Communication Form titled, “How Am I Doing?”

The following Communication Form is designed to be included during evaluations by clinicians. It may also be given to a person by a concerned friend.

Note: Communication Forms are checklists designed specifically to support self-knowledge, communication, and self-advocacy. It is a strategy designed and introduced by Catherine Faherty. Creating your own Communication Forms to support communication and self-advocacy – about any topic – is encouraged.

 What is the purpose of the Communication Form titled “How Am I Doing”? For people at the intersection of autism and disability, poverty, trauma, sexual violence, survival behavior, unsafe living conditions, etc., personal awareness, understanding, and communicating about any form of abuse and/or violence is extremely complicated. The end result is that help is often inaccessible to the person needing help.

The Communication Form “How Am I Doing?” is offered by Catherine Faherty (Autism Specialist, Author, and Ally) and Jade McWilliams (Autistic Advocate, Activist, Artist). It is our attempt to bring awareness to and facilitate communication in the life of a person experiencing any of these life conditions. The Communication Form (once filled out) is meant to get the attention of those who can help.

“How Am I Doing?” cannot be sold or otherwise distributed for pay. Permission is given for organizations, clinics, nonprofit groups, diagnosticians, and other professionals to use with individuals and clients. Please share widely and freely with agencies, therapists, and service providers, with the intent of supporting authentic communication.

How is the Communication Form “How Am I Doing” to be used? The Communication Form is to be given to a person by a professional and/or friend.  It is to help a person reflect on their living situation, and/or to note areas of concern and/or to ask for help, and/or to alert the professional to serious concerns.

It was designed to avoid the difficulty of face-to-face conversation. It is clear, concrete, and without the need to identify, process, or evaluate confusing emotional states. It was written for anyone who may not ask for help, for a variety of reasons. No talking is necessary to identify what is true; it can be completed in silence. It was written specifically for autistic styles of processing and communicating, but can be useful for anyone.

IMPORTANT: Do not mail it out as part of a package of forms prior to an evaluation or an appointment. It is meant to be presented in person – to be filled out when they are alone in a safe place – meaning not in the presence of family members, friends, or other people in the person’s life, even if the other people appear to be supportive.

Please keep in mind that the person filling this out may or may not be aware that there is anything to be concerned about. Some people after filling this out and later learning that there are serious concerns, may experience complicated emotions and/or surprise if you have follow-up questions. Emotions may or may not be expressed outwardly, in a manner that others may understand.


COMMUNICATION FORM

How Am I Doing?

Check all that is true for me. (I do not have to talk about what I have checked.)

 About food and housing:

☐ Some days I am very hungry, but there isn’t enough food.

☐ Sometimes I can’t sleep because I am so hungry.

☐ I usually have enough food to eat, every day.

☐ I live alone, most of the time.

☐ One or more people live with me.

☐ I am not sure where I will sleep tonight.

☐ I have my own bed and can sleep alone when I want to.

☐ I have to share a bed most of the time.

☐ I have my own key to where I live.

☐ If I knew that I had a good and safe place to move to, I would want to move there.

☐ There is something else about food or home that I can’t say.

About transportation and going out:

☐ I can go out, away from home, when I want to.

☐ I usually (circle what’s true)  –  drive  –   take a bus  –  taxi  –  get a ride –  walk  –  other

☐ I can go out to meet a friend when I want to.

☐ I am prevented from going out alone, or with someone else, when I want to.

☐ There is something I want to say, but I can’t say it.

About mood in general:

☐ I have cried in the past week.

☐ I have yelled in the past week.

☐ I have felt calm and peaceful in the past week.

☐ Someone gets angry at me when we are alone, together.

☐ I don’t know when or if the person will get mad at me, and yell.

☐ I don’t know when or if the person will try to hurt me.

☐ Sometimes I hurt myself.

☐ Sometimes I get sweaty and my heart beats very fast. I don’t know why.

☐ There is something else, but can’t say it.

☐ There is something else, but I am not supposed to tell anyone.

 About what I have checked (true for me) on this form:

☐ I don’t want to answer questions about what I have checked.

☐ I don’t want to answer questions now, but maybe later today, or on another day.

☐ I might want to answer questions, but I am worried I might get in trouble.

☐ If there are questions, I will try to answer them, after a short break.

☐ Please type your questions (no talking). I will try to answer them by typing. All silently.

Copyright 2018, Catherine Faherty & Jade McWilliams. Permission given for organizations, clinics, nonprofit groups, diagnosticians, and other professionals to use with individuals and clients. This Communication Form cannot be sold or otherwise distributed for pay. Please share widely and freely with agencies, therapists, and service providers, with the intent of supporting authentic communication. See Information Sheet for more info.

10 Guidelines for Telling Your Child about ASD

Back in the 1980s and 1990s, a highly controversial topic of conversation amongst parents and professionals was the question, “Should we tell our child that she has autism?”

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Today most will agree that such self-knowledge is essential, that children need to understand how and why they may feel different from others around them…and what it means. In the absence of accurate information, all sorts of wrong conclusions may automatically fill in the gaps, which negatively affects a person’s self-knowledge. Now the question has changed to “How do I tell my child that she is autistic?” I have developed these guidelines in the years since 1990 when I first tried to explain autism to a 10-year-old boy, one of my former students. The method you use must be autism-friendly! These ideas are visually clear and orderly, and features the familiar process of sorting concrete pieces of information into two categories. more “10 Guidelines for Telling Your Child about ASD”

Understanding Friends

A program to educate children about differences; to foster empathy and mutual understanding; with the option of supporting self-expression/self-advocacy by children on the spectrum.

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Understanding Friends is designed to be presented to classes of students in the elementary and middle grades. Adaptations can be made for older classes. This article contains lesson plans and a list of supplies that you will need. After presenting this program in all its revisions, to thousands of students since 1985, I have found that usually it is most effective to go beyond the generic program (Option A) and to discuss specific issues, giving accurate information about real students in concrete situations. Options B and C will help you with this. Option D suggests ways to include the student with ASD in the presentation of this program, if so desired by the student. more “Understanding Friends”

THE MISTAKE GAME

Teachers and parents can follow these instructions on how to make a funny, goofy game about making and correcting mistakes that your students or children can play, with the whole family or whole class!

SKILL TO LEARN: How to acknowledge that a mistake is discovered; understand that mistakes can be corrected; and feel okay with mistakes and the act of correcting.

NEW UNDERSTANDING: It’s okay to make mistakes. Mistakes can be corrected. Some mistakes can be funny. It’s even okay to laugh about one’s own mistakes. Everyone makes mistakes sometimes. Mistakes aren’t “bad”. Mistakes can be keys to learning new things.* more “THE MISTAKE GAME”

THE ARM’S LENGTH GAME

Teachers and parents can follow these instructions on how to make a game to help your students or children learn what exactly is an “arm’s length”. This is a prerequisite to the PERSONAL SPACE GAME that can be played with the whole family or whole class!

SKILL TO LEARN: How to allow a socially comfortable space between you and another person.

NEW UNDERSTANDING: I know what it means to stand an “arm’s length” away from someone else.

EXAMPLE SITUATION: The child may stand too close to others, so much so that it bothers most people.

PREPARATION FOR GAME: First, you prepare with the class. You will define, literally, what is meant by “an arm’s length” by using a measuring stick. Measure different children’s arms. Make a list on the board to show the range of “arm’s length”. Find the average arm’s length. With stiff cardboard or a piece of light wood, make a measuring stick that represents the average arm’s length. Write on it “Average Arm’s Length”. (You can make a math lesson out of figuring out the average arm length of the members of the class.)

THE ARM’S LENGTH GAME: A child picks a card out of a hat which has either a location, or object, or a person’s name on it. (Examples of what can be written on different cards are: “classroom door”, “Julie’s desk”, “my locker”, “Mrs. Smith”, “fish aquarium”, “bookshelf”, and individual children’s names, “Daniel”, “Athena”, “Rickie” etc…) After reading the card that he or she picked, the child is supposed to then go to that object, location, or person, and stand approximately an arm’s length from the object or the person.

Repeat the routine reminder that we are supposed to stand “approximately an arm’s length away from people most of the time”. The child will use the measuring stick which has been marked to show the average arm’s length to help him or her know how far away to stand.

As time goes on, the children can estimate (without using the measuring stick) and then someone else can check with the measuring stick to see if they are close to the proper distance. Continue the game by taking turns picking cards from the hat.

Eventually, you will modify this game, using the same general idea by playing THE PERSONAL SPACE GAME.

 First write a Social Story about personal space, and explain that personal space can be determined by using an arm’s length as a general measure. You will summarize by literally and concretely defining “personal space” as an average “arm’s length”. For more detailed instructions see directions for THE PERSONAL SPACE GAME.

Remember to write Social Stories™. Social Stories describe life. Teachers and parents are encouraged to be trained in writing Social Stories by Catherine Faherty, or another member of Carol Gray’s Team Social Stories™.