Tag Archives: physical prompting

Don’t just hand me things.

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This post has to do with the same topic as my old post Safety Hazards. By the way, the Foradil is no longer a problem for two reasons. One, I had a routine set up so that a staff person would hand me the inhaler with the capsule already inside and punctured. Two, insurance quit covering Foradil and gave me Serevent instead, which is a discus not a capsule.

And now I am typing around the body of a cat who timed her snuggle so that it came after the sound of the nebulizer shut off.

Some background: Now that they know the breathing trouble was bronchiectasis, not asthma and not me just being a pest, I have a treatment routine that makes the “breathing takes effort” thing and the “coughing only brings up phlegm the size of a pinhead” thing far less of a problem. I take two nebulizer treatments a day, each with a vial of 7% saline. But it’s really important to use my inhaler first or else the saline can do terrifying things to my airways that at best take eight puffs of my inhaler to keep me out of the ER.

So the usual routine is someone hands me my inhaler. I take two puffs. Someone hands me a nebulizer mask. I put it on. Depending on my position either I or the other person connect it to the tube and turn on the nebulizer.

So today someone walked into the room, handed me the nebulizer mask, and made a bunch of clanking sounds as well as a small sound like cuujooholdhis. So of course I put the mask on and things could have gone very badly.

The other thing is that I usually have to make an effort for words to be words and not random noise. It’s not just an auditory processing thing, it’s a cognitive/language processing thing where I spend most of my time in a default state where words haven’t even been thought of yet. And even when I concentrate I sort of phase out into that state a lot. So to me, most of my interactions on a typical day involve seeing patterns of movement, hearing patterns of step and tone and stuff, and mostly interacting by the process of being handed something, and then doing whatever I usually do with that object.

Which means “could you hold this?” is just a set of quiet sounds with an offhand, casual feel to them.

And handing me an object you don’t want me to immediately use can be a dangerous idea, depending on what you’re handing me.

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How (not) to ask me questions.

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This post is in the spirit of Eyeballs eyeballs eyeballs. Picture the person in strong/bold letters as talking very rapidly and very loudly with only the shortest pauses in between.

DUUYUUWAHNNIKAEH’? . Let’s see… “cat”, “do you,” what is she… how do I connect these to meanings… YORSAENWIHCHDUUYUUWAHNNIKAEH’ (head goes blank again, blank look must be on face) KAEH’ KAEH’ (WAVE OBJECT IN FACE AND START SLASHING HAND ACROSS IT) (okay what was she saying again, something about cats, why cats?) DUUYUUWAHNNIKAEH SUHMPEEPUHLLAYIK DHAIRSAENWIHCHKAE’ DIHNDHUHMIDUHL
“do you want”… “some people like”… argh why won’t she give me a minute to think? SUHMPEEPULLAYIK
DHAIRSAENWIHCHIHSKAEH’
why does she drive out any words and meanings I’m figuring out by piling more words into this? (IMPATIENTLY WAVE OBJECT IN FACE AND SLASH HAND ACROSS IT) KAEH’KAEH’LAYIKDHIHS …argh. Just say yes and she’ll stop.

Translation:

She’s holding a sandwich on a plate. She says, “Do you want it cut?” I sit there looking confused, finally having figured out that these are words and that one of them sounds like “cat”. Within half a beat of me figuring that out she says, “Your sandwich, do you want it cut?” This drives all the interpretation out of my brain and I have to start over. While she’s saying it I’m just barely getting meaning out of the first sentence. And as I slowly progress in understanding them, she keeps interrupting it. “Cut! Cut!” She mimes cutting through a sand with her hands. “Do you want it cut? Some people like their sandwiches cut in the middle.” I’m still trying to figure out what’s going on, having so far only managed to retain the idea that I’m being asked a question. She mimes cutting again. “Cut. Cut. Like this.” Etc. I figure out she’s asking something, that it’s in a yes/no question pattern, and that if I say yes she’ll probably stop throwing words in my face.

The problem is that a question has urgency about it. It has “you have to answer this” somewhere in it. It turns on this whole program in my head devoted to giving random answers to questions to get them to stop. And then a lot of people will barely wait a single moment after asking a question, to go on and ask more of them. They don’t realize that as they’re doing this they’re just throwing on more and more language to process. And that each time they ask a question, the message I get in my head is “Urgent, urgent, needs response, now need to figure out how to respond,” and I have to then backtrack and figure out what the question is if I don’t want to just give a random answer (I have a bunch of templates stored in my head for question types that have easy enough answers to randomly pull out to get people to stop asking them). And then halfway through my figuring it out it gets interrupted by another message of “Urgent! Urgent! Answer them!”

So the end result is a huge pile of urgency in my head and no comprehension until the person has finally shut up and gone away.

And text is only slightly better than this. If you expect me to rapidly process a question, you’re expecting that it’s a really good day for language processing. If you keep asking them over and over, you’ll just add to the stuff to process, not make it easier to answer. And there are a lot of people whose style of question-asking seems to be along the lines of stacking questions on top of each other. Sometimes it’s assorted variants on the same question. Sometimes it’s slightly or even majorly different questions asked two at a time and leaving me wondering which one to answer — “Do you want to do something do you want to go to the park?” is one of my least favorite question styles. It’s like a run-on question.

I noticed some time a year or two ago, that I do a lot of my communication with staff people without relying on the language content, and that one of the problems with new people is the amount of language I have to produce and understand in orienting them to the job. Someone who’s been here awhile will hand me something, and say what to do with it, and I won’t even hear them saying what to do, I just know from routine that it’s always what I do with it and the words don’t matter. Even if the words are something I have to answer, I find myself often able to give yes/no answers without having a clue what the person is saying. I noticed that a huge amount of the time people are working for me, they have no idea that I am not hearing the majority of the words they’re saying. I just know all the motions to go through and all the responses to give and I do it largely based on where they are positioned, where I am positioned, how each of us is moving, and what objects are being handed around.

And when people — strangers or just people unfamiliar with me — do notice that I’m not noticing what they’re saying, they seem to have a tendency to say something in a snippy tone along the lines of “Do you have a hearing problem or something?”

Note that I can often figure out what people are saying, sometimes even quite quickly. But it takes a certain level of effort, focus, concentration, energy, and ability to do that on that particular day. It helps if the topic is very familiar. And none of it ever feels natural or easy.

The problem is that explaining my incomprehension to others is so familiar that I can do that, and most of the responses, by rote, leaving them with the impression that their questions and responses are somehow all being understood when they’re really not.

I also do understand a whole lot of things with a delay. I now understand the entire conversation this person had with me half an hour ago. And there are still vivid memories as far back as 25 years ago that I am still trying to figure out the words to. I go over and over the sounds in my head and try to put them together into something meaningful. Often one day I’ll just spontaneously realize what someone said to me when I was 3 years old.

There are also times when there’s no comprehension possible, including no awareness that the words are even something that ought to concern me any more than white noise would. All of these different things are largely the same as the auditory version of the way I explained reading to be in my post titled Safety Hazards.

But at any rate — the best thing to do with a question is make sure I’m paying attention (and this doesn’t have to mean “looking at you”, it means focused on understanding what you’re saying), then ask one question (not a double-decker question either) and wait for an answer. You might get a quick one or a slow one, but the more you throw words on top of words, and the more pressure you put on, the more you slow me down. And the more likely you make it that I’ll give an inaccurate scripted answer if I answer at all — which isn’t fair to either of us, so I try hard to suppress that. If the interaction is over something where you can hand me an object that’s capable of prompting me in the right direction, all the better.