The Double-Edged Sword of Attentional Strengths in Autism

I have spent way too much time thinking about this situation. It doesn’t even matter. I know that. I’ve got big real-life stuff going on right now, and I really would prefer not to still be perseverating about something that happened more than a week ago. But can I just let go of this inconsequential interaction, set it aside, and move on?

Nah. As a person with both ADHD and autism, I’ve always had a variable relationship with my brain’s ability to pay attention. Sometimes, I can hyperfocus. Other times, I’ve been found literally spinning en route to the kitchen.

I’d like to tell you about the thing that happened, which does not matter whatsoever. I will share my first thoughts about the situation, and one side trip before getting into a bit of autistic brain talk. If you’re not here for the narrative, I got you. Scroll down to Autistic Brain Talk.

What Happened?

While getting a kidney ultrasound, the tech, who was around my age, asked, “Was that your daughter?”

“No kids,” I said.

With more than a little surprise on her face, she followed up, 🤔 “You were sitting right next to a young woman. Not your daughter?”

“In the waiting room just now?” I clarified.

“Yeah! The room was fairly empty except for you two!” she offered confidently, as if now I would have children.

“Wow,” I said. “Yeah. That’s my wife.” And for whatever reason I added, “She’s 57 years old.”

“Huh…” she concludes.

First Thoughts?

The photo here shows Rachael in the location where we were both seated in the waiting room. This is where this tech saw us together and formed this opinion.

This is a collage of Rachael and Erika at the VA. The insert photo shows Erika in the ultrasound room shortly after a tech repeatedly insisted that Rachael must be her daughter. The larger photo shows Rachael seated in the waiting room where she was seen by that tech sitting next to Erika. Both are GenX folks wearing n95 masks and appearing to be around the same age.

At the Veterans Administration (the VA), approximately 91% of all the patients in this hospital system and seen by these providers are men. I’m already among the 9%, and then I’m bringing a wife? This is not a situation they are as familiar with encountering as others may be out in the real world.

I just see my superstar wife here, with her silver hair, compression leggings, and her cane, and even though nothing I just mentioned is necessarily age-related, it’s strange for someone to see all of that and still assume relative youth, especially when the someone is one who (apparently) didn’t consider that I’d have come to the hospital today with a wife.

Side Adventure Re: Age

I’m sharing this so the reader can see how this is playing out. It’s not that I just keep thinking about the one event, although I am doing a lot of that. Rather, I think about what may have caused this upsetting interaction to occur.

And know that I will be equally upset by this event for the rest of my life. Although I will move on and somehow eventually put it aside, when something reminds me of the interaction here? I will feel the same things I felt during the interaction all over again. That’s a whole thing too. (Wow, this is a sub-side adventure. See also: emotional memory.)

In this case, what I can’t get past is that this woman thought Rachael was my child. Even though Rachael is very cute and young-styled this day, someone standing in front of the two of us, and then especially looking at me as she prepares to do a kidney ultrasound, could not possibly math it out that Rachael would be my child.

I don’t think either of us has ever had anyone overestimate our age or guess that we’re older than we are. I realize this might not come through in a little photo but let me give a quick illustration. Welcome to the ADHD side adventure.

When we moved to Minnesota, I went to get my license and brought my license from the last place we lived, as you do. Guess what they said at the Registry.

“Nah. This cannot be you. You are not this old. You can wait over there while we make calls.”

I don’t know what all they did, but two people were involved, I had to answer many questions, someone made phone calls, and eventually they became convinced that I was me, and so I must have been, at that time, 40.

When I say that, in person, I don’t look my age? I mean it like that much. I look older now, as years have passed, but I decidedly still do not give off “old” vibes. I’m not ageist or in denial about this. Trust.

Autistic Brain Talk

For those interested in autism research, a study by Dupuis et al. (2022) offers insights into how attentional strengths in autistic people, such as myself, present both advantages and challenges.

Attentional Strengths Definition

Attentional strengths comprise a set of skills related to how well someone can manage and direct their focus. These include the ability to maintain focus over time (sustained attention), manage multiple tasks (divided attention), and selectively concentrate on relevant information (selective attention).

The relevant research finding for this discussion is that the attentional capacity of autistic people tended to be accompanied by a complex balance of benefits and challenges, a sort of “blessing and a curse” sort of thing. On the one hand, “Yep! We’ve got some cognitive strengths and can do the focus!”

Yet on the other hand, those same strengths were associated with higher levels of perseveration and perfectionism.

“In other words, that same sustained attention, the focus that can be so helpful for autistic people in certain contexts, can also present a whole lot of challenges in situations requiring adaptability, lots of change, or the capacity to let shit go.”

– Erika Sanborne, AutisticPhD.com

And for those of us who are both Autistic and ADHD, which is a fairly common thing for Autistics to be, things are complicated in more of a “push then pull” sort of way. But understanding dynamics such as this is important.

Having a better understanding of how our own brains work can help us appreciate the full range of how attentional traits manifest with autism, beyond the typical deficits-focused narrative.

For professionals and caregivers, it’s crucial that strategies leverage attentional strengths while also supporting attentional areas where we struggle, recognizing that these are categorically the same kinds of things. Tailored interventions based on what supports (if any) an autistic person needs are always going to be the best ones to enhance quality of life and wellbeing.

Want to discuss this topic? There is a thread about it on the facebook page.

Reference

Dupuis, Annie, Piyumi Mudiyanselage, Christie L. Burton, Paul D. Arnold, Jennifer Crosbie and Russell J. Schachar. 2022. “Hyperfocus or Flow? Attentional Strengths in Autism Spectrum Disorder.” Frontiers in Psychiatry 13. doi: https://doi.org/10.3389/fpsyt.2022.886692.