Interview with Dr. Temple Grandin on How to Turn Autism Around

Transcript for Podcast Episode: 117
Interview with Dr. Temple Grandin on How To Turn Autism Around
Hosted by: Dr. Mary Barbera

Mary: In November of 2020, I sat down with Dr. Temple Grandin, who wrote the foreword for my new book, Turn Autism Around: An Action Guide for Parents of Young Children with Early Signs of Autism. Temple gives her input on the importance of treating autism, speech delays, sensory processing issues or anything else as intensively as possible by the parents empowering parents to take action and not to wait. So I hope you love this interview with Dr. Temple Grandin.

Mary: Thank you so much for joining us today. I am just honored to interview you and get to speak with you. So as you know, we talked about three times this spring about my new book that's coming out for parents of one to five-year-olds with autism or signs of autism. And when we first talked, when I started saying that my book was for the really little kids, it got you excited about possibly doing the foreword for it. And you told me at that time that you were really passionate about helping little kids.

Dr. Grandin: We've got to get on these little kids. And I'm saying all the time, I'm talking to people and I just talked to a mom. She's getting half an hour of therapy a week or something like that right now. And I explain that you've got to they've got to get a lot more hours and get someone to volunteer and help you ask for help, because we work on these little ones and get that speech going. I went into therapy at age two and a half. And I was very, very lucky two teachers that work in the basement of their house, older teachers. And one of the things they had did a lot of emphasis, along with all the speech they worked on, was turn taking games. And I think this helps a lot on impulsive behavior. So we're doing a board game or just a little activity where you take turns doing something. You have to learn to wait. And I think that's an important skill to learn. And Miss Reynolds my speech teacher. She did that all the time.

Dr. Grandin: And then the other big thing is when the grown-ups talk fast, it wanted to gibberish. I actually thought the grown-ups had their own special wine. And so my speech teacher would slow down and she'd hold up a cop, she'd hold up, cup up and she'd say a cup. And then she'd say, but she'd all right back and forth and regular and say really super slow, starting with one syllable words. And I became fully verbal and for my words came in very slowly. But I can't emphasize the importance of early intervention. And I got it. And it was really good early intervention.

Mary: What kind of signs did your mother see that concerned her?

Dr. Grandin: Well, I wasn't speaking and there was another little girl next door that was the same age. And I didn't behave the same way as she did. And I had all these tantrums. And I didn't want to be held and rocking and spinning the stuff and no speech.

Mary: Right. And this was a long time ago, this was in the late nineteen forties when you were very young.

Dr. Grandin: I went to the doctor in nineteen forty-nine, two and a half. And actually mother was really lucky. She took me to a neurologist, not a psychologist, a neurologist and named Bronson Cruthers who was really ahead of the time, and he had me checked for epilepsy and for deafness. Now even though it wasn't death. You see, that doesn't tell you about auditory detail. That just tells you can hear these little tones. And I was able to do that. So just even thinking about epilepsy with really ahead of the time that he referred my mother to this little speech therapy school that the two teachers had had a couple of Down Syndrome kids and that and they were all kids that were non-verbal, was about six kids in the class and when Miss Reynolds was working individually one of the students, then the other teacher did the turn taking games. And I think that's really important to teach the term taking because there's always a problem with impulsive behavior.

Dr. Grandin: And I can remember very young, maybe when I was about six, we were playing Parcheesi and I grabbed the shake the dice. And mother said, you've got to wait for your sister to take her turn. She would just give the instruction. You've got to wait and take your turn.

Mary: Yeah. When you were talking about slowing your words down and that's a huge technique that we use in our in my book, in my online courses is that we take a shoe box, for instance, kind of slid into it and then we have pictures of people the child knows or or so we might say, juice, juice, juice with one picture of juice. And the child say they can't speak at all. All they have to do is take the picture of the juice and put it in the shoe box, and that pairs the word with the item. And then many kids with using those approaches of slowing things down, like you said, focusing on one syllable words first and reinforcer things that the child might like. I always think of it like if I were learning a foreign language and somebody said, Oh, do you want to drink in some foreign language? I would have no idea what the gibberish was. Dead, water, water, water. I'd be like, I have to remember that that's important. So it sounds like they were really these teachers in their little school were really ahead of their times.

Dr. Grandin: And they were they were older people. I'm going to guess probably early, maybe late forties, early fifties. They were both gray hair and it was just in a little house in a housing development. But they were those older, experienced teachers. They knew how to work with kids. She knew just how much to push, because I've talked to people in the spectrum where you had the therapies that were pushing too hard, just driving them into sensory overload. How horrible that was. Miss Reynolds kind of knew just how hard to push, to push a little bit to get advance, but not go into sensory overload. It's just I call it the knack. Some teachers have it and some don't. On working with these kids.

Mary: Do you have a memory of going to that school?

Dr. Grandin: Yes, I do. Oh, many years ago. And I remember just a few things. I remember holding up the cup and saying Cup then. And I remember I was brought up the little safety. You don't point sharp objects, people and for the turn taking she point the blackboard pointer at different kids. And I was afraid of that. And then I remember a really fun activity where all children got American flags and we marched around with the music with them. And I remember marching out the back door of the house and we went outside with the flags and that was really fun.

Mary: I do find music is really motivating my son, who's twenty-four. I found a music therapist really early on and he takes to music. He loves music. He actually can play the autoharp now. He got lessons. And I find that some of the kids like the really the way into languages, songs and so on, violins and making activities like head, shoulders, knees and toes and marching with flags like that's it. That's incredible that you have memories way back.

Dr. Grandin: I remember the saying cup and she'd cue me. She'd say it both ways. I remember being at the table the point the blackboard pointer, I was afraid of that and marching around with flags. And then I remember the car accident that I rode up in emergency where I didn't want to wear this stupid hat. I remember this really, really well. So I chucked it out and I couldn't talk. At this point, I couldn't get my words out and I chucked it out onto the driveway at home. Mother says, get out, get it now. I thought, oh, chuck it out the window during the highway. Now, the cars in those days had cranked windows. My goodness, I wasn't strong enough to work the cranks. So I was in the back seat. I leaned over mother. She had the front window open and chucked the hat out and she swerved in a red tractor trailer, swerved and we hit each other. And I remember saying, ice, ice, ice is broken, glass one in all around us. We were not hurt. We were very lucky. I learned a new word that day.

Mary: Wow.

Dr. Grandin: But the reason why? You see, this is an example where I did not have a word to communicate. Oh, about three and a half on this half. I did not have a way to communicate that I did not want to wear the hat. And I can remember some. I just want to scream right now because I don't know how else to say I don't want to wear the hat. Yeah, that's why I am giving a kid what a communication is so important.

Mary: Right. And if they don't have a way they will tantrum or have.

Dr. Grandin: And that's exactly what I did. And when the grown-ups talk fast, it went to gibberish. But I also have had brain scans that showed that my circuit for what you see was short on fibers, not enough fiber optic lines on it. And then what research now is showing is that you work therapy. You can increase the bandwidth on the fibers that are left because I had a. I wrote in my very early stuff, it was like a big stutter. I was not Nicolay like kid, I'm just yacked I was not one of those. I was not one of these ones to act out a whole movie script or something like that. No, no, no, no. That was not me. Those kids don't know what the language means. Three-way speech can be messed up. Don't hear it clearly, even though you're not deaf, can't get it out. That's expressive. Or echolalia yack it out and they don't know what it means. Yeah, I was not the echolalic type.

Mary: So you had a hard time processing auditory input.

Dr. Grandin: And I had a hard time getting it out and I describe it as a stutter and she had pushed me that to get it out. And I would say things like Bro for broken. Day for the day. And I actually thought the grown-ups had a foreign language, special grown-up language. At one time I was very young. We lived in snow and we'd make snowmen. It was another turn taking game. I'd roll the bottom ball for the snowman is you would do the middle ball. I do the head. Then we had a whole box full of old junk. We decorated with scarves and things for eyes. And I remember one time we built snow chairs on the, my sister and I want to play pool and I sat in the snow chairs and all is how grown-ups talk.

Mary: You have so many memories from when you couldn't talk and you became verbal at four?

Dr. Grandin: By four. But I was still slow to get it out, mainstreamed into a normal kindergarten at age five for half a day, and then little tiny classes. Twelve kids in a class, old fashioned classroom. And so I was able to handle it without aid. That had been a bigger class. I would have had to have had an aid.

Mary: OK, were you hyperlexic in the beginning?

Dr. Grandin: No habit actually, no, not me. I got the third grade and I could not read.

Mary: OK, so you were more on the dyslexic side. A lot of kids with autism, like they either are really hyperlexic or they have trouble reading.

Dr. Grandin: Well, I had trouble reading and I did not have the visual problem where the print jingles on the page, that was not my problem. But the books we used with Dick and Jane books, I thought I hated them and just picking up those whole words did not work. So Mother taught me with phonics and because my teacher was very concerned that I was eight years old and still couldn't read, that's a problem. And so mother took and penned the alphabet up on the wall and had me learn the sounds. A is A and B is ba and memorized the sounds. And then we got a book worth reading like The Wizard of Oz, something you're actually interested in, probably about a higher level than third grade. And Mother would read it and then get right to the best part and then get me to sound out maybe two or three words. Then gradually she read less and less and I read more and more. And then she commenton the rules like an E is when you got the two together, the long vowel, the E on the end. Sometimes a rule works, sometimes it doesn't. And she just had me read out loud and we did this for maybe forty-five minutes a day during the week and in one semester I went from first grade reading to sixth grade level reading like very, very fast. My reading level went from none to above grade level.

Mary: That's amazing. And you are a little bit older then. Did you have older or younger siblings?

Dr. Grandin: I had a younger sister a year and a half younger than the other two siblings with a great big gap in between.

Mary: OK, so you are the oldest child?

Dr. Grandin: Yes, I was the oldest. That's right, yeah.

Mary: And I find that like my son, Lucas is our oldest too and it's not always oldest, but it seems like it sounds like your mother was just completely on it and driven from the very minute and she saw delays like that. Give her a lot of credit. I met your mother. She wrote an endorsement for my first book, and I really enjoyed meeting your mother. And it sounds like she was really ahead of her time, too, in terms of. Yes, getting a diagnosis of some sort, getting treatment.

Dr. Grandin: Original diagnosis was brain damaged because the neurologist was nineteen forty-nine. It would have been it didn't even know what autism was. Right. But I have all of the classic symptoms.

Mary: That was coined in what 1943?

Dr. Grandin: Yes. But you see that wouldn't have gotten over to the neurology department because you have silos in medicine and Branson Caruthers was a neurologist, not a psychologist or psychiatrist.

Mary: But you did eventually get a diagnosis of autism.

Dr. Grandin: But that came later, came a few years later.

Mary: So, you know, my book and my toddler course and my my focus on the little kids, my thought is it really doesn't matter if it's just a speech delay or sensory processing or a early signs of ADHD or learning disability or autism, any kind of this intervention of slowing words down, getting kids to talk, getting them to turn, take is ideal.

Dr. Grandin: And we got to get these kids talking. And I'm seeing like a lot of places. I've just talked to somebody just the other day where they're waiting two years for diagnosis and the kids getting no therapy to help them with talking. It's really, really bad, right? When I say, look, I don't care what the diagnosis says, the is pretty much the same. Once you rule out something physically wrong with their mouth of the throat, rule that out. Right. You got to start working on these little kids. You can't just let them vegetate screens. You just cannot. I tell people doing nothing is the worst thing you can do. Little kids, two-year-old, three-year-olds, four-year-olds that are not talking. The worst thing you can do is to do nothing.

Mary: And it's often the mother of the child who is has to be the leader, because if you're just making calls and while there's a two year wait here, there's a nine month wait here, stand in line. And that's why I am so excited about my book and so thrilled you agreed to write the foreword because this is really a step-by-step manual.

Dr. Grandin: Well, that's right. And then, of course, my favorite book, too, The Way I See It.

Mary: Tell us about that book.

Dr. Grandin: The way I see it? This is the fifth edition updated. It's a whole lot of little chapters and it covers my early intervention, but it also covers a whole bunch of other things, a lot of little chapters, very practical. Would be a great companion for your book. Yeah, I see it. And the fifth edition that we just updated it last year and you don't have to read it cover to cover. You can just go into the index, pick out the subject, interest you and read little short chapters. Really practical for parents and teachers.

Mary: Excellent. I've read a number of your books, but I haven't read that one, so I'm going to definitely get a hold of that now. But so we have chapters in my book on talking to increase, talking with things like shoe box, Mr. Potato Head, instead of those kind of toys that we slow everything down. We focus on one, two syllable words. We make it super positive. As a behavior analyst, my procedures are based on the science of ABA, but they're child friendly. Child's crying, they're not learning, and we know they're not learning.

Dr. Grandin: And then you may have driven them into sensory overload. Fortunately, some of those old fashioned, bad, rigid ABA that was done on some people on the spectrum years ago, drove them into sensory overload. So they hate ABA. And I make it very clear there's some good ABA that's really flexible and good old fashioned, bad, rigid stuff where they didn't understand sensory overload. And that was bad.

Mary: And I wholeheartedly agree. And I think that's another concern for parents is they start hearing all this while ABA is bad. Well, you shouldn't do this or try this. And it's like we need to use the science of what works, pairing words, making it fun, making it reinforcing, preventing problem behaviors, not making a child go into sensory overload and make it appealing and fun. And we need to show progress. Like in my book, we start out with a one-page assessment and a one page plan that I walk parents through how to do it. You don't have to just leave it to the professionals. Can you imagine if your mother would have just been like, well, wait till she gets to school and leave it to the professionals to help?

Dr. Grandin: You absolutely cannot wait. You just cannot wait.

Mary: Yeah. And the other thing your mother did was she hired a nanny.

Dr. Grandin: Yes. And the nanny did a lot of turn taking games as we would like. I would go out with the nanny, my sister and I to build a snowman. And then the nanny would have us take like I'd roll the bottom ball is you do the middle ball, I do the head. And then we had a box full of decorations with hats and scarves in it and then get put the hat on and I put a scarf on it. And then there was old pill bottles and stuff that we could use for eyes. And that was a snowman box and that was stuff the nanny did. Take one sled and we'd take turns using the sled. You see just really simple things. The other thing I always told parents all, you know, the kid knows the words the Jews. If he wants the juice, then you want to say use your words. Other thing I tell them is wait for the kid to respond. They're slow. I tell some of these kids like a phone on a really bad cell phone connection. Soyou're trying to download a webpage and. Wait, wait, wait. Some of these kids are like a phone on one bar. Give them time to respond might be fifteen or twenty seconds. That's a long time. Give them time to respond and always encourage them to use their words.

Mary: Yeah, definitely. So in addition to signs of autism, and talking and reducing tantrums, I also my work and my new book has a chapter on eating, sleeping, potty training, going to the doctor and dentists and haircuts, which can lead to sensory overload.So let's go over those kind of issues. Did you have eating problems, picky eating?

Dr. Grandin: I could have easily gotten into a grilled cheese sandwich habit, but I was allowed to have that on the weekends and it just wasn't allowed. I think some of this I allowed too much of what I was allowed to have. I hated raw egg white. They let you can let them have a few things they just hate. Raw egg white is like the vomit department for me. And they did not make me eat that. So the picky eating wasn't the problem. But I hated to have my hair washed. I hated getting water in my eyes. And even now, like when I take a shower, I hang a towel over the shower rod. So as soon as I get water in my eyes, I can dry my face while I'm in the shower. And I've talked to other people have passed that hint on and that's really helpful. The other thing is no surprises. Let me tell you, this is how not to do a vaccination. The doctor said to me, oh, let's look at the pretty bird feeder. And then he stuff the shot in me. And then I had to.

Dr. Grandin: But then what they did that was good after that is we'd go to the doctors and we'd go in the doctor's office part, not the medical part. And we'd look at my records and we'd find out whether or not I had ever shot. And then we'd get it over with and then the rest of the exam, I was fine. OK, because I wasn't having the suspense of whether or not I had to have a shot. Yeah, but a principle, no surprises. I let the kid watch what goes on at the dentist's office make things interesting rather than scary. We can look at X-rays of your teeth. That's kind of fun to see what your teeth in your jaw look like. Yeah. Turn that into something that's fun, but no surprises. I've had parents say, well, what about when the kid goes back to school and all the desks are separated? Well, don't have that as a surprise. That's no surprise.

Mary: Go in and take a picture that's going to look like and also the Lucas' gets allergy shots, for instance, and I know a technique for him, for shots, for anything. Haircuts in the past when we've had issues is he really likes blood draws, he really calms him, is counting. So, OK, we're going to count to three and then we're going to do the shot one, two, three. And then as they're doing the shot and injecting the allergy serum, then it's he's counting again so that we would go to blood draws, which isn't so frequent. OK, we're going to count. We're going to sing songs. We're going to. And the other thing is what we use a promise reinforcer. So when we're all done, we're going to get to go somewhere or we're going to have something fun that's wrong.

Dr. Grandin: And that that that would work with me to actually do this shot. Then we're going to get an ice cream or something. Right. And if you throw a fit in there, then you don't get the ice cream. That would be the one older boy back in the fifties. They had this horrible reusable glass syringes with needles that were never sharp. Good old-fashioned stuff. Yeah. But I remember when I got my tonsils out, the nurse did a really good thing. I was six years old. They still use the dish strainer thing, the ether. And we had enough for that put a dish of ether over your face on it. Oh, the nurse took the thing and just put it up to her face. And what? It doesn't hurt me. It's not going to hurt you. And she just put it on me. No struggle. I remember that really super well. I was six.

Mary: Yeah, yeah. Model.

Dr. Grandin: That was the way to do it. She says it's not going to hurt me. I'll just put it on you.

Mary: Yeah. Yeah, I know my son Lucas had to have a covid test done. And so I was like, I don't know how that's going to go. And we modeled it with the person getting the test. First we use the counting strategy. We offered the promise reinforcer at the end. And so he was able to do it. But I know especially with very young children who not only don't talk or don't talk much or don't talk at all, they might have a big comprehension issues, too. So that's right.

Dr. Grandin: You see, you don't, um now I knew age six. Why the tonsils came out because were kind of choking. They were swollen the back of my throat. They said they get that out. They will resist going to the hospital. I knew why we were doing it right. Was six fully verbal.

Mary: Right right. Now the book that I know you from most famously is Thinking in Pictures. That book also was kind of the basis for the movie about your life was the basis for the movie, which is called Temple Grandin. And it was out what year?

Dr. Grandin: 2010.

Mary: 2010. It won eleven Emmy Awards.

Dr. Grandin: Only got seven Emmy Awards.

Mary: Seven. OK, I thought it was said eleven somewhere where I was looking that up. I mean I thought I got one Emmy Award.

Dr. Grandin: That was the Golden Globe. We got one Golden Globe. Claire Danes to Screen Actors Guild Award. A Peabody Award to a bunch of awards it got.

Mary: OK, so maybe all together it was eleven anyway. All together. Yeah, yeah, yeah. So how involved were you with that movie about you?

Dr. Grandin: And I was very involved with the producer and the writer. And Emily Gursensains the producer was a mother of a severely autistic child. He's almost an adult then, and she wanted this movie to be right. And it took her ten years to put the right team together. Wow. A lot of names on the credits.

Dr. Grandin: Those were the key. There were there's a lot of people there that the teams that couldn't figure out how to do it. And the right team was eventually Mick Jackson, the director, Christopher Mongar, the writer Emily Sunshines. And then Mick hired Claire and they stuffed her hair up under a wig and she became me. Yeah, she did a really good job. But when I saw the first screening of the movie, it was like going in some strange time machine, the sixties and seventies. And the other thing I loved is I put all my engineering and design stuff in there and all the projects were accurate. That's what I really like. Now, the one scene in that I'm a mother doesn't like is the one where the doctor says we usually recommend an institution. Well, that is what was normally done in the fifties with kids that had my kind of problems. Usually we just put in an institution and fortunately, when the doctor recommended. Therapy now that seems historically accurate because what mother went do was way ahead of its time. Yeah, but that was typically what would have happened, right?

Mary: Right. So Thinking in Pictures, really details like that, you have just a really incredible visual perception of the world. Visual. That's right. And so did you have that all along?

Dr. Grandin: Well, I guess now the thing is, when I was in my 20s and started out in the cattle industry, I thought everybody was a visual thinker. Yeah, it's been interesting journey for me, learning that other people aren't visual thinkers. And I talk about the science behind some of the different thinkers in my book, The Autistic Brain. But in my twenties, I thought everybody was a visual thinker and I couldn't figure out why people are so strange for me to be looking at cattle were seeing. Well, if you're a verbal thinker, it's not really obvious to look at what cattle are seeing. You see that's some of the first work that I did.

Mary: Yeah, but it sounds like since you have such a strong memory of early childhood, which is incredible and three years old, you can visualize it still.

Dr. Grandin: And it's sort of like little tiny video like at the speech clinic it's like the three video clips as I've worked the same cup board pointer and marching around with flags. And then, of course, the car accident and we were on the way to speech therapy, when he had that accident. And I remember that very clearly in the new word that I learned. And it's like four little video clips. And then I remember a lot of things from elementary school, fun things we did on things that weren't fun. And yeah. Little tiny video clips that start out as still pictures and then I can run just a little tiny video clip for just a few seconds for each one of those things.

Mary: Yeah. So what are your thoughts on? I've done podcasts and video blogs, on like high functioning, low functioning. And I know, I don't like to use those terms because you can within each person or child, there's their unique strengths and their weaknesses. And somebody that looks really high functioning could be really impaired.

Dr. Grandin: And I just tend to use the terms one little because I was nonverbal as a young child. So let's say once I get past the age six or so, I'm going to call them fully verbal, partially verbal, non-verbal. Because that just describes them and what they actually are. The problem you got with autism is a continuous trait. I've looked into a lot of the genetics on it, and you go out to Silicon Valley and you've got computer scientists out there definitely have got autistic traits. And someone like Bill Gates has some autistic traits. I mean, watch the antitrust depositions. I also found out that when he first started his company, he'd look out in the parking lot and he memorized everybody's license plate and he'd know who was at work. Well, most people don't memorize everybody's license plate, you see. So it's a continuous trait. We're a little bit geeky, gives us the tech that we're using right now. Right. And you get more of that right. Then you've got real severe. And there's a paper I really like this called Genomic Tradeoffs or autism and schizophrenia. The steep price for a human brain.

Dr. Grandin: See the same genetics that makes all these stem cells grow, that make us have a huge brain, are also involved with autism, schizophrenia. Making a huge brain is kind of a messy proposition. And you get a little bit of a certain trait is helpful to get too much of that. It's real severe disability. You see, the problem is you've got the same name going from somebody that ought to be working in a skilled trade or someone like me, somebody in computer science, somebody can't dress themselves. You see, now I'm thinking about it visually. And you see, I'm not a verbal thinker. And I think it's kind of ridiculous to have the same name for that wide range. Now, you've got the fighting going on for the neurodiversity people and the parents with the very severe kids, because what do you get from that? Well, the little bit of autism. I don't think is a disability. Makes you an engineer. There'd be no computers with a little bit of autism. Because a brain can be more social or brain can be more cognitive. Here's another paper I really like to show it's a continuous trait.

Dr. Grandin: Solitary mammals as a model for autism. And let's take the big cat fams, all the cats, the big ones and small ones. The lions are more social than a tiger or the leopard or the panther. There's genetic crossover here. Less oxytocin. Is a panther defective? No. Now, if a panther couldn't learn to hunt or something, that would be definitely a severe disability. You see how I'm talking about a true continuous trait. When you think about it visually, I can see it as a true continuous trait. It's just like when you breed different dogs together to different mom and dad are totally different, distinct dog breeds. The offspring look like half and half. And then when it gets down to quarter lab, it's hard to tell. You see, those are continuous traits.

Mary: I'm not sure if you're familiar with the newer work of Ami Klin. So he is at Emory and he's a researcher. And I can say is I can send you his 2020 paper with him and colleagues, but they're really showing that the little kids, based on their eye tracking study and based on their twin research, that the autism is genetic. But even with identical twins, it's not guaranteed where you're going to be on the spectrum. And their studies have shown that the rate of autism plus intellectual disability is almost double in African-American children as opposed to white children. And so, like basically his work is saying what my new book is saying. It doesn't matter if you think it's a speech delay or doesn't matter, it's more severe autism. You got to get on it. And like you said, after six, then we can categorize them.

Dr. Grandin: That's what that's what his paper supports. Have you said, Cheryl, that paper sent it to Cheryl so you could print it out? Our nice printer. I really appreciate that. What you see, that's exactly the same thing I've been saying. Just from what I've observed and looking at literature, it's a true continuous trait and there's a zillion genes that make the brain big. The other thing is why the identical twins don't both have the same level as you. A lot of what's called random variation, where the nervous system so complicated, this growing in the uterus, they're not going to grow exactly the same way. Very similar, but not exactly the same way. You got too much stuff going on there. It's sort of like a condo complex. And they the slight variations in the buildings that don't really have any rhyme or reason. Somebody just did it. It's just random variation, different building things.

Mary: Klin and his colleagues also are identifying sub threshold autism where it's not going. It can actually be just a serious speech delay if you can be treated well.

Dr. Grandin: Especially with people out there in Silicon Valley. The other thing I'm seeing is that I've talked to many parents. Well, I got my kid out. I've got him a job and all this stuff and they'll say blossomed. You say you get somebody who's just sort of mild. You really work on learns how to work and stuff like that. He ends up in Silicon Valley, if you don't do that, you ends up in the basement playing video games. And the thing is, I'm a bottom-up thinker. So the more stuff I get out do, then the less autistic I'm going to act because I got more knowledge and I think a lot of it's increased detection. I worked twenty-five years heavy construction. I'm going to tell you right now that 20 percent the people I worked with, they could weld anything, build anything, draw and design complicated equipment with autistic, dyslexic or ADHD. How about a family of dyslexic, this is in the eighties building huge, gigantic, complex feed mills? And they had the visual processing problem where the print jiggles on the paper and they all wore tinted glasses and very successful company building feed mills. You see, this is where I want to bring Solve My World, because there were all kinds of kids that they were just the different kind of kid. But they got out in the world and they learned enough. You see, this is where they can kind of go one way or the other.

Dr. Grandin: And I'm seeing a lot of parents way too overprotective and just kids not learning any skills. Now, how about a six-year-old kid, this building beautiful Lego things and nobody thought to introduce tools. That's ridiculous. As a teenager. Good grades, Mom. So overprotectiveness not learned shopping. This is some of the stuff I'm seeing now that's ridiculous.

Mary: Yeah, your book, Developing Talents was really good. I read that a decade ago when my son was a teenager. And in that book you talk about, especially for kids that are more severe, like my son is, look at things he likes, like the pain. OK, maybe you could paint a room with you with a lot of supervision. And you that book talk about looking for work that can't be shipped overseas because everybody is going to need painters or landscaping.

Dr. Grandin: How about diesel mechanic? Not even a self-driving truck. You're not fixing it from overseas people to fix things. I just had them a shower repaired. I like to believe what they charged for that. Ridiculous. Not going to go away. Yeah. Yeah. So it's going to go away. It's a true continuous trait you see. So on the mild form of autism to give you it is just personality variation. But then there's a point where it gets more serious and you've got somebody where they're an adult, you can't do any normal activities, go to a restaurant, go to a game, go to a movie.

Mary: And it seems like the people that have followed my work because of the verbal behavior approach and now my new work, well, especially people that have followed me over the years, they tend to have more kids with moderate severe autism who are 15, but talking less than a three-year-old. So my audiences is a lot, usually more severe, but now that I'm going into the early intervention, so really trying to turn up the burners on that, because that's really where we can make whole life changes.

Dr. Grandin: We can make total life changes. You know what else I'm seeing? I'm seeing certain parts of the country when in fact, when I travel, I haven't traveled since March. Everything's shut down. But I had very sad therapists come up to me, I think it was in Massachusetts and they were doing a great job on the early intervention. The kids, a teenager and addicted to video games in the basement because he never had a job. And so there's someplace we're doing a really good job on early intervention, but we're not done working skills, things like volunteer job at a church. We need something to replace the paper else because those are such important skills. But I'm a total believer in early, early intervention because just during Covid, I'm talking to parents where even before covid started, they weren't getting enough therapy. I'm hearing many, many times, oh, we get an hour of speech a week. Well, that's not sufficient. And I said, you've got to do something you and you're going to have to ask volunteers to help you. We've got to work on the early intervention. It's super, super, super important what would have happened to me if I hadn't gotten early intervention?

Mary: Right. And if you have the resources, hire a nanny, get extra therapy because people are like, well, you know, does he need 20 hours a week? Does he need forty hours a week?

Dr. Grandin: I'm telling people if they can get fifteen or twenty, but I, I've talked a lot of super low-income people. You've got to get some grandmother from the church.

Mary: Get church volunteers, college experience, Boy Scouts, Girl Scouts that need service volunteer hours. Mommy's helpers. Yeah. You need to be resourceful. And it's not the amount of hours that you pay people. You also really ideally need to keep a child engaged for all of their waking hours or as many of them as possible. So that's one hundred hours a week.

Dr. Grandin: I was kept engaged because meals were formal and I'm going to have to go in five minutes. Meals were formal and I made a mistake. Like, I put my finger in the mashed potatoes. They didn't scream. No. They said, now use the fork. So meals were structured. I was allowed to have an hour off after lunch. We could go stem and another hour in the evening where I could do it. And the rest of the time I kept meals were engaging. Then we did all the outdoor games and stuff that were really engaging and take me to the grocery store. Grocery store, mother call it marketing. First National was the name of the grocery store. And I would go in it had a wood floor and I would go and get stuff off the shelf and we had a list. I thought marketing was a lot of fun. Yeah. And she'd take me there when I was so small, I don't know, six or seven I would go marketing. And then by that time I had a little allowance, but it was seven or eight years old. I could buy ten candy bars with that or five comics. But then I learned if I wanted the sixty-nine cent airplane. Plus, five dollars today on the sixty-nine-cent airplane had to save for two weeks, I was learning that at a very young age.

Mary: Yeah, and that's what when you think about one hundred hours, keep your kid engaged. This is bath time. This is groceries. This is and if you learn the tools like breaking things down, saving water, water, water, when the child wants water, it can become a part of what you do and the child can make progress. I know you have to go to my last question. Part of my goal for everything I do, my podcast, my book, everything I do is for parents, professionals and people with autism to be less stressed and lead happier lives. So do you have any stress management techniques or self-care things that you would recommend for people in general?

Dr. Grandin: Well, I would have loved a weighted blanket. I used to my bed really tight. I used to call it putting a letter in the envelope. Okay so a weighted blanket is something really helpful for I would have love that kid on. I would have liked those bicycle outfits that people wear that are tight. I would have liked that to sleep in. And then there's that. When I was older, I made my squeezing machine. Lots of exercise is good. And then another thing I did is I had my special TV show. I watched Howdy Doody and was allowed to watch that every night unless I was bad, like pitching tantrums. And then I got taken away for one night. But they even now just have a chance to just chill the sit and read science and nature. That's my idea of recreational reading now and then. I like to do that even now with time to do that.

Mary: Yeah, well, it sounds great.

Dr. Grandin: Lots of exercise.

Mary: I can see how that is a stress reduction to us as adults and as well as...

Dr. Grandin: The other things, sensory thing, deep pressure. Some kids respond to that. Some don't. See one of the problems with doing evidence-based research and some of that stuff is it only works on the pressure responders and not all autistic kids are pressure responders. Yeah, that's the problem. It's very, very variable in the sense I do not have the visual processing problems that some kids have. I don't have it.

Mary: Right. We all have our unique strengths and our weaknesses.

Dr. Grandin: And so we've got to get on the early intervention. And I tell parents, you've got two-year-olds are not talking and screaming and then a lot of repetitive kind of behavior. The worst thing you can do is nothing. You've got to start working with that kid. And here are some books you can get. Recommend my books. I recommend your books. You've got to get on it now. And if you can't get services, you've got to create your own services because you cannot let this kid vegetating in front of the screens. You just cannot.

Mary: Yeah, well, I think that's a great way to and I really appreciate your time today. I appreciate you writing the forward being a huge advocate for families. I know you've impacted my life and my son's life, and I know you've impacted so many around the world. So thank you so much for being so generous.

Dr. Grandin: It was really great to be here. And thank you so much.

Mary: OK, bye.