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Copy & Paste Diabetescore Emojis & Symbols 💉 Subcutaneous injections tend to be less painful

Tips 😷 Depending on the procedure, meet the one treating you to see if they are a good fit for you. If they seem nice and willing, find something where you can both agree to make it better for the both of you. If you can notify them ahead of time, mention your needs. “I have autism which might contribute to my discomfort. What can I bring to the clinic? Can I leave my pants on, or can I wear a skirt instead of having to undress? Can you prepare smaller medical tools? Do you have sedatives? Are numbing agents readily available? Do you have a room with an adjustable seat? What’s the best treatment for me? Are there other options to make it easier to get care?” Look up pictures of the place, visit it, read any rule policies and see if they can accommodate to getting special permission for certain aspects. Get a personalized treatment plan. Use telemedicine, an appointment over video, phone call or text chat, when available and appropriate. Ask about at home tests you can send. Tell your doctor about your worries. They might be able to help you address them.
💉 Subcutaneous injections tend to be less painful than intramuscular injections because the needles are smaller and do not have to push through as much tissue. 💉
Concerns to ask the doc if needed 😷 Although benefits can outweigh much, it’s still a worry. Even if it temporarily lasts a second, a person's pain should be taken into account. I’m not saying you should go under deep sedation just to get teeth cleaned, especially if you don’t need it. If you are having trouble tolerating certain exams, tell them to keep it in mind so the procedure can be easier on both of you. If you experience intense pain and find it hard to tolerate, request for ways to make it easier. Thank you for taking the time to care for me (be sure to show gratitude before, during and/or after) Can you explain the procedure to me? How long will it take? Can we count up or down to the number? Can you explain what you're doing as you begin to do it? Because it’s been hard in the past when X, so can we look at some techniques? Can I drink water before or during the procedure? Do you have a heat pack or ice pack nearby? I want to get it over with and I’d like it to be easy for both of us. If you have a distraction tool (like telling jokes) to use I’d still like to let you know about X knowing my concerns will still be taken into account. Can we talk beforehand and walk me through the procedure as it will happen, step by step? Do you have any non invasive ways to check for X? Can you do it another way instead? Do you have any smaller and/or softer instruments to get the job done? Can you apply something (like warmth, gel, etc.) to the instrument beforehand? Is there a way to get around it? Can I say if I wanted to stop (said procedure) during any time? Can I make informed decisions to decline X? When it comes to certain exams, I’ve sensory issues, trauma, etc. Do you know any breathing exercises or any methods to accommodate my specific needs? It’s not anything personal, it’s not distrust, but I want it to go easy for both of us. 😷
😷 If it’s a same day appointment without any preparation beforehand, still let them know any needs. Even if it’s not worth it to spend nearly an hour on preparing something especially for you, still let them know what might work best for you. If they need to use a speculum, ask for a small one! Even if they can’t use all their time convincing you of how convenient something might be, still tell them if you cannot do certain methods while feeling safe. Is there something on hand to relieve even a little pain? Can it be self administered at home? Can you sit in a different chair? If you cannot possibly resolve something as much as you’d like, ask for them to at least tell you what’s going on and ask how they might cope with similar sensations. Can an X-ray be done instead of a biopsy? If not, ask for them to take your concerns into account and go from there, such as a less invasive tool designed for the same purpose. Wear a long skirt or a dress so you can just pull it up rather than take your clothes off. You can also bring a jacket or different pants to change into. Take headphones and listen to music, explain you're nervous and would not like to hear much about what's going on but just to be told when they've started and when they've finished. Focus in on what you're listening to. Say if it’s your first time doing a certain procedure and mention your concerns. Acknowledge you understand people don’t necessarily enjoy it for fun. Knowing can make you less anxious. It’s definitely worth asking something like ‘I do find this procedure extremely painful, could you try with a X?’ The procedure is easier for them to perform if you’re not squirming around in pain so there’s no reason for them not to at least try. Pamper yourself. Count as you breathe. Breathe in 1-2-3-4. Breathe out 1-2-3-4. If the doctor's good, they'll keep you talking and talk to you for further distraction, and walk you through each step they take. Most of the time, certain tests don't take much longer than 30 seconds and afterwards they'll leave you alone so you can recover if you need it. Talk to them beforehand so they know you're anxious, and see what they can do to help you get through it. Knowing options are always open to you if you need it can help put you at ease. Knowing what certain tests feel like can make it go smoother and easier to manage. Mentally walk yourself through the procedure before it happens while doing slow breathing exercises - breath in for five counts and out for five (or longer) while walking yourself through what to expect with your eyes closed. If at any point you get nervous, keep breathing and open your eyes. Once comfortable, continue through the procedure and just keep breathing. Don’t dismiss true concerns so you can decide what might be best for you. Gather all available facts to make informed decisions with the medics. Discuss the procedure with the medic and what they will do and when it happens. While the procedure happens, ask them to explain what which thing it is they’re doing next and how it might feel. Tell them if at any point you express discomfort, they check in with you and do not proceed until you give them the green light. Make sure nothing is put in you if you have not consented to or understand the purpose of. It’ll help you stay in some control if you are allowed to say if you wanted to stop at any given time to get through it. Anyone could find any experience distressing, but one’s distress can be magnified by the facts of how they are autistic, traumatized, etc. Just like with any other condition, doctors should have to take into account a particular person in their office and adjust what they’re doing to meet the needs of said patient. Jot down in advance everything you want to discuss to know exactly why, when and how something is to be. Ask for details and mention anything. Think about the muscles in your legs as you close your eyes. Imagine you’re at home, or think of a show. Anything to make it seem less intimidating. Give them notes you’ve taken. Ask if you can pace. Even if you aren’t a child, you still may need the catering even if you understand what medics are for. Make kits. Ask them to listen to you and to take time with you to make it more comforting. Advocate as feedback. 😷
pls note the ai inflicts emotional damage (ᵕ—ᴗ—)
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🍑 https://www.mayoclinic.org/tests-procedures/pelvic-exam/about/pac-20385135 🍑
😷 https://lifehacker.com/what-your-pediatrician-should-and-shouldnt-do-during-a-1822524179 😷
😷 Wear a long skirt or a dress so you can just pull it up rather than taking your clothes. You can also bring a jacket or different pants to change into. 😷
😷 Pamper yourself. Count as you breathe. Breathe in 1-2-3-4. Breathe out 1-2-3-4. If the doctor's good, they'll keep you talking and talk to you for further distraction walking you through each step they take. Most of the time, certain tests don't take much longer than 30 seconds and afterwards they'll leave you alone so you can recover if you need it. Talk to them beforehand so they know you're anxious and see what they can do to help you get through it. Knowing options are always open to you if you need them can help put you at ease.
Tips 💉 Depending on the procedure meet the one treating you to see if they are a good fit for you. If they seem nice and willing, find something where you can both agree to make it better for the both of you. If you can notify them ahead of time, mention your needs. “I have autism which might contribute to my discomfort. What can I bring to the clinic? Can I leave my pants on, or can I wear a skirt instead of having to undress? Can you prepare smaller medical tools? Do you have sedatives? Are numbing agents readily available? Do you have a room with an adjustable seat? What’s the best treatment for me? Are there other options to make it easier to get care?” Look up pictures of the place, visit it, read any rule policies and see if they can accommodate to getting special permission for certain aspects. Get a personalized treatment plan. Mention you’ve special needs regarding X. Use telemedicine, an appointment over video, phone call or text chat, when available and appropriate. Ask about at home tests you can send. Tell your doctor about your worries. They might be able to help you address them.
😷 Take headphones and listen to music, explain you're nervous and would not like to hear much about what's going on but just to be told when they've started and when they've finished. Focus in on what you're listening to.
Skin 🧴 Skin protects the insides of the body. Human skin can range from light peachy cream colour to dark brown depending on the amount of melanin produced. Sun exposure and genetics can also play a role. 🧴
Say if it’s your first time doing a certain procedure and mention your concerns. Acknowledge you understand people don’t necessarily enjoy it for fun. Knowing can make you less anxious. 😷 It’s definitely worth asking something like ‘I do find this procedure extremely painful, could you try with a X?’ The procedure is easier for them to perform if you’re not squirming around in pain so there’s no reason for them not to at least try.
😷 If it’s a same day appointment without any preparation beforehand, still let them know any needs. Even if it’s not worth it to spend nearly an hour on preparing something especially for you, still let them know what might work best. If they need to use a speculum, ask for a small one! Even if they can’t use all their time convincing you of how convenient something might be, still tell them if you cannot do certain methods while feeling safe. Is there something on hand to relieve even a little pain? Can it be self administered at home? Can you sit in a different chair? If you cannot possibly resolve something as much as you’d like, ask for them to at least tell you what’s going on and ask how they might cope with similar sensations. Can an X-ray be done instead of a biopsy? If not, ask for them to take your concerns into account and go from there, such as a less invasive tool designed for the same purpose. 😷
💙 Most kids with ASD are either hypersensitive or hyposensitive to stimuli like noises, lights, touch, etc. If someone has Autism and/or PTSD, he/she may be more prone to sensory overload and startle more easily. That means there’s not much information about how typical treatment methods can or should be adjusted for patients with ASD. According to this article, a nurse could… Offer home-based services Use more visual aids, such as gradient scales to describe degrees of emotion Keep appointment times regular and predictable as much as possible Provide sensory toys or allow children to bring their own Emphasize the possibility of a “happy ending” after trauma―​“this correlates well with the documented effectiveness of social stories, narratives and role-playing in therapy involving individuals with ASD” Be mindful of how often society dismisses the emotions of autistic people Involve other trusted caregivers …and more. Essentially, the therapist should keep the child’s unique strengths and limitations in mind at each step and be open to flexibility. Remember to… Not take behavior personally Be willing to listen without pressuring him/her to talk Identify possible triggers and help him/her avoid them Remain calm and understanding when he/she is emotional Let him/her make age-appropriate choices so he/she feels in control of his/her life Be patient 💙
😷 Before beginning trauma-focused therapy it is important to stabilise the individual with emotional coping strategies and creating feelings of safety. Support strategies that have been found to be helpful in the general population include: mindfulness and grounding in the present moment creating feelings of safety (for example an object/picture that symbolises safety) sensory soothing Autistic people may require: a greater number of sessions a longer or shorter duration to each session regular breaks. 😷
😷 Treatments should be appropriately adapted for autistic people and their individual needs. (Rumball et al. 2020) and Kerns et al. (2022) suggest a number of other events that autistic people found traumatic: abandonment by/loss of a loved one (for example a family member, pet or support staff) sensory experiences (for example fire alarms) transitions and change (for example school transitions, routine changes with the seasons, unpredictability in day to day life) social difficulties and confusion (for example difficulties interpreting social cues, misunderstandings and conflicts) events related to one’s own mental health difficulties (for example psychotic experiences). Autistic people may also be more likely to find these experiences traumatic due to autistic characteristics such as: sensory sensitivities communication and social interaction differences distress around changes to routines distress if prevented from taking part in repetitive and restricted behaviours such as stimming. Some theories suggest that other factors associated with being autistic, may mean an increased risk of developing or maintaining PTSD symptoms But just because symptoms aren’t crippling doesn’t mean you're not affected. 😷
🔪☆°・*:.。.☆💉 ☆.。.:*・°☆✂️
Knowing what certain tests feel like can make it go smoother and easier to manage. Mentally walk yourself through the procedure before it happens while doing slow breathing exercises - breath in for five counts and out for five (or longer) while walking yourself through what to expect with your eyes closed. If at any point you get nervous, keep breathing and open your eyes. Once comfortable, continue through the procedure and just keep breathing. 😷
😷 https://www.health.gov.au/ministers/the-hon-ged-kearney-mp/media/pap-smears-can-be-replaced-by-do-it-yourself-cervical-cancer-tests 😷
🍑 https://www.health.gov.au/self-collection-for-the-cervical-screening-test 🍑
🍑 https://www.healthdirect.gov.au/blog/self-test-makes-cervical-screening-pap-smear-even-easier 🍑
😷 https://about.kaiserpermanente.org/health-and-wellness/our-care/exploring-the-promise-of-at-home-cervical-cancer-screening 😷
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Why autistic people are like cats: - We are highly sensitive. - We don't like loud or sudden noises. - We are easily spooked and startled. - Especially because we are zoning out, like, all the time. - We love to be held and touched and petted and cuddled bUT ONLY IF IT WAS OUR IDEA! - We're picky eaters. - Easily distracted. - Solitary creatures. - Takes us a while to warm up to people and be comfortable around them. - Our idea of being "social" is just hanging around the vicinity or in the same room as other people but not necessarily interacting with them. - We are finicky, particular, meticulous creatures of habit and we have a comfort zone we will defend with our lives. - If we deem you worthy, you will be allowed into our comfort zone. - Gaining our love and trust is super rewarding because it is not easily done. Be flattered. - If you touch us unexpectedly we will flinch or jump. - We are awesome predators and get super intense about stuff one nickname for the ADHD gene is "the hunter gene") - We are cute and lovable and have a lot of personality. - Many autistic children love to feel enclosed and secure and so love secret hiding places and cubby holes (i.e., "if I fits, I sits") - We sometimes appear to freak out at nothing and scamper away for no reason but really it's because we can hear things you can't and some sounds bother us. - Because we have such hyper-sensitive senses, any snuggles you give us will be a million times more rewarding for you because you'll know and appreciate just how intensely we're enjoying them. - Please give us food or we will boop your nose in your sleep.
😷 https://neurodivergentinsights.com/misdiagnosis-monday/ptsd-and-autism 😷
💙 https://neurodivergentinsights.com/misdiagnosis-monday/ptsd-and-autism 💙
"disabilities aren't aesthetic" Yes, but you don't need to say this under the posts of disabled people showing off cute mobility aids, decorated med organisers, a cute bed set up, the art piece that represents their disabilities, etc. Whether theyre your fellow disabled folk or especially so if you're able-bodied/neurotypical, allow disabled people freedom of expression and the little joys they can. People cope with their disabilites in diverse ways, and sometimes that means you will see a disabled person romanticizing their life, or making their aids aesthetic. Someone existing and expressing themselves, making their lives more comfortable and enjoyable, should not be seen as ”glorifying” anything. I’m not telling anyone to go make themselves disabled, nobody should take their health for granted.
Info tips for practitioners w/ autism and/or sensitivities First, thank you for caring. Not trying to question your expertise in health. Now, Autism is a spectrum. It’s not something one can turn off. It’s not a choice. Most of us are not trying to be demanding. If any thing, we’re afraid of being seen as childish, picky, high maintenance, bossy, rude, etc. We can easily get overwhelmed. We want to compromise with you. If we ask for another nurse to do something or if we know we cannot handle a procedure without certain accommodations, it’s not personally attacking against you. You have the power to provide the care and provide us any options; individuals know their own personal tolerance and needs. We do not ever want to start arguments. We do not want to inconvenience you over something, as we do not feel entitled. Having sensitivities not by choice, as it is more than inconvenience but also painful. We always feel when you do your best. We’re both human, autistic or not. It is not a choice.
| ̄ ̄ ̄ ̄ ̄ ̄ ̄ ̄ ̄ ̄ ̄| | I love my friends a lot, | | I just suck at talking | | to them regularly | |___________| (\__/) || (•ㅅ•) || /   づ
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SPORTS OFFERED The Allen Delegation currently supports: Aquatics (swim) Athletics Basketball Bocce Bowling Flag Football (no skills level at this time) Golf Power Lifting (weights) Soccer (futbol) ​Tennis Volleyball ​Unified Sports (doubles) Allen Special Olympics Delegation (ASOD)
ℑ𝔪 𝔧𝔲𝔰𝔱 𝔟𝔢𝔦𝔫𝔤 𝔪𝔶 𝔞𝔲𝔱𝔦𝔰𝔱𝔦𝔠 𝔰𝔢𝔩𝔣. 💀
Hi, friends! I like emojicombos.com because it’s easy for me to use, being public domain. I also like to express myself through writing, as an author with Autism. So thank you Emoji combos and keep it up!
😷 Remember that you are not alone and can discuss these issues with a trusted mental health provider. Exploring treatment options with a healthcare provider Exercising to reduce stress Setting realistic goals Breaking up large tasks into smaller ones Spending time with friends and family Confiding in trusted friends or relatives Seeking out comforting situations, places, and people Seeking out support from friends and family Finding a support group Learning to feel good about one’s actions in the face of danger Having a positive coping strategy Being able to act and respond effectively despite feeling fearful Medication and expectation management strategies may also be included in an overall treatment plan. 😷
😷 Keep a diary of the situations that make you feel anxious and note how you’ve reacted in each situation. This will help you identify potential triggers for your anxiety. 😷
😷 If you can, look for a trauma-informed healthcare provider, or a provider that has experience helping people who have experienced trauma. If your current provider doesn’t listen to your concerns or makes you uncomfortable, remember that you can absolutely seek out a different practitioner. 😷
For Employers w/ disabled workers If a person who has a disability wants to work they might have difficulty getting jobs. There are different types of disabilities to varying degrees. First, inform them the expectations of the job. Make sure they know how to do the job as you train. Give warnings (and explain why behind the warning) before resorting to termination, as some people might not under stand what they did wrong. Even if the disability is confidential, explain to coworkers not to give the employee a hard time, without divulging. Don’t touch the employee or their belongings (including any mobility aids) without asking them first. Allow the employee extra time if necessary so as to not overwhelm them. Monitor the surroundings to make sure no harassment takes place, possible barriers to accessibility, etc. Try not to get frustrated if they do something differently than what others might do, such as note reminders, etc.
What’s disabilities? Being disabled can have various meanings. Physical disabilities are usually more visible. Even so, it might not be readily apparent. One individual can have more than one disability. But it’s not by choice, even in an elective amputation, mental disorders, ptsd vía warfare, etc. Some disabilities are more invisible, if internal or having to do with mentality. No matter what disability, it’s important to not have unreachable standards whilst at the same time not be patronising. Some disabilities are from congenital, meaning they were born with it or had their whole life. Some disabilities are acquired later in life such as an external injury they got.
💉 https://news.vanderbilt.edu/2011/09/21/bloodwork-toolkit/ 💉
😷 https://www.psychologytoday.com/us/blog/autism-and-anxiety/201904/medical-visits-and-autism-better-way 😷
😷 https://www.findatopdoc.com/Parenting/When-a-Child-with-Autism-Refuses-Treatment 😷
💙 An Autism Specific Care Plan helps families give hospital staff important information. It tells them how to communicate and interact with the child and keep them safe. Families who use Autism Specific Care Plans feel happier with their care and feel that health care providers are better at working with their child or teen with autism. Hospitals and emergency rooms can also think about making changes to help patients with autism. Small changes can all help lower anxiety for kids and adults with autism. Some of these changes include keeping wait times short, creating a calm space, and playing a movie in the waiting area. Making sure parents are part of all medical care and treated as experts on their child can help both families and staff. Finally, hospital staff can try communicating in the way the patient prefers (talking vs. typing, etc.). 💙
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A recent paper published in the journal Clinical Infectious Diseases suggested that tetanus and diphtheria booster vaccines are not necessary for adults who have completed their childhood vaccination series. This advice aligns with the current World Health Organization (WHO) The conclusion aligns with the World Health Organization's recent recommendations to only routinely give adults tetanus and diphtheria vaccines if they didn't receive a full series of shots as children. Adults do not need tetanus or diphtheria booster shots if they've already completed their childhood vaccination series against these rare, but debilitating diseases, according to research published in the journal Clinical Infectious Diseases..
DOCTORs APPOINTMENTs Before a procédure, get to meet the physıcıans and acknowledge their authority before you mention your sensitivities. Find a way to make a compromise. Even request more time for an appointment if you want to have topical numbing agents wait to work, to discuss alternatives, etc. Before a procédure, look up the physıcıans and/or the clınıcal website. Find pictures of the inner building and search for FAQ, policies, procedures, reviews, etc. Before a procédure, bring a fully charged phone and any sensory necessities such as plastic cups for water, ice pack, self testing kits, written notes and copies, etc. TIPS For CHECKs Feel the instruments and get comfortable with them. Ex: at the dentist, you’re weary of the suction straw. If no plastic cups for rinsing, ask them for some or, have them turn the suction on a low setting and feel it with your fıngers before they use it in your møuth. Perhaps they can put something on if you don’t like the suck¡ng nóise. See how you feel with the specific docтor. Ex: Dr. A seems hurried and strict, but Dr. B seems more empathetic. Or perhaps ask if a nurse can be in the room with you to. Try having the docтor teach you how much you can do. Ex: for a strep thr*at test, ask if you can swab your own thr*at, even have them hold your hand whilst you do it in a mirror. Or tell them the way your thr*at structure may find it easier to tilt, etc. (my search NeuroFabulous)
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Autistic and Being Startled Easily... @neurodivergent_lou Autistic people may struggle with being startled easily, whether that be by a sudden phone call or someone walking into a room. This is something that autistic may experience more intensely than non-autistic people for a variety of different reasons. Autistic people may be 'startled' easily due to hyper-sensitivity to sensory input. For example, for autistic people noise may feel increasingly amplified. The sound of someone coming into a room can be incredibly startling and sudden. Sensory overwhelm isn't necessarily just about the noise itself but can also be related to the layers of sound or unpredictability of it, As autistic people, we may struggle with feeling on edge a lot of the time and being in 'fight or flight mode'. For example, the world can generally feel unpredictable and we may have repeated past experiences of being misunderstood (e.g. due to autistic communication differences). This feeling of being on edge can contribute to being easily startled. It also feels related to how autistic people experience focus and attention. Autistic people may have a tendency toward hyper-focus and getting almost lost into a subject of interest. We may also end up deep in thought or dissociate. This can mean that someone coming into the room can feel particularly disruptive. The shift in attention can be difficult too. One minute your attention is absorbed in a certain thing and then suddenly a person walks in, makes you jump and shifts your attention completely. The theory of monotropism suggests that autistic minds tend to have their focus pulled more intensely towards a smaller number of interests at any given time, leaving less processing resources for other things. Another part of this is waiting to potentially be startled and the stress of waiting for this. For example, if we are waiting for a phone call, it can be stressful anticipating a sudden loud noise. It can make us feel on edge and unable to do anything else.
😷 https://www.statnews.com/2020/02/25/adults-dont-need-booster-vaccinations-for-tetanus-diphtheria-study/ 😷
😷 https://www.sensoryfriendly.net/how-to-create-a-sensory-friendly-ambulance/ 😷
GAS or APPENDICITIS? https://www.medicalnewstoday.com/articles/what-does-appendicitis-feel-like Most people recover well if they receive a diagnosis and treatment early enough. Most people with temporary mild-to- moderate abdominal pain have gas or symptoms of indigestion. If the pain is mild to moderate, improves over time, and feels as if it is moving through the intestines, it could instead be signs of gas. Typically, appendicitis will start with pain that may come and go in the middle of the tummy. Within hours, the pain will travel to the lower right side of the abdomen and become constant and severe. However, the risk of rupture is relatively rare after 36 hours. If a person has severe pain in the lower right of their abdomen, pain that worsens when moving or touching the abdomen, as well as other symptoms such as fever and nausea, it could indicate appendicitis. Risk factors for appendicitis include: Age: Most people get appendicitis at 10–20 years of age. Sex: Evidence notes that those assigned male at birth (AMAB) are slightly more likelyTrusted Source to develop appendicitis than those assigned female at birth (AFAB). Low fiber diet: A low fiber diet can potentially cause fats, undigested fiber, and inorganic salts to build up in the appendix and cause inflammation or obstruction. Genes: Some studies suggest that genetics can play a role in appendicitis. A 2018 population study notes that individuals with a family history of appendicitis have a higher risk of appendicitis. A surgeon will usually perform appendectomy using one of two procedures: open surgery or laparoscopic surgery. To address complications, healthcare professionals may also use other treatments, such as: antibiotics removing infected abdominal tissue draining pus from the abscess or infection site blood transfusions intravenous electrolyte or fluid therapy Some individuals with appendicitis may haveTrusted Source an inability to pass gas, which is the source of discomfort when a person has gas. With gas, people may have the sensation that gas is moving through the intestines, they may feel mild-to-moderate pain anywhere in the abdomen, and discomfort will usually resolve quickly after passing gas. However, with appendicitis, pain typically starts in the middle of the abdomen, then travels to the lower right-hand side of the abdomen, where it becomes severe and constant. Warning signs typically progress in the following order: sudden pain that begins near the belly button pain that intensifies over time and moves to the lower right of the abdomen lack of energy and loss of appetite worsening symptoms, which can include nausea, constipation, inability to pass gas, and diarrhea fever The most common symptom of appendicitis is abdominal pain. Other possible symptoms of appendicitis can includeTrusted Source: loss of appetite nausea and vomiting diarrhea constipation unexplained exhaustion excessive gas or inability to pass gas swelling in the abdomen fever increased urinary frequency and urgency pain while extending the right leg or the right hip https://www.medicalnewstoday.com/articles/what-does-appendicitis-feel-like
😷 https://theconversation.com/if-your-child-is-afraid-of-or-refusing-a-medical-procedure-heres-how-to-help-170923 😷
😷 https://kidsinpain.ca/wp-content/uploads/2021/11/Vaccine-Pain-Needle-Fear-Resources-v2-November-2021.pdf 😷
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❝ʰᵃᵗᵉ ᵗʰᵉ ˢᶤᶰ ˡᵒᵛᵉ ᵗʰᵉ ˢᶤᶰᶰᵉʳ❞
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CHIP OFF THE OLD TALKS ii (Autistic Author) Chip's eyes fill with tears, and he looks away, trying to hide his emotions. "I just want to understand," he says, his voice small. "I don't need to explain myself to you," he snaps, his eye cold and distant. But Chip is undeterred. He's seen his mother's gentle touch work wonders on his father during his seizures, so he decides to try it. He reaches out and places a small hand on Plankton's shoulder. "It's ok, Dad," he whispers. "You can tell me." Plankton flinches at the touch, his antennae stiffening. "I said it's not your business," he repeats, his voice a low growl. Karen can see the internal struggle playing out on his face, the effort it takes to maintain his anger when all he really wants is to retreat into safety. "Plankton," Karen says softly, placing her hand over Chip's. "It's ok." Her voice is a gentle reminder of the love that exists between them all, a love that has grown and adapted to Plankton's condition over the years. But anger in Plankton's eye doesn't fade. He stares at his son, his jaw tight, his antennae quivering with barely restrained frustration. Karen can feel the tension in his arm, the way his muscles are taut under her touch. "It's ok," she repeats, her voice a soothing balm. "Chip just wants to understand." But Plankton's anger doesn't dissipate. He sits there, his eye still cold and distant, his body rigid with tension. "I don't need to justify myself," he says, his voice a knife slicing through the air. Karen's heart sinks further. This was not how she had hoped the conversation would go. "Dad," Chip starts, his voice trembling. "I just want to know why-" "I SAID it's not your business," Plankton barks, his eye flashing. Plankton's anger is a storm that needs to pass before they can talk it out, and Karen doesn't want to force the issue here. Karen nods at Chip, signaling for him to give his father space. With a sad smile, she stands up and takes the frisbee from his hand. "Why don't you go play for a little while?" she suggests, her voice gentle. "Give Dad and me some time to talk." Chip nods, his eyes brimming with unshed tears. He takes a few steps away before turning back to look at his dad. "I'm here if you need me," he says, trying to keep the quiver out of his voice. Then he runs off, the frisbee clutched tightly in his hand. Plankton's anger lingers like a fog around him, thick and heavy. Karen can see it in the way he sits, his shoulders hunched and his antennae flat against his head. She knows he needs a moment to compose himself, to come down from overstimulation. The silence stretches between them, taut with unspoken words and fear. Plankton's gaze follows Chip as he disappears into the playground, the frisbee a small beacon of hope in his hand. Karen waits, her heart aching for the pain she knows her son is feeling, the pain she feels herself. When Plankton's breathing finally starts to slow, she decides to break the silence. "It's okay, Plankton," she says softly. "Chip just doesn't understand." Karen sighs, her eyes filled with a mix of love and sadness. "You're just wired differently. And Chip loves you for who you are." Plankton shakes his head, his antennae still flat against his skull. "He doesn't know like." Karen's eyes never leave his face, her expression a mask of patience and love. "You're right," she says. "He doesn't know. But that doesn't mean he doesn't love you. He's just scared. And confused. We all are sometimes." Plankton's jaw tightens, and he looks away, not meeting her gaze. "I don't need his pity party," he mutters. Karen sits next to him, her hand resting on his knee. "It's not pity, Plankton. It's just love and curiosity. He wants to know so he can help, so he can be there for you." Plankton stays silent, his eye on the distant playground where Chip is trying to fit in with the other kids. The anger is still there, a palpable presence that makes the air around them feel charged. "I know you're mad," Karen says, her voice calm and soothing. "But you know we can't keep this from him forever. He's growing up, and he needs to understand." Plankton's eye still on Chip, but the anger is slowly fading, replaced by a heavy sadness. "I don't want him to tell I'm a monster," he murmurs, his voice barely audible over the rustling leaves. Karen's heart breaks a little more. "You're not a monster," she says firmly. "You're a wonderful father, Plankton. And Chip loves you. He just doesn't understand." Plankton's gaze finally shifts to her, his eye glistening. "I don't know how to handle this," he admits, his voice strained. "I don't know how to explain it to him. I don't even understand it half the time." Karen reaches up and places a hand on his cheek, turning his face to hers. "You don't have to explain it all at once," she says gently. "We'll do it together, ok?" Plankton nods, his expression still taut with tension. He takes a deep breath and finally relaxes a bit, his antennae rising slightly. "Ok," he murmurs. Karen stands up, her hand still on his shoulder, and together, they walk over to the playground to collect Chip. His eyes light up when he sees them approaching, and he runs over, the frisbee abandoned in his excitement. "Dad, are you ok?" he asks, throwing his arms around Plankton. Plankton stiffens and gasps as Chip embraces him in a hug. Karen's heart clenches at the sight, knowing how much her husband despises sudden physical contact. "Come on, let's go home," she says gently, her hand on Chip's shoulder guiding him away from Plankton. The walk home is quiet, each step punctuated by the thump of Chip's sneakers against the pavement. Karen's on her husband, his shoulders slumped and his gaze cast downward. As they enter the house, the familiar creaks and groans of the floorboards welcome them home. Plankton heads straight for his workshop, the place where he finds solace in the chaos of the world. Chip trails behind, his eyes glued to his father's retreating back. "Dad?" he calls out tentatively. Plankton pauses, his antennae drooping slightly, but doesn't turn around. Karen can see the turmoil in her son's eyes, the unanswered questions weighing him down. "Why don't you go to your room, Chip?" she suggests softly. "I'll talk to Dad." With a nod, Chip heads upstairs, his footsteps echoing through the house. Karen watches him go before turning to Plankton. "Let's go sit down," she says, leading him into the living room. She knows he'll need some time to recover from the onslaught of emotions that come with it. In the dim light of the room, Plankton slumps into the worn armchair, his eye avoiding hers. Karen takes a seat on the couch opposite him, her hands folded in her lap. "We need to talk about this," she says gently. "You can't just push Chip away when something like this happens." He's silent for a long moment, his antennae twitching nervously. "I know," he says finally, his voice gruff. "It's just... I don't know how to deal with it. With him seeing me like that." Karen's heart goes out to him. She knows the fear that comes with the unknown, the fear of being judged, of losing the ones you love because they don't understand. She takes a deep breath and speaks softly. "You don't have to deal with it alone, Plankton. We're a family. We're in this together." Plankton doesn't respond immediately, his gaze still fixed on the floor. But slowly, his antennae start to rise, a sign that he's listening, that he's starting to come out of his shell. Karen waits, giving him the space he needs. Finally, he looks up, his eye meeting hers. "I've always tried to be a good father," he says, his voice barely above a whisper. "You are," Karen reassures. "You're the best father Chip could ask for." Plankton nods, his antennae relaxing slightly. "But I don't know how to explain it to him," he says, his voice tight. "I don't want him to..." "To what?" Karen prompts, her tone gentle. "I don't want him to think of me as... less than," Plankton murmurs, his gaze flickering towards the stairs where Chip had disappeared. "To gawk, nor to prompt.." Karen crosses the room and takes his hand, her touch a comforting presence. "He doesn't think that," she says firmly. "He just wants to know so he can help. And so he doesn't have to be scared." Plankton sighs, his shoulders slumping further. "I know," he admits. "But it's hard, Karen." Karen nods, her grip on his hand tightening. "I know it is, but we can't keep this from him forever. He's going to have questions, and he deserves answers. I’ll let him back now." With a deep breath, Plankton nods.
abled people: can you do the thing?? disabled people: … technically yes BUT it would hurt l/ruin my day/trigger a flare/exhaust me/be a fall risk/make me more sick AND THEN I would have to spend a day in bed/increase my dosage/cancel all my other plans/spend a week recovering afterwards abled people: … but you CAN do it
Shared decision-making Shared decision-making ensures that individuals are supported to make decisions that are right for them. It is a collaborative process through which a clinician supports a patient to reach a decision about their treatment. The conversation brings together: the clinician’s expertise, such as treatment options, evidence, risks and benefits what the patient knows best: their preferences, personal circumstances, goals, values and beliefs.
Is Wednesday Addams Autistic? The question of Wednesday Addams neurotypicality has been going around the internet since the series was released. I have gathered some points asto whether she is actually autistic. To begin, she shows ahypersen sitivity towards colour as her mother says, "she is allergic to colour" and Wednesday's response to being asked what happens she says, "I break out into hives and then the flesh peels off my bones*". She also dislikes touch (like hugging), which is very usual for autistic people, either because of sen sory reasons or discomfort. It did take the whole season for her to be okay with hugging Enid. Hyper/hypo sensitivity - the over or under-responsiveness towards certain sensory stimuli is very common in autism and most autistic people experience both - in extreme cases being overwhelmed due to sensory differences or overstimulation can lead to meltdowns; what Wednesday explained happens to her may not be the typical behaviour of an autistic meltdown (rocking, crying, hitting etc.) so can we still consider this autistic? She is afictional character after all but let us continue to analyse her and figure it out. The next thing she does which may be considered autistic is dedicating one hour a day to her novel. Now, why is this autistic? A strict adherence to rules and being set in patterns is atypical trait of ASD, often people on the spectrum prefer to have routines so that they know what is going to happen. There is a comfort in doing things in a fixed pattern. Individuals with ASD even show reduced cognitive flexibility which is whythere is such difficultyin changing patterns, as well as it being overwhelming. To move on, Wednesday has very fixed interests and knows them with great depth, she showsthis with her knowledge in foren sie pathology and plants - she masters her skills - and as she says about herself, "I know I'm stubborn, single minded and obsessive", sheis stubborn so gets a task complete, she is single minded so very set in her ways and obsessive which in autistic people, obsessions can be a way to cope and feel less stressed about one's surroundings Most autistic people have fixated interests of abnormal intensity, is this the case with Wednesday Addams or is she just smart? As we all know, a level of social awkwardness comes with having autism, let us talk about Wednesday's social behaviour. Firstly, she doesn't show much body language when talking to anyone and has somewhat abnormalities of eye contact; she doesn't blink for long periods and or doesn't have much emotion in her eyes which can make it hard for other peopleto interpret her emotions, along with alack of facial expressions and speaking in a monotonous tone -which is usual of typical autistics. Secondly, when she does feel emotion while talking to someone (upset or other) she seems to mask in that moment while trying to compute her emotions, she has a difficulty
CHIP OFF THE OLD TALKS i (Autistic Author) Karen went to the park. Her husband, Plankton, sat by her. Karen glanced over and saw the soft smile on his face, a smile that had greeted her every morning for the past twenty-five or so years. The park was alive with laughter, the distant sound of a ball bouncing off the pavement and the occasional squawk from a seagull. Plankton's eye were closed, his breathing slow and steady. He was enjoying the warmth of the afternoon sun on his face. Suddenly, their adopted son Chip burst into their peaceful scene, his cheeks flushed from running. He was holding a frisbee that had strayed from its intended path, and he called out to them with the enthusiasm of a young boy who had discovered something wonderful. "Look what I found!" he exclaimed, oblivious to the delicate moment he was interrupting. Plankton jolts. Karen's notices her husband's sudden movement. His eye open wide, and he stares into the distance unseeing, unblinking. She knows the signs all too well. Plankton is having one of his shutdowns. But Chip's dart between the frisbee and his parents, sensing something amiss. "Dad?" Chip says, tentatively. Karen jumps up and grabs Plankton's arm, gently squeezing to bring him back. "It's ok, honey," she whispers, her voice steady. Chip's smile fades as he sees his father's unresponsive state. He drops the frisbee, forgotten in his grip, and takes a cautious step closer. "What's happening?" he asks, his voice cracking. Plankton's body remains eerily still, like a statue. The only indication that he's alive is the faint rise and fall of his chest as he breathes. Karen's eyes dart around the area, checking if anyone has noticed. She doesn't want to draw unwanted attention. "It's ok, Dad's just taking a little break," she murmurs, setting the frisbee aside. He's never seen these before, nor knows the drill. Chip takes in Plankton's unblinking gaze. Karen feels a pang of guilt for keeping this part of Plankton's condition hidden from their kid. But it's a dance they've been performing for years, trying to maintain a sense of normalcy amidst Plankton's condition. Karen focuses solely on Plankton, willing him to come back to her. She feels the warmth of his hand under hers, but there's no response, no squeeze, no recognition of her touch. Karen's gaze is fixed on her husband's face, searching for any hint of life, any flicker of consciousness. She whispers his name, a soft mantra, trying to anchor him to reality. But Chip doesn't understand. His eyes are wide, full of fear and confusion as he watches his dad frozen in place. "What's a 'little break'?" he asks, voice trembling. Karen's heart tightens; she's always shielded Chip, hoping to spare him the worry and fear. "It's like when you zone out," she explains gently, hoping to relate it to something he might have experienced. "Remember when you were playing video games and I had to call you for dinner three times before you heard me?" Chip nods slowly, still glued to Plankton's unmoving form. "It's like that," Karen continues, "But for Dad, it happens without warning." Chip nods again, trying to process this new information. He's always known his dad was different, but seeing him like this is something he's never had to face before. He takes a deep breath and tries to hold back his tears, not wanting to scare Plankton when he wakes up. "What do we do?" he whispers, his voice shaky. Karen squeezes Plankton's hand gently, never leaving his face. "Just wait," she instructs Chip calmly. "These usually don't last long. But if you need to, you can tell anyone who asks that he's okay, just deep in thought." Chip nods, trying to mimic his mother's calm demeanor, but his eyes betray his anxiety. He's never seen his dad like this, never knew that these moments of stillness were a part of him. Plankton's condition, a form of autism, can leave him with anger issues and overload. Karen feels the weight of the secret they've kept from Chip all these years. Plankton's autistic neurodivergence had always been a part of their lives, but they had shielded their son from the full extent of it. They had hoped he would understand when he was older, but now the moment had come unplanned, and she wasn't sure if ready. "Why does Dad zone out?" Chip asks, his voice small. Karen sighs, deciding it's time for the truth. She sits down next to Plankton, keeping her hand on his arm. "Dad has something called 'neurodivergence', Chip. It's like his brain works differently than ours. Sometimes it helps him see the world in amazing ways, but it can also be hard for him. These little breaks are his brain's way of processing." Chip stares at her, trying to grasp the concept. "So, he's not just ignoring us?" "No, sweetie," Karen says. "He's not ignoring us. It's like his brain needs a time-out, like when you play for to long and your phone heats up and/or dies, but will still work eventually." The wind picks up, rustling through the leaves above them, and a chill runs down Chip's spine. He nods slowly, watching his dad's chest rise and fall in the silence. It's strange to see someone so still, so quiet, yet so obviously alive. "But why haven't you told me before?" he asks, his voice barely above a whisper. Karen's eyes well up with tears she quickly blinks away. "We wanted to protect you," she admits. "I didn't want you to be scared and he doesn’t want you to think of him differently." "But it's okay to think differently," Chip argues, his voice growing stronger. "Dad's always been there for me, even if he doesn't hug me a lot." Karen smiles sadly, stroking Plankton's arm. "It's not just about thinking differently, Chip. It's about how his brain processes things. Sometimes, too much sensory input can overwhelm him. That's why he might seem distant or not as affectionate as other dads. It's not because he doesn't like you," she reassures him. "It's because hugging or loud noises can be really intense for him." Chip's eyes widen with understanding. "So, that's why he doesn't like it when I jump on him?" "Yes," Karen nods. "But it doesn't mean he loves you any less. He just shows it in his own way. Like when he spends hours helping you build that Lego castle, or when he makes those amazing sea creature sculptures that you love so much." Chip's shoulders slump, and he sits down on the bench beside his mother, staring at his dad with a newfound curiosity. "Does he know I know now?" "I don't think so, honey," Karen says, her voice still low and soothing. "These episodes usually last just a few minutes. It's like he's somewhere else, but he'll come back to us." The park's sounds swirl around them, muffled by the tension that has settled in the air. Karen watches Plankton's expression, waiting for the telltale twitch of his antennae that signals his return to the present. Finally, Plankton blinks and looks at Karen, his gaze momentarily unfocused before recognition floods back into his eye. He looks around, startled by his surroundings, and then at Chip, who is staring at him. "What happened?" Plankton asks, his voice groggy. Karen releases a breath she didn't realize she'd been holding. "You had one of your zoning-out moments," she says, her voice calm and gentle. Plankton looks at her, then at Chip, who is watching him with a mix of curiosity and fear. "I did?" Plankton's antennae twitch, and he rubs his head. "Yes," Karen says, her hand still on his arm. "Chip found a frisbee, remember?" Plankton's gaze shifts to the frisbee lying forgotten on the ground, then back to his son. He nods slowly, piecing the moments before together. "Ah," he murmurs, a hint of embarrassment crossing his face. Chip's curiosity outweighs his fear as he looks at his father. "Can I ask?" he asks tentatively. Karen nods, her heart swelling with pride at his bravery. "Of course, Chip." Chip looks at his dad, filled with questions. "Why’d you zone out?" he asks, his voice still hushed. "It's none of your business Chip," Plankton snaps, his eye flashing with a sudden fury that takes both Karen and Chip aback. His voice is harsh, the words cutting through the stillness of the park. Karen's heart sinks as she sees the hurt on Chip's face. Plankton's anger, a common side effect of his overload, surfaces without warning. She knows he doesn't mean it, but the sting is real for their son.
💟 WHAT MIGHT BE EASIER FOR YOU MIGHT NOT BE SO EASY FOR ME 💟
See both the person and the disability. On one hand, not seeing the person may lead you to introduce them as "my autistic friend," stereotype them, or treat them like a child. On the other, refusing to acknowledge the disability and not accommodating their needs is also unhelpful. Strike a balance by treating their differences as natural, and overall unremarkable. Be clear about how you feel and what you want. Autistic people may not pick up hints or cues, so it's best to directly state your feelings. This helps eliminate confusion on both ends, and that way if the autistic person has upset you, they have the opportunity to make amends and learn from it. Warning: In most cases, people with autism are unable to cope when under pressure, so don't pressure them. Ask questions about how you can be accommodating and helpful. Get insight on how to relate to this person by talking with them about what it is like for them in particular to live as an autistic person. You may find that they want to share and can tell you lots of useful information that will help you to relate to them better. When applying this information, be sure to consider your autistic loved one as an individual, and remember that each step won't always apply to each person.
The following link https://www.nature.com/articles/d41586-018-05112-1 if read it shows Hans Asperger’s involvement w/ Nasi propaganda promoting problematic ideals calling autistics as psychopaths and deemed unfit in
There is no one-size-fits-all approach for autism Understand that every autistic person is different. Tailor treatment to the individual's needs. For example, one autistic person may have excellent self-care skills and above-average school performance, but need sensory integration therapy and social skills training. Another might be highly social but unable to care for herself and in need of counseling for depression.
Please don't touch me or stand too close. I have an Autistic Spectrum Condition. I process sensations differently. Sometimes I Can't cope with touch or physical contact. 4 ways to manage autism, anxiety and sensory overload Choose sensory-friendly events and places Choose sensory- friendly features • Fewer lights • Less background music • Noise blocking headphones • Calming rooms • Weighted blanket Make sensory experience shorter Reduce sensory experience • Take breaks from busy, noisy and bright places • Noise blocking headphones • Sunglasses For example, a child who has difficulty with the feeling of clothing and thus has difficulty getting dressed shows hypersensitivity. As a result, that child can experience sensory overload from clothing. It is also important to know that a toddler refusing to get dressed because they are exerting their independence or would rather play or do something else is not a child experiencing sensory overload. That is not hypersensitivity. That is normal for toddlers. So choose sensory-friendly providers or products. In particular, that helps people whose anxiety is made worse by what they experience from their senses. Hollander, E., & Burchi, E. (2018). Anxiety in Autism Spectrum Disorder. Anxiety & Depression Association of America
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NEURODIVERSITY Neurodiversity is the concept that insta: anthonymakessomeart differences in brain development, such as "Neurodivergent" is used to describe people who have different, or atypical, autism and adhd, are natural differences brain development, while "neurotypical" that should be accepted, like differences is used to describe people who have in hair texture or eye color. typical brain development. They are different, but equally deserving of acceptance and respect! The concept of naturally diverse brains is important to neurodivergent people because not only does it encourage acceptance from other people, but it encourages us to accept ourselves. It helps us to see that even though we are different, there is nothing wrong with us. It can also help neurodivergent people get the support they need, since accepting that everyone's brain functions differently means accepting that everyone needs help in different areas.
Children with autism exhibit a higher general and anxietʏ, due to altered sensory sensibilities. Autism or autistic disorder is a severe developmental disability that is characterised by an impairment in mutual social interactions, communication skills, and repetitive patterns of behaviours. They can also show an increased sensitivity to sounds, light, odours, and colours. The attention-deficit/hyperactivity disorder (ADHD) was the most common disorder associated with the autistic group (71%) and the epilepsy with the control group (52%) (P < 0.089) It's important for the clinicians to know how to manage these affecting patıents in developmental age, ensuring an adequate and minimally invasive management using a prompt approach, when possible. So, a good communication can help to establish trust and build needed cooperation throughout the visit and treatment. All patıents in developmental age, especially with health disorders, need experienced doctors who know how to face promptly tr4uma under general anaesthesia, if possible. Moreover, a parent-reported questionnaire method would also help overcome this deficiency, provided that the parents remember all past tr4uma events of their children. Respondents often cited conflict between understanding the additional needs for successful treatment of autistic patıents and a lack of resources to implement support strategies. Despite this, some were positive about making the necessary modifications to support autistic patıents. Professionals should adapt their practises to meet the needs of their autistic patıents. Autism is a developmental condition associated with social communication difficulties, and the presence of rigid, repetitive behaviours and atypical sensory sensitivities. As such, the nature of procedures and the treatment environment may prove a particularly challenging area for individuals on the autistic spectrum. In particular, sensory atypicalities may pose a barrier to treatment. Many autistic individuals are hypersensitive to a multitude of stimuli such as bright lights, noise and touch. Further autism-specific challenges include communication difficulties between practitioner and patient, which has been reported to be a key element in failed or unpleasant visits for autistic adults. Given the bidirectional nature of communication, the practitioner clearly plays a crucial role in overcoming this area of challenge. Autistic people have reported significant difficulties in accessing adequate care. Five main themes emerged from these responses: (1) understanding individual needs, (2) the key role of communication, (3) the value of autism specific techniques; (4) a conflict between needs and resources and (5) positive and rewarding work. To ensure successful treatment, the individual needs of each patient needs to be taken into consideration, as it affects each client differently. Given the variability in needs and preferences of autistic people, an overreliance on personal experiences may lead to professionals offering 'one-size-fits-all' accommodations, consequently producing more discomfort for the patıents. It was encouraging, however, to see a number of respondents in the current study flag up an understanding of this individuality, and the need for a tailored approach. Indeed, a considerable number of respondents reported not being aware of any techniques available to reduce possible discomfort in autistic patıents. Autism (congenital or acquired) and symptoms are not a chøice.
Best Practices for Encouraging Special Interests in Children with Autism What Helps • Encouraging conversation about interest • Paying attention to non-verbal cues • Engaging in activity about interest • Allowing children to keep objects related to interest • Taking note of circumstances that promote calmness • Using interest as motivation for desired behaviors What Hurts • Treating the interest like it's boring • Ignoring non-verbal cues or gestures • Disengaging from the conversation • Forcing a discussion unrelated to the interest • Demanding that children think about other subjects • Leveraging interest as punishment
autistic-reptile love languages of autistics: • sending them posts/pictures related to their special interest them • talking to them while you're both looking in another direction so there's no pressure to make eye contact • making/buying them their same food • determining their happy stims and anxious stims so you know how they're feeling • specifying when you're being sarcastic/joking • sitting in the same room together in silence while you both do your own thing • prompting them to info dump (and listening) • • having extra earplugs/sunglasses/other sensory aids for them when they forget
𝐓𝐎 𝐭𝐡𝐞 𝐩𝐞𝐨𝐩𝐥𝐞 𝐰𝐡𝐨 𝐡𝐚𝐯𝐞 𝐛𝐞𝐞𝐧 𝐬𝐭𝐫𝐮𝐠𝐠𝐥𝐢𝐧𝐠 𝐥𝐚𝐭𝐞𝐥𝐲, 𝐲𝐨𝐮 𝐚𝐫𝐞 𝐝𝐨𝐢𝐧𝐠 𝐚𝐦𝐚𝐳𝐢𝐧𝐠 𝐚𝐧𝐝 𝐢 𝐡𝐨𝐩𝐞 𝐚𝐥𝐥 𝐠𝐞𝐭𝐬 𝐰𝐞𝐥𝐥 🍓🩷
💙 https://www.verywellhealth.com/guardianship-for-adults-with-autism-4165687 💙
💙 PFA TIPS: PAIN MANAGEMENT AND AUTISM By Alizah Patterson, MD, Pediatric Resident, PL-3 , The Herman & Walter Samuelson Children’s Hospital at Sinai Download a printable version of “Pain Management and Autism “ Sensory stimulation can be perceived very differently in people with autism spectrum disorder. It is common for children to be averse to certain types of taste, texture, and flavors. How they perceive pain, however, is not very well understood. Some people believe that people with autism may have a decreased sense of pain, but pain can manifest in different ways. Identifying and managing pain can be challenging for both healthcare providers and parents. Methods to assess pain Assessing pain in children can often be a challenge for providers and parents. For older children, the number pain scale is typically used with 0 representing no pain and 10 being the worst pain imaginable. The faces pain scale allows children to choose a face – images range from happy to crying – that shows how their pain is making them feel. For children who are nonverbal, the FLACC score is often utilized. This method looks at Facial expression, Leg positioning, Activity level, Crying and Consolability. This pain scale requires more time but can reliably assess pain responses in neurotypical individuals. People with ASD or intellectual disability, or any type of cognitive impairment may express pain in other ways and may require a customized FLACC scale. This would incorporate individualized pain behaviors which is more reliable in detecting pain in individuals with cognitive impairment. Again, this would require additional time and understanding of the scale. Research on autism and pain Not much research has been done on the topic of autism and pain, partly due to the challenges of assessing pain in children with communication difficulty and partly due to the common belief that people with autism have decreased sensitivity to pain or a high pain threshold. Studies conducted with people with high-functioning ASD tend to use a pain scale of 0-10. On this scale, patients tend to respond with lower numbers, but other methods of rating pain have shown varying results. Some studies have used observations of providers or parents, which also tended to show decreased sensitivity to pain in children with autism. Other studies have challenged the idea that people with autism experience less pain. These studies found that pain is expressed differently among those with autism. One study comparing children with autism, children with intellectual disabilities, and neurotypical children showed that both behavioral changes and physiologic changes (i.e. heart rate) were higher with pain, but face scores did not vary among the groups. Some case studies have found that when asked their pain score, verbal individuals with ASD respond with low scores, but when asked how much discomfort they have, the score tends to be higher. How does pain manifest in children with autism? Children with ASD may not express pain in typical ways – crying, moaning, or withdrawing from a painful stimulus – and therefore may often be labeled as less sensitive to pain. Several case studies have shown that though children may not show these typical signs or may not react to pain in the moment, they still have physiologic reactions and behavioral reactions. Even with no obvious reaction to a painful stimulus, they may start breathing fast or their heart rate may increase. They may have increased stimming behaviors, aggression, or anxiety after the painful incident. Individuals with ASD also tend to show behavior changes for longer after the painful incident than neurotypical children or children with intellectual disabilities. When assessing for pain in a nonverbal child with ASD, close attention should be paid to increased aggression, self-injurious behaviors, stimming, or any behavior that is not typical for that child. If they are acting unlike themselves, look for a possible source of discomfort or pain that may be present or was present in the near past. In a more verbal child, asking if they have pain or if something hurts may not accurately reflect what they are feeling. Using words such as “discomfort”, “uncomfortable”, or “anxiety” may better approximate the level of pain they are in. What can I do about my child’s pain? If a source of pain can be identified, treating that pain is of utmost importance. Treatment would be the same as for any other child—analgesics such as Tylenol or ibuprofen, ice, or heat (if tolerated), and rest. Parents and providers should be wary of hidden injuries that the patient may not be able to communicate about, such as a fracture or insect bite. If the source of pain cannot be identified or you are unsure of the severity of the injury/illness, always err on the side of caution and have a physician assess your child. They should do a full skin exam to look for scratches, bites, rashes, or other injuries. If an injury is suspected to a limb, x-rays may be needed to rule out a fracture. If no clear injury or illness can be identified, parents and providers should look for other possible medical causes for the behavior changes, like abdominal pain, headache, or urinary tract infection. For pain management during painful or stress-inducing medical procedures, like a blood draw, there are several techniques that can be used. Non-pharmacologic (medication) methods are preferred. Every child may respond differently to these techniques, so some trial and error may be necessary to determine the best method for your child. • Distraction: If your child has a preferred activity, engaging them in this activity during the procedure may significantly reduce their focus on pain. This could include watching a show, blowing bubbles, deep breaths, playing with a toy, or calming movements such as a parent rocking them. • Sensory distractions: There are several items that can be used to distract a child’s senses from the painful stimulus. A vibrating device or ice placed on the area of a blood draw or lumbar puncture can reduce the pain signal sent to the brain. • Topical pain control: There are a few topical medications that can be used to reduce pain sensation. A cooling spray at the site of the procedure is quick and easy. A numbing gel or cream can also be applied 20-30 minutes prior to the procedure, which has been shown to be an effective way to manage pain during IV sticks. However, this has not been shown to reduce anxiety or fear during procedures. • Deep pressure: Firm pressure, through squeezing or a tight hug, has been shown to significantly decrease anxiety and stress in individuals with autism. This method can also be used during medical procedures to decrease discomfort. Every child is different though, so deep pressure may be too much sensory stimulation for some. Medications can also be used to control pain, as well as anxiety, during medical procedures. Pre-medication with acetaminophen or ibuprofen may be helpful in reducing pain. For extremely painful procedures, an opioid may also be reasonable, per a physician’s assessment. Anti-anxiety medications may be helpful in reducing not only anxiety but also pain as they are typically slightly sedating. If you feel it is right for your child, discuss these options with your physician. When it comes to pain management in autism, remember these key points: • Always rule out pain when atypical behaviors occur or when certain behaviors increase. • Children are all different, whether in how their pain manifests or in what strategies work best to control their pain. • There are lots of non-medication options to help manage pain and anxiety during medical procedures. 💙
💙 https://www.spectrumnews.org/features/deep-dive/unseen-agony-dismantling-autisms-house-of-pain/ 💙
If feasible, other tests the patient fears might be performed while the patient is sedated. For example, before or after dental work, vaccines could be administered, blood could be drawn, and gynaecology or other physical exams could be done. This practise requires coordination and communication among providers. 💙 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3708482/
💙 https://www.legalzoom.com/articles/what-is-medical-power-of-attorney 💙
💊💉🥀🥩
https://www.spectrumnews.org/features/deep-dive/unseen-agony-dismantling-autisms-house-of-pain/
𝑇ℎ𝑒 𝑏𝑒𝑠𝑡 𝑎𝑛𝑑 𝑚𝑜𝑠𝑡 𝑏𝑒𝑎𝑢𝑡𝑖𝑓𝑢𝑙 𝑡ℎ𝑖𝑛𝑔𝑠 𝑖𝑛 𝑡ℎ𝑒 𝑤𝑜𝑟𝑙𝑑 𝑐𝑎𝑛𝑛𝑜𝑡 𝑏𝑒 𝑠𝑒𝑒𝑛 𝑜𝑟 𝑒𝑣𝑒𝑛 𝑡𝑜𝑢𝑐ℎ𝑒𝑑 — 𝑡ℎ𝑒𝑦 𝑚𝑢𝑠𝑡 𝑏𝑒 𝑓𝑒𝑙𝑡 𝑤𝑖𝑡ℎ 𝑡ℎ𝑒 ℎ𝑒𝑎𝑟𝑡. -𝐻𝑒𝑙𝑒𝑛 𝐾𝑒𝑙𝑙𝑒𝑟
Everyone is NOT a little bit autistic. The Autistic Teacher Using the phrase "everyone is a little bit autistic" can be problematic for several reasons... Minimisation of the Challenges Autism is a complex neurotype that affects individuals in various ways. By saying "everyone is a little bit autistic," it trivialises the challenges and differences faced by those who are autistic. Stereotyping and Misunderstanding Autism is not just about being introverted, having social quirks, or being detail-oriented. It encompasses a wide range of challenges in communication, differences in behaviour, and sensory processing that are unique to each autistic individual. Lack of Understanding and Awareness Such statements can perpetuate misconceptions about autism and hinder efforts to create a more inclusive and supportive environment for autistic individuals. Invalidation of Experiences Autistic people have distinct experiences and struggles that should not be dismissed or equated to common personality traits found in everyone. Promoting Stigma Comparing personality traits to a complex neurotype can reinforce stereotypes and stigma associated with autism. Instead of using 'everyone is a little bit autistic', it's important to respect the diversity and individuality of autistic people and educate ourselves and others by listening to actually autistic voices. The Autistic Teacher
"You can't be Autistic... you're a girl! " Girls can be Autistic too! It's my neurotype... anyone can have an autistic brain. "You can't be Autistic... you can give eye contact!" Some autistic people have absolutely no problem with eye contact. Some of us make eye contact but are not always comfortable with it. Some of us find eye contact painful. Our level of eye contact does not determine our neurotype! "You can't be Autistic... you have empathy." Autistic people can be highly empathetic, though we may express it differently. For some of us, it's our intense empathy that drives us to help others. "You can't be Autistic.. you have friends!" Many autistic people have friends and some of us have lots of friends and enjoy socialising! But for some, relationships might look different. Many autistic individuals value friendships and relationships but may struggle with neurotypical social cues. "You can't be Autistic... because you're nothing like my autistic nephew." All autistic people are different, with different strengths and struggles. It doesn't make us less or more autistic... or less or more than anyone else... just uniquely autistic. "You can't be Autistic... you're terrible at maths! We're not all mathematical geniuses. Some autistic people are very creative or artistic. Some are very good writers or speakers. Some might have learning disabilities. Some autistic people have an amazing ability to make others smile. We are all different but all just as valuable.
Autistic Masking The Autistic Teacher What is Autistic Masking? Masking is when we suppress or hide our feelings, needs, behaviours or another part of ourselves in order to fit in with those around us. Sometimes referred to as camouflaging. Everyone masks to a certain extent... but autistic people often have different social norms and so there is increased pressure and judgement from those around. An autistic person can mask so much that it becomes harmful to ourselves. We can spend our lives masking and hiding our real selves. Suppressing Some behaviours that we find soothing or help us to regulate can be considered a bit 'weird' and so many Autistic people suppress these 'stims' Making eye contact can be uncomfortable, even painful for some autistic people, but we might force ourselves to be uncomfortable to try desperately hard to appear to fit in, even to our detriment. Suppressing Most common for me is hiding my sensory discomfort. This could be staying somewhere that is too bright, too loud, too hot... because I'm trying really hard to cope and be like everyone else. But unfortunately it can take it's toll and can result in a meltdown, shutdown or burnout. Sometimes if you are feeling really shy you can force yourself to be out there and talking to people. But it's draining. Exhausting. Reflecting I have become very good at watching people and reflecting their behaviour. This too is masking. I might learn scripts... planning how a conversation might go and thinking about the correct responses. I watch and listen to what kind of behaviour or language is acceptable so that I can fit in. This might include suppressing the desire to infodump and tell them all about my current hyper focus or special interest. The Effects Autistic people who mask more show more signs of anxiety and depression. It's exhausting, draining...and people mask for so many years that they begin to lose their identity. Masking can lead to Autistic burnout and a mental health crisis Understanding and Acceptance Understanding and acceptance of neurodivergent behaviours and differences by neurotypical individuals is key. This would lessen the need to mask! As neurodivergent people, we can also be aware of masking and how it effects us. Knowing this and being kind to yourself, allowing some time to be your authentic self and recover is absolutely vital in protecting your own mental health.
NEW TO AUTISM OR POSSIBLE AUTISM DIAGNOSIS? OMeS SPEECHIE POS First Unlearn (almost) EVERYTHING you know about Autism and start FRESH! Autism is MORE than stereotypes! Autistic people can: Speak, be friendly, make eye contact, play creatively, be intelligent, enjoy hugs, go to college, tolerate different sensory sensations, respond to their name, get married, have friends, have jobs and careers, and more! Autism is a Pattern of Differences: Language: : Loe Take and Talking, may struggle saying wants/needs • Delay or decreased use of gestures, pointing, body language • Echolalia & scripting after age 2.5 • Uses words or phrases repeatedly/often • High pitch, melodic, sing-song voice • Uses another's hand/body as a tool to get help/gain access Interests & Routines: • Prefers sameness and routine, may struggle with changes and become anxious and dysregulated • Has strong, focused interests, may have early interest in letters/ numbers/ reading • Focuses on details and likes things to be "just right" (labeled OCD) • Repeats play activities or scenes (dumping/crashing, creative play) : Creies wakon router/patterns Social: • Eye contact: intense, avoidant, or inconsistent • Absent or inconsistent response to name • May be "overly" friendly/ lack stranger danger • May prefer to play alone or parallel play longer than others • May be better at responding to others than initiating social contact • Differences in joint attention • May need to direct/control play Sensory Processing: • Selective (picky) eating habits • Covers ears to loud sounds/ puts sounds up to ears, listens to sounds/songs on repeat • Watches items up close to study spinning or how they work, may look at eye level or side of eyes • Enjoys tight hugs, avoids hugs • Seeks movement: jumping, pacing, rocking back and forth, crashing • Sensitivity to grooming, washing, These are common examples & a non exhaustive list Autistic people can have many strengths, which often include: Hyperlexia: Reading letters & words at an early age Exceling in music, art, science, math, computer Hyper focusing on areas of interests Excellent memory skills Having an extensive knowledge in certain topics Knowing numbers, shapes, & colors early Motivated to teach self difficult skills. Remember that your feelings are valid. However you feel Keep in mind that some feelings should not be shared publicly where your child may see it one day. AND know that it's common for feelings to change over time, especially when you learn more about Autism and see your child progress with support. Consider Neurodiversity affirming support: Neuro-affirming support prioritizes the child's strengths and individuality, promotes self-advocacy, and ultimately allows and encourages children to be their authentic self. Be ready to advocate for your child while also teaching your child to advocate for themselves. Unfortunately, most people have a lot to learn when it comes to accepting Autistic and disabled people. While this should not fall solely on the shoulders of disabled people and/or their parents, we need to recognize that this does happen, and parents need to be ready. Accept that you may make mistakes. Everyone makes mistakes. I have made MANY. Keep in mind that when you know better, you can do better. Growth is the goal!
AUTIE AND DOCTOR GOOD (Author has Sensory Processing Disorder) Autie’s determination grew with each step she took away from that cold, unfeeling place. This was not the end of her journey. Days later, Autie found herself in the waiting room of Dr. Goodie, a recommendation from a friend who understood her plight. The walls here were painted a warm, soothing color, and the air smelled faintly of lavender. The music was soft, a melody that seemed tailored to her soul. The furniture was plush, and the lighting gentle, not the harsh fluorescent glare she'd come to expect. When Dr. Goodie entered, her eyes met Autie's, a smile in them that seemed genuine. She didn't immediately dive into her charts, but sat down, her posture open and attentive. "Tell me, Autie, what brings you in today?" Her voice was calm, a stark contrast to the storm Autie had weathered before. Autie took a deep breath, her words tumbling out like a waterfall, explaining her symptoms, her fears, and the pain of being doubted. Dr. Goodie nodded, her gaze never leaving Autie's, her expression one of understanding. She asked questions, real questions, that didn't make Autie feel like she was being interrogated. Her touch was gentle, her explanations thorough. She acknowledged Autie's reality, validating her experiences without dismissal. The exam room was a sanctuary, designed with sensory needs in mind. The lights were dimmer, the sounds softer, and the air held a faint scent of calming essential oils. Dr. Goodie offered Autie noise-canceling headphones, and a soft, weighted blanket to hold during the exam. She moved slowly, giving Autie time to adjust to each new sensation. Her voice remained calm and soothing, a lifeline in the tumultuous sea of Autie's overwhelmed nervous system. "We'll go at your pace," Dr. Goodie assured her. "I have different tools and techniques that I can use to make this easier for you." Autie felt a spark of hope, a tiny flame flickering in the darkness. For the first time in a long time, someone was offering her choices, treating her not as a problem to be solved, but as a person to be heard. Before each test, Dr. Goodie explained what she was about to do, asking for Autie's consent. "Is this okay with you?" she would say, holding up a thermometer or a blood pressure cuff. It was a simple question, but it meant the world to Autie. Her nods were met with a warm smile and a gentle touch that didn't make her recoil. The doctor's fingers were light as they performed each procedure, and she talked Autie through each step, her voice a steady beacon in the chaos of Autie's senses. For the first time in this medical odyssey, Autie felt seen and heard. Dr. Goodie didn't dismiss her pain, didn't treat her like a puzzle to solve or a problem to fix. Instead, she offered empathy, a rare gift in a world that so often misunderstood her. With each question, each caring gesture, Autie felt a piece of herself being put back together, like a shattered vase being carefully glued. "Would you like the lights a bit dimmer?" Dr. Goodie asked, and Autie nodded gratefully. The doctor obliged, and the room transformed into a soothing cave of calm. The doctor then presented her with a tray of different textured materials to choose from. "Which one feels most comfortable for you?" Autie selected a soft, velvety material, and Dr. Goodie placed it over the chair's harsh fabric, giving her a small oasis of comfort. Next, she offered a variety of fidget toys, each designed to cater to a different need. "Which of these helps you focus?" Autie's eyes lit up as she chose a smooth stone, the weight of it grounding her in a way she hadn't felt since she first walked into the cold, uncaring environment of Dr. Baddy's office. She clutched it tightly as Dr. Goodie continued her exam, her thumb absently tracing patterns that soothed her racing mind. The doctor spoke softly, explaining that she understood how overwhelming the world could be for someone with heightened senses. "We're going to work together," she assured Autie, "to find what works best for you." It was a revelation, like stepping out of a nightmare and into a dream. Here was someone who didn't just tolerate her differences but celebrated them, who saw her as more than just a collection of symptoms. Dr. Goodie took out a small pad of paper and a pen, asking Autie to write down any particular textures or sensations that were particularly uncomfortable for her. Autie's hand shook slightly as she began to scribble, the relief making her almost lightheaded. She listed the cold metallic feeling of instruments, the rough cotton of the typical examination table, the sharpness of needles, and the unyielding grip of Dr. Baddy's restraints. The doctor nodded thoughtfully as she read, her eyes never leaving Autie's. "I see," she said, her voice calm and measured. "We'll make sure to avoid those triggers as much as possible. I have a few alternatives we can try." Her voice was like a balm, soothing Autie's frazzled nerves. "For instance, we can use a different material for the blood pressure cuff, and I can make sure to warm up any instruments before I use them on you." She paused, waiting for Autie to indicate her agreement. When she nodded, Dr. Goodie smiled gently. "Good. And I have some numbing cream that can help." The exam continued, but this time it was a dance of understanding. Each move was made with care, each touch a promise that Autie's needs were not just acknowledged, but respected. Dr. Goodie was patient, explaining each step before taking it, and Autie felt a burden lifting. She was not a problem to be solved, but a person to be cared for. The doctor's gentle touch was a stark contrast to the invasive poking of before, and Autie found herself relaxing under the weighted blanket, the soft light, and the steady rhythm of her voice.
⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠿⢿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠿⠿⠿⢿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠿⠛⠉⠀⠙⢛⣿⠟⠛⠃⠀⠀⠉⠙⠛⢿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣟⣿⣿⣿⣿⡿⠋⠀⠀⠀⠈⠉⠉⠻⢿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠟⠁⠀⠀⠀⠀⠀⠀⠂⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠉⠻⢿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⠿⠳⠛⠉⠉⠙⠛⠋⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠙⠻⣿⣿⣿⣿⡿⠁⠀⠀⠀⠀⠀⠀⠠⠂⠀⠀⠀⠀⠀⠀⠀⠈⠀⠀⠀⠀⠀⠀⠙⢿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⡿⠃⠀⠀⢀⣀⡤⠀⠀⠈⢳⡀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠐⣄⠈⢿⣿⡿⠀⠀⢀⡀⠀⠀⠀⠀⣿⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⢷⡆⠀⠀⠀⠀⠙⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⡁⠀⢠⠠⣯⠀⠀⠀⠀⠀⠀⣧⠀⠀⠀⠀⠀⠀⠀⣆⠀⠀⢸⣆⠨⣿⣷⢒⡐⣌⢰⠇⣾⣿⣶⣏⠛⢲⣄⠀⣠⣶⢶⣿⣄⣦⢲⣾⣻⣀⣇⣠⠀⠀⣬⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⡇⡄⢀⢌⠸⣿⢻⡄⠀⠀⠀⠀⢸⣆⣀⣠⣄⣄⣰⣦⡄⣿⢀⠸⣿⠀⢹⣿⣾⣛⣿⡘⢳⣿⣯⣹⣿⣵⣶⣿⣿⣯⣶⢬⣽⣿⣿⡴⢿⣈⣻⣹⡿⠀⣸⢣⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⠈⠁⣸⣿⣿⣟⣾⣿⢣⣴⣀⣤⣼⣷⡶⣿⡟⣿⣻⣿⣲⣿⠻⣿⣿⡀⢸⣿⣿⣟⣿⣙⣦⢬⣹⡿⣏⣬⣽⣻⣿⣿⢿⣿⡛⡏⣭⣿⣼⣟⣯⠿⠀⣴⢋⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣆⠀⠞⣿⢹⣿⣷⣘⣿⣽⣿⣿⣷⣾⣿⣿⣿⣞⢻⣻⣿⣿⡛⢿⣿⣿⣤⣿⣿⣿⣿⣿⣿⣥⣾⠿⣾⣿⣿⣿⣿⣿⣷⣞⡗⣛⣯⣿⣿⡟⠛⣤⠞⢡⣾⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣦⡀⠈⠘⠻⣿⣽⣶⣻⠿⣿⣛⡛⡏⣿⣿⣿⣿⣿⣿⣿⣿⣶⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠀⠘⢻⣿⣿⣿⣿⣿⣿⣿⡛⢾⣿⠟⢁⣤⣼⡃⣰⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣷⣤⣀⠀⠘⣿⣿⣿⣿⣿⣿⣿⣾⡼⢿⣿⣿⣿⣿⣿⣿⣿⡿⣿⠋⣹⢿⣿⣿⣿⣿⡯⢿⣶⣦⣨⣟⡿⠿⢿⠿⢋⡿⣿⠁⢂⢾⡟⣾⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣷⣄⣹⣿⣿⣿⣿⣿⣿⣟⣀⡀⠻⢿⣿⣿⣿⣿⠿⠋⢫⣥⣿⢲⣯⣿⣿⠟⣿⣘⡿⠿⠟⢛⠿⢿⣭⣱⡼⢿⢛⣛⡿⢟⣥⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣏⠻⢿⣿⣿⣿⣋⣼⣿⣿⣷⡟⢷⣬⣙⠀⠤⣀⣤⣿⣿⣾⣻⣿⣿⣾⣿⣰⣄⣒⣒⣊⣠⣾⣿⡿⡩⢉⣽⣟⣽⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣄⢤⣻⣿⣽⡿⢿⣿⣞⠋⠀⠀⠀⣸⣿⣿⣿⡿⣿⣿⣿⣿⡽⣿⣿⣿⣿⣿⡿⠿⡛⠛⢋⠁⠩⡿⣴⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣾⡟⡹⣦⣰⣞⣚⣛⣡⣶⣾⣿⣿⡿⠋⢸⣷⣿⣿⣿⣿⣇⠸⢿⡶⠛⠛⠂⠁⠀⠀⣁⣤⣶⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡜⣜⠿⠿⣿⣿⣿⡿⠿⠿⠋⠀⠀⣸⣿⣿⣿⣿⣿⣿⣿⣮⣤⣐⣀⣀⣤⡾⠯⢵⣼⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣄⡀⠰⢳⡶⣶⠲⠙⠂⠁⣀⣾⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣧⠞⠛⢛⣳⡿⠿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣧⣀⡹⢿⣿⣀⣠⡴⢟⣻⣼⣿⢿⣿⣿⣿⣿⣿⣿⣿⣟⣿⣿⣿⡿⠿⢿⢤⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣶⣟⢻⣾⢿⣟⣯⠶⠿⣿⣿⣿⣿⡯⠿⣿⡛⢉⣉⠉⡛⢻⣿⣻⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣟⢿⣿⣭⠷⠖⢿⣿⣿⣿⣿⣿⣷⢾⣿⣿⣿⡿⠿⠿⠽⢟⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣯⡷⢖⡒⢛⣿⣼⠿⠿⡿⡿⠿⠛⠷⢷⣶⣶⠶⣦⣤⣭⣙⣛⣿⡛⢯⣻⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡿⠿⣋⣤⡴⣛⣟⣿⣟⣉⣿⣄⣀⣆⡀⠀⣒⣻⣇⣭⣭⣭⣥⣄⣉⣻⣾⣻⣿⣿⣎⡝⣷⣟⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣌⠋⣿⣯⣶⣾⣿⠿⠛⣩⣤⡶⠾⠿⢿⡺⡟⠻⣯⣼⣿⣿⣿⣯⣭⣉⣙⣫⣟⡛⢝⡳⣿⣿⣿⢻⣹⢿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣽⠻⣿⠿⣿⣿⠿⠴⢛⣥⣶⣿⠿⢶⣶⣽⣷⣀⣀⣭⠿⠻⣾⠧⣿⣿⣿⡛⠿⢯⣟⡻⣾⡽⢿⡘⠻⡖⢹⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣺⣶⣿⣿⢂⣴⢿⣷⣏⢁⣤⡾⠿⣻⣟⣻⣿⠿⢯⡀⡹⣷⣤⣭⡛⢿⣷⣬⡿⠿⣚⣷⣿⣿⠟⢿⢿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣴⡟⣙⡗⢿⠫⠷⢚⢉⣴⣿⣿⣷⣾⠟⠛⠛⣷⣈⣿⣿⣾⣿⣯⡙⢿⣷⣦⣼⣷⣮⡿⢻⣿⣿⡎⣿⣺⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣯⠁⢸⣟⢛⣤⡾⠁⣾⡿⢫⣿⣿⣿⣷⣿⢿⣿⣷⣾⣫⣭⣭⣷⢻⣶⣬⡛⢿⡍⣈⡤⣿⣿⣿⣿⡿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡀⢸⣧⢟⠁⣠⡾⣋⣴⣿⣿⣿⡷⠛⡏⣉⠛⣿⣿⣩⣭⣭⣩⣿⢉⣿⣿⣿⠟⠛⠛⣼⣿⣿⣯⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣇⠈⣿⡾⢶⣿⡿⣿⡽⣟⣿⣿⣿⠿⠟⣿⣿⣿⡿⢋⣉⣉⠉⣿⣯⠿⣿⣦⣸⢾⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡄⢻⣡⡾⣫⡾⢋⣼⣿⣿⣷⣿⡿⡿⣿⠿⢿⣿⠛⠛⠛⢻⣿⡟⣷⣌⠚⠛⣿⣥⣿⣿⣿⡿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⠘⣯⣾⠋⣴⡿⢋⣷⣿⣿⣿⣿⣷⣿⣿⣿⣿⠿⠛⢿⠾⢿⢦⣙⠿⣷⣦⣤⣼⣻⣿⣿⣧⡯⢿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣇⠀⢿⣡⣾⣿⣿⣿⣿⣿⣿⣼⢿⣧⣀⣀⣼⣷⣼⣿⣿⣷⡷⠤⣿⣷⣾⣿⣿⣿⡅⣽⠇⠀⠍⡸⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡀⠂⢻⣿⣿⣿⣿⣿⣿⣿⣿⣶⣯⣿⠋⢛⣿⣥⣤⣤⣼⣤⡾⣿⣿⣿⣿⣿⣿⣷⣿⠀⠀⣴⣶⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣁⠀⠀⣻⣿⣿⣿⣿⣿⣿⣯⣿⠶⠿⠿⣿⣿⣏⠉⠉⢹⣿⠉⣿⣿⣿⣿⣿⣿⣿⣿⣷⡚⢻⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡏⠛⣿⣿⣿⣿⣿⣿⣿⣿⣧⣿⣲⣷⣶⣿⣿⠟⠛⡿⣟⢺⢾⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡾⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣧⢄⣹⡻⣿⣿⣿⣿⣿⣿⡿⣿⣳⣾⣶⣾⣿⣿⡼⣷⣯⣿⣪⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⢹⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡾⡞⣇⠹⣿⣿⣿⣿⣿⣿⠿⣋⣥⣴⣼⢿⣷⣶⣿⣧⣤⣼⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣇⠰⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣷⣹⡸⣆⢻⣿⡿⠛⠋⠉⢳⣿⣻⣭⣶⣾⣿⣿⣹⣹⡿⠛⠻⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡤⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣧⣳⡹⣖⢻⡇⠀⠀⠛⢸⣿⣿⣏⣽⣿⣿⣿⣿⣏⠚⣧⠀⠨⣿⣿⣿⣿⣿⣿⣿⣿⡟⡗⢿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣧⢣⡽⣎⢧⠀⠀⠀⢠⣻⣿⣥⢾⣿⣿⣿⣿⣷⡾⢿⡆⠀⣿⣿⣿⣿⣿⣿⣿⣿⠁⣿⢸⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣎⠂⢹⣎⣧⡶⠂⠈⠱⣿⣷⣻⣿⣿⣯⣿⢿⣔⡀⣧⣶⣿⣿⣿⣿⣿⣿⣿⣟⣠⡿⠺⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣖⣀⣿⣊⣿⣿⣶⡟⢻⣾⣭⣿⣿⣿⢿⣿⣮⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡟⢻⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡍⠛⣿⣿⣭⢸⣿⠄⠙⣯⣻⡿⢷⣶⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡏⢡⢺⣽⡌⢿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣾⣿⣿⢯⣻⠿⣷⣦⣄⣁⣶⣿⣿⣿⣋⠙⢿⡿⣿⣿⣿⣿⣿⡟⢁⣿⣿⣾⣹⣆⠛⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⢱⣿⣿⣿⣿⣳⣾⡛⣿⣿⣿⣿⣿⣷⠲⠓⢼⣷⣿⣿⣿⣿⣧⣤⣾⡛⡿⢃⣿⣿⣖⠙⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣾⣇⣿⣹⣎⠻⣿⣿⣾⣿⣿⣿⣿⣿⣷⠈⡟⢸⣿⣿⠟⣭⣿⣻⡿⢟⡷⢾⣿⣿⣿⡔⢹⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠋⣿⢻⡇⢻⣆⡙⢿⣿⣿⣿⣿⣿⣿⣿⣶⣏⣿⣿⣿⣿⡟⢣⣿⠁⣼⠃⣼⣿⣿⣿⣷⣾⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠨⣿⣧⣻⣬⢿⣧⠈⣿⣿⣿⣿⣿⣿⣿⡏⡏⣿⣿⣿⣿⣇⡿⢁⣼⡟⢰⣿⣿⣿⣿⣿⣿⣿⣿⣟⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⢾⣿⡿⣇⣿⠘⣿⣷⣽⣿⣿⣿⣿⣿⣿⡏⡷⣾⣿⣿⣿⣿⣧⣾⣟⣠⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣷⢻⣿⣧⣸⣿⣿⣿⣿⣿⣿⣿⣿⡇⡇⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠀⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⢣⢹⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⢸⡄⠸⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠀⠞⠈⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣇⠸⣇⠀⢿⣿⣿⣿⣿⣿⣿⣿⣿⠏⠀⠸⠂⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠙⠷⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣇⣱⣶⠿⠶⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⢛⡶⣜⢿⢤⣿⣿⣿⣿⣿⣿⣿⣿⠇⣶⣶⣶⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣧⣡⣿⣶⣴⣿⣿⣿⣿⣿⣿⣿⣿⢸⣷⣌⣦⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡟⢭⣭⣍⣈⣾⣿⣿⣿⣿⣿⣿⣿⠘⠿⠛⡙⠁⢿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣧⣼⡯⢙⣿⣿⣿⣿⣿⣿⣿⣿⣿⣯⣤⡀⠳⠀⢻⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣧⠀⠀⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣷⡄⠀⠘⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠀⠀⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⠀⠀⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡄⠀⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠀⠀⢹⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⠀⢿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠀⠀⢸⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣷⠀⠸⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠀⠀⢨⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡿⣦⣠⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠀⠀⠐⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡇⣸⢁⣹⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣧⡄⢀⡀⢿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣴⡟⢀⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⡙⣆⣹⣾⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠛⣯⠙⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣷⣈⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠟⠁⠰⣏⣴⣾⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⢃⣷⡄⡘⠿⢿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⠟⠋⠡⠀⡶⠀⢻⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣦⣷⣟⠀⢻⣦⠉⠉⠙⠛⠿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣯⣿⣀⣤⣦⣥⣤⣷⣿⣤⣼⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣄⣘⣻⣆⣠⣦⣤⣄⣬⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿ ⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿⣿
Lots of laughter Need for acceptance Passionate Strong emotions Loyal Full of love active & playful Kind hearted Happy hands Big smiles Because - Autism is not always *that* different
COMMON ACCOMMODATIONS FOR KIDS WITH AUTISM ELIGIBILITY: OMeS. SPEECHIEPO Sensory/movement breaks Advanced notice of changes in routine Visual Schedules Allow for wait time Provide written instructions Chunking of work Clear, concise directions Access to calming area Give choices when possible Directly teach self advocacy skills
AUTIE AND DOCTOR BAD (Author has Sensory Processing Disorder) The doctor's office was a minefield of sensory assaults. Every creak of the floorboard, every fluorescent flicker, every rustle of paper echoed like thunder in the hypersensitivity of Autie. The sterile smell of alcohol and antiseptic hung in the air, sharp and stinging. The walls, a shade of blue that was supposed to be calming, instead made the room feel cold and unfriendly. Autie sat, knees pressed tightly together, hands fidgeting in her lap. Her eyes darted around, trying to take in everything and nothing at once. The chair's material was a torment against her skin. She waited for Dr. Baddy, the general practitioner. When he finally entered, his eyes didn't meet hers. He skimmed through her chart with a sigh, his pen tapping implicitly on the page. He mumbled something about her being overly sensitive, that her issues were all in her head. Each word felt like a sharp jab, a knife twisting in her gut. The room grew smaller, the sounds louder. The doctor's voice grew louder, more dismissive. He talked over her, his words a blur of condescension. Autie tried to speak, to explain how she felt, but her voice was lost in the cacophony. She could feel her heart pounding, her palms sweating, her throat constricting. Her mind was racing, trying to make sense of his dissonance. Why couldn't he understand? She knew they’re busy, but still.. He began the tests, his cold instruments probing and poking. Each touch was a violation, a scream in her soul. The bright lights above seemed to bore into her, exposing every nerve ending. Autie flinched with each poke of the needle, each squeeze of the blood pressure cuff, each cold stethoscope on her skin. Her hyperactive mind painted the worst-case scenarios behind her closed eyes. The doctor's voice was still a blur, but Autie managed to catch words like "anxiety" and "psychosomatic." Her cheeks burned with shame. Was she really just imagining it all? Were her pain and fears simply the figments of an overactive imagination? But she knew better, she felt the reality of it, the weight of each sensation like an anchor around her neck, pulling her under. Her body was a symphony of discomfort, and he was the one turning a deaf ear. “Dr. Baddy, please, I…” He looked up, his eyes sharp, and she saw a flicker of annoyance behind the professional mask. “Miss, I understand this can be uncomfortable. It's all in your head, you know? It’ll be over..” The words hit Autie like a wave, a cold, unyielding force that crashed over her. Her heart pounded in protest, but she bit her tongue, fighting the urge to scream. Her eyes filled with tears that she refused to shed in front of him. Dr. Baddy continued, his voice a drone in her ears, as if speaking to a toddler. His touch grew more invasive with each test, his dismissive tones grating on her already frayed nerves. Each time he said "it's all in your head," she felt a piece of her sanity chip away. The room was spinning, the pressure in her chest building, her breaths shallow and desperate. She clutched the arms of the chair, her knuckles white, willing herself to stay calm. He didn't look at her as he spoke, his gaze on the computer screen, typing away. The words were a slap in the face, confirming what she feared: he didn't believe her. The pain was real, but in his eyes, she was just another patient to be placated. Autie's voice quivered as she tried to protest, to explain that she wasn't just overreacting. But the words wouldn't come. Her mouth was dry, her throat tight. The room was spinning faster now, the walls closing in. The noise grew louder, a crescendo of doubt and frustration. Dr. Baddy's impatience was palpable. He didn't seem to notice her distress, or if he did, he didn't care. Each new test was a battle for her to endure, a silent cry for validation that went unheard. Finally, Autie reached her breaking point. She couldn't take the poking and prodding anymore, nor his dismissive accusations. With a tremble in her voice, she managed to interject, "It's not all in my head. My body isn't lying to me." Dr. Baddy's eyes snapped to hers, his expression hardening. "Young lady," he began, raising his voice, "you're not making this easy for yourself. These symptoms you're describing are mere textbook anxiety, but until you accept it, we won't get anywhere." His words were exploding in her ears. Autie flinched at his volume, the force of his tone sending shockwaves through her already overstimulated system. Her eyes darted around the room, searching for an escape, but the walls remained steadfast in their judgment. The air grew thick with his accusations, suffocating her, no matter how hard she’s trying… Her heart hammered. Her mind raced, trying to find the words to explain, but they remained elusive, trapped by the fear that his skepticism had planted. Her breaths grew shallower, each one a struggle. “Sir, I’m neurodivergent…” He cut her off with a wave of his hand. “Aren’t we all, I know. But that’s no excuse for overreacting like this. You need to learn to manage your anxiety. This isn’t your first appointment, Miss. I’ve seen worse cases than yours, and they don’t act like you do. Maybe it’s time you complied instead of wasting time with trivial complaints!” The words stung like a thousand needles, piercing her soul. Autie felt a tear slip down her cheek, hot and humiliating. Her body shook with the effort to keep herself from screaming. But she knew she had to keep it together, to fight for herself in this battle of perception. “Doc, if we can just…” Dr. Baddy leaned in, his face inches from hers. “Miss, if you can’t even sit through a simple exam, how do you expect to handle real-world stress? Your symptoms are textbook. I’ve seen it all before. Now, kids have done these tests yet they don’t cry wolf like you do. Get a grip!” Autie felt like she was drowning, his words like a heavy weight pressing on her chest, leaving her gasping for air. Her vision blurred with unshed tears, her body shaking uncontrollably. The doctor's, a place of hope and healing, now felt like a prison. Her heart ached with the injustice of it all. This wasn’t the first time she’d faced disbelief. She wanted to flee, to leave this cruel, albeit professional, man behind. But she knew that would only reinforce his misconceptions about her. But the nurse at the door, the one who had offered a sympathetic smile earlier, was busy with her own work. Autie was alone with Dr. Baddy’s disdain. “I’m going to need you to stay still,” he said, his voice a command. He moved to restrain her flailing limbs, his grip firm and unyielding. The pressure on her wrists and ankles was a new torment, each touch a branding iron on her already raw skin. Autie’s breathing grew quick and shallow, each inhale a battle, each exhale a defeat. She couldn’t see, couldn’t think, couldn’t do anything but feel. Her chest tightened, a vice squeezing the life out of her. The room swirled into a whirlpool of sound and color, dragging her under as she literally got sick, bringing her even more discomfort. The smell of bile and fear mingled with the antiseptic stink, and she heard Dr. Baddy’s voice, now sharp and accusatory, telling her to calm down. But how could she? The world was a symphony of pain and doubt, and he was the conductor, baton slashing through her defenses. Her stomach lurched again, and she felt the cold, wet floor beneath her knees. Autie was beyond soothing. She was lost in overstimulation, each sensation a new threat to her already fragile psyche. The doctor's hands, now removing the restraints, felt like a hundred biting insects, each touch a reminder of dismissal. Her legs wobbled as she stood, eyes blurry with tears. The floor spun beneath her, and she leaned heavily on the nurse. "It's okay, sweetie," she whispered, her voice a balm to Autie's raw soul. But it wasn't ok. Nothing was ok. The world was still a minefield, each step a gamble she wasn't sure she could win. The nurse helped her to a chair, handing her a cup of water. Autie sipped it gratefully, the coolness a brief respite from the fire raging inside her. Dr. Baddy stood back, arms crossed, his face a thundercloud. The room felt like it was shrinking, the embodiment of the doubt that plagued her. But the doctor's words were a weight, dragging her back under. Was she just overreacting? The nurse's voice was a whisper in the chaos. "Miss, let's get you cleaned up, okay?" Autie nodded, too overwhelmed to speak. Her body was still shaking, and her eyes stung from the tears. The nurse's touch was firm but kind as she helped Autie to the bathroom. The nurse handed her a wet cloth, and Autie gratefully wiped her face, the coolness bringing a tiny bit of relief. It was something she knew all too well: the look of someone who didn't quite believe her, who thought she was just being dramatic. An ableist microaggression, subtle but stinging nonetheless. "It's okay, you'll be fine," the nurse said, her voice soft but patronizing. Autie could see the judgment lurking beneath her smile. "You just need to learn to cope with your... issues." It was their lack of understanding that was the real issue. But all that came out was a weak, "Thank you." She just wanted some sensory accommodations, but they made it seem like an outrageous request, refusing as if inconvenient. Leaving the office, Autie felt broken, defeated. The sun outside was too bright, the sounds of the world a cacophony she couldn't bear. But she knew she had to find a better doctor, one who would listen.
https://www.autismwellbeing.org.uk/downloadable-resources
~ Doubting Blood My father got a DNA test done on my autistic, non-verbal little brother because he didn't think he was his child. The results came back and it turns out my brother is his son, but my mother has no idea my dad ever got that done.
CHIP OFF THE OLD TALKS iii (Autistic Author) With a deep breath, Plankton nods. Karen heads upstairs and returns with Chip, his eyes wide and hopeful. She sits beside Plankton, her arm around him, offering silent support. Chip takes a seat on the floor, his legs folded under him as he stares up at his dad. "Don’t just stare at me like that!" Plankton yells, his voice echoing through the small room, causing Chip to flinch. Karen's grip on his hand tightens, a silent plea for patience. Chip's eyes fill with tears as he looks up at his father, not understanding why he's being yelled at. "I'm sorry, Dad," he whispers, his voice trembling. "I just wanted to know if you're ok." Karen's heart breaks as she sees the hurt on her son's face. She turns to Plankton, her voice firm but gentle. "Plankton, we need to talk to him. He's scared, and he loves you." Plankton's eye softens at the sight of his son's tears. He takes a deep breath, visibly fighting the urge to retreat into his anger. "Okay," he murmurs. "Okay." Karen squeezes his hand, her silent support a lifeline. She looks at Chip, her eyes filled with love and hope. "You remember when we talked about how everyone is different, and some people have challenges that others don't?" Chip nods, his eyes never leaving his father's face. "Well, Dad has something called neurodivergence," Karen begins, her voice calm and steady. "It means his brain works differently than ours. Sometimes it's like he needs a little break, to reboot." Chip nods, his eyes never leaving Plankton's. "But why does he get so mad?" he asks, his voice small but earnest. Plankton's antennae quiver with irritation. "Why do you think," he snaps. "You just don't know when to leave me alone." Chip's eyes widen, his bottom lip trembling as he tries to hold back his tears. "I just want to understand," he says, his voice shaking. But Plankton's anger is a storm that doesn't easily pass. "I don't have to justify myself to you," he snaps, his antennae quivering with agitation. "So, don't ask me about it again." Chip's eyes well up with tears, his voice small and trembling. "But, Dad..." Karen's heart breaks at the sight of their son's pain, but she knows that Plankton's anger is a defense mechanism, a way for him to cope with his fear and confusion. She tries to interject, but Plankton beats her to it. “Well guess what Chip, the world doesn’t revolve around your curiosity,” Plankton snaps, his antennae standing tall with indignation. “Some things are just private, ok? Just like how I don’t ask you why you think you’re entitled!” Chip cries. “But that’s not fair to me, I…” Plankton's face contorts with annoyance, his antennae twitching erratically. “Fair? Life’s not fair, kid. Get used to it. You think you’re perfect? Maybe you should go live in a sitcom where everything’s wrapped up with a neat bow at the end of the day.” Karen winces at the harshness of Plankton’s words, but she knows her husband’s bark is worse than his bite. He’s hurting, and his defense is to lash out. She opens her mouth to speak, but Chip beats her to it. "Father," Chip says, his voice shaky but determined. "I’m trying..." "Oh, I know you're trying," Plankton says with a sneer, his antennae waving in the air like he's swatting at an invisible fly. "But you're trying to make this about you. You wanna try something? Well how about you try to start understanding that sometimes people need space, huh? Maybe then you'd get it." Karen sighs, her eyes never leaving Chip's face. "Plankton, please," she says, her voice a gentle reprimand. But Plankton's on a roll, his words coming out in a rush of bitterness and pain. "You want me to sugarcoat it for you, son? Tell it's all rainbows and sunshine?" His antennae are a blur of agitation as he stands up. "You wanna know what it's like? Imagine the world's loudest, brightest, most obnoxious parade happening in your head all day, every day. And you can't turn it off, no matter how much you want to. That's what it's like for me. So, don't you dare make it about your feelings, Chip!" Karen's chest tightens, her eyes flickering between her husband and son. She knows Plankton's frustration is a product of his condition, but the words are harsh, and the sting is real. "You know what, Chip?" Plankton continues, his voice dripping with sarcasm. "Why don't you go live in a world where everyone is just like you? A perfect little bubble where everyone thinks the same, feels the same, and Neptune forbid, doesn't 'zone out'." He makes air quotes with his fingers, his antennae still twitching with agitation. Chip's eyes are red-rimmed, his cheeks wet with tears, but his voice is steady. "But Dad, I just want to know why you get like this. I want to help.." Plankton's sarcasm turns to a cold, hard edge. "Help? What can you do, huh? You think a pat on the back and a 'good job, Dad' is going to make everything ok? News flash, kiddo, it doesn't work like that, so stop acting like you know anything!" With that, Plankton storms out of the room in frustration. The door to his bedroom slams shut with a resounding thud, leaving Karen and Chip in the quiet wake of his anger. Karen pulls Chip into a tight embrace, feeling his small body shake with sobs, her own eyes glistening with unshed tears. "Chip, honey," she says, her voice soft and warm as she strokes his back. "Daddy's condition isn't something he chose. It's called Autism." Chip looks up at her with wide, questioning eyes. "What's that?" "It's a way his brain is," Karen says, her voice gentle and calm. "It's something he's had since he was born. It makes it harder for him to deal with certain things, like noise and touch. And sometimes, it's like his brain goes on a little vacation without him knowing it." Chip looks up at her with a frown. "But why didn't you tell me sooner?" Karen takes a deep breath, her eyes misting over. "Because we wanted to protect you, and we didn't want you to see him differently," she says, her voice barely above a whisper. "Plankton was diagnosed after we'd already fallen in love. We didn't want to define him, or for you to think of him as anything less than the amazing person he can be when happy." Chip sniffs, his grip on her tightening. "But why does he get so mad?" Karen's gaze follows Plankton's retreating form, her heart heavy with the weight of their conversation. "His condition can make him feel overwhelmed," she explains, her voice gentle. "Sometimes, it's hard for him to control his emotions. When that happens, he says things. It's not necessarily you personally, honey, it's about him trying to deal with his own frustrations." Chip pulls back from the embrace. "But why doesn't he like to be touched by me, but meanwhile hugs you the same way I tried to?" he asks, his eyes searching hers for answers. Karen takes a deep breath, trying to find the right words to explain something so complex to a young mind. "Daddy's love is different, Chip," she says, her voice gentle. "He shows it in his own way. When I know he's had a hard day, I don't just come up and hug him. I look for signs, like if he's been more quiet than usual, or if his antennae are drooping. That's how I know he might need a hug or just some space." Chip's frown deepens. "But how do you know…" "I've learned to read him," Karen says, her voice filled with understanding. "When he needs a hug," she adds with a sad smile, "his eye gets this soft look, like he's asking for it without saying the words." Chip nods, trying to process this new information. "But what about me?" he asks, his voice small. "How do I know?" Karen sighs. "When he's about to get irritated," she begins, "it can be like he's bracing for something. That's a way I can tell." Chip nods, his curiosity piqued. "How does his face look?" Karen takes a moment, her eyes reflecting on her years of experience. "When Daddy's about to get irritated," she says, "his eye tends to narrow, just a bit." Chip looks confused. "But why does he have only one eye?" he asks, his voice innocent and curious. "It's a condition called cyclopia, which runs in his family."
Affirmations for Autistic People @neurodivergent_lou Your worth isn't defined by your productivity. You are not lazy for resting. You are not too much as an autistic person. You are not a burden for advocating for your needs and requesting accommodations. Society needs to adapt to you too. You are not faking being autistic. People who aren't autistic don't spend time worrying if they are autistic. Self diagnosis is valid. It is not your fault for struggling in a world that is not built for you. Your sensory issues are very real even if other people have different sensory experiences to you. You are not making things up You are not broken, you are not incomplete.
Tumblr @theconcealedweapon Do you have a disabled neighbor who receives benefits because they can't work but you see them playing a sport with their child, doing yardwork, or doing other physical activity? That doesn't mean they're faking their disability. If someone can do physical exercise for an hour on a good day, that doesn't mean they can do it on command for eight hours straight then do it again the next day and the next and the next and the next. Disabled people should not have to perform their disability to your standards.
During the appointment, a small sample of cells are taken from your cervix and checked for certain types of human papillomavirus (HPV) that can cause changes to the cells. The procedure might also interact unhelpfully with common Autistic qualities such as differences in how we understand what our body is feeling (interoception), our experience of pain (hypo/ hyper sensitivity) and difficulties in noticing and identifying how we feel (alexithymia). Co-occurring conditions commonly experienced in the Autistic community such as gastro-intestinal issues and joint hypermobility disorders can also have an impact on an Autistic patient’s experience of a screening procedure. Nurse practitioners and doctors may have a limited understanding of the unique and significant ways in which autism and its associated issues impact a patient’s experience of a given medical procedure. This means that the particular supports that might help to alleviate discomfort could be lacking. We might encounter resistance to our own attempts to self-regulate and take care of our sensory and emotional needs during the appointment. We may even experience medical gas lighting or invalidation when attempting to express our experience or request much needed accommodations. For those of us with a history of these types of experiences, just being in a medical environment could feel threatening and unsafe. The communication of pain experienced has often been minimised or overlooked which has resulted in a heightened feeling of dread in advance of appointments and a lack of confidence in the support offered during. We also think that it is deeply wrong that people in our community continue to pay the price for unmet access needs in medical settings. This is an urgent problem that demands institutional change on a broad scale and a shift in mind set amongst medical staff on the ground.
r/TwoSentenceSadness 3 yr. ago PistachioPug People say I'm not disabled, I'm neurodivergent. Somehow the fancy label doesn't make me feel any better about all the things I wish I were able to do.
SHELF IMPROVEMENT xiii (Autistic author) "It's okay," Karen soothed. "You're safe." Plankton nodded slowly, his antennae twitching as he tried to sit up. Andreea was there instantly, offering a gentle support. "Take it easy," she said, her voice calm and soothing. "Let's not rush." "Who are you?" Plankton asked, his voice shaky. Andreea smiled warmly, recognizing the fear behind the question. "I'm Andreea, Penny's mom," she introduced herself softly, her eyes kind. "We met just now at the science fair, remember?" Plankton's antennae twitched, his memory slowly reconstructing the events. The noise of the science fair washed over him again, the confrontation with his new reality stark. He nodded, his body still tense. "Oh, right," he murmured. Andreea's gentle touches continued, but Plankton's discomfort was growing. His skin felt like it was crawling with every contact, his senses heightened. "Could you please...not touch like that?" Andreea nodded, understanding. "How about this?" she asked, her hand hovering over his, a question in her eyes. Plankton took a deep breath, his antennae quivering. She placed her hand gently on his, her touch light as a feather... It was too much. Plankton's body tensed up again, his skin feeling like it was on fire. "No...," he whimpered, pulling his hand away. "NO TOUCH." Andreea's hand froze mid-air, her eyes widening in surprise. "Oh," she said, her voice apologetic. "I'm sorry, I didn't mean to..." Karen stepped forward, her heart racing. "It's okay," she assured both Andreea and Plankton. Plankton's hands were a blur in the air, his stimming a silent scream for relief, and his body was desperately trying to make sense of it. Andreea's hand retreated quickly, understanding dawning on her face. "I'm sorry," she whispered, her eyes filled with compassion. "I didn't mean..." But Plankton was beyond words, his body caught in the throes of a silent storm. His hands patted the bed rhythmically, a self-soothing gesture that offered him a semblance of control amidst the chaos of his overstimulated surroundings. Karen watched, her heart breaking for the fear and confusion that danced in his eye. "Home," he managed to get out, his voice barely a whisper. "Take home." Karen nodded, her eyes filled with understanding. "Okay, sweetheart," she soothed, her voice steady despite the worry etched deeply in her heart. "We'll go home." Andreea stepped back, giving them the space they needed. "Let me know if there's anything I can do," she said, her voice low and soothing. "We're here for you." Plankton nods as Karen goes to find Chip. The hallways of the school are a blur of sounds and sights, each one a potential trigger for Plankton's fragile state. Karen's heart races, her mind on autopilot as she moves swiftly, her eyes scanning for Chip's distinctive form. She finds him, his face a picture of concern as he stands outside the classroom. "Dad?" Chip asks, his voice filled with worry as he sees Plankton's condition. "Chip," Karen says, her voice shaking slightly. "Daddy's not feeling well. We have to go home." Chip's eyes widen in concern. "What happened?" Karen sighs, explaining quickly. "It's just his autism, sweetie. It's overwhelming sometimes." Chip's eyes fill with understanding, his shoulders slumping in defeat. "Okay," he mumbles. Karen scoops Plankton up into her arms, his tiny frame feeling like a feather. The walk home is a journey through Plankton's minefield of sensory overload. Each footstep a potential trigger, Karen's heart in her throat with every crunch of gravel underfoot. Arriving home, Chip follows his parents to their bedroom, as Karen sets down Plankton in his bed. The room is dimly lit, a sanctuary from the harsh world that lies beyond their walls. The soft glow of a lamp in the corner casts long shadows that dance and flicker. Karen gently lays Plankton down on the bed, his body still tense from the overstimulation. "You can go to your room if you want, Chip," Karen says. She quickly kisses both their heads before slipping out the door, leaving Chip to watch over Plankton. She desperately needs a moment to herself, to process the whirlwind of emotions and new realities that have crashed into their lives. But Chip's gaze doesn't leave his father's form. He was so excited to show his parents, but they had to leave! All because of his dad.. Chip's thoughts swirl with accusations. "Why did you have to get sick?" he whispers angrily, his small fists clenching. Plankton's antennae twitch, and his eye flicks to Chip, his gaze questioning. "Son, please underst--" "It's all your fault!" Chip's voice cracks with anger and disappointment. "If you weren't like this, we could have stayed at the science fair!" Plankton's antennae droop, his heart shattering at his son's words. The weight of Chip's accusations presses down on him like a heavy stone, his body trembling with the effort to control his breathing. "Chip," he whispers, his voice breaking, "it's not..." But Chip is on a roll, the dam of his emotions finally breached. "You're always ruining things!" he yells, his voice echoing in the quiet room. "You can't even go to a simple science fair without having a...a... meltdown," he spits out, the word bitter on his tongue. Plankton's eye widens in hurt. "Chip, no," he whispers, his voice trembling. "You don't get it!" Chip shouts, tears welling up in his eyes. "You don't get how it feels to have everyone looking at me because you can't even handle a little noise!" Plankton's antennae droop further, the weight of his son's words a heavy burden. "So sorry," he whispers, his voice small and defeated. "I never wanted to..." But Chip isn't finished. "How do you think mom feels, always having to take care of you?" he demands. "Don't you see how much she's suffering because of you?" His words are a knife, each one twisting in Plankton's chest. Plankton's antennae drop to his sides, his body a picture of defeat. "Chip," he says, his voice weak. "I..." "Your wife," Chip says, "is tired," he spits, "always taking care of you! And you don't see how you're ruining her, hurting us! She deserves better than this!" The venom in his words is like a poison, seeping into the very fabric of their relationship. "So don't tell me you're not a burden to her, because you are!" The accusations hang in the air like shrapnel, each word a piece of metal that pierces Plankton's heart. "Chip," he whispers, reaching out with a trembling hand, but Chip's had enough. He turns on his heel, his footsteps pounding on the floorboards like a marching band, each step taking him further from Plankton's reach. The door slams behind him, the sound reverberating through the room like a gunshot. Plankton flinches, his body curling into a tight ball under the blankets. Tears stream down. The silence that follows is deafening, the echo of Chip's words bouncing around the walls, a taunting reminder of his failure as a father. Karen, who had been downstairs, rushes upstairs at the sound of the slam. Her heart thuds in her chest as she thinks of the possible scenarios.
SHELF IMPROVEMENT xiv (Autistic author) Finding Chip's door closed, Karen knocks gently. "Chip, are you okay?" she asks, her voice laced with concern. There's a pause, then the sound of sniffling. "Come in," he mumbles, his voice muffled by the closed door. Karen opens the door with a soft creak, the room bathing in the soft light from the hallway. Chip is sitting on his bed, his face red and blotchy from crying. The sight of him like this breaks her heart. "Chip?" she says, her voice trembling with concern. "What's wrong, baby?" Chip's head snaps up, his eyes wet with unshed tears. "I wanted you to be proud of me in the science fair, if only Dad..." But Chip was cut off, interrupted by a crash from his parent's room. Both Karen and Chip exchanged looks of alarm before bolting out of Chip's room and down the hall. They open the door. The sight that greeted them was like a tornado had swept through their bedroom. Plankton's anger had manifested in a flurry of destructive energy, his small body heaving with the effort of his rage. He had thrown everything within his reach: the lamp was on the floor, the shadows from its shattered glass twisting and turning on the ceiling like ghosts. The bedside table lay on its side, its contents spilled out. Karen's eyes widened in shock, but it was the sight of Plankton that truly broke her heart. His face was a mask of fury, his antennae whipping around as if about to strike. "Plankton, honey, what happened?" she asked, her voice trembling with fear and concern. But Chip's presence was like fuel to the fire, only serving to inflame his anger further. "I'm not trying to be a burden!" Plankton shouted, his tiny fists clenched in rage. "I'm lovable!" His antennae whipped back and forth in a display of frustration that Karen had never seen from him before. Karen took a step back, swallowing the lump in her throat. "Plankton," she pleaded, her voice shaky. "You..." But Plankton was beyond reason, his autistic mind overwhelmed by the accusations. "I'M. NOT. A. BURDEN!" he screamed at Chip, his tiny fists shaking with the intensity of his emotions. Karen's eyes widened in shock. Plankton had never been like this before. His autism had brought moments of stress, but she had never seen this raw anger. Chip looked from his mother to his father, his own eyes brimming with tears. He understood now that his words had caused this. He had never meant to make his father feel that way. "Dad," he whispers, his voice shaking. "I'm sorr-" But Plankton's anger had consumed him. "But I didn't know how she now feels about me?" he yelled, his voice echoing off the walls. "How tired is she, from caring for me?" His eye was wild, his tiny frame shaking with the effort of his outburst. "And no more lying!" Karen's heart was racing. She knew she had to intervene before things got worse. She stepped tentatively into the room, her hands held out in a calming motion. "Plankton," she said, her voice soothing. "What did Chip say to upset you?" She turns to Chip. Chip's eyes dropped to the floor, his cheeks flushing with guilt. He swallowed hard, his voice a whisper. "I didn't mean it," he managed to get out. "I just got..." But Karen's gaze was on Plankton, her heart breaking for the pain she could see in his eye. "Chip, tell me," she said, her voice firm but gentle. "What did you say to your father?" Chip took a deep breath, his eyes darting to the floor. "I...I told him he's a burden," he whispered, his voice barely above a whisper. "That mom deserves better, that...that he's ruining our lives." The admission was like a punch to his own stomach. "Because I can see how tired you're feeling with his tantrums, and it's not fair that YOU have to deal with this," he added, gesturing to his dad. "I told him you don't like to suffer becau…" But before he could finish, Karen's hand was on his shoulder, squeezing gently. "Chip," she said, cutting him off. "That's enough." Her voice was calm, but it held a firmness that made him swallow his next words. She turned to Plankton, her gaze filled with compassion and understanding. "You're not a burden, sweetheart," she said, her voice steady as a rock in a storm. "You're our family, and we love you." "Mom, that's no excuse to keep him around," Chip snaps. Plankton's antennae quiver, his rage now filled with even more hurt and anger. "Chip," Karen says, her voice a gentle reprimand. "That's not how we speak to each other." She kneels beside Plankton's shaking form, her hand reaching out to him. Plankton's eye locks onto her hand. He flinches away, his breathing erratic. "Don't touch me," he says, his voice cold and hard. Karen's hand freezes in midair, the sting of his words cutting deep. "Okay," she whispers, retracting her hand slowly. "Okay." Her heart is a whirlwind of emotions. She understands Chip's frustration, but she also sees the devastation on Plankton's face. She takes a deep breath, steadying herself before speaking. "Chip, please," she says, her voice firm but gentle. "We have to be understanding." But Chip's pain is like a volcano, erupting without warning. "Understanding?!" he yells. "What about what I feel?" He turns to Plankton, his eyes wet with tears. "Do you even know how hard it is for me to see Mom tired from you all the time?" Plankton's face falls. "I never meant to..." But Chip's tantrum isn't over. "You're always so selfish!" he shouts, the words stinging like whips. "You don't think about us, about what we need! And now, because of you, I'm missing the science fair! So much for your 'love'!" He snaps, poking Plankton. Hard. Hard enough to make him whine. Plankton's anger spikes. "Don't touch me!" he yells, his voice echoing in the small space. Chip rolls his eyes and proceeds to touch Plankton again. This time, the reaction is swift and violent. Plankton's tiny arm shoots out like a whip, slapping Chip's hand away. "I SAID NO TOUCH!" he screams, the force of his words shaking the room.
PLUSH ONE v (By NeuroFabulous) They sit there in silence, their hands clasped. Karen can feel the steady rhythm of his breath, his hand twitching slightly with each exhale. She squeezes his hand, a silent promise of support. "I'm here," she whispers again, her voice a balm to the raw edges of his fear. Plankton's body relaxes into hers, his gaze fixed on their intertwined fingers. Karen's mind races, trying to understand the complex web of sensory input that now dictates his reality. Every touch, every sound, every sight could be either a comfort or a cacophony. "I'm gonna go clean up the metal container." Karen says, giving him a kiss on the forehead before going. After she left, Plankton thought about his rivalry with Krabs. He didn't want Krabs to be suspicious if he suddenly stops trying to steal his formula. He doesn't want Krabs to find out or figure out about his autism. So he wrote down "I went across the street" on a note if Karen came back. Then, he went to the Krusty Krab restaurant. The bright lights and the noise of the kitchen now overwhelms him. He found a corner and sat down, his eye squeezed shut. His heart raced as he tried to think about the mission. It's a place he's been in countless times, but he's autistic now. Yet he knew and remembered the environment, despite the new sensory experience. Plankton took a deep breath and forced his eye open, his gaze darts around, trying to find the safety vault he knew so well. He saw the familiar soda machine, the greasy counters, and the gleaming spatulas, but everything felt wrong. The smell of cooking oil was too intense, the clatter of pans too loud. His mind raced, trying to process the cacophony of sensory input. He needs to focus on getting the recipe out of that safe! Slowly, Plankton stood, his legs wobbly from the effort to filter out the chaos. He knew he had to keep moving, to complete his task. Now to figure out the combination. He approached the safe, his hands trembling with the effort to block out the noise. The buttons on the safe were cold under his fingertips, and he felt the familiar thrill of a challenge. His mind raced, trying to remember his past schemes and the patterns that had always come so naturally to him. But it was like trying to recall a dream. The numbers and sequences danced just out of reach, taunting him with their elusiveness. His eye darted around, catching sight of the menu board, the colorful condiments, and the glint of the cash register. It was all too much. He stepped back, his breaths coming quick and shallow. He needed to find his center, to focus on the task at hand. He closed his eye and thought of Karen, the feel of her hand in his, the sound of her voice. It grounded him, calmed the storm in his head. With renewed determination, he opened his eye. The safe was a monolith, a silent witness to his tumultuous thoughts. He studied the buttons, the cold metal under his fingertips. He knew the pattern had to be simple, something Krabs would think secure. Plankton's mind raced, trying to decipher the sequence that had once come to him so easily. He closed his eye, trying to concentrate, but the sounds and smells of the kitchen crashed over him like a wave. The cacophony was unbearable, a stark contrast to the quiet orderliness of his laboratory. He took a deep breath, focusing on the cool metal of the safe. He had to get the Krabby Patty formula. For Karen, for himself. This was a purpose, his obsession. But now, everything felt different. The familiar had become strange, the simple complex. With trembling hands, Plankton started to press buttons on the safe, his mind racing with the patterns of his past attempts. But his brain didn't respond in the usual way. The numbers jumbled, the sequences slipped away. He felt the weight of his failure pressing down on him, the kitchen sounds amplifying his anxiety. What numbers would Krabs put in? He took a deep breath and tried to visualize their conversations, the tiny details that might hold the key. But every memory was now filtered through the lens of his new autistic brain. It was like trying to solve a puzzle with half the pieces missing. His hand hovered over the dial, his eye blinking rapidly. "Krabs," he murmured to himself. "What would Krabs say?" The name echoed in his head, a beacon in the fog. Plankton knew his rival's patterns, his obsessions. He thought of Krabs' parsimony, his love for his secret formula. It had to be something significant to him, something that made sense in his own peculiar way. Plankton's thumb tapped the side of the safe, his mind racing through memories. And then it clicked. Krabs had always talked about his mother's birthday, a sacred number, a key to his heart. Plankton tried the combination, his heart pounding. The dial spun smoothly, the clicks sounding like a symphony in his heightened hearing. 14-6-82. The safe whirred to life, the door popping open. Plankton's eye widened in amazement, his heart racing. He'd done it. He reached in and grabbed the precious envelope. The Krabby Patty formula, in Krabs' own scrawl. It was within his grasp. Now to get out of here! But how? What's made him always get caught before? The chaos of the kitchen faded away, and he saw the pattern. It was his lack of disguise, his hasty exits. This time would be different. He needed to blend in, to become part of the background. He needed to calm down, to think through his actions logically. He couldn't let his excitement overwhelm him. Plankton had to get out without drawing attention to himself. He thought back to the times he'd seen Krabs interact with his employees, the casual way he'd moved through the kitchen... Plankton then spotted the air vent! Sure enough, he and the recipe both fit through. He emerged into the alley, his heart racing. The cold air was a slap in the face, but it also brought with it a sense of clarity. He knew his sensory overload would make a hasty retreat impossible. But he's out of the Krusty Krab! He ran back to his own place across the street. Plankton stumbled into his lab, his eye taking in the familiar sights with new intensity. The colors were too bright, the smells too potent, the sounds of his own inventions too loud. But here, he knew he was safe. He laid the envelope on his workbench, his hand shaking with excitement. This was his life's work, the elixir to his problems. But now, with the Krabby Patty formula in his grasp, he wasn't sure what to do next. His mind raced with the sensory input from the kitchen, making it difficult to think clearly. The lab's chaos seemed to calm him, though. The familiar sounds of beeping machines and the faint scent of chemicals soothed his overwhelmed senses. He took a deep breath, his hand steadying. The envelope sat there, a symbol of his old life. His obsession with the Krabby Patty formula had been the driving force behind their rivalry for so long. Now, his autism didn't erase his past, it just colored it differently. The desire to be successful, to have what Krabs had, remained. But the way he approached the world had changed. He knew the taste, the smell, the very essence of a Krabby Patty. It was a part of him now, a memory that could never fade. He stared at the envelope, his heart racing. Plankton took a deep breath, his eye focusing on the paper. His hands trembled as he opened it, the formula's secrets were written in a made up code by Krabs. But Plankton's autism made it decipherable to him! The letters and numbers danced on the page, but instead of the jumbled mess he'd expected, they formed patterns, beautiful patterns that his brain craved. He saw the structure, the order, the way each ingredient intertwined with the next. It was like a symphony of flavors, and he was the conductor. His heart raced as he read through the document, his mind whirling with the possibilities. He threw away the handwritten note from before as he brought the formula into the bedroom with him. Plankton sat on the bed, his mind racing. The code was complex, but he could see the patterns. It was like the universe had laid bare its secrets to him.
CHIP OFF THE OLD TALKS iv (Autistic Author) With Chip's curiosity still piqued, Karen leads the way to Plankton's bedroom. She knows her husband needs time to process his own feelings, but she also knows that Chip's desire to understand is genuine. As they approach and crack open the door, they see Plankton in the bed on his back. He's asleep, the only sound in the room being soft snores. The room is dimly lit, with only the glow of a nightlight casting a gentle hue across his face. His antennae still, and his body is relaxed, a stark contrast to the tension that had consumed him earlier. Chip looks at his dad with a mix of fear and curiosity, unsure of what to do or say. Karen motions for Chip to come closer, her eyes never leaving Plankton's peaceful form. "Look," she whispers, her hand hovering over Plankton's shoulder. "You can touch him like this." Karen's hand lightly brushes against Plankton's arm, her touch as soft as a feather. Plankton's antennae twitched slightly, but he doesn't wake up. His snoring doesn't change, but she can feel the tension in his muscles ease slightly. "You see?" she murmurs. "Just a way of saying 'I'm here, and I love you' without overwhelming him." Chip nods, his eyes glued to the demonstration. His small hand reaches out tentatively, mimicking the gentle strokes Karen had shown him. Plankton's body relaxes further, and Karen feels a glimmer of hope. "Just like that," she whispers, her hand guiding Chip's. "It's all about being gentle and understanding. And when he's ready, he'll show you his love in his own way." Chip nods, his eyes never leaving Plankton's sleeping form. He's trying so hard to be strong, but Karen can see the fear and confusion in the way his little hands tremble. "Ok, let's go," she whispers, leading Chip out of the room. "We'll give him some time to rest. And when he wakes up, we'll talk to him again." In the hallway, Chip's questions come in a rush. "But what do we say? What do we do?" Karen crouches down to meet his gaze, her expression serious. "We're going to keep trying, okay?" she says, wiping a tear from his cheek. "We'll learn together how to be there for Daddy without making him feel overwhelmed." Chip nods, his voice a whisper. "I don't want to make him mad," he says, his eyes filling with fear. "You didn't make him mad," Karen reassures him, her voice calm. "You just surprised him. And it's okay to be surprised. But now we know how to handle it better." Later in the early evening, Karen hears Plankton's footsteps as he makes his way back into the living room. The room is still, the only sound the soft ticking of the grandfather clock in the corner. Plankton’s antennae are still, his eye no longer flashing so much with anger. He looks at Karen and Chip, who are sitting on the couch. “Hey, buddy,” Karen says, her voice tentative but hopeful. “How are you feeling?” Plankton sighs heavily, his antennae drooping slightly. “Tired,” he admits, his voice gruff. “But somewhat better.” Chip looks up at his father. “Hey, Dad,” he says softly. Plankton’s eye flicks to him, then back to the floor. “Chip,” he responds, his voice flat but almost sounding surprised. Karen sees the opening she’s been waiting for and jumps in. “Why don’t you sit with us, Plankton?” she suggests, patting the cushion next to her. After a moment's hesitation, Plankton lowers himself onto the couch, his antennae dropping slightly in defeat. He doesn’t look at either of them, focusing instead on the floorboards. Karen takes a deep breath, her heart racing with a mix of hope and trepidation. Karen takes a deep breath, her hand reaching for Chip's. "Chip found a cool rock at the park today." Plankton's antennae twitch slightly, and he looks up at Chip. "A rock, huh?" he asks, his tone neutral. "Yeah," Chip says, his voice small. "It's got all these cool colors, like the ocean." He holds out the rock, a silent peace offering. Plankton looks at the rock, his eye narrowing slightly as he takes it. His antennae twitch, but there's a glimmer of something else in his gaze—interest, maybe, or a hint of softness. He turns it over in his hand, inspecting it. "It's... nice," he murmurs. Karen squeezes Chip's hand, her heart swelling with hope. Maybe, just maybe, this could be the start of something new. "Why don't you tell him more about it?" she prompts gently. "It's got these little specks that sparkle in the light," he says, his voice gaining a bit of excitement. "I think it's a special rock." Plankton looks. "It is," he says, his voice a little less gruff. He looks at Karen, his eye searching hers. She nods encouragingly. “How was your day?” Plankton asks, his voice tentative. “It was okay,” Chip replies, still focused on the rock. “Just okay?” Plankton asks, his antennae lifting slightly. Chip nods, his gaze shifting to his dad. Chip sniffs. Plankton sets the rock down on the coffee table with a gentle thud, his antennae twitching with concern. “What, son?” Karen’s heart skips a beat, hoping this small act of kindness is a step towards a more open conversation. Chip's eyes dart between his parents, unsure how much to share. Karen gives him a nod of encouragement. “It was just a bit... scary at the park today,” Chip admits, his voice shaky. “Remember when we talked after the park?” Karen reminds him gently. Plankton’s antennae droop, and he nods, visibly trying to control his emotions. “Yes,” he murmurs. “I remember.” “Chip didn’t mean to upset you,” Karen says, her voice gentle. “He just wanted to understand what was happening. He’s curious, like all kids are. And when he saw you like that, he was scared. He just wanted to make sure you were okay and to help if he could.” “Hm.” Plankton says neutrally. Karen takes a deep breath and continues. “Chip’s been asking me a lot of questions, and I think it’s important we talk to him about yo...” Plankton sighs. "You know I hate talking about it." Karen nods. "I know," she says, her voice soothing. "But Chip's worried about you. He loves you, and he wants to know how he can help." Chip looks up at his dad, his eyes wide and earnest. "I just want you to be happy," he says, his voice trembling. Karen squeezes Plankton's hand, her voice gentle. "Chip wants to know what's going on with you, Plankton," she says. "He's not trying to be nosy or annoying. He's trying to understand what to do or not do." Plankton's antennae twitch, and he nods slowly. "I know," he murmurs. "It's just..." Karen's eyes are filled with understanding. "It's hard to be vulnerable, I know," she says. "But we need to help our son understand." Plankton looks at Chip, his expression unreadable. "Okay," he says finally. "I'll talk to him." Chip's eyes light up, hope shining through his tears. "Really?" "Really," Plankton says with a sigh, his antennae relaxing slightly. "But it's going to be on my terms, okay?" Karen nods. "Of course." Plankton takes a deep breath, his antennae drooping slightly as he steels himself for the conversation. "So, Chip," he says, his voice a little softer. "You know how sometimes you get really, really tired and need to sit down and rest?" Chip nods eagerly, his eyes fixed on his father's face. "Yeah, I know that feeling," he says. "Well, it's kind of like that," he says. "But for me, it's not just about being tired. It's like my brain needs a little break sometimes. And when it does, I might not be able to talk or move for a bit." Chip nods, his grip on Karen's hand loosening as he listens intently. "But why don't you tell us when you need a break?" he asks. "Sometimes, it happens too fast for me to say anything," Plankton explains. "It's like my brain just decides to take a little vacation without asking permission." Karen's filled with a mix of pride and sadness as she watches her son and husband finally discussing this openly. "So, when you get like that," Chip says, his voice tentative, "is it like you're in a dream?" Plankton glances at him, his antennae still. "In a way, yes," he says slowly. "It's like I'm not really here, but I can still sense." Chip nods, his curiosity unabated. "What do you sense?" Plankton takes a moment to consider his words. "I can still hear, but without comprehending," he says, "and feel things around me, but it's like... like everything's muffled, and I'm watching from far away." Chip looks thoughtful. "Can you tell when it's happening?" Plankton nods, his antennae lifting slightly. "Sometimes," he admits. "But not always."
Sensory inputs can be any stimuli entering through one of the sensory modalities: sight, sound, gustation, olfaction, and tactile sensations. Tactile sensations include responses to pressure and temperature. Over stimulation is the product of sensory overload. Overstimulation (OS) occurs when there is “to much” of some external stimulus or stimuli for a person's brain to process and integrate effectively. Sensory overload can be triggered by a singular event or a build up thereof. When the brain has to put all of its resources into sensory processing, it can shut off other functions, like speech, decision making and information processing. Using noise-cancelling headphones to vastly reduce external sound, which can help to stop sensory over load. Weighted sensory products, such as blankets or vests, to provide pressure and soothing proprioceptive input. Avoiding open questions – if you need their input on something, aim to use closed yes/no questions. It causes feelings of discomfort and being overwhelmed. Moving away from sources of sensory input, such as loud sounds or strong smells, can reduce these feelings. However, it is a core characteristic of autism, where individuals often experience heightened sensitivity to stimuli. It's important to note that not all autistic individuals experience overstimulation in the same way or to the same degree. Some may have a higher threshold for sensory input and be less easily overwhelmed, while others may become overstimulated even in relatively calm environments. Stimming, short for self-stimulating behaviors, is a repetitive movement or action that can include body movements, vocal noises, or sensory stimulation. It can be a way to manage excess energy, self-soothe, or cope with emotions. Stimming can also help regulate sensory input, either increasing stimulation or decreasing sensory overload. Stimming behaviors can consist of tactile, visual, auditory, vocal, proprioceptive (which pertains to limb sensing), olfactory, and vestibular stimming (which pertains to balance).
https://www.wikihow.com/Interpret-Autistic-Body-Language
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