What We Value: SPELL
There are things we hold dear when providing developmental support for individuals with Autism Spectrum Disorder (ASD), as well as when consulting with their families and related parties.
Even though we use the terms "developmental disability" or "ASD," the way these characteristics manifest is extremely diverse, and there are many situations where it is difficult to decide how to approach them. At such times, what we think about is, "What does it mean to support someone?".
The Purpose of Support
We hope that individuals with ASD can live happy lives in their own unique way, and we think about daily support together to achieve that. While specific ideas may differ for each individual, we believe there is a common direction for support, so we would like to focus on that point today.
What is SPELL?
SPELL is a philosophy advocated by the National Autistic Society (NAS) in the UK. We strive to incorporate the SPELL philosophy into every situation. Below is a brief explanation of SPELL.
Structure
Being predictable (having foresight), being understandable, and being a safe environment are emphasized. We aim to set up an environment that organizes information and minimizes confusion. For example, visually presenting schedules and activity details in advance using notes, or summarizing consultation content in a way that is easy for the individual to understand, are also forms of Structure.
Positive
A positive atmosphere and approach are valued. For the individual, making unreasonable demands or setting tasks, and adopting a high-handed or coercive attitude is not effective. Since it is not uncommon for individuals with ASD to feel anxious, adopting a coercive or high-handed attitude only increases their anxiety and tension, making it difficult for them to demonstrate their inherent abilities. However, this does not mean accepting all words and actions of people with ASD. For example, suppose there is a situation where a person with ASD, due to their characteristics, takes actions that are generally unacceptable. Depending on the individual's characteristics and level of understanding, we calmly and logically explain why their behavior is unacceptable, while also considering the background issues of why they acted that way and making necessary environmental adjustments. For those for whom such a response is difficult, structuring the environment where the problem occurred is necessary. From their perspective, we consider whether there might be a problem on the environment's side. Without such a perspective, repeating reprimands or imposing punishments only strengthens the individual's sense of self-denial and anxiety, which can escalate the problem or lead to avoidance or rejection of activities. Also, to avoid misunderstanding, not forcing them or not putting too much burden on them is different from not providing necessary new activities or interventions. Minimizing the disadvantages arising from characteristics and providing learning opportunities for support necessary for the individual, and providing activities and plans that are meaningful to the individual are important.
Empathy
We understand the individual ASD characteristics, and based on that, we provide empathy that takes those characteristics into account. In other words, we believe that empathizing with the pain and joy felt by people with ASD, and thinking together about concrete support as needed, is the basis of support. For example, we must know that changes that neurotypical people might not care about can be a major cause of pain or confusion for people with ASD. In such cases, it is desirable to avoid sudden changes as much as possible, make them predictable by informing them in advance, and provide considerations and ingenuity such as showing them visually to make them easy to understand. Some people with ASD are sensitive to sensory stimuli, so we must not forget to empathize with such sensitivity. For those with auditory hypersensitivity, we understand that certain sounds cause considerable pain, and we think of ways to avoid them or prevent them with earmuffs, earplugs, or noise canceling. Understanding what is stressful for people with ASD and reducing stressors is also important empathy. I would like to emphasize that the idea of getting them used to or overcoming stress and pain can, as a result, corner the individual and become one of the factors leading to maladaptation in social situations.
Low Arousal
As a basis for responding to and intervening with people with ASD, it is important to interact calmly. This means keeping the tone of voice, facial expressions, and attitude Low Arousal. If you take a high-handed attitude with a loud voice or give strict guidance, they may follow instructions or the problem may appear to be solved on the spot. At first glance, it may look like it went well, but that is a power-versus-power relationship, and they are only following out of fear of the supporter. If a coercive response continues, there is a risk that they will not respond at all to instructions or interventions from someone they think is weaker than themselves. I have met people of various ages and intellectual levels, and having consulted with them for a long time, unfortunately, I have experienced such situations. However, that is not coexistence at all, and I feel it is far from support. In principle, while empathizing, we want to explore the problems behind the current difficulties and hardships together, and aim for a situation where hardships and pain are reduced, and not only the individual but also everyone around them can spend their time calmly.
Links
We value connections and cooperation with the surrounding community and region. It is important to note that connections here do not only mean preventing isolation or promoting contact with the local community. It also includes the important element of maintaining and promoting connections with supporters and society by ensuring that consideration for characteristics is made in various aspects of life, and at the same time, that continuity and consistency of support such as those considerations and ingenuity are achieved. It is necessary for people with ASD to live a meaningful life without anxiety and to participate in society that supporters such as families, teachers, doctors, and psychologists work together as a team under a consistent policy to support them. Although the way ASD characteristics manifest differs depending on age, situation, and past experience, the basic characteristics continue throughout life. This means that even if the degree and form of support and consideration change, support that takes characteristics into account is necessary throughout life.
Yokohama Developmental Consultation Room, Yasuei Sasaki