A Strengths-Based Approach to Autism: Neurodiversity and Partnering With the Autism Community

Abstract

The autism community represents a broad spectrum of individuals, including those experiencing autism, their parents and/or caregivers, friends and family members, professionals serving these individuals, and other allies and advocates. Beliefs, experiences, and values across the community can be quite varied. As such, it is important for the professionals serving the autism community to be well-informed about current discussions occurring within the community related to neurodiversity, a strengths-based approach to partnering with autism community, identity-first language, and concepts such as presumed competence. Given the frequency with which speech-language pathologists (SLPs) serve the autism community, the aim of this article is to introduce and briefly discuss these topics.

Full text

A Strengths-Based Approach to Autism: Neurodiversity and
Partnering With the Autism Community
Amy L. Donaldson
Department of Speech and Hearing Sciences, Portland State University
Portland, OR
Karen Krejcha
Executive Director and Co-Founder, Autism Empowerment
Vancouver, WA
Andy McMillin
Department of Speech and Hearing Sciences, Portland State University
Portland, OR
Disclosures
Financial: Amy L. Donaldson has no relevant financial interests to disclose. Karen Krejcha has no
relevant financial interests to disclose. Andy McMillin has no relevant financial interests to disclose.
Nonfinancial: Amy L. Donaldson has no relevant nonfinancial interests to disclose. Karen Krejcha
has no relevant nonfinancial interests to disclose. Andy McMillin has no relevant nonfinancial
interests to disclose.
Abstract
The autism community represents a broad spectrum of individuals, including those
experiencing autism, their parents and/or caregivers, friends and family members,
professionals serving these individuals, and other allies and advocates. Beliefs, experiences,
and values across the community can be quite varied. As such, it is important for the
professionals serving the autism community to be well-informed about current discussions
occurring within the community related to neurodiversity, a strengths-based approach to
partnering with autism community, identity-first language, and concepts such as presumed
competence. Given the frequency with which speech-language pathologists (SLPs) serve the
autism community, the aim of this article is to introduce and briefly discuss these topics.
Speech-language pathologists (SLPs) play an important role on interdisciplinary teams that
serve the autism community. According to the American Speech-Language Hearing Association
(ASHA, 2016), 90% of school-based SLPs reported serving students experiencing autism spectrum
disorder (ASD); in addition, SLPs in early intervention, private practice, medical, and other clinical
settings all report serving children, adolescents, and adults with ASD (Coffey & Donaldson, 2015;
Paynter & Keen, 2015; Plumb & Plexico, 2013). Given the strong presence of such individuals on
the caseloads of SLPs, it is important for professionals to understand the dynamic nature of the
autism community and how to best partner with its members. Indeed, as evidence-based clinicians,
it is incumbent upon SLPs to gather information about family, individual, and consumer values,
beliefs and preferences and utilize such information in family-centered assessment and intervention
planning (ASHA, n.d.; Crais, Roy, & Free, 2006).
Much like autism presents as a spectrum across individuals, one might describe the
members of its community in the same way. The community includes individuals with ASD,
caregivers, family members, service providers, and other stakeholders. Diversity of opinions and
perspectives within the community is reflected in many ways–from self-identification to pursuit of
intervention (Davidson & Orsini, 2013). As Kenny and colleagues stated (2016), “Members of the
56
Perspectives of the ASHA Special Interest Groups
SIG 1, Vol. 2(Part 1), 2017, Copyright © 2017 American Speech-Language-Hearing Association
Downloaded From: http://perspectives.pubs.asha.org/pdfaccess.ashx?url=/data/journals/persp/935966/ by a ReadCube User on 02/01/2017
Terms of Use: http://pubs.asha.org/ss/rights_and_permissions.aspx

autism community–autistic people, their family and friends and broader support network –often
disagree over how to describe autism”(p. 442).
Traditionally, many community members (particularly service providers) have espoused
a“medical model”of autism. This model views ASD from a deficit-based perspective with an aim
toward normalization and elimination of symptoms; in some cases, autism is compared to a
disease, with the goal of being “cured”(Kapp, Gillespie-Lynch, Sherman, & Hutman, 2012).
Further, the medical model influence has resulted in far greater research funding focused on
determining the etiology of autism and for early intervention than for supports for those currently
experiencing autism (Holmer Nadesan, 2013; Singh, Illes, Lazzeroni, & Hallmayer, 2009).
The other end of the spectrum is the view of ASD, and of disability in general, from a
social model of disability (Carol, 2010). This approach is informed by the critical disability research
over the last 30 years, and captures the political movement of those with disabilities who argue
for changing discriminatory social mechanisms and for the attainment of civil rights for disabled
people (Carol, 2010; Soffer & Almog-Bar, 2016). When barriers are removed, disabled people can
be independent and equal in society, with choice and control over their own lives. For those on the
autism spectrum, it specifically represents a neurodiversity perspective.
Neurodiversity advocates promote a view that autism and other neurological conditions
are natural variants of human neurological outcomes—natural difference, rather than disorder
(Sarrett, 2016; Straus, 2016). Indeed, the unique strengths, challenges, and differences
associated with autism are central to one’s identity (Kapp et al., 2012). Neurodiversity advocates
support interventions in which therapists capitalize upon one’s strengths to support one’s
challenges, while respecting the uniqueness of each individual. This approach seeks to challenge
current research funding priorities that focus primarily on etiology and remediation; but, rather
shift to research for improving the quality of life of people experiencing autism, particularly those
who view their “autism as a positive aspect of identity,”as well as research to decrease health-
care disparities (Raymaker & Nicolaidis, 2013, p. 178).
Given the wide diversity within the autism community and the key role of SLPs in
partnering with this community, we have two main aims for this article. Our first aim is to provide
a brief introduction of the neurodiversity movement and its key principles for SLPs who may
be new to this viewpoint. As prominent members of interdisciplinary teams who may encounter
families new to a diagnosis of ASD, it is important for SLPs to understand the variability of
perspectives within the autism community and be prepared to provide a wide range of resources
for the families they serve. Our second aim is to discuss how professionals might best partner
with the autism community from a strengths-based perspective. In our experience, it is best to
approach assessment and treatment from a strengths-based perspective regardless of the beliefs
of the family experiencing autism—whether they espouse a medical model, a social disability
model, a neurodiversity model, or somewhere along the continuum.
Neurodiversity and a Strengths-Based Perspective
The term “neurodiversity,”which suggests recognition of neurological variation or brain-
based differences as the result of natural human variation (Jaarsma & Welin, 2012), was first
coined in the 1990s by an Australian advocate, Judy Singer (1998), and later reported in an
article by journalist, Harvey Blume.
Neurodiversity may be every bit as crucial for the human race as biodiversity is for life
in general. Who can say what form of wiring will prove best at any given moment?
Cybernetics and computer culture, for example, may favor a somewhat autistic cast of
mind. (Blume, 1998)
57
Downloaded From: http://perspectives.pubs.asha.org/pdfaccess.ashx?url=/data/journals/persp/935966/ by a ReadCube User on 02/01/2017
Terms of Use: http://pubs.asha.org/ss/rights_and_permissions.aspx

Neurodiversity provides a framework for many key principles that support a strengths-based
approach to partnering with the autism community. These principles cross multiple areas
integral to an SLP’s clinical practice, including communication, social interaction, and motivation.
Word Choice Is Important
As communication specialists, SLPs know that words are powerful. As such, it is helpful
for our discipline to understand some of the current conversations and cultural dialogue related
to self-identity within the autism community. There is ongoing debate with regard to the “D”in
ASD. Some argue that “disorder”should be changed to “difference,”while others have started
using the term “condition”. Indeed, Lai, Lombardo, Chakrabarti, & Baron-Cohen (2013) stated,
…we have opted for the more neutral term “ASC”(Autism Spectrum Conditions) to signal
that this is a biomedical diagnosis in which the individual needs support, and which
leaves room for areas of strength as well as difficulty, without the somewhat negative
overtones of the term “disorder,”which implies something is “broken.”(p. 1)
Another equally important topic is identity-first versus person-first language. The standard in our
discipline (as in many other rehabilitation professions) is the use of person-first language when
serving clients. However, it is important to listen to and respect the wishes of those community
memberswithwhomwepartner.MuchliketheDeaf community and disability advocacy
community, many individuals in the autism community choose to use the identity-first language
of “autistic”or “autistic person”rather than “person with autism”(Dunn & Andrews, 2015; Kapp
et al., 2012; Ortega, 2013). Sinclair (1999) was the first autistic self-advocate to write about this
topic, offering several reasons for identity-first language: (a) autism cannot be separated from
the person, as person-first language seems to encourage; (b) autism is an important part of an
individual; and (c) autism is not something “bad”to be separated from a person. Sinclair (1999)
states, “I am autistic because I accept and value myself the way I am.”Further, several top-tier
research journals (e.g., Autism: The International Journal of Research and Practice and The Journal
of General Internal Medicine) have now started using identity-first language in recognition of this
cultural and community distinction.
Most recently, Kenny and colleagues (2016) completed a survey of the autism community
in the United Kingdom to identify their preferred terms for describing autism. The community
members who responded to the survey (n=3470) included autistic people (n=502), parents of
people with autism (n=2207), professionals involved in the autism community (n=1109), and
family members and friends (n=380). Survey results indicated that the term “autistic”was favored
by autistic individuals, family members/friends, and parents (61%, 52% and 51% respectively),
but considerably less so by professionals (38%). An opposite trend was noted for “person with
autism;”49% of professionals favored the phrase, whereas only 28% of autistic individuals and
22% of parents preferred the phrase.
Across all groups use of the term “low-functioning autism”was limited, as it makes
assumptions regarding one’scompetence;thesamewasconcluded regarding the term “high-
functioning autism”. For example, one respondent reported,
In my experience if you’re viewed as high functioning, then your needs are often
dismissed. If you’re viewed as low functioning, then your strengths are often dismissed.
Also, ‘functioning’is something that can vary between tasks and on different days
according to stress levels, for example. (Kenny et al., 2016, p. 452)
Many in the autism community advocate discontinuing use of functioning terms for exactly these
reasons (see Edow, 2015 and Ollibean, 2016 for additional discussion on this topic).
As aforementioned, a spectrum within the autism community exists. Many individuals
(and their families) use identity-first language, others use person-first language, and some use
these interchangeably (Davidson & Orsini, 2013; Kenny et al., 2016). Given these factors, the
authors have used both terms within this paper, and when working with the autism community
58
Downloaded From: http://perspectives.pubs.asha.org/pdfaccess.ashx?url=/data/journals/persp/935966/ by a ReadCube User on 02/01/2017
Terms of Use: http://pubs.asha.org/ss/rights_and_permissions.aspx

we defer to the self-identification (with regard to language use) of the families we serve who
experience autism. In other words, within a clinical or educational context, we advocate for
professionals to follow the preferences of the individuals and families they serve –if an individual
indicates that they identify as a “person with autism,”it’s respectful and appropriate for us to
follow that lead. If the family indicates they prefer the term “autistic,”the same principle applies.
As professionals, we feel it is not our place to determine how an individual self-identifies, but
rather to listen and respect that individual’s right to do so. Additionally, we feel it is important to
educate speech-language pathology students, other team members, and those who interact with
the autism community about neurodiversity and identity-first language, so that they become
accustomed to hearing both person-first and identity-first language within professional contexts.
Finally, although Asperger syndrome is no longer included as a distinct condition in the
most recent Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5; American Psychiatric
Association, 2013), many youth and adults previously diagnosed as such continue to self-identify
as Asperger or “Aspie”(Kenny et al., 2016). This segment of the autism community has established
a strong presence in autism self-advocacy (Calzada, Pistrang, & Mandy, 2012; Global and Regional
Asperger Syndrome Partnership, 2017) and shares their experiences through books (Kim, 2014),
online blogs (e.g., Dude, I’m an Aspie n.d.; Musings of an Aspie, n.d.), and community activism (e.g.,
Oregon Commission on Autism Spectrum Disorder, n.d.). Professionals partnering with the autism
community can benefit not only from a recognition of the range of ways that individuals self-
identify, but also by gathering resources (locally, regionally, and online) to share with the clients
they serve, enabling families to connect with other members of the community who may share their
experiences and/or bring a new perspective to their understanding of autism. To this end, the
authors have provided a brief list of resources for professionals who are new to neurodiversity and
autism self-advocacy. The list is not intended to be exhaustive, but rather a starting place for those
seeking additional information (see Appendix A). We also strongly encourage professionals to read
the personal blogs of autistic individuals to learn their first-hand, insider perspectives (as often
professionalsonlyhaveinteractionswithparents of children with ASD); these can be found
through a simple Internet search.
Partnering With the Autism Community
The family-centered approach to service provision has long advocated partnering with
the communities SLPs serve. Although one might associate family-centered services with young
children, this approach is not limited by chronological boundaries (Bruce, DiVenere, & Bergeron,
1998); rather, it can apply to all populations SLPs serve. It is a model of collaboration and an
approach to relationship building that moves away from the traditional service provider as
“expert”model of intervention. Indeed, a true partnership requires development of a working
relationship between an individual and/or family member and the clinician where each is
contributing to the learning of the other and shared decision-making is the goal (Bruce et al.,
1998; Dunst, Trivette, & Deal, 1988). This type of partnership can promote a strengths-based
approach to serving individuals with ASD in that it enables a clinician to “meet a family where
they are at”in their personal journey/experience with autism. The clinician can learn about the
family’s experience with autism and what perspectives they hold related to culture and identity.
The clinician can assist the family in learning about the autistic’s strengths and challenges and
use this information to jointly establish priorities for functional intervention outcomes, tapping
into strengths to support challenges. Finally, by partnering with the individual and family, the
clinician is upholding a key tenet of the disability community—“Nothing about us without us”
(Charlton, 2000), that is also the motto of the Autistic Self Advocacy Network (ASAN, 2017).
Community-based participatory research is another area rife with opportunity to partner
with the autism community. As Raymaker and Nicolaidis (2013) discuss, like many minority
communities, the autism community has been the subject of much research, but rarely have they
been involved in the development of said research, which can lead to feelings of distrust, issues
with study validity, and challenges with study effectiveness. They suggest use of participatory
research approaches that include community members as full members of the research team,
59
Downloaded From: http://perspectives.pubs.asha.org/pdfaccess.ashx?url=/data/journals/persp/935966/ by a ReadCube User on 02/01/2017
Terms of Use: http://pubs.asha.org/ss/rights_and_permissions.aspx

not “simply a source of raw data”(p. 169). This approach ensures that research projects, from
ideation to dissemination are rooted in community contexts and priorities, and shaped by immediate
community feedback. Research outcomes that are generated from such partnerships will contribute
to our corpus of evidence-based practices in socially and ecologically valid ways that may not have
been considered in the past.
A Familiar Model
Finally, the neurodiversity movement is not unique in cultivating views that are consistent
with a social model of disability. SLPs will most likely be familiar with the social model from their
interactions with the stuttering community, where several voices of advocacy have emerged.
Indeed, ASHA’s Special Interest Division 4: Fluency and Fluency Disorders issued a report noting
that “no systematic research was carried out”to support establishing the policy of person-first
language (ASHA, 1999, p. 33). St. Louis (1999) and Dietrich, Jensen, and Williams (2001) each
compared public attitudes and reactions to the identity-first label “stutterer”compared with the
person-first label “person who stutters”and found no differences in reactions to these two terms.
Since then, the question of identity as a “person who stutters”or as a “stutterer”has
been a frequent topic of conversation among people who stutter, particularly in support group
situations and on conversation-based podcasts such as StutterTalk. Many people embrace
person-first language related to stuttering, though just as with the neurodiversity movement,
there are others who specifically reject person-first labeling and embrace identity-first language.
For example, Schick (2015) notes ways in which person-first language can backfire, dividing
disabled communities and thus diluting their potential power.
Voices advocating for partnerships between clinicians and clients have also been noted
in the stuttering community. Advocates of comprehensive treatment approaches to stuttering
have long suggested that one size does not fit all when it comes to treating stuttering, and that
the inclusion of the client’s goals is essential in any treatment plan (Yaruss, Coleman, & Quesal,
2012). Similarly, Watermeyer and Kathard (2016) argue that treatment plans that focus on
fluency may inadvertently reinforce prevailing cultural attitudes toward stuttering, which are
primarily negative. And the journalist Barry Yeoman, in a recent keynote address to the National
Stuttering Association’s New York City Chapters Conference, called for a culture that recognizes,
“that speech therapy is an option …but it’s not the only option. And that if we choose it, we get to
decide which type of therapy we need”. He further advocates for a cultivation of pride in stuttering
itself, saying that “speaking with a stutter, even a severe one, is an option, that there is no shame
in it, and that there is in fact music in it”(2016).
Stuttering pride is also reflected in the Did I Stutter Project (n.d.). They view stuttered
speech as a naturally occurring variant in human communication, and make the case that a part
of valuing diversity must include valuing stuttered speech. In alignment with the neurodiversity
movement, the Did I Stutter Project calls upon us to recognize the underlying neurological makeup
that likely contributes to stuttering, and to value this neurological diversity in the same way that
we value other aspects of human diversity.
Presumed Competence
A key component of a strengths-based approach to assessment and intervention for
serving any population is the notion of presumed competence –the assumption that the individual
brings capability, strengths, and competency to a task or endeavor. This viewpoint is of particular
importance when partnering with autistic individuals who have limited or no verbal language
for communication, as society often makes assumptions about the receptive language and/or
cognitive skills of these individuals (Dawson, Soulieres, Gernsbacher, & Mottron, 2007).
In 2013, Emerson and Dearden used a presumed competence model to examine a
language intervention for a nonverbal 10-year old child with autism. They examined the assumption
that because he was nonverbal, he also presented with limited receptive language skills. Based on
this assumption, the child’sschoolhadadopteda“minimal speech [intervention] approach”—use of
60
Downloaded From: http://perspectives.pubs.asha.org/pdfaccess.ashx?url=/data/journals/persp/935966/ by a ReadCube User on 02/01/2017
Terms of Use: http://pubs.asha.org/ss/rights_and_permissions.aspx

single-word or two-word phrases and use of gestures (Potter & Whittaker, 2001). Emerson and
Dearden adopted what they deemed a “less dangerous assumption”approach by “assuming
understanding and adjusting language when comprehension difficulties became apparent…The
intention was to gradually simplify language if children were demonstrating difficulty comprehending
full sentences”(p. 234). Following this presumed competence approach to intervention, the child
demonstrated response to increasingly complex questions, as well as literacy skills that had been
previously undocumented. The authors noted that one of the main findings of the study was
…that the greatest barrier to Jack’s progress may have been the assumption of limited
ability by the teaching staff…Staff were initially very skeptical about the approach
adopted by the researchers. They repeatedly questioned the researchers’use of language
and warned that the students would not understand. Staff initially interpreted Jack’s
responses as random answers. When he correctly selected written words from a choice of
two or three they presumed that this was due to chance, no matter how many repetitions
he completed correctly. However, once he was consistently identifying the correct word
from a choice of six, staff began to recognize that Jack could read. (Emerson & Dearden,
p. 243)
Kasa-Hendrickson & Buswell (2007) and Hussman (2015) offer some strategies for promotion of
presumed competency. These include:
•use age-appropriate communication with clients;
•support clients in demonstrating their strengths;
•assume that every individual will benefit from learning age-appropriate skills/
curriculum;
•directly ask client for permission before sharing any information;
•support access to age-appropriate information/curriculum through accommodations
and adaptations;
•look for solutions to success—“how can this work?”;
•support communication using multiple modalities; pay particular attention to
supporting communication between peers;
•do not speak about the client in front of the client; include the person as you would a
neurotypical person (a person with “typical development”).
•do not speak for the client—allow them to speak for themselves;
•recall that “challenging”behavior often serves a communicative or sensory function—
with your team, try to determine the function of the behavior, rather than automatically
attempting the eliminate it. The function is important—support the client in meeting
that need (see Bopp, Brown, & Mirenda, 2004 for information about an SLP’s role in a
team-based Functional Behavior Assessment); and
•do not assume lack of comprehension—before interpreting information, look for signs
for understanding.
Self-Determination
Another key concept of a strengths-based approach to assessment and intervention is
self-determination. Self-determination refers to an individual’s ability to be the agent of their own
actions, to pursue their own goals, to face challenges, to achieve success and to learn from mistakes
(Wehmeyer & Abery, 2013). Further, one’s pursuit of such goals and how this impacts one’s quality
of life is also considered to be a factor of self-determination (Turnbull & Turnbull, 2001). Core
assumptions of self-determination include: all people can engage in self-determination, and
61
Downloaded From: http://perspectives.pubs.asha.org/pdfaccess.ashx?url=/data/journals/persp/935966/ by a ReadCube User on 02/01/2017
Terms of Use: http://pubs.asha.org/ss/rights_and_permissions.aspx

severity or type of disability does not preclude one’s self-determination participation (Loman,
Vatland, Strickland-Cohen, Horner, & Walker, 2010). Promotion of self-determination, regardless
of cognitive skills and use of verbal language is consistent with the goals of autistic self-advocacy
and the ideals of partnering with the autism community. Indeed, the Developmental Disabilities
Assistance and Bill of Rights Act of 2000 (Public Law 106-402) defines self-determination activities
as “activities that result in individuals with developmental disabilities, with appropriate assistance,
having—
A. the ability and opportunity to communicate and make personal decisions;
B. the ability and opportunity to communicate choices and exercise control over the type
and intensity of services, supports, and other assistance the individuals receive;
C. the authority to control resources to obtain needed services, supports, and other
assistance;
D. opportunities to participate in, and contribute to, their communities; and
E. support, including financial support, to advocate for themselves and others, to develop
leadership skills, through training in self-advocacy, to participate in coalitions, to educate
policymakers, and to play a role in the development of public policies that affect individuals
with developmental disabilities.”(Administration for Community Living, 2013)
Self-determination has long been supported in the rehabilitation, education and psychology
literature as an important tenet of our professional work (see Turnbull & Turnbull, 2001 and
Ruppar, 2014 for further discussion and examples). Clinicians can promote self-determination
in a variety of ways. One significant way to promote self-determination and also capitalize on
evidence-based practices for serving individuals with ASD is to encourage and teach choice
making. Wehmeyer & Abery (2013) discuss how choice making is a fundamental component
of self-determination. By encouraging an individual with autism to make choices, the clinician
is promoting independence and improved quality of life. Choice making includes identifying
possible options, evaluating the pros and cons of the options, making a choice, developing an
action plan, and experiencing the choice (Loman et al., 2010). The choice making process can
be targeted across all types of decisions, from everyday choices (e.g., activities, toys, foods) to
more significant life decisions (e.g., class choices, jobs, places to live). Further, providing choices
within intervention is a key feature of evidence-based practices, such as Pivotal Response Training
(Koegel et al., 1989) and the Early Start Denver Model (Dawson et al., 2010; Rogers & Dawson,
2009). By offering choices to young children with ASD within intervention, one maintains the
child’s motivation to engage; such motivation has been found to be pivotal for learning for young
children with ASD (Schreibman et al., 2015). Another way to promote self-determination is the
use of self-directed learning in which clinicians and teachers provide supports for individuals to
set goals and self-monitor their progress (Loman et al., 2010). This approach involves teaching of
problem-solving strategies to support self-monitoring of skills and places the individual with ASD
in control of determining progress and providing self-reinforcement for accomplishment of goals.
Following teaching of strategies, clinicians and teachers must provide multiple opportunities for
individuals with autism to practice these skills.
Environmental Supports
Autistic learners have been identified as having particular strengths and preference for
processing visual information (Mesibov et al., 2005). As such, visual supports have been examined
to determine their effectiveness in supporting learning. Both the National Autism Center’s
National Standards Project (2015) and the National Professional Development Center on Autism
Spectrum Disorders (n.d.; AFIRM Team 2015) have identified visual supports as an established
evidence-based practice. Visual supports can include pictures, objects, written words, schedules,
labels, maps, scripts, visual boundaries, arrangement of the environment, timelines, and
organization systems. These concrete visual cues can be used alone or in conjunction with verbal
62
Downloaded From: http://perspectives.pubs.asha.org/pdfaccess.ashx?url=/data/journals/persp/935966/ by a ReadCube User on 02/01/2017
Terms of Use: http://pubs.asha.org/ss/rights_and_permissions.aspx

cues to provide the learner with information about an expected routine, activity, behavior, and/or
how to complete a task. Visual supports have been used successfully to support children and
adolescents with autism with play, social communication, cognitive, academic, motor and adaptive
skills (AFIRM Team, 2015). In addition to tapping into potential visual strengths, use of visual
supports provides predictability around future events and transitions, as well as concrete
expectations and boundaries, which may support some individual’s preference for predictability
and order (Ryan & Raisanen, 2008; ASAN, 2017). For further information on visual supports,
including implementation tips and data collection sheets, please see AFIRM Team, 2015.
Additional environmental supports that will enable one to approach assessment and
intervention from a strengths-based perspective include attention to the individual’s sensory needs.
The ASAN (2017) states, “While all Autistics are as unique as any other human beings, they share
some characteristics typical of autism in common.”One such characteristic is experiencing the
world differently with regard to one’s senses. Autistic individuals might experience sensitivity
to light, sound, smell, taste, temperature, texture, or touch. They might demonstrate difficulty
interpreting physical sensations or might experience such sensations differently than neurotypical
individuals (e.g., synesthesia; ASAN, 2017). Through discussion of these sensory differences with
our autistic clients and/or in collaboration with our occupational therapy (OT) colleagues, we can
arrange the environment to strengthen the performance of our clients (e.g., dimming the lights,
providing noise-cancelling headphones, creating a quiet place for calm self-regulation, etc.).
Passion Is a Strength
According to the DSM-5, restricted interests are one of the defining features of ASD (APA,
2013). This is also noted by ASAN, but can be viewed from a strengths-based perspective. ASAN
(2017) notes that autistic individuals present with “deeply focused thinking and passionate
interest in specific subjects”. As aforementioned, motivation is a pivotal behavior for children
with ASD. For example, Baker, Koegel, and Koegel (1998) examined use of a passionate interest
(maps) as the focal point of a game involving a child with autism and neurotypical peers during
recess. Following an intervention that incorporated use of maps in a tag game, the child with
ASD not only increased his social interactions with peers, but also generalized his interactions
to other non-map activities initiated by his peers. Clinicians can tap into the strengths of the
autistic children they serve by capitalizing on their intense interests and assisting them in
sharing these interests with peers. Further, clinicians can coach parents and teachers in this
practice as well. For example, a child who struggles in reading but has a passion for weather
might excel at a book report that incorporates his love of weather. Such special interests can
be tied to numerous academic domains, including math, writing, music, history, and life skills.
As the research indicates, this will increase social interaction and engagement; in addition, it will
build equity in peer relationships by giving the child with autism an opportunity to share their
knowledge and identify friends who may share similar interests. After all, that’s a key component
of friendship –someone who shares one’s interests.
Quality of Life
Success in sharing one’s interests leads to increased social interactions (Baker et al., 1998;
Donaldson, 2015) and, presumably, feelings of self-efficacy and quality of life (QoL). Biggs and
Carter (2016) examined QoL factors for adolescents with autism as they transitioned from school
age to young adulthood. Parent report indicated ratings of QoL for children with ASD or intellectual
disability to be significantly lower than a control group of neurotypical same-age peers. However,
the authors indicated that increased involvement in extra-curricular and community activities
was associated with higher social support and peer relationship ratings. Further, they stated that
the strengths of the adolescents (i.e., courage, empathy, forgiveness, gratitude, humor, kindness,
optimism, resilience, self-control, and self-efficacy—as measured by the Assessment Scale for
Positive Character Traits- Developmental Disabilities), was one of the strongest predictors of QoL.
Conversely, neither ratings of required support nor level of functioning were a significant indicator
of QoL. Given these findings, the authors suggested ensuring opportunities for community
63
Downloaded From: http://perspectives.pubs.asha.org/pdfaccess.ashx?url=/data/journals/persp/935966/ by a ReadCube User on 02/01/2017
Terms of Use: http://pubs.asha.org/ss/rights_and_permissions.aspx

involvement, increased focus on strengths, preferences and interests of autistic individuals, and
support for inclusive learning environments (Biggs & Carter, 2016).
Conclusions
The autism community represents a spectrum of individuals who present with different
perspectives, cultural and community beliefs, strengths, and needs for support. From a
neurodiversity model encompassed within a broader social model of disability to a medical model
of ASD, the community of autism is large and ever growing. As SLPs, we have the opportunity to
partner with the families who experience autism from a strengths-based framework. We should
be prepared to build a relationship of joint learning and decision-making, presuming competence
in all tasks, maximizing the individual’s strengths and passions, setting up the environment
attuned to their sensory uniqueness, empowering their self-determination, and focusing on the
broader picture of quality of life through functional community, peer-based, goals that tap into
personal strengths and social interaction.
References
Administration for Community Living. (2013). The developmental disabilities Assistance and bill of rights
act of 2000 (Public Law 106–402). Retrieved from https://acl.gov/Programs/AIDD/DDA_BOR_ACT_2000/
Index.aspx
AFIRM Team. (2015). Visual supports. Chapel Hill, NC: National Professional Development Center on
Autism Spectrum Disorders, FPG Child Development Center, University of North Carolina. Retrieved from
http://afirm.fpg.unc.edu/visual-supports
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed).
Washington, DC: Author.
American Speech-Language-Hearing Association. (2016). 2016 schools survey: SLP caseload characteristics.
Retrieved from http://www.asha.org/uploadedFiles/2016-Schools-Survey-SLP-Caseload-Characteristics.pdf
American Speech-Language Hearing Association. (n.d.) Autism. Retrieved from http://www.asha.org/
Practice-Portal/Clinical-Topics/Autism/
American Speech-Language-Hearing Association. (1999, March). Terminology pertaining to fluency and
fluency disorders: Guidelines. Asha, 41(Suppl. 19), 29–36.
Autistic Self Advocacy Network. (2017). Retrieved from http://autisticadvocacy.org/
Baker, M. J., Koegel, R. L., & Koegel, L. K. (1998). Increasing the social behavior of young children with autism
using their obsessive behaviors. Research and Practice for Persons with Severe Disabilities, 23(4), 300–308.
Biggs, E. E., & Carter, E. W. (2016). Quality of life for transition-age youth with autism or intellectual
disability. Journal of Autism and Developmental Disorders, 46, 190–204.
Blume, H. (1998, September). Neurodiversity: On the neurological underpinnings of Geekdom. The Atlantic.
Bopp, K. D., Brown, K. E., & Mirenda, P. (2004). Speech-language pathologists’roles in the delivery of
positive behavior support for individuals with developmental disabilities. American Journal of Speech-
Language Pathology, 13, 5–19.
Bruce, M. C., DiVenere, N., & Bergeron, C. (1998). Preparing students to understand and honor families as
partners. American Journal of Speech-Language Pathology, 7(3), 85–94.
Calzada, L. R., Pistrang, N., & Mandy, W. (2012). High-functioning autism and Asperger’s disorder: utility
and meaning for families. Journal of Autism and Developmental Disabilities, 42, 230–243.
Carol, T. (2010). How is disability understood? An examination of sociological approaches. Disability and
Society, 19(6), 569–583.
Charlton, J. I. (2000). Nothing about us without us: Disability oppression and empowerment. Berkeley CA:
University of California Press.
Coffey, J., & Donaldson, A. L. (2015). Survey of speech-language pathology intervention practices for serving
individuals with autism spectrum disorders. Poster presented at Oregon Speech-Language Hearing
Association Conference, Portland, OR.
64
Downloaded From: http://perspectives.pubs.asha.org/pdfaccess.ashx?url=/data/journals/persp/935966/ by a ReadCube User on 02/01/2017
Terms of Use: http://pubs.asha.org/ss/rights_and_permissions.aspx

Crais, E. R., Roy, V. P., & Free, K. (2006). Parents’and professionals’perceptions of the implementation of
family-centered practices in child assessments. American Journal of Speech-Language Pathology, 15, 365–377.
Davidson, J., & Orsini, M. (2013). Worlds of autism: Across the spectrum of neurological difference.
Minneapolis, MN: University of Minnesota Press.
Dawson, G., Rogers, S. J., Munson, J., Smith, C. M., Winter, J., Greenson, J., ... Varley, J. (2010).
Randomized controlled trial of the early start Denver model: A developmental behavioral intervention for
toddlers with autism: Effects on IQ, adaptive behavior, and autism diagnosis. Pediatrics, 125(1), 17–23.
Dawson, M., Soulieres, I., Gernsbacher, M. A., & Mottron, L. (2007). The level and nature of autistic
intelligence. Psychological Science, 18(8), 657–662.
Did I Stutter? (n.d.) Retrieved from http://www.didistutter.org/
Dietrich, S., Jensen, K. H., & Williams, D. E. (2001). Effects of the label “stutterer”on student perceptions.
Journal of Fluency Disorders, 26, 55–66.
Donaldson, A. L. (2015). SocialsibS: A family-based approach to social communication intervention for
children with autism spectrum disorder. Paper presented at the American Speech-Language Hearing
Association Convention, Denver, CO; November.
Dude, I’m an Aspie. (n.d.) Retrieved from http://www.dudeimanaspie.com/
Dunn, D. S., & Andrews, E. E. (2015). Person-first and identity-first language: Developing psychologists’
cultural competence using disability language. American Psychologist, 70(3), 255–264.
Dunst, C., Trivette, C., & Deal, A. (1988). Enabling and empowering families. Cambridge, MA: Brookline.
Edow, J. (2015). High-functioning or low-functioning? Retrieved from http://www.judyendow.com/advocacy/
high-functioning-or-low-functioning/
Emerson, A., & Dearden, J. (2013). The effect of using ‘full’language when working with a child with autism:
Adopting the ‘least dangerous assumption’.Child Language Teaching and Therapy, 29(2), 233–244.
Global and Regional Asperger Syndrome Partnership. (2017). Retrieved from https://grasp.org/
Holmer Nadesan, M. (2013). Constructing autism: Unraveling the “truth”and understanding the social.
New York, NY: Routledge.
Hussman, J. P. (2015). Presume competence: A guide to successful, evidence-based principles for
supporting and engaging individuals with autism. Retrieved from http://www.hussmanautism.org/wp-
content/uploads/2015/11/PresumeCompetence_HussmanInstitute.pdf
Jaarsma, P., & Welin, S. (2012). Autism as a natural human variation: Reflections on the claims of the
neurodiversity movement. Health Care Analysis, 20(1), 20–30.
Kapp, S. K., Gillespie-Lynch, K., Sherman, L. E., & Hutman, T. (2012). Deficit, difference, or both? Autism
and neurodiversity. Developmental Psychology, 49(1), 59–71.
Kasa-Hendrickson, C., & Buswell, W. (2007). Strategies for presuming competence (T. P. Center, Ed.).
Pittsburgh, PA. Retrieved from http://www.disabilityrightsmt.org/janda3/files/articles/1279056624_
PresumingCompetence.pdf
Kenny, L., Hattersley, C., Molins, B., Buckley, C., Povey, C., & Pellicano, E. (2016). Which terms should be
used to describe autism? Perspectives from the UK autism community. Autism, 20(4), 442–462.
Kim, C. (2014). Nerdy, shy, and socially inappropriate: A user guide to an Asperger life. Philadelphia, PA:
Jessica Kingsley Publishers.
Koegel, R. L., Schreibman, L., Good, A., Cerniglia, L., Murphy, C., & Koegel, L. C. (1989). How to teach
pivotal responses to children with autism: A training manual. Santa Barbara, CA: University of California
Press.
Lai, M.-C., Lombardo, M.V., Chakrabarti, B., & Baron-Cohen, S. (2013). Subgrouping the Autism
“Spectrum”: Reflections on DSM-5. PLOS: Biology, 11(4), e1001544. doi:10.1371/journal/pbio.1001544
Loman, S., Vatland, C., Strickland-Cohen, K., Horner, R., & Walker, H. (2010). Promoting self-determination:
A practice guide. Funded by the U.S. Department of Health & Human Services, Administration on Developmental
Disabilities. Retrieved from http://ngsd.org/sites/default/files/promoting_self-determination_a_practice_
guide.pdf
65
Downloaded From: http://perspectives.pubs.asha.org/pdfaccess.ashx?url=/data/journals/persp/935966/ by a ReadCube User on 02/01/2017
Terms of Use: http://pubs.asha.org/ss/rights_and_permissions.aspx

Mesibov, G. B., Shea, V., & Schopler, E. (with Adams, L., Burgess, S., Chapman, S. M., Merkler, E.,
Mosconi, M., Tanner, C., & Van Bourgondien, M. E.) (2005). The TEACCH approach to autism spectrum
disorders. New York, NY: Springer.
Musings of an Aspie. (n.d). Retrieved from https://musingsofanaspie.com/
National Autism Center. (2015). Findings and conclusions: National standards project, phase 2. Randolph,
MA: National Autism Center.
Ollibean. (2016). More problems with functioning labels. Retrieved from http://ollibean.com/problems-
functioning-labels/
Oregon Commission on Autism Spectrum Disorder. (n.d.) Retrieved from http://orcommissionasd.org/
Paynter, J. M., & Keen, D. (2015). Knowledge and use of intervention practices by community-based early
intervention service providers. Journal of Autism and Developmental Disorders, 45, 1614–1623.
Plumb, A. M., & Plexico, L. W. (2013). Autism spectrum disorders: Experience, training and confidence levels
of school-based speech-language pathologists. Language, Speech, and Hearing Services in Schools, 44, 89–104.
Potter, C., & Whittaker, C. (2001). Enabling communication in children with autism. London: Jessica Kingsley.
Ortega, F. (2013). Cerebralizing autism within the neurodiversity movement. In J. Davidson & M. Orsini (Eds.),
Worlds of autism: Across the spectrum of neurological difference. Minneapolis, MN: University of Minnesota
Press.
Raymaker, D., & Nicolaidis, C. (2013). Participatory research with autistic communities: Shifting the system.
In J. Davidson & M. Orsini (Eds.), Worlds of autism: Across the spectrum of neurological difference. Minneapolis:
University of Minnesota Press.
Rogers, S. J., & Dawson, G. (2009). Early start denver model for young children with autism: Promoting
language, learning and engagement. New York, NY: Guilford Press.
Ruppar, A. L. (2014). “Knowledge is power”: Reading, writing and promoting self-determination among
adolescents with multiple disabilities. Perspectives on Augmentative and Alternative Communication, 23,
192–201.
Ryan, S., & Raisanen, U. (2008). “It’s like you are just a spectator in this thing”: Experiencing social life the
‘aspie’way. Emotion, Space and Society, 1(2), 135–143.
Sarrett, J. C. (2016). Biocertification and neurodiversity: the role and implications of self-diagnosis in
autistic communities. Neuroethics, 9, 23–36.
Schick, E. (2015, May 4). Problems with person-first language. Retrieved from http://www.didistutter.org/
blog/category/personfirst-language
Schreibman, L., Dawson, G., Stahmer, A. C., Landa, R., Rogers, S. J., McGee, G. G., ... Halladay, A. (2015).
Naturalistic developmental behavioral interventions: Empirically validated treatments for autism spectrum
disorder. Journal of Autism and Developmental Disorders, 45(8), 2411–2428. doi: 10.1007/s10803-015-2407-8
Sinclair, J. (1999). Why I dislike “Person first”language. Retrieved from http://www.larry-arnold.net/
Autonomy/index.php/autonomy/article/view/OP1/pdf
Singer, J. (1998). Odd people in: The birth of community amongst people on the autism spectrum: A
personal exploration of a new social movement based on neurological diversity. Honours dissertation,
University of Technology, Sydney.
Singh, J., Illes, J., Lazzeroni, L., & Hallmayer, J. (2009). Trends in US autism research funding. Journal of
Autism and Developmental Disorders, 39, 788–795.
Soffer, M., & Almog-Bar, M. (2016). Therapy or human right? The meaning of recreation for children and
youth with disabilities in the “Krembo Wings”youth movement. Disability and Health Journal, 9, 399–405.
St. Louis, K. O. (1999). Person-first labeling and stuttering. Journal of Fluency Disorders, 24, 1–24.
Straus, J. (2016). Autism and postwar serialism as neurodiverse forms of cultural modernism. In B. Howe,
S. Jensen-Moulton, N. Lerner, & J. Straus (Eds.), The Oxford handbook of music and disability studies.
Oxford: Oxford University Press.
The National Professional Development Center on Autism Spectrum Disorders (n.d.). Retrieved from http://
autismpdc.fpg.unc.edu/evidence-based-practices
Turnbull, A., & Turnbull, R. (2001). Self-determination for individuals with significant cognitive disabilities
and their families. Journal for the Association for Persons with Severe Handicaps, 26(1), 56–62.
66
Downloaded From: http://perspectives.pubs.asha.org/pdfaccess.ashx?url=/data/journals/persp/935966/ by a ReadCube User on 02/01/2017
Terms of Use: http://pubs.asha.org/ss/rights_and_permissions.aspx

Watermeyer,B.,&Kathard,H.(2016).Tobeornottobe:Stutteringandthehumancostsofbeing
“un-disabled”.International Journal of Speech-Language Pathology, 18(1), 11–19.
Wehmeyer, M. L., & Abery, B. H. (2013). Self-determination and choice. Intellectual and Developmental
Disabilities, 51(5), 399–411.
Yaruss, J. S., Coleman, C. E., & Quesal, R. W. (2012). Stuttering in school-age children: A comprehensive
approach to treatment. Language, Speech, and Hearing Services in Schools, 43, 536–548.
Yeoman, B. (2016). Keynote address. National Stuttering Association New York City Chapters Conference
on the Past, Present, and Future of Stuttering. New York. Retrieved from http://barryyeoman.com/wp-
content/uploads/2016/05/Keynote-speech-Barry-Yeoman-NYC-Stutters-5-15-16.pdf
History:
Received August 15, 2016
Revised October 14, 2016
Accepted November 13, 2016
https://doi.org/10.1044/persp2.SIG1.56
67
Downloaded From: http://perspectives.pubs.asha.org/pdfaccess.ashx?url=/data/journals/persp/935966/ by a ReadCube User on 02/01/2017
Terms of Use: http://pubs.asha.org/ss/rights_and_permissions.aspx

Appendix A. General Resources
Autism Self-Advocacy Network: http://autisticadvocacy.org/
Autism Society of America: http://www.autism-society.org/
Autism Empowerment: http://www.autismempowerment.org/
Autism Women’s Network: http://autismwomensnetwork.org/
Global and Regional Asperger Syndrome Partnership: http://grasp.org/
68
Downloaded From: http://perspectives.pubs.asha.org/pdfaccess.ashx?url=/data/journals/persp/935966/ by a ReadCube User on 02/01/2017
Terms of Use: http://pubs.asha.org/ss/rights_and_permissions.aspx