Our Core Value: "PEACE"

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Hello. This is Sasaki from the Yokohama Developmental Consultation Office.
April 2nd to 8th is World Autism Awareness Day as well as Developmental Disabilities Awareness Week. Just like last year, and with the intention of raising awareness, I filmed a video with our office representatives, Dr. Tokio Uchiyama and Dr. Yota Uno.

We discussed several topics during that time, and I would like to share with you our core values (the standards of value we hold dear) that we touched upon there.

Aiming for an Improvement in Quality of Life

As Dr. Uchiyama explains in the video, there are various methods and ways of thinking about how to support people with autism. Among them, we do not consider things like "reducing autistic traits," "making them closer to normal," or "raising IQ (intelligence quotient)."

This is because what we are aiming for is an "improvement in quality of life (QOL)," meaning that each person's life becomes richer. When thinking from that perspective, the following report has been made regarding the relationship between QOL, IQ, and current PARS (a semi-structured interview for understanding ASD traits) scores.

In other words, when considering QOL, it is likely more important to receive appropriate support as needed and to avoid unnecessary negative experiences than to focus on IQ or the traits themselves. A large-scale survey in the UK also reported that appropriate support tailored to one's traits has a positive impact on QOL (Autism Research 11(8), 1138-1147).

Therefore, how we provide support is important, and our philosophy and core values serve as guidelines for doing so. Previously, we introduced the UK National Autistic Society's SPELL framework as a way of thinking that we value.

This time, I would like to introduce our office's core values.

Five Things We Value

We held discussions among the staff, narrowed down many points we wanted to value to five, and used their initials to express them as "PEACE."

Below, I will briefly explain each one.

Positive - Positive Support

We value affirming, rather than denying, the fact that someone is on the autism spectrum (ASD). People with ASD are a minority in society as a whole. Therefore, they may face difficulties in a society built for the majority.

However, being in the minority is not inherently bad. I believe it is important not to focus on weaknesses, but to look at positive aspects and strengths (not necessarily being better than others, but things they enjoy and can engage in without becoming overly exhausted).

For example, while having narrow interests might be seen as a negative, these individuals may also be people who deeply pursue or are passionate about what they love. That is precisely why, rather than trying too hard to broaden their interests because others think it is for the best (unless they want to do so themselves), it is better to acknowledge what the person is interested in. Also, instead of just placing restrictions or prohibitions in daily life, communicating what you want them to do and what you expect in a positive way is one form of positive interaction (for example, explaining "please walk" instead of "don't run!").

Empathy - Empathy

We value empathizing with the difficulties that people with ASD feel due to their traits without denying them (this does not mean empathizing with every word or action, but rather empathizing with the difficulties that stem from their traits) and thinking about things together. For example, for someone who is sensitive to sound, instead of saying "this level of sound is fine, right?" or "let's just endure it," we recognize that even if it is a sound that doesn't bother us, it is painful for them.

While finishing up or switching tasks is also important, since difficulty in those areas is a trait in itself, we empathize with the fact that being asked to finish up or switch tasks is not easy for them.

In that context, I believe we are required to think together about "what might be possible" and "how we can slightly reduce the burden or distress."

Autism friendly: An environment that considers ASD characteristics

We value adjusting the environment and our approach to suit individuals with ASD. This also includes the "Structure" found in TEACCH and SPELL. While that is not everything, I have previously written an article about "structuring," so please take a look if you are interested.

Calm: A gentle approach

We value interacting in a calm atmosphere, rather than being strict, scolding in a loud voice, or speaking in noisy situations. Often, when anger is at the forefront, it simply causes anxiety, so we are conscious of keeping our tone of voice, facial expressions, and attitude calm to reduce unnecessary anxiety and tension as much as possible. This does not mean that we should never point things out; it means that while there may be times when we need to point things out, there is no need to express it in a loud or harsh tone, and it should be conveyed in a quiet tone. This is almost synonymous with "Low arousal" in the SPELL framework.

Evidence based: Support based on evidence

Throughout history, unfounded theories regarding the causes and treatments of ASD have circulated. For example, in the 1940s, it was seriously argued that the cause of ASD was that parents were as cold as a refrigerator. There have also been debates about vaccinations and specific substances being the cause of ASD. Regarding support and treatment, there are many that lack medical or scientific evidence.

Of course, I think our own subjectivity may sometimes enter into it, but we value providing support based on objective assessments and what has already been clarified—that is, evidence (for example, because research has shown that individuals with ASD have a bias in how they receive auditory information, visual support is more important; or, it is not that they do not empathize, but that the points they empathize with differ from the majority, so while we accept their points of empathy positively, we also explain the perspective of the majority).

Summary

Although it has been very brief, I have explained the "PEACE" that we value (as an aside, I explain it in more than double the detail in this note's circle and the Facebook group "Online Seminar").

Positive: Positive support
Empathy: Empathy
Autism friendly: An environment that considers ASD characteristics
Calm: A gentle approach
Evidence based: Support based on evidence

It is a philosophy infused with our desire for everyone to be peaceful and calm with one another.
For a richer future for individuals with ASD, we want to continue working steadily on what we can do.

Yokohama Developmental Consultation Office
Yasuei Sasaki