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The Least Dangerous Assumption

At a recent presentation at a college in Boston, a student asked me how I establish rapport with my autistic clients. Establishing rapport is very important for clinicians as it makes the patient more apt to comply with instructions. I told him that that is usually not a problem for me: I always presume competence and treat my clients as I would anyone else. Some parents (and clinicians) have been puzzled by this—and some have even been alarmed.

At The Lurie Center, I was introducing myself to a potential subject and his mother, and reviewing the parameters of the study with them. I addressed her son (who was in his late teens) as I asked him to sign the consent form. The mother clearly was not accustomed to this situation. As she gathered up her son and her jacket, she scolded me, “You’re talking to him as if he understands you. Don’t you know he’s mentally retarded?” She then stalked out.

It's hard not to judge that mother, or other mothers who have told me similar things. Maybe I caught her on a bad day. I have a son, and even though he is neurotypical, he was a handful as a teenager, so I have sympathy for the parent of a neurodiverse child of any age. I'm sure that mother loves her son as much as I love mine. What I don't understand is how someone can not see the humanity standing right in front of them.

As Anne Donnellan and Martha Leary have said, "The least dangerous assumption is to assume competence." If you aim too high, the worst that can happen is that the person fails and you must start again at a lower level. If you aim too low (and refuse to budge), you condemn him or her to a life of being controlled by others and vulnerable to abuse. Keep your mind open to the possibility that there is a thinking, sentient being inside your child.

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