How to navigate an ND-related work situatiin

[AuroraBorealis]

I deal with a lot of kids with ADHD on my job in child and adolescent psychiatry. Autism too, though much less, and the intersection between those two.
I have had several situations now where the parents have told the kids in my presence to stop fidgeting, to look me in the face when we're talking, or even to look me in the eyes when talking. So far, I have wiggled my way through those situations by quickly saying that I don't mind at all if they don't want to look me in the face, and as for the fidgeting, I've offered a fidget toys similar to the one I use all the time. But I kind of want a strategy for those situations, because I notice that I react spontaneously and personal in those.

How could I react to that, so that I
1) reassure the kids that they're okay to fidget and look me into the face while they're with me,
2) teach the parents that it's okay to not suppress those things all the time,
3) do that while not undermining the parents' authority and education in front of them?
I want to take a stand about this, but I can't afford to get so personally affected about it. I am a doctor and a therapist in that situation.

Thanks for suggestions!

 

[AuroraBorealis]

Sorry, I meant of course "that they're okay to fidget and not look me into the face while they're with me" in point 1.

 

[Suzanne]

I am responding, despite being no expert myself.

Can you detect how the parents feel when you say it is ok. Do they frown? Offer up and objection? Do they know that you yourself are on the spectrum?

Parents hate to see a "defect" in their child, because that child is a shadow of themselves. Also, sadly, parents tend to be in competition with other parents and thus, want to make their child look "normal".

I live in France and it is a French thing to kiss on both cheeks. Even children are urged to kiss a stranger, as it is shown to be polite. But, I disagree with that, because the parents have free will and removing that from their offspring. Now, albeit, extremely crudely, I attempt to say that it doesn't matter if the child does not wish to kiss me! If I were a child, I would hate it. I am deeply conscious of the adult disapproval in my direction, but at the same time, I cannot deal with pretense ie kissing for the sake of it.

So, based on that. The parents must know something about you and they have placed their child in your care. Make it a chance to talk to the parent individually and explain the situation; that stunting their child's innocence behaviour will lead to emotional damage and why not determine what it is that they are against and assure them that it shows a beautiful quality in a child.

However, eye contact is actually a must, because it does demonstrate rudeness to look else where or even bordom. So, a child can learn to make eye contact, but a little at a time and of course, dangerous to their selves, stims must be diverted.

What I do when I find myself feeling very uncomfortable with eye contact, I look slightly away, but make sounds to show I am listening.

Is there anything in my post that can possibly help you?

 

[Tiffany Kate]

I'm thinking, it's not just "you and the parents", it's "you and the parents and everybody else in the world". You're dealing with these kids who will need the skills to operate in a world that isn't set up for neurodivergence. In an ideal world, people's (non-harmful) differences would be accepted, but that's not the world we live in. When in Rome, do as the Romans do: when in a neurotypical world, accept that sometimes you need to put them at their ease.

I don't know how old the kids are, but maybe it's worth explaining to them that SOME people like you to look them in the face, or not fidget, when you're talking to them or they are talking to you. Other people don't mind. So why don't we work on ways to deal with both sorts of people? (e.g., if someone wants you to look them in the face, maybe concentrate on the tip of their nose, or their forehead or ear, or find a way to fidget that provides the right stimulus but without being quite so obvious.)

Regarding teaching parents, maybe:
- First, validate their feelings. Probably part (a big part?) of what they are concerned about is that if little Johnny doesn't look people in the eye/fidgets all the time, OTHER PEOPLE will think little Johnny is weird and will treat him badly. Therefore, little Johnny needs to learn not to be/look weird.
- Describe what you know about this, and your experience, both personal and professional. Do you "do eye contact"? If not, how do you manage it? What effect has it had on your life? Do you fidget? How does it help you, and how do you manage it in your personal and professional life?
- Information. Is there any information out there on the subject that you could review with the parents or direct them to? This reassures them that it's not just you - that this topic is a thing, and there are ways to deal with it. Even write something that they can take away with them. Also that fidgeting can help little Johnny concentrate, so little Johnny will actually do better if he fidgets. How does eye contact actually FEEL to an autistic person?
- Discuss ways forward, solutions - are there things in between "don't fidget" and "fidget as much as you like" that will allow little Johnny to learn strategies to manage different situations? Even if not now, maybe when he's older, which you could discuss. Collaborating and coming up with something that looks like a "compromise" may also help with parents, as accepting what you say on the subject doesn't then feel like they're "giving in" or that you're saying they were just plain wrong.

Some of it is about easing parents' quite reasonable fears for their child, and some of it is about giving them a way to accept your advice gracefully without loss of face.

There's an article here about vaccine hesitancy, but a lot of the information applies to counselling/advising patients in other situations too. https://cdn.mdedge.com/files/s3fs-public/Document/May-2018/JFP06706348.PDF