Business Cards for children on the spectrum. An idea whose time has come!

My Card….
I had a patient in the office the other day; let’s call him Joe. Joe is 9 years old, non-verbal, hyperactive, very friendly, and oh yes, he has autism. He invades the personal space of others, in search of his two favorite things: food, and smart phones. When Joe was a toddler or preschooler, his behaviors were “cute.” As he has become older, however, these behaviors have become more discrepant from those of his same-age peers, and harder to control – especially in public. Where once Joe was greeted with indulgent smiles from strangers at the mall, or in a restaurant, now Joe elicits mild consternation, and a hasty glance from the other person to see if mom or dad are in charge of this boisterous young man. They always are. In a couple of years, however, Joe will be bigger, stronger, and faster than either of his parents. When he’s done with puberty he will be over six feet and 200 pounds. And, as the mother of another of my patients observed sadly: “The world looks very differently on an autistic man than on an autistic child.”

Joe’s parents are doing everything to instill social skills in Joe. But I still worry about that one split second when Joe might get away from his parents, and a tragic chain reaction ensues: Joe inadvertently frightens someone; a mall security officer responds, Joe is unable to respond; the situation escalates. You can fill in the final details.

Fortunately, there is an initiative to train first responders to recognize ASD. Autism Speaks, in conjunction with a web PR outfit by the name of SEO, now offers ASD ID cards at a nominal price. The cards and training are intended to alert first responders. This is a good start, but I have a few nits to pick with this program: First, there is no place on the card for a photo of the child, and second, the cards were created with first responders in mind, not the card carrier. I think both of these are reflections of the same problem, and underlying philosophy behind the cards. Let me explain…
I have read that in Japan, the exchange of business cards is universal. One has not been properly introduced without an exchange of cards. The card is an extension of one’s public image…. and not reserved for first responders. My point is this: Training a person with ASD to reach for their ID card in a crisis ain’t gonna work. In a crisis, we fall back on the familiar – whatever that happens to be. If it’s eloping, or melting down, or stimming, or whatever, that’s what the person with ASD is going to do. Not some unfamiliar behavior, such as pulling out a long-forgotten laminated ID card, located who-knows-where. What I’m proposing is a radical mind-shift: Train kids, teens or adults with ASD to “give the other person your business card” with every first encounter with an unfamiliar person. The clerk in the checkout line, the waiter in a restaurant, a new acquaintance on the playground – whoever. The point is to make handing out cards part of the person’s basic, day-to-day repertoire of behavior – not some emergency maneuver when caught in a bind of some sort.

The downside to this, of course, is that your family member is self-identifying him/herself as being on the spectrum. (I did come across this comment on an AS chat group: “I don’t want an ID card. I don’t want to be identified as being autistic before being a person. It might work for some people but for me I’d find it dehumanising.” I think the writer’s premise is mistaken: I’m not talking about identifying someone as autistic “before being a person. ” Rather, I’m talking about recognizing the person’s autism as part of their personhood. Recognizing the other person’s autism means re-examining one’s own assumptions: “Is this person really being rude and hostile, or are they just being their normal [autistic] selves, and it’s up to me to re-frame my own perceptions?” The burden is on the non-autistic person! But they need a chance to think it through. The 5 seconds it takes to read a proffered card can function as a cooling-off period, as well as a teachable moment.) In my view, the benefits outweigh the disadvantages. This is where the content of the card comes into play: If the card is part of the person’s identity, not just something to hand over to first responders, then the card (a) should include the person’s picture, and (b) should express the person’s individuality in some way. Handing out cards should be fun, and should be a chance to say something unique about one’s self, not a self-stigmatizing exercise.

Somewhere there is a borderland…. I’m not saying that every single adult with mild AS should be handing out cards to all comers. But I am suggesting that kids and teens with moderate atypicality, especially those who have limited verbal skills, become accustomed to handing out cards as part of their initial routine of greeting others, rather than as a last resort in emergency situations.
I did a quick search on the internet for child-friendly cards, or anyone else advocating that children (and adolescents or adults) routinely hand out cards, and I came up empty-handed. There were several sites offering cards designed for first responders, and cards for parents that basically say “My child has autism; what’s your problem?” But I couldn’t find anything meant as a child-centric, child-friendly card for kids to use.
Am I way off base here?

Pick a card — Any Card
Here are some of the links I found to cards and discussions of cards. Commonwealth countries (England, Ireland, Canada) seem to be miles (kilometers?) ahead of us Yanks in terms of recognizing the utility of cards for adults on the spectrum. My vote goes to the last link in this list, issued by the Calgary police department.
http://www.arghighland.co.uk/
http://www.policeoracle.com/news/Merseyside-Launches-Autism-Card_16122.html
http://www.autismireland.ie/autism-id-card/
http://www.squidoo.com/free-printable-autism-information-cards
http://www.danasview.net/cards.htm
http://www.washingtonautismadvocacy.org/updates/2013/03/04/wall-of-courage-autism-id-cards/
http://www.autismcalgary.com/2013/01/calgary-police-diversity-unit-disability-id-cards/

James Coplan, MD is an Internationally recognized clinician, author, and public speaker in the fields of early child development, early language development and autistic spectrum disorders.