That’s MY Arm

I have the good fortune of spending time every week with dozens of individuals diagnosed with autism – toddlers, children, teens, and adults. Among other things, it is interesting to see the consequences of their interpreting language literally. Here are a few examples from the past few weeks.

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A teenager with autism was in the doctor’s office for a check-up that required a blood test. The nurse looked at the youngster and said, “Can I have your arm?” The teen turned to the nurse, and, with a puzzled look, said, “No, that’s MY arm.”

On the medical front, one of my long-time students took the facts and figures he learned in his high school health and nutrition class to heart. He counts every gram of fat and sugar, exercises faithfully, and is very uncomfortable with his family members who do not strive for the same perfection. He has been known to throw away unhealthy foods at his home and even at my home when he comes for music therapy in the late afternoon. He shocked a young mom in the store when he stopped her as she was picking up some popcicles for her children, telling her about the problems with eating “sugar water colored with unhealthy red dye.”

A student in elementary school is always eager to help when I come to her classroom for a weekly group music therapy session. Today I looked at her and said, “Suzanne, run over to the door and get my guitar.” She looked up, hesitated for a moment, then broke out into a headlong run toward the classroom door.

A teacher told a restless, squirmy fourth grader he could not go outside until he finished his math problems. Several minutes later, the school had a fire drill and the student refused to go outside. He had not yet completed the math problems, and he took his teacher’s words literally about finishing his work before going outside.

When he got distracted while playing piano during music therapy this afternoon, I reminded a youngster to “look at the music.” I was implying that he needed to look at the written page so he could know what notes to play next, but he took the words very literally and looked very intently at the piano keyboard. After all, I said, “look at the music.” ☺

TIP FOR THE DAY: These are just a few examples of the many times in a day I see individuals with autism get out of sync because of their inclination for interpreting words and phrases literally. Some are very sensitive to their misinterpretations, so our best response is to quietly state guide them to the correct response or to encourage them to be flexible.

NOTE TO READERS AND LISTENERS: I am Cathy Knoll, a board certified music therapist and long-time friend of many folks with autism. At we are committed to providing free, practical, everyday tips for making life better for people with autism. Feel free to send me a confidential email at with your thoughts or challenging situations or innovative solution. And don’t forget to check out our website for a wealth of ideas and a glimpse into the world of autism.

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