How to Tell your Child About the Medical Diagnosis of a Loved One, Part II

Preparing to have this Conversation with your Autistic Child

In sharing a medical diagnosis with an autistic child about a loved one, many of the recommendations for neurotypical children (found here) are also relevant for an autistic child, with additional recommendations. It’s important to prepare by talking with your parenting partner and making sure you’re ready emotionally. Keep the conversation simple and honest, considering the age of your child. Think about who should be there and find a quiet space  to talk. During the conversation, mention the people who help and explain any changes that may happen in their routine. By adjusting the approach to fit the child’s understanding, you can have a caring and clear conversation that helps them process the situation.

Communication Tips for Communicating with an Autistic Person

When communicating with your autistic child, it’s important to capture and maintain your child’s attention. This might mean finding ways to engage with their special interests beforehand to ensure they’re focused during the conversation. Spending time on this preparation can make a significant difference in the effectiveness of the discussion.

Simplicity is key. While this advice isn’t new, it’s essential to grasp its importance, particularly for individuals with autism who may struggle with processing excessive information. Speak slowly, use fewer words, and avoid too many questions, especially open-ended ones. Being literal in communication is very important. Steer clear of metaphors or sarcasm, especially in discussions about sickness and death. When checking for comprehension, be mindful of homophones that might confuse the message and consider whether your child needs extra time to process independently. Also, observe their body language for signs of distress, and if needed, offer breaks or alternative activities to ease any intense emotions.

Language to Avoid

In one research study about the use of euphemisms in medical settings, it was stated that most people will avoid using the words dead, death, and dying (Herbert, 2016). Instead it is common to use ‘passed on’, ‘deceased’, or ‘kicked the bucket’. Although you probably wouldn’t use ‘kick the bucket’ to describe the passing of a loved one, it’s important to consider that these indirect descriptions may hinder your child’s understanding. Additionally, when describing sickness, avoid using euphemisms and other idioms that may distract your child from the meaning of the phrase. Instead of ‘feeling under the weather’ or ‘took a turn for the worse’, use direct language that describes the situation. Additionally, avoid metaphors. This can also make the message more confusing to your child.

Important Differences

While many common recommendations are not affected by these autistic-specific recommendations, there are a few important differences to highlight. While there isn’t a lot of research specifically about telling an autistic child about a loved one’s illness, there are some general tips to consider. People with autism often appreciate directness, so you might not need to adjust your language much based on their age. Instead of worrying about whether it’s “developmentally appropriate,” focus on avoiding idioms and metaphors that might confuse them.

In the previous blog, using dolls and pictures was suggested to help children understand. These can still be helpful, but you might also try using social stories to improve understanding. Additionally, if your child doesn’t like physical affection, don’t force hugs or cuddles. Understanding your child’s needs is key in these difficult times.

Before, it was recommended to plan for a long conversation, but for an autistic child, keeping things short and simple is advised. You might need to break the conversation into smaller parts or take breaks for your child to process. Don’t be surprised if they don’t react strongly; it doesn’t mean they don’t understand. Be ready to address any behaviors that arise and know how to guide the conversation back on track.

Conclusion

There are not many explicitly different recommendations for having these types of conversations with your neurodivergent child compared to a neurotypical child, though the ones listed here are important. In fact, there is not much research about translating that conversation to best fit your child with autism. While these recommendations may help promote understanding and processing of this information, the most important recommendation is to adjust this conversation based on what you know about what your child’s needs. 

 

References

McCarthy, C., MD. (2020, January 14). How to talk to children about the serious illness of a loved one. Harvard Health. https://www.health.harvard.edu/blog/how-to-talk-to-children-about-the-serious-illness-of-a-loved-one-2019120218468#:~:text=Talk%20about%20how%20this%20will,care%20of%20during%20the%20illness.

Telling a child someone they love has cancer. (n.d.). American Cancer Society. https://www.cancer.org/cancer/caregivers/helping-children-when-a-family-member-has-cancer/dealing-with-treatment/talking-to-kids.html

Communication tips. (n.d.). https://www.autism.org.uk/advice-and-guidance/topics/communication/tips

Autism Specialty Group & AUTISM SPECIALTY GROUP. (2023, June 21). Autism Communication Strategies, Communicating with Autistic Children — Autism Specialty Group. Autism Specialty Group. https://www.autismspecialtygroup.com/blog/autism-communication-strategies

Garcia, A. (2019, April 19). Read this if you don’t know how to talk to someone who has autism. Healthline. https://www.healthline.com/health/autism/dear-neurotypical-guide-to-autism#3.-Listen-carefully

Herbert, Anthony. (2016). The Role of Euphemisms in Healthcare Communication. Journal of Healthcare Communications.