This means he often goes to great lengths to avoid having to make a choice, delaying it until there are no options left (even if it means ending up with a bad result).
And that’s the way it can be for a lot of autistic kids and adults.
But why is decision making so stressful? And what can you do to help?
Why is it tough?
Decision making belongs to a set of thinking skills known as executive functions, which also includes stuff like planning, organizing, attention, problem solving and the ability to multi-task. These skills are complex because they involve the bringing together of many other brain functions, just like an executive of a large corporation.
Making a decision involves a sequence of thinking skills that looks something like this:
- Understand the problem
- Think of the options
- Compare them
- Choose one
- Act on your decision
1. Understand the problem
The first step in making a decision is to realize that you need to make one. This relies heavily on listening and language comprehension skills, so if you have delays in auditory processing or receptive language you might struggle to notice and understand that someone is asking you to choose.
2. Think of the options
We use listening and receptive language to understand the options that are (and are not) available to us, so again delays in these areas can cause problems. Literal thinking can also lead to misunderstandings, and it’s really hard to make a choice when you get the options wrong. When someone invites you over for coffee and asks what you’d like to drink, the figurative options (tea, coffee, water) are quite different to the literal ones (a raspberry milkshake).
Difficulties with expressive language or social communication can make it hard to check exactly which options are available. Even just thinking about the options can be stressful, since every choice is an unknown and that kind of uncertainty can create a lot of anxiety for those who prefer sameness.
3. Compare the options
Weighing up the options means thinking ahead to the possible outcomes...
- If I choose to go to the park what will happen?
- Will I have fun there?
- Will anything bad happen to me?
- Will I have more fun than if I choose to go to the beach?
While some autistic people can be excellent at remembering things that they’ve already experienced (every Thomas the Tank Engine character), they often find it harder to extend these experiences to create something new (inventing a new character). This makes it a challenge to picture alternate realities that haven’t yet happened.
Making a decision also involves a lot of attention shifts - stop what you’re doing to think about choosing, move from one option to another, disengage from that to actually choose one and then act on the decision. All of those shifts in attention take time, and may take even longer for someone who’s autistic. To the outside observer these delays can look like inaction or ignoring, and reminders or prompts to hurry up just interrupt the whole process and send everything back to square one.
Perseveration, rigid thinking and attention to detail can all affect the decision making process. When your mind finds it easy and comforting to lock onto a train of thought, it can be a challenge to make it move between choices to weigh up the pros and cons. A tendency to get stuck on details can make it easy to get caught up on the specifics of each option or to go off on thought tangents, which makes it harder to compare them against each other.
Decisions also usually come with a lot of implied nuances that can be hard for a literal thinker to pick up on. You might ask your son if he wants a glass of water or a glass of milk, and the choice becomes impossible for him to make because he wants it in his sippy cup.
4. Choose an option
When you're focused on details it's hard to step back and see the bigger picture - in this case, to concentrate on the overall goal of making a decision. If transitions are stressful it's easy to get stuck thinking about the options and have trouble moving on to actually choosing one.
Emotional memories help us to imagine the kind of experience each option will bring, so if you have trouble identifying how you feel about things it can be really hard to know which option you prefer. Experiences that bring intense emotions are more easily remembered, so it can be easier to rule out the things that you hate than picking the ones that you like, and that process of elimination can drag out the decision.
The act of actually choosing an option can be stressful for those with perfectionist traits, who experience anxiety over the possibility of making the wrong choice. If none of the choices are suitable, or the consequences are scary or undesirable, rigid thinking can also make it hard to let that go and move on to making a decision.
Tasks which exhaust our executive functions - like trying to focus attention away from distractions or process a flood of extra input - have been shown to negatively impact the ability to make decisions. Autistic kids and adults often spend a large part of their day on high alert, trying to maintain focus and deal with sensory overload. Decision making itself is a mentally exhausting task, so it’s understandable that sometimes there might not be enough gas left in the tank to complete the process.
5. Act on your decision
Once you’ve weighed up all of the options and chosen one, you need to do something about it. This usually involves some form of language or social communication (ordering the food you want) or motor skills (taking a piece of apple from the plate). Having challenges in these areas can make the act of choosing unrewarding - there's no point in making a choice if you can't act on it - and the mental exertion and stress can leave the brain too exhausted to properly process what to do next.
How can you help?
- Reduce the number of choices they need to make
- Offer choices earlier in the day when they’re less tired
- Use a choice board
- Avoid offering choices during times of stress
- Give fewer options to choose from
- Make the options visual and tangible
- Keep language simple
- Use nonverbal prompts where possible
- Allow plenty of time for decisions and don’t rush
- Don’t interrupt - not saying anything doesn’t mean nothing’s happening
- Allow them to communicate choices nonverbally (by pointing to it or picking it up)
- Practice comparing things, spotting commonalities and differences
Image from Flickr user Lori Greig
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