Autistic Inertia & my ‘AHA’ Moment

As you know, I am in the process of learning about new concepts that I believe to be under-recognized but super important for occupational therapists (& others!) to keep in mind when working with our clients & families on the autism spectrum so we can better assess & understand behaviours that we see. These concepts are best remembered by using the BIMS acronym: Burnout, Inertia, Meltdowns & Shutdowns

 Last time I spoke about autistic burnout- if you missed it, you can find the information on my last Blog post: Autistic Burnout: What it is & Why it Matters to our Occupational Therapy Practices.   

What is autistic inertia?

According to autistic researcher, Karen Leneh Buckle, autism inertia can be defined as a “debilitating difficulty with acting on intentions” & (amongst many other factors) encompasses challenges with both initiating & stopping motor actions. You can read Karen’s insightful open access paper on this subject & the many different ways autistic inertia presents in autistic people: “No Way Out Except from External Intervention”: First-Hand Accounts of Autistic Inertia.

Why does having an understanding of autistic inertia matter to our occupational therapy practices?

To me this was a REVELATION & AHA MOMENT! – the recognition that motor differences in autism extended beyond what we usually think of, say, motor milestones, motor planning skills, quality of movement patterns, etc. I suddenly understood that a gap existed between the autistic person’s intentions & their actions- an idea that we can  grasp when it comes to conditions such as Parkinson’s or Huntington’s Disease but is certainly not clear when thinking about autism. I realized that for some, these motor differences cannot be controlled any more than I can control my Argentinian-Spanish accent, lol (due to many reasons I’m sure but motor speech is one of them!)

Once I realized that interfering behaviours may be indeed beyond a person’s voluntary control -the intended tap on the back becomes a push, the intended whisper becomes a yell, the empty school form signals challenges with initiation of the task as opposed to oppositional behaviour, the intended desire to stop pointing to something becomes an uncontrollable gesture & so on…- I learned to appreciate how exhausting it must be to live in a body that is not under one’s full control & within a society that does not usually understand you.

Why is considering autistic inertia important for occupational therapy practitioners?

It is important to consider autistic inertia when working with autistic people as they may experience difficulties with starting and stopping activities (as well as other features described in Leneh’s article) that are often misinterpreted as ‘non-compliant’ behaviours or a general lack of motivation. I do love this quote below from Naoki Higashida’s book The Reason I Jump.

“One of the biggest misunderstandings you have about us is your belief that our feelings aren’t as subtle and complex as yours. Because how we behave can appear so childish in your eyes, you tend to assume that we are childish on the inside too. Stuck here inside these unresponsive bodies of ours, with feelings we can’t properly express, it’s always a struggle just to survive.”

– Naoki Higashida, 2013

More of a reason for us to move towards adopting a stance of compassion & curiosity first when we see ‘challenging’ behaviours.

A lot to reflect on for sure!