Helen is thirty-four years old. She was diagnosed with ASD and mild learning disability at the age of seven. She has good verbal skills and is literate, although her receptive communication seems lower than her expressive communication. Because of this, she tends to respond to questions from professionals with set answers that she has learnt will satisfy. She often responds to questions either with ‘mustn’t grumble’ or ‘nothing for me to worry about’. People who don’t know Helen often don’t notice that these are learnt responses. An interview, which uses open questions like ‘how are you feeling?’ will elicit these kinds of responses. Helen attends surgery with her support worker, who explains that he suspects Helen is depressed.

• Explain in the simplest terms possible what your role is and how you might be able to help Helen feel better.
• Ask Helen direct and specific questions to gain the information you need, e.g. ‘What did you eat yesterday?’ Rather than ‘How have you been eating?’.
• Seek Helen’s permission to question the support worker if necessary.
• As you explain your treatment plan, pause at regular intervals to check with Helen that she has understood and to give her time to ask questions.
• Ask Helen directly whether she has any questions as she may not feel able to do so without a prompt.
• Provide a written version of the treatment and follow-up plan so that Helen has something concrete she can take away and discuss with her support worker.