There can be a fine line between accommodating someone’s needs and patronizing them.
But it’s not a line like the one on the right side of the road that you can only-sort-of pay mind to as you cruise along; it’s much more like the double solid center line–you cross it, you run the risk of serious trouble. Unlike the bright yellow against the blacktop, though, it’s more like a dark gray… it can be very difficult for the a person to tell whether his words or actions toward another are patronizing or just accommodating. For the one on the receiving end, though, the difference is obvious.
I live in a nursing home. I am decades younger than the next youngest patient. As far as I know, there is only one other patient on my floor of 56 beds who may, sometimes, know what day or even what year it is. My roommate is in her 80s and is one of maybe three people who carry on any sort of conversation; she has some dementia and repeats herself and loses words a lot, but she is pleasant and kind and we get along very well. Many of the people here seem like bodies from which the mind has long since fled.
There are a couple of nurses who treat all the patients like children. One of them always comes in with a very sing-song voice. ”Honey, it’s time for your meds, o-kaaaaay?!” Every shift, to every patient. I hear her go up and down the hall. Another nurse was being trained and came into my half-a-room this morning, saying things like, “Oh, my! Somebody sure does like shoes!” and “Well, don’t we like pink!” and “I heard you get to go out today! Isn’t that special!” I had just woken up and had to leave in a limited amount of time, so I was working hard to get through my wake up routine (don’t you dare mess with my wake up routine!). I said, “I’m sorry but I’m not awake and really don’t feel like talking.”
Which was totally a way of getting out of the situation, because the truth is that I just don’t know how to deal with people who patronize me.
It was obvious. She was trying to make conversation, which is fine, but dude, unless you’re a Diet Mountain Dew or my Lucy-Goosey-Gander, I don’t want to converse with you until I’ve been up for an hour. Even my superhero of a day nurse who usually wakes me up knows not to get too chatty, too soon, or I just tune out. But the tone of her voice as well as her choice of words made it really obvious that she was treating me like I was about five years old.
Now, here’s the thing: I’m 25 but I’m not… really… exactly an adult. I was in the car with my sister this morning and she asked what I’d gotten a family member for her wedding. Huh? I need to bring a gift? She was flabbergasted and could not stop repeating, “How do you not know this? You have to know you bring a gift to a wedding, Lydia.” Well, I’ve only been to one, and that was four years ago… so, no, sorry. I wasn’t aware. I told her later that, yes, chronologically, I am an adult… and mentally, I am getting there and making progress, but I’m just not there yet. Any attempts at rushing me will. not. work. I am not able to will my brain to develop faster than it is going to develop.
Thus, sometimes, I need accommodations.
Accommodations look different for different people and even for the same person in different situations. In school, a student might need extended test-taking time. He might need the test to be read aloud. He might need to use a colored overlay to help his brain process the visual input. He might need to sit in a specific location in the classroom. He might need sensory breaks. Maybe he types instead of writing my hand.
In conversation, a person with autism might need you to speak more slowly or make your point with fewer words. It helps if a conversation partner speaks in such a way that doesn’t beat around the bush, especially if the information is important. If it’s important, spell it out, and it might help if you double check for understanding before we part ways.
Accommodations at work could mean anything from no fluorescent lights to a different kind of chair to extra time to get up and walk around. It could mean employing alternate forms of communication (email instead of phone calls, for example), asking for advance notice of schedule changes, or working with a job coach.
There is absolutely no way to enforce accommodations in friendships… and I will only speak for myself on this, but if a friendship with me is going to work, the only way is if there is a lot of grace on both sides. My NT friends do things that make absolutely no sense to me and sometimes seem pretty rude… and guess what? I DO THE SAME TO THEM! The most important accommodation is that we both give one another the benefit of the doubt and trust that whatever we perceived to be wacky from the other was, in truth, meant well.
Note: Absolutely none of the above-listed accommodations involve talking down to someone or limiting his potential to exercise agency, make reasonable choices, or show his ability. That is called patronizing.
The way I write about it, it sounds like there is a really obvious difference between the two, but there isn’t always. What do you do when you’re not sure how much a person understands of what you’re saying to him? Do you use simpler vocabulary? Is that accommodating or patronizing? The answer is yes and no. Personally, I would speak to every person with autism– EVERY person– as if he understood every word I say. How many times have we heard stories of families who talk about their nonverbal children in front of them and, when the children grow up, they communicate (through alternative methods) that they understood every word? Don’t make that mistake. Assume they understand everything you say, and talk like they understand it. Expose them to the fully glory of language. When you’re finished saying whatever it is, offer a brief summary at the end. Thus, you expose the person to language but you also communicate in as simple a way as possible… avoiding patronizing but accommodating for the person’s needs.
Adults are not children. Young adults with autism who have complex medical issues and live in nursing homes, who love pink and Disney and kitties, are not children. I am an adult who needs certain accommodations but who will write circles around most anybody and give any nurse a run for her money on medical knowledge (don’t worry, I don’t go around making nurses angry with me all the time!). My point is that it is not always necessary to “slow down, and don’t use any big words!” The elderly people in my nursing home deserve dignity and respect. They deserve privacy, they deserve input in their care when possible, and they deserve individuality. These people have lived long and successful lives, and they deserve respect. I refuse to let anyone strip me of those rights, and it upsets me to watch the other residents lose theirs. It also upsets me to watch others with autism be treated like they are unintelligent, when they are intelligent and capable.
I feel like I should have a slogan–no patronization, just accommodation!