of the view, this concept pervades psychology.

A more modern view includes a place for "strategic" self-disclosure. Essentially, you can disclose personal information, but it should be in service of some therapeutic goal. That's just basic professionalism. You don't want to be working with any professional and have them bog you down with personal details that are not related to the work-at-hand; especially if you're paying them to listen. Typically, psychologists will refrain from mentioning their own histories of mental illness because in many cases it can undermine the therapy. Part of effective therapy requires the client to respect and value the therapist's judgment, admission of significant weakness may undermine this. On the other hand, there are situations where this admission works in the favor of the therapy. For example, if a client is having doubts about a specific intervention strategy, but has a good relationship and confidence in the therapist, it may help to sway them by saying that "it worked on me."

In this case, you're describing a therapist who views his ASD status as a positive, rather than a negative. By having an ASD diagnosis, supposedly this therapist is better able to empathize with children on the spectrum. Using the above criteria, it may be appropriate to disclose this to a client, because it may help to boost their confidence in the treatment. On the other hand, it may work against you. Personally, I wouldn't blindly trust a claim that - the fact that I have an ASD makes me understand others with ASDs. I have worked with many people where they clearly have little empathy or understanding for people who share their ASD diagnosis. On the other hand, I don't see it as impossible. Indeed, if the person meets all the other qualifications, I would probably be eager to see if that were true.

Many parents aren't as open-minded or forgiving as I am, so it could work against you too. I'm also not a parent, and am only working in hypotheticals here. I imagine when it is someone's own child they may be less willing to take a chance on something like that. I think strategically it is likely a polarizing sort of thing, where some people will want you because of it, and others will immediately write you off because of it. In those types of situations, I'd rather let the work speak for itself. It may therefore be better not to emphasize the ASD diagnosis if you don't have to (i.e. if you can pass as neurotypical in a professional setting).

Also if you are going to work into someones home then it might be useful they know you have asd if there is anything you won't be able to tolerate. For eg they may have strong smelling glade plug in fresheners in every room and you may have a problem with that so they would need to be removed.

Mixed feelings on this even as an aspie. It depends a lot on what your clients' specific needs are. My son gets way less contact with NTs than other kids b/c of our personal circumstances. So for us, we have aspie role models, for our son and we have that kind of empathy built into our family unit. So if we were in the market for a therapist, an NT might be good b/c my son could get help with NT ToM and have typical NT reactions to look at and analyze so he could understand non-verbal NT communication. An NT family might look at it the exact opposite way.

It is not that I would discriminate against an AS practitioner. It is just that if I was paying money for my child to learn more about NTs, it may or may not be the best fit. If I was paying money for internal understandings of meltdowns and that kind of thing then it might be a good fit. If I wanted strategies of coping with the NT world it might be a good fit. It just depended what my specific goals were, if that makes sense.

Edited for punctuation error.

Last edited by ASDMommyASDKid on 21 Jan 2014, 6:21 pm, edited 2 times in total.

I would say both (a person on the spectrum AND a therapist). And yes, the therapist can serve as a role model for the child. There are two types of models possible: a mastery model and a coping model. A mastery model is someone who already knows the skill very well and never had any problems acquiring it - that would be more like an NT therapist. A coping model is someone who learns the skill but goes through similar challenges to the client in learning that skill, which would be a person with ASD who knows the coping skills but still has some struggles around them. According to research, coping models are more effective for teaching a skill than mastery models. This makes a lot of sense. However, I wouldn't assume that the child would be able to learn coping strategies just because I could - we're all different (but a parent might think that way).

Yeah, to me saying "it worked for me" is not sound professional practice because there's so much diversity on the spectrum and just because something worked for me doesn't mean it will work for this particular child. That's why there are behavioural assessments. Additionally, sometimes treatment involves trial-and-error where something doesn't work as well as predicted,
so the approach needs to be modified. Perhaps my insight into myself might help with that intuitively a little bit, but that's not the main benefit of having the diagnosis as the therapist. I think the biggest benefit would be possibly being able to establish a better therapeutic relationship with the client because your behavioural patterns are more similar to the client. Also, it can possibly make me more mindful of how certain challenges might impact the client, as opposed to someone who just learned about ASD from books and observed autistic behaviours from the outside.

I wouldn't talk about my experience beyond an initial disclosure. As you said, extensive personal disclosure is not sound professional practice, either. I am very strict with only talking about work-related things when I'm at work. The initial disclosure would be just an FYI, but beyond that, I would be there to talk about the client and about work duties, not about myself. Besides, doing that might make it seem that I am seeking advice for my personal issues. I wonder if I could put this forth somehow along with disclosure to remove any doubts about it.

I also thought along those lines; some families would be accepting while others would think it's too much of a risk to take. And no, I can't pass as neurotypical, as I said. Frankly, I hate the whole passing-for-NT thing and I'd rather be able to lead a fully functional life than pretend to be NT and get completely burnt out and unable to do anything after 2 hours of being around people. As Rabbers said, I also might need some accommodations. People's homes are usually pretty sensory friendly, though, from my past experiences.

ASDMommyASDKid, I can understand that perspective. I think an ideal situation would be two therapists working with a child, one NT and one with ASD, so that the child gets the best of both worlds so to say (and the therapists learn from each other!).

...except for the fact that autism is a neurological condition, not a psychological one. Are you saying that if my child had CP or MS, that it would be wrong for a therapist to disclose that they, too, have CP or MS?

And then there is the fact that ABA is not "therapy" in the sense that psychotherapy is. No one is there to discuss their deep seated issues or fears.

Even within the field of psychology, there are appropriate times for disclosure. To make a blanket statement such as this is...well...I've worked in psych for many years and my professional experience and opinion is that disclosure can sometimes be appropriate, welcomed, and professional.

I think the nature of ASD makes it more problematic than depression or ADHD in this context. The problem in this setting is that the well-known symptoms of ASD (e.g., mind-blindness and perseveration) go counter to traditional understandings of what makes a good therapist (i.e. intuition, empathy, flexibility). It works against you in many cases, just as having dyslexia would work against you if you were applying for a job as a copy editor.

I agree with you that ABA is different and maybe being a good scientist with a lifetime of experience with the disorder are strengths as an ABA therapist, but it's the perception of others that's important here.

Absolutely! That sounds like an ideal approach to me.

I think willingness of the child/patient to engage is essential for therapy to have any chance of success. My daughter saw a therapist for about a year. The first few months went pretty well as an introduction to the nature of AS. But their relationship deteriorated as the therapist tried to move into areas that were more stressful/challenging. My daughter just would not talk about certain issues. The therapist couldn't fit the situation into one of the plans or strategies she had learned in school. Eventually we gave up and my daughter refuses to see another therapist because she says it's a waste of time (and she doesn't want to open up about her feelings).

That therapist's warm personality was an advantage in the early stages, but later I felt that she didn't really understand my daughter's thinking. I felt that she didn't take my daughter's behavior seriously enough. I felt that personal experience with AS would have been a huge advantage.

Funny, my son's first therapist must have been on the spectrum, and so far as I knew was totally unaware of it, which I kind of considered to be a negative (and which didn't help my son at all - I generally give therapists an honest trial unless they are downright awful.) When we started, I kind of suspected she was ASD and I was pretty excited about the idea - sort of a like-minded life coach, if you will...but it didn't work out because she spent a lot of time lecturing instead of actually drawing my son out. (Not that I haven't seen this same sort of behavior in neurotypical therapists, it was just an interesting situation.)

The disclosure thing is tricky. This is not an analogous situation, but one where the boundary was crossed that I've never forgotten: back in the day when I was getting treatment for depression, I once had a therapist call me and cancel an appointment "because her brother just committed suicide." Wildly inappropriate, even if true: simply stating "family emergency" is enough.

You might try the old "I was the kind of kid who..." thing instead of actually naming the disorder. You know, "When I was little, I was very much like (patient) in that I would (behavior.) I did finally learn to (solution.)" That way, the door is open for parents to ask if your similarity to their child is because you share the diagnosis, but you aren't making it be a defining characteristic of yourself. (I'd also use this system with CP or MS, for that matter - not because there's any shame in either, but because it feels like you would be CP, AS, or MS first and therapist second and I don't think anyone wants that.)

I guess if I were in your shoes, I would make sure the door was very, very open for parents to ask that question, but I wouldn't volunteer the information up front using the diagnostic terms.

Haha, that's probably what a lot of parents might expect from someone on the spectrum. It's not really that respectful or probably that effective, either, because the child is not really contributing to the process that way. One of my very first one-on-one employment experiences was with someone who had very poor auditory processing. I've noticed that the more I talked, the more he shut down and made mistakes. I've learned a lot from that experience, including a rule that, when you're in that position with your client, it's generally better to speak the bare minimum, while mostly doing anything else job-related that not involve speaking.

That's what I have mostly been doing up to this point. Most people did figure it out eventually and mentioned it later as though it was a fact that was known all along (I never ever said it around them, I swear!). For the above two jobs, the parents who hired me already knew me in advance and knew that I'm on the spectrum. At the job above, I initially did many things that would probably get me fired immediately at any other job. But this boy's mom guided me a lot, told me what not to do and what to do, and I learned quickly. She also advised me once to disclose at another place I was going to get interviewed at. I think it is a good idea not to mention the label itself. I just want to, during the initial interview, figure out how to hint at it enough so that the parent could figure out that I have ASD without me actually having to say it. I feel a lot more comfortable in the situation when I know that there is knowledge of why I'm different. Sometimes, I can see from how a person interacts with me that they know that I have ASD without stating it; that is, though, provided that they do behave that way. If they don't, I might get all nervous and uncertain, because before I became aware of my diagnosis I had a past full of unexpected rejections and it was traumatizing to say the least. If only I could figure out how to create this balance between disclosure and non-disclosure, because I know for a fact that I come across as very different in a typical social situation (including interviews).

I am still monitoring this thread for replies and reading every single one. It's fascinating how everyone's take on this is slightly different. If you have anything else to contribute, please do!

You know what I would take as a model? How homosexuals handle their sexuality nowadays - at least in situations where they are likely to be safe. You can make it known that you are out and proud without actually bringing the words into the conversation unless someone asks you, and I think that's what you're looking for here.