Embracing Autism: A Strengths-Based Perspective on Autism and Wellbeing with Megan Cherewick

In this episode of the Speech, Language, and Therapy Podcast, we discuss the rich and diverse spectrum of autism with our special guest, Megan Cherewick. Megan, an assistant professor at the Colorado School of Public Health and senior investigator at the University of Colorado Center for Global Health, brings a unique blend of personal and professional insights to the discussion. We explore the often-overlooked strengths and capabilities of autistic individuals, moving beyond the traditional deficit-focused lens. Megan offers a distinctive and beneficial perspective, blending her international health and developmental science research with parental insights gained through her daughter's autism diagnosis.

This episode challenges common misconceptions and highlights the importance of recognizing and leveraging the unique abilities of autistic individuals. Join us as we discuss practical strategies for promoting wellbeing, fostering a strength-based approach, and reshaping our understanding of neurodiversity. Whether you're a professional, caregiver, or someone interested in mental health and autism, this conversation offers valuable perspectives and empowering insights.

Resources:
https://autisticadvocacy.org/

proofpositive.org

Transcript

  Welcome to the speech, language and therapy podcast. Where we unite speech, language, pathology, audiology, and psychology to support the wellbeing of individuals facing communication challenges and their families.

 I'm very excited for you to hear today's conversation that intertwines, neurodiversity, mental health, and the rich spectrum of autism.  We often hear about autism in terms of challenges and deficits, but what about the unique strengths and capabilities that autistic individuals possess?  I think this is a really important question. And. so I'm really grateful that Megan chairwoman has joined us to share her insights today.   Megan's work moves us beyond the traditional deficit focus lands. End towards an understanding of autism as a diverse spectrum of abilities and strengths.  We also had a really interesting conversation about how we can build from these strengths  and promote. wellbeing in autistic individuals.  And I just really enjoyed talking with Megan. She's so approachable, thoughtful, and practical. It was a great conversation that  I think will be really beneficial to professionals and caregivers in the support network of autistic individuals. So let's introduce our guest. Today, we're honored to welcome Megan chair, wick and assistant professor in the Colorado school of health center for global health.  Megan earned her PhD in international health from Johns Hopkins university  and she completed a post-doctoral fellowship in developmental science at the university of California, Berkeley.  Megan's work has made significant contributions to the field of mental health and neurodiversity. And I'm just so thankful that she's agreed to join us today.
  Welcome to the show, Megan, and just really glad that you're 

here. Thank you so much, Kyle. I'm happy to be 

here. Yes, I'm so glad you're here.  Could you give our listeners some insight into your background and how you became interested in autism, neurodiversity, and mental health?

Absolutely.  So  I did my Ph. D. A. Johns Hopkins and international health. And within that context, I was really interested in supporting adolescence and looking at risk and resilience processes. So understanding both protective and promotive. Factors that improved mental health in adolescence in a variety of different contacts, whether that be natural disasters, conflict or complex emergencies. 

And so when I finished my PhD,  I did a postdoctoral fellowship at University of California, Berkeley in developmental science. And that's when I really became interested in how The brain and what we know about the brain can help us to create better and more effective interventions.  We typically know that adolescent interventions have failed.

And so thinking about how can we use and translate what we know about  neuroscience to make interventions effective  after finishing that.  Postdoctoral fellowship, I started at university of Colorado and at the Colorado school of public health. And at the same time, my daughter was just beginning to show symptoms of autism spectrum disorder and had a very profound speech and language and communication delay.

 So it was through that process of learning about what was happening with her and her own developmental trajectory and what kinds of supports or approaches would be most effective to her that I really started thinking about how developmental science and autism and neurodiversity could better meet and support her needs.

 Yeah, you bring a really unique perspective to this, Megan.  It's just really important and an interesting area of work.  One of the many things that I really like about your work is that you come at it from a perspective of strengths.  So, could you talk a little bit more about that?  



When I was researching autism, I was really struck by  The kinds of recommendations that I was getting and how they were always focused on these deficits and disorders and challenging behaviors.

 And I started reading all the research I possibly could and realized. That autism also includes remarkable strengths and differences and that we could leverage those strengths and differences to make supportive services more effective and balanced.  to match the child and where they were developmentally to best support them and make them successful.

 I'm also incredibly motivated by these very startling statistics of risk for mental health conditions.  being victims of sexual violence and assault anxiety, depression, suicidal ideation and started realizing that from a very young age, many autistic Children are taught that who they are and these differences and strengths that they have aren't being leveraged or supported or mattering.

And I truly believe that it is. This kind of cascade of experiences that these children have that explains that increased risk. And I wanted to take a different approach and say, what if we recognize differences as differences really highlighted these opportunities to amplify strengths that children have to make our supportive services and interventions more effective.

 Yeah, exactly. And that's a really nice segue to these domains of strengths that you've been talking about. So could you tell us more about these and Holly challenged, some common misconceptions that we often hear?



Yeah, 

absolutely.  Historically we've focused on kind of deficits that children might have.  We also know that. The way the autistic brains are developing is adaptive. Their brain is developing to best fit their environment in ways that are best for that child.

And that comes with these really unique strengths that many of us don't have.  for example perceptual strengths.  we often think of these as sensory sensitivities or sensory seeking behaviors, but they also represent. This remarkable acuity or differentiation of how they're processing sensory information.

So being extremely sensitive and being able to differentiate things like tastes and smells and. tactile things and music. And these are remarkable. We don't want to extinguish them. We want to use them to best support a child and help them form a healthy identity.  there's other strengths. So for example, in reasoning or logical processing, I'm really being able to recognize patterns and.

systems. And again, sometimes we say, Oh, but there's a speech and language and communication delay. But some autistic kids also have hyperlexia, meaning that they can read before years of the same age. What does that mean? Right. That's a strength. That's something remarkable that we can nourish and cultivate. 

Preferred interests, I would say are another strength. And that's the hyper focus on something that is especially enticing to a child. So sometimes that might be things like transportation or learning how a car works learning different, everything about animals or. specific type of animal. And the last area that I feel like is a kind of group of strengths that are often overlooked are character strengths.

So many autistic individuals will say that a strength of autism is being funny and being nonjudgmental of differences and others. Being able to be balanced and understanding and having a really strong sense of fairness and justice,  having creativity, honesty, integrity. These are all strengths that employers and people in our society value and want and look for in their social relationships.

And yet we don't. Um, often take note of the fact that autistic individuals might be especially, skilled in these areas. And so how can we use those strengths as well in our approaches to supporting 

them? Oh, I love that perspective. I almost feel like in some way my brain just went through an eye exam and I got corrective lenses, you know, in terms of  putting  everything in focus, in the right focus, like you said. 

We do. I, I agree with what my, my experience matches yours that we do often hear kind of a deficits model. Um, and I can, I can see where that would cascade.  Whereas like you're saying, if we recognize these strengths and use those towards kind of the developmental side of it, emotional social, that can make such a huge difference. 

Megan, this is so good. This is so interesting. I just love this. So thanks again. 

Yeah, and sometimes I, try to explain this to people by thinking about how we all have these differences. 

So we might go to a restaurant and think that a level 3 is spicy. Others might think that a level 1 is spicy. Others might let go. Think that a level five is spicy when we're walking outside, we might feel comfortable in short sleeves where someone else wants a winter coat on  just differences. It's not that one is better and one is worse.

They're differences and how we adjust and are able to be successful in the world.  It's not really about a judgment of bad or good. It's just about a difference in how we're experiencing the world. 



That's really a thought provoking perspective. And it leads right into this next area of your work that I wanted to discuss with you, which was, you've been writing about a mechanism of change as it relates to wellbeing and mental health.  And I found this really fascinating. So could you talk a little bit more about that?



Yeah, so I think in the mental health field, there's been a lot more focus on mechanisms of change because we might know that different interventions are effective, but we don't always know why they're effective.  And so looking at mechanisms of change is really understanding  for who, why, when. And under what circumstances this intervention may be effective because we want to be able to replicate the intervention for other populations.

 And it also gives us an opportunity to eliminate components that aren't producing the effect and to strengthen the components that are producing the effect. So for me, when I I'm looking at the mechanisms of change of different intervention approaches. I'm most interested in the ways that an intervention can produce effects at multiple levels and in different areas.

So a particular mechanism of change, such as. Having closer social relationships and peer support. It might impact both mental health and wellbeing. So it might reduce depression and anxiety, and it might promote things like optimism and happiness. So we want to identify what those key ingredients are so that we can make more effective and more efficient interventions.

  It's difficult because I think that any intervention approach really, With autistic populations, it's unlikely to be one size fits all because we know that the experience of autism is very different for different individuals.

 At the same time, we know that there's certain approaches that can be better matched to different developmental periods. It's one of the reasons why there's such heavy investment in early intervention and young ages.  And that's  that's partially due to the fact that the brain is more plastic or receptive to learning and changing during that time.

But I think there's missed opportunities too. So we also know that during early adolescence, especially the transition of puberty, the brain is already naturally plastic and more receptive to particular types of learning. And that includes social and emotional learning. But now as the research is developing, we've also found that there's ways to leverage strengths to increase those windows of learning and plasticity.

So it may be that, for example, children that have remarkable auditory acuity and can really. Have exceptional strengths in that area. It may actually turn on parts of their brain that help them to learn. And so can we use that strength to teach other skills or use that strength to encourage social learning or emotional learning,  while also reinforcing something that feels good to that child.

Yeah, , it really highlights the importance of being attentive to these strengths.

And also being flexible.  

 Even from my own personal experience supporting an autistic child, I can say that  I think we have to be careful about.

What we as a caregiver, especially for young children. Want to be a goal or an objective of therapy and what is best for that child, right? And so being flexible and you know, we might say, okay, we want this child to interact with  their sibling more. It might not actually be the right time developmentally for that child to master or achieve that goal.

So really taking a child's lead and saying, okay, well, we want them to start doing this or communicating in this way, but it might not be best match for the way that that child is learning and,  for example, there's research that shows that specific therapies that focus on something, for example, like stopping stimming behavior or achieving objectives that aren't aligned to an individual child can actually extinguish the strengths that that child showed because their brain wasn't primed.

To learn that specific goal at the time that we decided that was the goal. And so I think we have to be really careful in following a child's lead and understanding that what our goals are may not be best aligned for what the child wants. And so really letting the child show us what is most motivating and exciting and interesting is probably the best target for that specific period of time.



, yeah, I really love that. You know, independence and autonomy are just fundamental human values. And I just really appreciate working from this strength based perspective. Let's build on this just a little bit more. , can you tell us about how a strength based approach might differ from maybe that kind of traditional deficit focus model?

Yeah. So one, I think that a strength based approach is looking for those little opportunities, right? And really being attuned to what the child is doing and motivated by.  And so let's say a child finds. Bubbles. Fascinating, right? And so we might think, perfect, we're going to use bubbles to have this child gesture more or say more.

 Bubbles are motivating to that child. It doesn't mean that that's going to help that child learn that gesture necessarily, or learn to say. the word more, but it doesn't mean that bubbles can't be motivating in a different way. Maybe bubbles can be used to encourage social interaction, right? Because that child feels comfortable being around five different people because there's bubbles,  So thinking about how to recognize something that's intrinsically motivating or something that's a strength and then matching the goal or the approach to whatever that motivation is.  And really having alignment between Different actors in that child's life between parents, between teachers, peers, even siblings, other family members, I think is really important and can reinforce whatever we're recognizing or seeing.

And it really leverages the creativity of a constellation of people in that child's world. So much of what we've been, we've seen. My own daughter develop has been because of the collaboration between teachers and therapists and ourselves and really thinking like, Hey, did you see them do that? Do you think we could try it in this way?

Could we, maybe we should do speech therapy in the bathtub. She loves water. Let's try that. Right? So just thinking about different approaches and really leveraging the creativity of multiple actors, I think is really important. 

Yes, I agree. That is so important. And it goes to something we were talking about earlier, the power of interdisciplinary collaboration and curiosity.

 I'd love to hear some more examples of practical therapy or intervention strategies  

yeah. So I think sometimes It's really motivating for parents and therapists to pursue a specific trajectory. Like, let's teach these gestures or these words or use an A and C, and then they'll be able to get to here and then they'll be able to get to there.

But I think what we know, not only in autistic children, but all children, are that these developmental trajectories are not concrete. Some children learn to walk before they learn to crawl.  We know that many autistic children are learning, learning processors, right? They learn in phrases. And so being able to, I think, embrace the fact that things may not be ordered in the way that we would expect and think about how can we leverage what is happening to create a next step based on that and not on a kind of traditional  developmental trajectory that we would imagine is really, really useful. 

And I know from our personal experience, we were really trying to focus on gesturing with our child because she wasn't speaking.  But it didn't take for her. It never has. for now. She never really embraced using gestures.  And I think it was actually okay to say, that's okay. Like we will have these tools available to you.

We'll have pictures, picture exchange boards that you can show us what you're asking for as tools just available to you. But we'll wait till you're ready. and now, I mean, she's learning to speak and learning the alphabet faster than my five year old, right? And it was just not the right time to be like really focusing on that at age two.

Now is the right time to really be supporting her language acquisition and 

development. Yeah,  you know, it goes to progress doesn't have to be linear and it speaks to your strength space approach rather than maybe being stuck in that gear how can we use the strengths to kind of continue the snowball in this area of development that is ready for development?

I think that's really cool. What are some other ways that caregivers or   other support persons can use these insights to help autistic individuals in their, in their daily lives?  

I think something that's really important is to support always autonomy. Self determination and intrinsic motivation.

It's really important for an individual to feel like they're worthy, how they're experiencing the world and feeling is important and recognized by people. In order to develop that. Self autonomy and not feeling like I have to comply because that's what they want. We want to support young people to show us what do they want, what are they excited about?

And I think that  at least. In part from my own experience, and also from research, we're so heavily invested in caregiver interventions and caregiver coaching. And while I think there's so much value in that, it's also an immense amount of pressure to put on caregivers that are often working full time jobs, have competing demands, have other children.

I think the more that we can expand the responsibility of support services to other people. In their environment, even a sibling explaining to a sibling like this is something you can do that might help Indra or or help your child or this is something that the school can do. Let's try it. Let me know if it works.

Let's try something else.  Being really, really frank with the therapist. Like, I don't think that she's going to say more right now. Could we work on something else? I think that's really important because at least in a lot of my research in low and middle income countries, caregivers are extremely exhausted and overwhelmed by the amount of information that they're receiving.

And it's not to say it's not important, but there's other really important people in that child's life that can also help. And I think we need to recognize that and engage those individuals and have them be part of the learning 

process. Yeah, well said. And, you know, we're talking about many different situations and, and experiences and backgrounds, but it, to me, it sounds like perhaps, um, a peer mediated type of intervention might  be at the intersection of part of this as well.

 Absolutely. I mean, so that's one of my, um. Real focus is looking at peer mediated interventions, especially during early adolescence. So between the ages of eight and 14, when kids are going through puberty,  their brains are already primed, all brains, autistic brains, all brains are primed to learn from their peers.

And so can we use some of these strengths to Promote that learning to have a peer be excited about something that an autistic child is excited about, , whether that's Legos or bubbles or whatever it is, but to really use peers as well as, , Both actors that can enhance that intrinsic motivation and validate the interest of a child and the exceptional skills of the 

child.

So I'm interested in peer mediated interventions during adolescence, but I'm also experiencing the benefits of peer mediated approaches in very early childhood because my daughter's four.  She's in an inclusive school, and I can't tell you how remarkable it has been for her to be in that environment and learn from her peers.

And these young people are so kind, so compassionate, so willing to help. And they're doing that every single day in little ways and big ways. And she's experiencing that and absorbing all of that, that someone will come and comfort her or help her put her shoe back on because she was upset that it came off.

And one moment that I love from her current preschool  happened at recess one day and. My daughter typically likes to play individually outside by herself  and some of the girls in her class were sitting in a circle and playing and my daughter just walks over to the circle and just plops  down right in the middle.

Right? And I have no idea why it might have been because she's like circle or it could be like, I fit there. Right? But the reaction of her peers, like, I mean, obviously first, like what's happening, but then the kindness and saying like, Oh, interest in the middle of the circle. Now let's interact with her.

Let's play with her. That kind of moment isn't something that you can design. It's something that happens. organically and must have been incredibly socially rewarding for her that I took this risk and I sat down in the middle of the circle and now they're talking to me and I'm playing with them and, you know, we're having a great time and I think that sometimes, you know, In adolescence, we could coach peers to be supportive  but in younger childhood, I think we should trust that young people are just supportive.

They're really good, sweet people  and where we need to explain, oh, that's just a, that's a difference. She needs this to support her learning. We can do that, but really trusting that even young children can, in some senses, be non specialist interventionists. Because they're teaching a young child, you know, these really important  moments of acceptance 

and joy.  

Oh, I just really love that. And it makes me think about cultivating that in other adults that are in that child's life.



Yeah, so I, I think that is really common, especially, especially with older generations, grandparents, they might have a particular conceptualization of what autism is. I think that can be more challenging because you can advocate and explain what's  happening with your child and what autism is and how it's special and that there's these strengths.

And really, I think that helping to facilitate these, Like joyful moments can help to undo some of that fear of, well, I don't know what to do with, you know, this child has a meltdown by showing them like, Hey, look, this is something that your grandchild really enjoys.  let's use that to be able to have you both have a connection.

I think that can be really motivating for older generations because ultimately they do want that connection. Right. And so if you can show like There, you can have this connection but we might have to approach things a little bit differently. And I want you to learn what it is that this child really loves and likes and that you have that feeling of connection.

 And I know, for example, with  My daughter's teachers, they're not trained specifically in supporting autistic children, yet they're so motivated to support her because they're also seeing all the cool things that she's learning and doing. And we share that with her teachers regularly, like, Hey, she said this when she came home, she was talking about that, that you mentioned in class and there.

Excited. It's so rewarding because they know that they're contributing to a really positive developmental trajectory. 



Yeah, that that can be so rewarding.   Megan, do you have anything that you would say to adults or adolescents with autism? In terms of recognizing their strengths and using those towards their own wellbeing. 



Sure. So I think that something I would say is that it's really important to accurately represent what you're awesome at and what you might be need some help with some accommodation, right? So you can say, I'm amazing at. Having an incredible attention to detail. I notice mistakes and I will be able to proofread your documents or I'm an amazing logical thinker and I can think outside the box.

So give me a challenge and I can find a solution. But just so you know, um, sometimes I. Find certain sensory things uncomfortable. And so it would be helpful for me if, you know, I could wear noise canceling headphones or  it might be best if I work in an environment that limits some of those sensory exposures. 

So I think being able to advocate for yourself, really being able to represent all the remarkable strengths that you have. And also being honest about accommodations that you might need can help reduce those conflicts where someone's surprised that you might be uncomfortable in a certain situation.

Oh, for sure. And I find that mindset can really Make a big difference. I have a friend who's about my age and, you know, he tells his, his story of being young and having a lot of anxiety about his grammar being perfect,  and everything being on time and, you know, kind of that being a source of anxiety.



But now he's, encountered people who found those to be strengths. He loves to keep score and keep time at the basketball games. And that's a way of being involved. He works as a editor  at a small newspaper. And he's fabulous at it. He's worked in customer service where  the business recognized he may not be, uh, the best  on the phone, but he can do great chat,  and just in, in, in the, in the ultimate frosting on the cake is   he says, well, small talk isn't my best, but I really love public speaking about my experience in life and just shifting that.  Um, having that mindset of what, what are these strengths and how can they transform into something that they can connect with other people with and they can build on and perhaps have a career in as well.

I think that's such a powerful mindset. 

Absolutely. I think it's so important to remember that  autistic brains are not broken. This is a remarkable, adaptive, common. Trajectory that we know happens in all human populations. These are not broken brains. These are different brains. That's right. All these special strengths and also have some challenges and all humans have strengths and challenges and just not to be made to feel less than it's a difference.

And if you encounter challenges, it's It's not always because you're the problem, right? We're learning as a society to make more inclusive spaces that can meet the needs of all populations. And it's taking time, but it's happening. And we need autistic individuals to lead those changes and to really center and uplift their voices. 

Well 

said. Well said.  I'm a gusher and I'm feeling inspired, uh, Megan. So thank you so much for this so far.  As we get towards the end of this, what are some of the most important takeaways you'd like our listeners,  to, to take from our conversation?  

So I think that as a society, we are changing the way that we think about autism and neurodiversity and the medical.

Model of autism is likely going to drag behind, right? And we have seen that historically homosexuality was in the DSM for a long period of time.  But that doesn't have to define where we're going or  what we'll achieve in the future. Exactly. Part of this is really centered on language. So, I mean, even the term  autism spectrum disorder, it's disorders included, right?

And disorder implies dysfunction,  that's not true for everybody that is autistic or neurodiverse. So the more that we can try to change our language. To better match the experience of autistic individuals and to better match what we're advocating for, which is a more inclusive society.  I think that's really important.

And so for me, I, we also know, for example, that many autistic individuals prefer identity first language instead of person first language. For me, I was trained that you only use person first language. So you say, this is a person with. Depression, not, this is a depressed individuals, but autistic, many, many autistic people are saying, no, I want identity first language.

You don't have to say I'm a person with autism. I'm autistic. Right. It's part of my identity. Yeah. And really respecting that there might still be differences in how people want to use different language. And we should respect that. But we can still move the needle. We don't have to say you know, my child's obsessed with cars.

We can say other things like my child finds cars fascinating. He's really passionate about them. We don't have to say my child's rigid with routines. We can say something like, Oh, you know, my child prefers consistency and saying that's, or wants to know what's happening now.  So just changing language to recognize that.

Things that we might not expect in someone else doesn't always have to be labeled or described in a way that's kind of deprecating or seen as a bad thing. These are also things that we can flip and say in a positive way. Like, this is how my child  expresses her joy. You might see her move her hands like This that's her being happy.

You should be excited when you see that be excited because it means she's happy instead of saying like, Oh, she's stimming, right? Like we can change our language to better match the experience of individuals and how to advocate for the future that we want all, all people to enjoy.  

I love that. That struck right to my heart and , as a speech language pathologist, language is power and, um, that's really well said. Yeah. So for people who have  heard this conversation and are wanting to learn more or looking for good resources, are there some that you'd recommend?  

So, for me, I have found that the most accessible resources for really embracing the strength based approach to autism honestly comes from speech language pathologists, occupational therapists.

I find that they are The leading edge of advocating for these changes that might be surprising because we often think of, you know, doctors and specialists as having the newest ideas. And for me, I find that going on to Instagram, Facebook, any social media and following accounts that really support a neurodiversity perspective will. 

really empower you to think about changes that you can make yourself, give you new ideas, make you more thoughtful about what the best fit is for supporting someone in your life that might be seeing the world differently.  I truly, I'm not just saying that because I know you're not,  but it is, it really is so true. 

And to really being open, thinking about what are these progressive change makers advocating for and why, right. And that has really changed my own. Mind and my approach of supporting my daughter is just following amazing speech language pathologists and occupational therapists have been completely life changing 

for me.

Wonderful.  Any that you'd care to share that have been personally meaningful?  

Yeah, so I really like Neuro Wild on Instagram and really enjoy the way that she also creates kind of drawings to show what she means by different topics she's advocating for.

And one of my favorite SLPs is, um, miss Speechy p um, she's really excellent. I love. Seeing what she advocates for and it's always digestible  and  learn, play, thrive on Instagram has also been really motivating to me, especially thinking about things like bodily autonomy and how we can support that intrinsic motivation.

And, I, I find that.  personally, like, resonates really well with me. . But there, to me, there's no better kind of resource than, Then these therapists that are thinking outside the box.

Awesome. Awesome. It goes to the, that minds mindset shift that we're speaking about strengths and curiosity and autonomy and independence and shared goal making. I, I love it.  Megan, this has been extremely enlightening, uh, inspiring and and I just really am thankful for the work that you're doing and that you're willing to share your time with us today.

So just. Thank you so much for joining us. 

Absolutely. Happy to. 

  Thank you so much for listening to today's episode. I hope our conversation has been helpful. Offering new ideas and tools to support those with communication challenges.  So until next time. I'm encouraging you to continue to do what you can to ensure every form of communication is valued. And to help build communities that honor the dignity rights and wellbeing of all.