The training in question here is categorized based upon what one might consider age-related "normal" development. Where I think things can get confusing is in those cases... perhaps your own experience is important here... is when we do not actually "know" the person to determine actual intellectual "competence". That old saying, "You can't judge the book by the cover." aptly applies here, but in our Huberis, we often times do the opposite... judging the book by the cover. There's a lot of ignorance out there. A lot of room for improvement.
Thanks for clarifying about age-related "normal".
I can see that re: judging a book by its cover... I am constantly misjudged based on how I come across, sometimes I think just at a glance.
As I've said here and there on the forums before (just to say "pls forgive me for repeating myself") I experience both being overestimated and underestimated but being underestimated is the more frequent experience....I am not entirely sure just how weird or "special needs" I seem to medical people (or anyone else....I dont necessarily register these things in others, people comment someone is different or odd and I am often surprised and have to consciously work it out...I just sort of take people as they are, I lack any instinctive "normalcy" radar unless I have reasons to do conscious and specific comparisons between an individual and others for a particular reason -- for example, my psychologist, after meeting my soon-to-be-ex family doctor with me, she said about him "He's a very strange man" -- not in a negative sense, she just found him very unusual and her tone was thoughtful and curious, matter-of-fact; she also said he seemed very kind, which was my impression as well...I was surprised she thought he was strange.)
I suspect in my case, with regards to being misjudged and infantilized, a lot of it is behavioral oddities combined with how I communicate -- things that people read a lot into and/or interpret too broadly or just wildly incorrectly (things like rocking/stimming and making no eye contact; a tendency to blank out the world by pulling my shirt or coat over my head and going silent when terrified or furious or both and about to have a meltdown -- I'm trying to regroup and calm myself but some people may actually believe I think I'm hiding...like that I actually think if I just block my view of the world around me I've magically disappeared...and I have only once in my life managed to try to explain that I know they can still see me and I'm just trying to regulate sensory input and calm down because I'm overwhelmed and freaking out (and I think even with an explanation that's maybe still really weird)....ER doctors kind of freaked out over this last time I was at an ER and started talking down to me worse when I resurfaced; my requirement for a comfort object and at least one sensory/fidget toy (usually silicone bubble poppers, tangles, or silicone chewables) to cope with anxiety and stay focused and grounded; clumsiness; how I speak; how often I misunderstand what people say because they offer too little information or make it all too vague and abstract, expecting me to fill in the blanks and specifics when in reality I can't do it at all mostly, and when I can I tend to get it wrong; difficulty knowing how loud or quiet my voice is; strange intonation; how I tend to take everything at face value in concrete, literal terms and assume rhetorical questions are actual questions; how i completely misinterpret when I am forced to try to figure out endless hints that I recognize as such) .
I wouldn't say I am minimally verbal but there is a massive disconnect between how I speak and how I write...
If I am at my best (not tired, not sick, not completely overwhelmed and maybe simultaneously full of just enough stress hormones but not past the point where stress further impairs me), and am also well-prepared, I can pull off very fluent and articulate scripts and very, very rare off-the-cuff eloquence if what I'm saying is very brief; But the rest of the time:
My speech is halting and awkward with chaotic pacing, and with more terrible syntax and grammar and waaaaay more misleading or just completely incorrect word choice than my casual writing;
I take such long pauses while finding words or trying to get my mouth to move right to say a difficult-to-pronounce word, that listeners think I've finished speaking before I'm even halfway through a statement;
I confuse people by abruptly stopping partway through a string of words and starting over again because i've realized I've chosen the wrong words or cannot finish a sentence with the first words I've come up with or cannot figure out in real-time what things I need to say to be understood vs what can be left out, let alone while simultaneously trying to find the words for the things I need to say;
I'm terrible at formulating questions and usually just try to state what I don't understand...I think this is often not understood at all or sometimes taken as argument when I mean it as a plea for explanation or information....;
I can't summarize to save my life unless it's in the most vague way possible using scripted statements;
My heavily detailed, concrete thought processes get first (sometimes only ever:_) translated into words of a similar nature and people cannot figure out my point and think I've gone off topic or misunderstood when I haven't (the fact that I actually
am tangentional and have severe ADHD does not help people understand this - I can see the difference of course, because I know my point and can see my own thoughts, but they of course cannot -- they cannot differentate between an attempt on my part to communicate a complex statement or collection thereof wherein I have difficulty with what I call "bridging/ relationship" words and summary words, vs me going off on a tangent )
With judging a book by its cover, I always assume time contraints are probably a factor(?); It's not like you always have adequate (or any, like in urgent/emergent situations) time to get to know an unfamiliar patient's communication style and ability, or level of capacity for even just that situation.
I so agree it's largely ignorance, but I always imagine time is a factor, too - cognitive shortcuts and familiar assumptions support efficiency but also maintain ignorance; learning new concepts (especially when they challenge long-established conceptual models of things) takes longer the more complex and unfamiliar they are.
(And thank you for sharing your knowledge and wisdom, too.)
