Autistic SLT

"Use a First-Then / Now-Next board"

This has been one of the most common answers Elaine McGreevy (Access Communication Ltd) I see to questions like: "How do I get this autistic child to do...?"....“How do I get them to stop...?” to leave...?”

Visual schedules, timers, countdowns and First - Then / Now and Next supports are not inherently problematic. Yes, they can be useful ways of reducing uncertainty and supporting transitions for some people, in some situations. But often, First-Then/Now-Next schedules are implemented without sufficient curiosity about the child's experience, regulation state, or perspective. The focus becomes the child having to adapt to the demands of the environment rather than exploring whether the environment itself might also need to change.

When an Autistic child is deeply engaged in monotropic flow, immersed in an interest, regulating through movement, or finding safety within a familiar activity or object, the question should not automatically become, "How do I get them to move on?" or “How do I get them to let go of this?” Yes, there are times when transitions are necessary. The issue is though, are we approaching this transition collaboratively, respectfully and with an understanding of what the child needs in this moment? Do we consider what this activity or object provides that the next activity or object may not? When an Autistic child is moving back and forth between activities and doesn't appear able to settle to one thing for long, the automatic response shouldn't necessarily be "They need a schedule."

There are other important questions to consider before making assumptions and introducing solutions unilaterally:

💠Does moving quickly between activities help them express preferences?
💠Does movement reflect curiosity, sensory-seeking, uncertainty, anxiety, overwhelm, or difficulty finding something that feels meaningful or safe?
💠Does movement tell us something about how they are experiencing the activities, the demands being placed upon them, or the environment itself?
💠What might we miss if we move to directing their engagement?
💠What would happen if we gave them more time, agency and opportunities to communicate preferences before introducing a ‘First – Then’ as a directive?
💠How can we navigate the experience of exploring, choosing, initiating and transitioning collaboratively?

It's important to examine the assumptions underlying the use of visuals. Consider - Whose agenda is being prioritised? Whose needs are being met? Whose definition of a "successful transition" are we working towards?

There is an important difference between supporting a transition and securing compliance with a transition. One is grounded in communication, collaboration and respect. The other risks becoming compliant at the expense of agency, autonomy and trust.

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www.autisticslt.com

Baby & toddler groups as an Autistic Parent:

They’re often framed as supportive spaces but for many Autistic parents, they are anything but. They can involve sensory overload, a bombardment of cognitive and social demands, and a whole lot of masking. I wrote this because those groups often mirrored my own social experiences growing up - just in a different context and at a different stage of life.

📖 Read here: https://www.autisticslt.com/babygroups

Navigating Baby Groups as an Autistic Parent | AutisticSLT Baby and toddler groups can be challenging for autistic parents due to sensory overload, communication differences, executive functioning, and the Double Empathy Problem.

Why eye contact isn’t a reliable measure of attention:

Eye contact is often treated as a sign that someone is listening and engaged, but it isn’t a reliable indicator of either. For many children and adults, eye contact can feel distracting and can actually make it harder to process what is being said. Eye contact is influenced by a range of factors, including sensory processing differences, anxiety, safety with the communication partner, regulation state, culture, fatigue, and masking.

Someone can maintain eye contact and not be fully processing what is being said. Some Autistic children may make 'good' eye contact in short, repetitive, predictable interactions, but that doesn’t mean it is comfortable - or necessary for connection.

Research suggests that forced eye contact in Autistic people can trigger stress responses in the brain, increasing anxiety and reducing the ability to process language and communicate. Therefore, encouraging eye contact can reinforce masking. In my work with families and young people, I still see eye contact goals written into . Phrases like “look at me when I’m talking to you” are still common despite what we now understand about neurodivergent communication.

If you're a professional who is still writing eye contact goals, you may be measuring compliance - not attention and communication.

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Autistic SLT | Emily Price | Empowering Autistic children and adults I’m Emily, an Autistic Speech and Language Therapist in Greater Manchester, UK. I provide neurodivergent-affirming speech and language therapy for autistic children, teens and adults, supporting communication in a way that respects neurodivergence. I combine lived experience with clinical expertis...

Love this by Sonny Hallett! ! It reminds me of Brené Brown's BRAVING acronym when she's talking about trust (which coincidentally I have tattooed on my arm...)

So ultimately, it's not about “can I trust them?” but “can I trust myself that if XYZ happens, I will....[take care of myself]"

When therapists distrust clients Some brief thoughts on trust in therapy