Crip Camp Conversations: Disability Leaders Respond to Coronavirus




The Best Audience Chat Comment undoubtedly was
"I feel like my life will now be measured as “pre this talk” versus “post this talk”. Thank you for this!" 

Amazing experience being on the panel for this webinar. Glad to be able to add value to this very important issue. 


I got several requests to share what I'd "talked" about in the webinar. 
Here are the slides and transcript of audio. 

Introduction 



Image Description. Young Indian American male sitting in front of a laptop. Black hair. Wearing a cap and T-shirt that say Berkeley.

Hi everyone. Thank you for having me here. My name is Hari Srinivasan. I’m a non speaking autistic. I type to communicate. I have a bunch of other challenges like oral-motor apraxia, ADHD, OCD, anxiety etc. 

I’m a student at UC Berkeley with a major in psychology  and minor in disability studies. 

This is my third semester as student instructor for a faculty sponsored semester long class on autism. I think of it as a way to change awareness in the way 30 students each semester will come to view disability and autism in their future lives. A majority of the students are non-autistic and able-bodied. We had a very interesting discussion on autism and covid-19 just two weeks ago. 

I’m also a student journalist for the Daily Californian. I get to write about many disability related issues which have included a column on autism. My two recent articles focused on social distancing and on healthcare issues surrounding the disability community during this pandemic. If you google my name and Daily Cal you should find links to these articles. 



I joined the board of ASAN, the Autistic Self Advocacy Network earlier this year. 

As the pandemic unfolded ASAN has really been working with other disability orgs to advocate for our civil rights. An early area was medical rationing, the combined advocacy has lead to non discrimination directives at various levels. But we have to continue to be vigilant that this is translated to in the field. 

ASAN is also branching out now to work on issues like making sure people who need a support person can bring their family member or communication partner with them if they are hospitalized, even if the hospital has a no visitors policy, as a reasonable accommodation under the americans with disabilities act. As a person with high support needs, this is an area close to home for me. 

In terms of home and community based services, ASAN is pushing very hard for the next covid bill to include emergency grants to service providers so that people can be supported in their homes, and to keep people from ending up in congregate settings. To make that possible, support people need personal protective equipment and higher pay, as well as emergency child care and paid leave. Some agencies need to hire more folks and rearrange how they provide services etc. ASAN is also tracking infections, hospitalizations, deaths from covid-19, of people with disabilities living in congregate settings, because we know those settings are so much deadlier than a person's own home. 

Several disability orgs, including ASAN, are partners on the #WeAreEssential social media campaign, which lays out a lot of these issues along with others.

Issues facing Students and Families during this time

Hari, we know covid19 has had a great impact on students and families. Can you tell us about student responses or your thoughts on this?



I’ve been informally polling other peer autistics and their families to find out their challenges. And, as an autistic with high support needs, I experience many of these issues myself as well. 

To start with, this pandemic is kind of like a waiting game filled with endless uncertainty and anxiety. If the abled bodied population themselves are having increasing mental health issues, it’s a multiplier effect on the disabled population. I’m hearing that even kids under 10 are getting prescribed antidepressants. 

In autistics this uncertainty and anxiety can also manifest in so many different ways. There has been a huge increase in all kinds of maladaptive behaviors, whether it's meltdowns, obsessive compulsive behaviors, aggression, self-injurious behavior, disturbances in sleep patterns and other things that add to the already stressful times. 

It's the disruption or even lack of access to support services, therapies and education itself. The remote education model or tele therapy does not work for many who need that physical one on one support and have other needs. I want to quote one parent who says that “only certain people with certain needs qualify for tele therapy.”  Students  who are transitioning between the school and adult programs, like one of my friends, are stuck in limbo with no help at all.  

Many autistics had been working on building independence in community based skills or social interaction skills. Many don’t have the same access to the outdoors or nature hikes as before even for physical exercise. 

Even prior to the pandemic, we as a community have experienced a great deal of social isolation and stigma; this lockdown has given it a frightening face.  Lack of these critical supports, therapies and social opportunities will mean a regression in skills for autistics. 

At the same time, many other skills and behaviors have to be un learned for the current time, such as shaking hands or holding the door open for others. Then there is other hygiene issues - autistics with impulse control issues find it hard to not touch surfaces or maintain a six feet distance. 

Even for those who are able to avail of some form of remote instruction, whether at school or college level, there are big time gaps between the classes, with basically nothing to do. While some have figured out ways to cope, others find this to be very isolating and suffocating. One of my peers says he is “super duper frustrated.”

A bright spot is that some autistics are enjoying remote instruction, where you are free from social interaction pressures. I can just mute my zoom to cut off my stemming noises. Keeping up with social expectations can be exhausting for autistics. 


Wearing a mask has presented another challenge as many autistics have sensory issues. 

Every autistic has a different set of challenges and things that calm or work for them.
 It takes time for families and other caregivers to figure these out. Those with higher support needs rely on caretaker familiar with their needs. During this pandemic the caregiver role defaults to the immediate family for many autistics.  What happens if those caregivers fall ill or if the individuals themselves fall ill. Will healthcare workers even know what to do, how to handle our “behaviors” and other unique needs?. 

Autism is wide spectrum which means that many have health co-morbidities, like seizures and gut conditions. Even during non-pandemic times, many of these go undiagnosed. How will doctors even begin to treat us. 

Many of us will need our support person with us if we need to be isolated or hospitalized. It is a scary thought to imagine being alone in a hospital. I am so happy ASAN, Communication First and other orgs are working on this issue,  That support people be not just be allowed to accompany us, but also be provided the PPE protective gear. 

Some of my peers have needed hospitalization for other issues during this time, which can be absolutely un nerving. 

 I can’t even begin to articulate the plight of autistics who are in group residential settings, especially the larger ones.They like nursing homes for the elderly, are sitting ducks. 



Now for another perspective.  I mentioned earlier that we had discussed autism and covid at the autism class at U C Berkeley for which I am a student instructor. A majority of the class are able-bodied students. What really struck me was the lack of awareness on the part of the non-disabled community. Some of the student responses in my class - from surprise to shock is so telling.  Here are a couple of sample reactions. 

“This entire pandemic is making me absolutely sick about how the disability community is being treated. Dehumanized and devalued. It’s not fair, it doesn’t make any sense”

“The disregard for people with autism, or any intellectual disability, by hospitals in the time of covid 19. It is saddening to see, especially when it is in direct noncompliance with the Americans with Disabilities act.”

“Something that surprised me was how people on the spectrum are being treated throughout covid 19. It actually makes me so upset that people need just as much medical attention as those that are being affected. Just because we are having a pandemic does not mean the normal life things just suddenly stop.”

The point I want to make by showing you these student reactions is that we need to work even more vigorously on awareness of these issues in the mainstream community to bring about change. We need even more allies in the non disabled community. Only then will change be easier and can happen. The current scorched earth scenario is laying bare all the inadequacies of the system. This is like a shocking wake up call of sorts.

What gives me hope

What is giving you hope or resiliency right now?



I am in awe, of the fierce advocacy efforts being done by organizations and individuals to keep our civil rights alive by making noise and lobbying and widely publicizing our issues. We need to make a lot more noise.

This time of need has also given way to so many random acts of generosity and kindness.
An example is the many different online free classes that have sprung up to help us through this hard time. I am able to try out new classes and am no longer limited by having to travel to a remote location amid traffic  to try these things.

Our new normal has meant that many of what we thought had to be social norms are no longer applicable. You don’t have to sit in a cubicle from nine to five to be able to hold down a job for instance. You can turn off the camera or the mic on your zoom if you want. You can choose to be heard and seen. 

I am also encouraged at how greener our earth is getting in just such a short span of time. Just cutting down traffic can have such a huge impact on our air quality. It gives me much hope that we can do something about climate change. And with people in lockdown, the animals are finally getting to enjoy the outdoors in peace which is again telling of their oppression. 

I am in deep admiration that many in the disabled community are not just helping out each other during this time but also participating in the greater community good, like making masks for healthcare workers.

Our strength of character and resilience is shining through. And that gives me so much hope for now, and the future.

A Call to Action

We have enough time for each panelist to make one call to action.



This has been a tremendous wake up call of sorts for all of us.

 I'll keep this call to action very short with ASAN’s big ask right now. 

We really really need people to call, to email, to tweet your congressperson, and demand funding for home and community based services. 
autisticadvocacy.org/2020/03/action-alert-covid19-relief/



Additional Audience Chat Comments
Fantastic insights indeed Hari. Thank you so much for sharing
Thank you Hari - great insights!
Thank you Hari for your positive words of hope.
Great insights Hari. 




Third Semester teaching an Autism Class at UC Berkeley




Autism DeCal at UC Berkeley

The DeCal is Up
Another exciting semester of teaching the 1:59 Autism Decal for the Spring 2020 semester. Looking forward to interacting with the 25 students enrolled in the class and the hearing from the guest speakers we have lined up. 

The weeks leading up to the start are hectic as we try to organize the speaker line up and the panels and the topics and material we will be teaching. 


https://drive.google.com/file/d/1TGHaMNI3SFH6wDxvfalDvhXZxoCP3C0D/view?usp=sharing
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Week 1

2/5: With fellow decal teachers - Juliana, Diana, Devina. Its good to have so many students interested in both attending and teaching the class. Like Julianna mentioned in class, it was nice for her to experience both ends - as a student and teacher. Devina was a student 2 semesters back and co-taught the class last semester. Julianna and Diana were students last semester.

With fellow student co-teachers Julianna, Diana and Devina
A very talkative and interesting group showed up this semester and participated with gusto in the icebreakers. It's gonna be a lively semester. 


Unlike previous semesters, we were not able to do the PollEv in the first class. There is no phone connection in this classroom as it is located on the 1st-floor basement of Moffit Library. 


So a word cloud was created on the board instead:-

"What word comes to mind when you hear the word autism"
Some of the responses were - Flow, Social Isolation, Sameness, Co-morbidity, Miscategorized, Communication Barrier, Specific Knowledge/Interests, Stigma




The class size Increases
Just heard, the class size is being increased to 30+ due to high demand!! I see 31 students enrolled in my CalCentral. It is kind of thrilling on many levels - that in some way I'm managing to make a small difference. And of course at a bigger level that societal awareness will increase - each new student will go onto being a snowdrop in the avalanche or autism inclusion. 

I love that we have such a wide range of majors - Applied Math/Integrative Biology, Architecture, Business Administration, Cognitive Science, Conserv and Resource Studies, Economics, Environmental Science, Linguistics, Political Science, Public Health, Sociology, and a few undeclared lower classmen. 



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Week2

2/12: We welcomed the new students who have joined the class and increased our class strength to 30. 

A student even emailed me after class today disappointed that the enrollment was now closed. The add/drop deadline is today and we were sent a reminder email about this by the Psych Dept Counselor, saying all class enrollments would be wrapped up today and all waitlists closed.

Our first guest speaker was Prof Clarissa Kripke of UCSF on Sensorimotor Issues. What an informative lecture and a real treat for the 30 students in the class. There was simply not enough time to cover all that she had to say. Students had questions for her even after the class had ended. 

The fire alarm went off in the middle of class as someone accidentally opened an emergency exit. It was an annoying droning sound that went for almost 10 mins. As you can imagine many of us autistics are extra sensitive to sound so if it was annoying to the NT students in the class, it had a multiplier effect on me. 





Prof. Kripke had some handouts for anyone interested: Clinical: Patient-Centered Care [Medical and Social Models of Disability], Advocacy Advice from Self-Advocates. What I Wish My Doctor Knew About [Me As a Person with Sensory Sensitivities], [Non-Traditional Communicators]. Training: Best Practices: Behavior Support. [First-Hand Perspectives on Behavioral Interventions for Autistic People]

One point which has been highlighted in my Disability Studies classes and discussed at the RadMad Disability Lab just last week was how many places in the campus had physical accessibility issues. Dr. Kripke also drew attention to how a wheelchair user would not be able to present in this class. 


This classroom has a stepped down auditorium type seating inside, leading down to the stage. You can get into the Moffit Library building and down to the 1st floor via elevator. But wheelchair user would have to stay back on the top row near the door of the classroom, they could not come down to the stage to present. That means that that a panelist I was going to invite to participate in our  ASD adult panel will not be able to as she is a wheelchair user!!

Rachel Kripke-Ludwig joined us in class today. Rachel goes to Open Mind School and points to a letterboard to communicate as she is a non-speaking autistic. It is good for the students to see all profiles of autism - how else will they understand what Autism is?


Feedback 
2/13: Got such lovely feedback from a student today: 

Hari, I just wanted to reach out and say thank you for the work you put into this decal. This is by far, the coolest class I have ever taken. I tell all my friends about how awesome this course is. I appreciate all of the hard work you put into it, and am eager to learn more.

Week 4 & 5 - ASD Panels
Our "Adults on the Spectrum" panels spoke of their lived experiences as an autistic. The class has so many varied and interesting questions for them.

1st ASD Adults Panel - Reid, Nate, Emma and David
2nd ASD Adult. Panel - Ari, Brazos, Brian and Esperanza

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Week 6 - Prof Steve Hinshaw

3/11: Another marvelous talk by Prof Steve Hinshaw at our Autism Decal class today on Stigma and Autism. In the last 2 semesters, (to my knowledge) at least 2 students have switched their major to Psychology, after hearing him speak at the 1:59 ASD class. Prof Hinshaw drew both on his own personal experiences as well as his work in the Mental Health, ADHD and Stigma fields.

Last week, the university was 'encouraging' classes be offered online and that became mandatory as of yesterday. We all received emails with different options to do online delivery and our team decided to go with ZoomPro as we thought that would be more interactive and work well for both our internal and external speakers. 

Of course we ran into glitches in getting the ZoomPro account set up - apparently the demand was huge from the faculty itself, and they had not taken into account that undergraduate student instructors would need ZoomPro too. Luckily our Psych dept advisor, was able to help us resolve this and we should be set with ZoomPro accounts for next week. For this week, Prof Hinshaw, who is the faculty sponsor for this class, graciously hosted the class using his faculty ZoomPro account. 

It certainly did feel different doing the class remotely. Still it went off pretty well I think.


Week 8 - Igor Silva

3/18: Igor Silva was the guest speaker at our Autism Decal class today to speak on "Autism as Superpower." Igor is a fellow autistic and international law student at Berkeley Law. Right off the bat, his passion for autism activism came through as he drew attention to the importance of political identity for the "autism movement", celebrated the accomplishments of autistics like Greta Thunberg and pointed out parallels to other movements like climate change, women's rights movement, LGBTQ movment etc.

I think the talk enabled the students in the class to think of autistics as beyond just a  group that faces mixed levels of everyday challenges with social-communication, sensory processing issues etc. 

And of course given our current online instruction due to the coronavirus, it was all via zoom. 

(Check out Igor's website https://igorpereira.com/)
 



Week 8 - Parent Panel


4/1: It's been an unsettling two weeks with the exponential growth curves of the coronavirus. We were back this week with a parent panel. Joining us were Christine, Denise, Nicole and Sarika to speak of the complex experiences of parenting autistic individuals, a task that does not end even in adulthood. We appreciate their being able to take the time in the middle of this pandemic which adds extra stressors not only for them but also in the care and mental health of the autistic member of their household. 




Here is a video of our parent panel and what they had to say





Week 9: Lecture/Discusion: Therapies/Interventions, Technology+Autism


Week 10: Lecture/Discussion: Disability Law, Autism+Covid, Careers in Autism



Week 11- Co-morbidities in Autism



Week 12 - Group Presentations on Representation of Autism in Media


Feedback about the class from Students - Thank you - this was an amazing class

This course has been one of the most eye-opening courses I have taken so far.


I wanted to give a big thank you to Hari and all of the facilitators. I try to take a decal every semester... This decal was very well run and educational, I feel like I learned more from it than any other decal I’ve taken at Cal.


After having been in several UC Berkeley psychology courses with Hari, and reading his writing in the Daily Cal and on his blog, I knew I wanted to take this course. I am so grateful to Hari, Devina, Juliana, and Diana for cultivating such a meaningful space for neurotypical and neurodivergent individuals alike—all of whom arrived in the classroom with a different relation to and understanding of autism—that left an enormous impact on me. From organizing thoughtful panels filled with amazing individuals (from college students to parents to professionals...all were remarkable!), to generating thought-provoking discussions on bCourses and in course assignments, to openly welcoming anonymous questions in every course, you all did a tremendous job at facilitating a class environment that was as comfortable as it was informative.... I am so honored to have been a part of this course—logging onto the Zoom calls and seeing each of your faces has been huge in not only my learning, but also my wellness. Each of you makes me feel so inspired, and I am fortunate to have been taught by you.



I enjoyed hearing Hari's inspirational story because it really reflects just how little society knows about ASD...


This course was such a fun addition to my semester,


Another aspect of the course I liked was that it was taught by a person with autism.  Hari could teach us about a particular topic while adding in his own experience, which made the class so much more interesting than typical psychology classes.



In this course, I learned many new things and got to see a whole new perspective as I didn’t know much about autism.


For any Cal student, I would definitely recommend this Decal. For me, this course was a blessing and helped me better understand what is autism.



This was the first class discussing disability studies that I’ve taken, and I loved it. I loved how so many facets of autism were covered. I loved the guest speakers, and the fact that autistic voices really shaped this class. The DeCal format made it so that the class was casual in the sense that there was less pressure on grades. Instead, there was emphasis on building community and providing space for discussion, led by facilitators who were knowledgeable, kind, and enthusiastic about the subject matter...Thank you for all of your hard work putting on one of the most memorable classes I will take at Cal and for a wonderful semester despite the unexpected circumstances...I am really thankful to have taken this course and am thankful for all the hard work put in by Hari and the Facilitators and everyone involved from even the beginnings of this course.



It was important for me to learn from Hari’s perspective (and many of the guests invited in) what It felt like to not be able to communicate thoughts and feelings...This was my first decal and this is my last semester at Berkeley. I’m very glad I took this class. I


I think that completing this decal has been deeply beneficial to me...Overall, this decal was a great success. The facilitators were incredibly supportive and passionate about the subject. There was no stress about grades. We were just there together to learn more about autism and the community it encompasses – from those on the spectrum to their friends and family. And we learned about this in the most successful way, through conversations with people whose lives were in some way connected to autism.


 I overall enjoyed the course and I hope this class and organization becomes huge. It deserves it entirely.


The course facilitators (Hari particularly) have worked extremely hard to get ASD community members to come share their research and experiences with a curious student body, and for that I am truly thankful…. I will certainly recommend this course to fellow students as ASD is a topic that needs to be shared not just with people interested in the topic, but with anyone passionate about changing the world


First off, I would like to express how grateful I am for this class...This class has opened my eyes to so many things...Hari specifically is one of my favorite things about this class. I am so honored to be in a class led by him. He is such an inspiration to me because I feel that people always want to put others down because they are different. But Hari is such an inspiration because he is pursuing a higher education degree while being nonverbal. It proves that just because someone may be nonverbal does not mean they lack the skills to communicate. Especially now with so much advanced technology, cases such as Hari’s should prove that with the proper tools, support system, and help, almost anything is possible. It is up to us to be more vocal about how we can further support the ASD community and create educational and honest dialogue that correctly re-introduces the public to ASD without creating any negative and untrue stereotypes. I can honestly say this class has changed my life. I feel so much more aware of what is going on around me having to do with ASD as well as any forms of disability. I am more conscious of language I may hear people use that is hurtful and derogatory and I will be able to correct others. I can only hope that with everything I have learned I will be able to inform others and create a less ignorant world. Thank you to Hari and the facilitators for putting together such an amazing course. I am honored to have been able to attend such an amazing class


This class has truly been a joy to take...Thank you so much to Hari for proving that it is possible to overcome many of the obstacles placed in your path...On a final note, I want to say that this class has been extremely eye-opening for me - someone who has had no previous experience with this subject. It has brought awareness to me and I have no doubt it will continue to do so in the future. I truly believe this class is an exceptional method to learning more about the spectrum


One main takeaway I value from this course is the falsity of the terms“higher-functioning” and “lower-functioning”. All of the presentations, readings, and panel demonstrated that these terms are not accurate ways of distinguishing people on the spectrum.We learned that being a person with autism who is non-verbal or who stims a lot, in no way means they are “lower-functioning” than a person with autism who is verbal or sits more still.This fact is something I really value. I think it is applicable to everyone and everything. Intelligence and capability is expressed differently in everyone...Thank you so much for a great semester.


I am so happy I took this decal because I have learned so much and it has opened my eyes to the different intersections of disabilities.


I am truly glad I took this class because Iseemed to have a pretty big paradigm shift. ..Another thing I learned from this class was the aspect of communication. Since my brother is verbal, I really only thought that there were two types of autistic people. One that is verbal and one that is nonverbal and unable to communicate at all. However, I learned that communication comes in all shapes and forms.From an iPad to a tapping system, people on the spectrum even if they are nonverbal may be able to communicate. And I think it is really important to empower those on the spectrum and give them the tools to allow them to do so.Instead of thinking that someone is unable to form an opinion for themselves we should try to stay out of their way as possible and just let them be because people on the spectrum are humans too.


Even though I had been exposed to autism my whole life, I feel like this is the first time Ihad my eyes opened.


This was a class that was much more eye opening than I initially thought it would be. As someone who did not have any prior knowledge about autism, I walked into my first class very clueless and unsure of what to expect. I am happy to say that by the end of the semester, I have learned a lot more about autism and can appreciate it much better...Overall, this was an amazing experience and I am glad that I decided to sign up for this class!


Thank you again for organizing such a great course and guide me through this wonderful journey to a new world! Hope I could make my contribution to help people with ASD enjoy a better life in the future


Having Hari as an instructor added to the course as someone with Autism; his personal experience and anecdotes personalized each lecture. .. I would gladly recommend this course to friends in the future .. I hope this course continues to grow in popularity as it has a lot of insight to offer our Cal community



Older Teaching Experiences









O Body Where Art Thou

In the Daily Californian, 2 years ago


The lack of Body Awareness or inability of the brain to form a Body Schema is a little known phenomenon in autism. I attempt to explain the neuroscience. 

This is the ninth of my series of 10 articles for my weekly opinion column "The Person Inside" for the Daily Californian. 
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Headline: O body, where art thou?


My hands repeatedly go up to my face, down to the arms of the chair and then back to my lap. My leg and my body keep making small movements. The girl sitting next to me in the lecture hall looks askance at me several times because I appear to be constantly fidgeting. 


The lecture begins, and the picture of the somatosensory map in the brain flashes on the screen, followed by other neuroscience concepts such as mirror neurons. My brain, ears and eyes all perk up in interest. 


Even as I am sitting there listening to the lecture, my mind is busily trying to extrapolate the lecture material to what is currently known about the neuroscience of autism and how it plays out in my life every day, since I am an individual with autism.  


I am especially intrigued by the body map that the brain forms of the different parts of the body in space and time. My mind tries to pull in strings of thought and form a web of understanding as I ponder whether this body map underlies many of the challenges we autistics face. By linking  the neuroscience of autism with observations of my functioning, I am better able to understand my everyday challenges.


You see, for a subset of autistics like me, the brain is not able to form a proper map or body schematic. I can at times feel like parts of my body are missing and that I am not grounded. 


My body adapts through movement. For example, the brain asks the hand where it is, and a connection is formed when the hand moves. The brain is now able to map the hand in its body schematic. But these connections are temporary, which means that if I sit absolutely still for too long in the lecture hall, I may just fall asleep. What other students see are the constant impulsive body movements.


I also tend to rely on vision a lot to help me know where my body is. When I see my leg, my brain registers its presence in my body map. I don’t like to close my eyes during the day because I may lose track of my body. 


For my brain, it’s like looking at a fun house mirror that gives a very different image of you every time you look into it. The image in the mirror is what you are and not who you think you are. 


I tend to use the presence of people around me to help keep my body space organized and keep me grounded. I would feel lost and helpless in a large room with no people. Touching someone or someone touching me even very lightly can help my body parts feel connected to each other and makes me feel grounded.


I think about the slide on mirror neurons from lecture. Mirror neurons in the brain activate when you see another person perform an action — it’s almost like you yourself were performing that action. Mirror neurons are thought to be linked to perception, language ability and even empathy. 

Many professionals believe that there is a delay in the formation of mirror neurons in autistics like me. I wonder if that is because of my imperfect body map, since I am not able to repeat the same neural pathways as many times as non-autistics can. 


I try to pull in more strings of neuroscience, such as apraxia, into this body map puzzle that I am pondering. Apraxia is the difficulty with complex purposeful movements needed for everyday life, such as speech. It is possible that my imperfect body schema contributes to the apraxias that I and many other autistics face.

 

I attempt to straighten out a string that’s been hanging loose on my web of understanding. It’s a catch-22 when you factor in sensory input from the environment. I believe that my sensory input from the environment has to be uniform to form a good body schematic. At the same time, I need to have a good body schematic to interact well with the environment. But I don’t have a good body map, so the sensory environment can be overwhelming and intense for me at times. 


I leave my lecture that day feeling very contemplative as I walk down Oppenheimer Way. My web of understanding still feels somewhat incomplete. While I am excited at all the progress that has been made in understanding the neuroscience of autism, I can only hope that solutions will also follow soon — ones that will help us autistics have a better life.  


Masking as an evolutionary advantage



What is Masking & Camouflaging
Masking and camouflaging are terms used to describe strategies autistics might employ to hide or minimize their autistic traits in social situations. These behaviors can include mimicking NT behaviors, suppressing stimming, or forcing oneself to make eye contact during conversations. 

It is often a coping strategy used by autistics to navigate social situations that can be overwhelming or challenging. It is a means to "fit-in" and also a question of basic safety for some, as the display of atypical behaviors can lead to aversive/negative reactions from others.  

There are subtle distinctions between the two terms.
  • Masking refers to the conscious or unconscious effort to hide or suppress autistic traits or behaviors to fit into social situations. This can include copying social behaviors, hiding interests that might be deemed atypical, or suppressing feelings of discomfort in social settings.
  • Camouflaging, while similar to masking, can sometimes be seen as a broader concept that includes masking as a subset. Camouflaging may involve more active efforts to construct a persona that is socially acceptable or to "pass" as neurotypical. This could involve learning and implementing specific social strategies, such as scripts for conversation or specific body language cues.
Consequences
  • The effort to constantly hide one's true self can be exhausting and damaging to one's sense of identity and self-esteem (ie: more cognitive effort + more mental health issues). Can contribute to autistic burnout

Do only certain "type" of autistics engage in masking/camouflaging?
  • No. Masking and Camouflaging is engaged in by autistics across the spectrum. 
  • People with higher support needs very much try, but just may be "less adept" at pulling off camouflaging due to communication and sensory challenges. Everyone has the desire to be safe from potential negative consequences. For higher support needs autistics, it can come down to basic safety as the display of atypical behaviors can lead to negative reactions and consequences from others. eg: you can get thrown off a plane for displaying stims or you get additional security screenings at airports because you engage in some repetitive stims which cops may perceive as "suspicious."  

More common or effectively practiced by females.

While research shows both male and female autistics engage in masking/camouflaging, there is evidence to suggest that it might be more common or effectively practiced by females. 


Could Camouflaging be a contributing factor in the later dx in female autistics?

This difference has been proposed as one reason for under-dx or late dx in females.  Females might be better at hiding their autistic traits, leading to their struggles being overlooked or attributed to other factors.

In Prof Steve Hinshaw's class, I also learned that 'externalizing behaviors' is often more observable in boys from their first decade itself (eg: acting out, aggression, boisterous) - so they catch the boys early in terms of dx. In girls the externalizing behaviors become more observable in their second decade (eg: eating disorders, NSSI - non suicidal self injurious behaviors etc) - so catching them later. 


Can Camouflaging be an evolutionary advantage for females?

I think the idea that females are better at camouflaging as an evolutionary advantage is an intriguing hypothesis. The argument would be that this ability allows female autistics to better integrate into social groups, potentially providing benefits in terms of social integration. 

However, it's important to note the negative effects on mental health that come with having to continually engage (cognitive effort) in camouflaging.


When Masking/Camouflaging is layered onto Triple-Bind

I first heard of Triple-Bind in Professor Steve Hinshaw's class and immediately thought of how Masking would be layered on top of Triple-Bind

"Triple Bind," poses a multifaceted challenge for women (disabled or non-disabled), requiring them to navigate a complex labyrinth of societal expectations. Hinshaw's framework suggests that women are pressured to excel in traditionally male-dominated arenas, asserting themselves competitively and ambitiously. Concurrently, they are expected to embody the nurturing, demure qualities historically associated with femininity. Adding a third layer, women are also pressured to adhere to stringent standards of attractiveness and sexuality. This triadic set of expectations creates a near-impossible standard for women to live up to, encapsulating the pervasive societal pressures that contribute to stress, anxiety, and a multitude of other psychological burdens.

Autistic females, therefore, must navigate not only the stringent expectations laid out by the Triple Bind but also the added layer of disguising their neurodivergence (camouflaging) to blend into a world that predominantly values neurotypical behaviors.

A Disability Studies Perspective
Exploring the intersection of the Triple Bind and Masking/Camouflaging through the lens of Critical Disability studies and Crip Theory offers profound insights. These academic disciplines critique societal norms that marginalize those with disabilities, advocating for a broader, more inclusive definition of normalcy. They emphasize the value of diversity and challenge the structures that define disability as a deviation from an arbitrary norm. Queer Theory, in particular, enriches this analysis by highlighting how gender and sexuality norms intersect with disability, further complicating the social experiences of autistic women who may also identify as LGBTQ. By examining the experiences of autistic women in the context of these theories, we can uncover the systemic barriers that perpetuate exclusion and advocate for a society that celebrates rather than stigmatizes differences.


Psychological Measures 

The Camouflaging Autistic Traits Questionnaire (CAT-Q) was introduced in 2019 by Laura Hull and colleagues. It aims to quantify the effort and strategies employed by autistic individuals (particularly females or AFAB, assigned female at birth) to camouflage their autistic traits. It measures the discrepancy between the individual's natural autistic behaviors and the behaviors they exhibit in social contexts, essentially capturing the social coping strategies that are not naturally aligned with their intrinsic autistic characteristics.  A self-report  approach allows for the collection of subjective data on camouflaging behaviors, which are inherently internal and personal.

The questionnaire is divided into multiple items that assess various dimensions of camouflaging
  • Masking: Efforts to hide autistic characteristics.
  • Compensation: Strategies to offset difficulties in social situations (e.g., memorizing social scripts).
  • Assimilation: Efforts to fit in with others by copying or mimicking non-autistic behaviors.


Research Citations
  • Lai, M.C., Lombardo, M.V., Pasco, G., et al. (2011). A behavioral comparison of male and female adults with high functioning autism spectrum conditions. PLoS ONE, 6(6), e20835. This study provides insights into the behavioral patterns of adults with autism, including aspects that might relate to masking and camouflaging.
  • Hull, L., Petrides, K.V., Allison, C., et al. (2017). “Putting on My Best Normal”: Social Camouflaging in Adults with Autism Spectrum Conditions. Journal of Autism and Developmental Disorders, 47(8), 2519–2534. This article explores the concept of social camouflaging in adults with autism and discusses the implications for mental health.
  • Dean, M., Harwood, R., & Kasari, C. (2017). The art of camouflage: Gender differences in the social behaviors of girls and boys with autism spectrum disorder. Autism, 21(6), 678–689. This study specifically addresses gender differences in social behaviors, including masking and camouflaging, among children with autism.
  • Goodley, D. (2014). Dis/ability studies: Theorising disablism and ableism. Routledge.
  • Hinshaw, S. (2009). The triple bind: Saving our teenage girls from today's pressures. Ballantine Books.

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