Prompt dependence:
Does it affect intimate adult NT/ASD relationships?

A marriage is “the legally or formally recognized union of a man and a woman (or, in some jurisdictions, two people of the same sex) as partners in a relationship”, "a happy marriage" according to Cambridge Dictionary. It is a state sanctioned partnership which in order to work successfully requires sharing, mutual problem solving by agreement, negotiation and compromise. Each party adapts equally and fairly to the needs and lifestyle of the other. Each party adopts a spirit of mutual, positive, supportive behaviour to keep the partnership moving forward making the experience fulfilling and loving for both. There are expectations that the “vows” given during the ceremony will be faithfully carried out.

A legal contract between two people also requires that both parties disclose any necessary information or impediment that would affect their ability to efficiently and willingly carry out the duties involved in that partnership. Without the necessary disclosure by one party who is/was unable to fulfill their 'marriage contract' obligations because of a neuro-bio-developmental disorder/disability/condition, the contract could be construed as obviously meaningless.

Prompts are clues given to someone as to what to do next or how to do something. They can be in the form of verbal prompts or instructions; physical prompts such as a nudge; modelling so the other person can copy your movements when doing something such as woodwork; written instructions such as a list. The prompt can be as simple as “There’s someone knocking, please open the door” to much more complex processes.

The idea is that the person being prompted will learn that skill and be able to reproduce it independently next time or very soon, when they next do the same task.

There is also the expectation that the skill learned will be generalised to new situations and used, perhaps in a modified form according to the context of the task or situation. An innate knowledge of Theory of Mind, empathy and ability to know what it’s like be in someone else’s shoes is vital, in fluid, ever changing social and day to day situations both inside and outside the home. Awareness of the importance of various events and occasions, whilst prioritising these is vital.

These prompting processes work well with neurotypically developing children and the prompt can be removed or faded as the child’s development grows.

When a child has autism/high functioning autism, by definition, they are unable, to generalise the learning to another situation and are context blind. They lack Theory of Mind and the ability to adapt immediately to the complex interactions in social and family situations. In fact, they may never reach the required milestones to accomplish these attributes.
Regarding a marriage/partnership this lack of ability to learn something new and adapt to appropriate contexts is a major issue. It is about what the adult with ASD (by definition) is unable to do and as a result what the spouse without ASD must do, to have the necessary outcome achieved. This is necessary for the good of the couple and family life because each person’s appropriate support is essential for day to day living, happiness and enrichment of life.

The person with ASD is often overloaded by the simplest of day to day functions in a family due to the failure of achievement of mature developmental milestones. The neurotypical spouse has tried every avenue to help without success.

Life with an adult on the autism spectrum is filled with examples where other family members need to constantly prompt the adult with autism so everyone else can have a more harmonious family life. This ability and knowledge of how to seamlessly fulfill the requirements of home life and be a positive contributing member is mostly missing from the schema* of an adult with ASD unless prompted by other people.

The need to constantly prompt an adult spouse who is on the autism spectrum in order to have them fulfill at least some of the requirements of a responsible adult and possibly parent, at home, is exhausting for the neurotypical spouse. It is a relentless round of essential prompting behaviour on the part of the neurotypical spouse to maintain the household. The adult with ASD often becomes resentful at being required to do things they don’t want to or don’t know how to. Continuous prompting is stressful for the neurotypical spouse and the spouse with autism may become passive-aggressive and/or controlling as a result of the expectations they see no need to fulfill.

When someone is unable to extrapolate, generalise and is context blind it is time consuming and frustrating for everyone as someone else needs to constantly give instructions to the person with ASD to fill the gaps in their skill set. People with ASD will also spend a lot of time copying and mimicking what their spouse/partner does or how they solve their problems. The suggestion from experts that to “fix” the relationship the only thing needed is for the neurotypical to follow a list of instructions themselves, such as: speak clearly and literally, give one instruction at a time, ask for hugs or a goodbye kiss, is absolutely ludicrous. Now both parties are hamstrung and at the mercy of constant prompting of themselves and the other party. This does not make sense.

The adult spouse with autism is just that: an adult with adult responsibilities and as such, has deep responsibility for the well-being of other members of the family, just as the neurotypical adult spouse does. It is impossible in many neurotypical spouses’ experience to maintain the level of prompting required naturally or suggested by counsellors and experts in autism spectrum disorders, when the other adult is unwilling or unable to carry out the required tasks.

Therefore, the only possible solution to this obvious stress is for the neurotypical spouse to leave their autistic partner alone, unprompted and unassisted unless there are dire consequences for the other family members as a result of the decision not to prompt. Allow the autistic adult to solve their own problems.

Adults with varying degrees of autism have been marrying and having children since Time began. It has only been within the very recent past that adults with autism were recognized. There is no cure for autism. For neurotypical family members, this fact is sobering. Change and growth within the adult spousal relationship is almost impossible whilst the need for continuous prompting by the neurotypical is present. Without support and assistance the future looks bleak for NT-ASD intimate relationships.

Definitions:

*Piaget described schemas in the early stages of development as mental representations or ideas about what things are and how we deal with them beginning in infancy. He also proposed that as we grow and develop we broaden our schemas with each new experience or situation we encounter. Failure to achieve the required mature developmental milestones by adults results in a failure to adapt to new situations easily.

When Piaget talked about the development of a person's mental processes, he was referring to increases in the number and complexity of the schemata that a person had learned. To Piaget, cognitive development was a progressive reorganization of mental processes as a result of biological maturation and environmental experience.

 A schema can be defined as a set of linked mental representations of the world, which we use both to understand and to respond to situations. According to Piaget, children are born with a very basic mental structure (genetically inherited and evolved) on which all subsequent learning and knowledge is based. Jean Piaget (1952; see also Wadsworth, 2004) viewed intellectual growth as a process of adaptation (adjustment) to the world.

Wadsworth (2004) suggests that schemata (the plural of schema) be thought of as 'index cards' filed in the brain, each one telling an individual how to react to incoming stimuli or information. The theory explains the mechanisms and processes by which the infant, and then the child, develops into an adult who can reason and think using hypotheses. 

According to Piaget (1958), assimilation and accommodation require an active (and also able) learner, not a passive one, because problem-solving skills cannot be taught, they must be discovered.

Critique:
Are the stages real? Vygotsky and Bruner would rather not talk about stages at all, preferring to see development as a continuous process. Others have queried the age ranges of the stages. Some studies have shown that progress to the formal operational stage is not guaranteed. For example, Keating (1979) reported that 40-60% of college students fail at formal operation tasks.

References:
www.simplypsychology.org/piaget.html by S McLeod
Bruner, J. S. (1966). Toward a theory of instruction. Cambridge, Mass.: Belkapp Press.
Vygotsky, L. S. (1978). Mind in society: The development of higher psychological processes. Cambridge, MA: Harvard University Press

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