The autism label would be used less frequently, under a proposal by the American Psychiatric Association. I don’t know what this will mean for my daughter, but I do know what the label has meant.
The doctor who told us that Kai was on the autism spectrum immediately wanted to know how that made us feel. My gut reaction: “it seems like just a label.” I thought of my 7th grade friend Dave who was odd and couldn’t get better than Ds, no matter what he did. I thought of the third grader who I tutored in reading, who just smiled shyly and never read a word.
Yes, the doctor said, it’s just a label. Back when we were growing up, we just thought some kids were weird or slow. They got bad grades, lurked on the fringes, then grew up and figured out ways to fit in. Some became janitors. Some became investment bankers.
Having a label gave us ideas to make Kai’s maturation less traumatic. Her teachers know how to help her curb her nervous ticks. Her brother knows how to instruct her on interpersonal behavior without scolding. Her mom can predict melt-down situations and prepare to ease all of us through them. I can temper my concern about her academic progress by rejoicing in her unique spirit.
I guess the psychiatrists are concerned that autism labels are being handed out too liberally. I don’t think kids and parents care much what it’s called, but we do welcome the therapies that come with the diagnosis. Kai learned about personal space and thought bubbles in social classes. She learned self-confidence in a special skiing program at Breckenridge. She learned focus and drive through horseback riding therapy.
I think her teachers at Highland Elementary in Littleton would have developed a successful individual education program for her, regardless the diagnosis. But I think the label helped them fine-tune it.
The label helped us get some of her therapy covered by insurance because of a new Colorado law.
I worry that if the APA draws the label line differently that many families will be left to fumble in the dark.
Autism: What the label means to me and my daughter
Inspiring words on MLK Day
I am inspired by quotes. My all-time favorite, Margaret Mead:
Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever does.
Today, Martin Luther King Jr. Day, the controversy over an out-of-context quote at his D.C. memorial allowed TV annd radio to replay one of his best fire-and-brimstone speeches:
Yes, if you want to say that I was a drum major, say that I was a drum major for justice. Say that I was a drum major for peace, I was a drum major for righteousness, and all of the other shallow things will not matter.
Listen to it. What power he had.
I gathered a basketful of new quotes last week as the new CEO of the Hispanic Chamber of Commerce of Metro Denver rallied the board of directors and staff. Guillermo “Bill” Vidal, a Cuban orphan who became mayor of Denver, oozes inspiration and leadership. He shepherded a spirited discussion and marshalled the energy of 40 people.
He opened with a collection of his favorite quotes, which quickly found their way to my notes:
Leadership is the ability to translate vision into reality.
A ship in harbor is safe, but that is not what ships were built for.
A poor carpenter always blames his tools.
People don’t follow programs they follow leaders who inspire them.
If you see a snake, kill the damn thing. Don’t form a committee on killing snakes.
The Hispanic Chamber had a tough 2011, losing its former CEO to a domestic violence charge. But I left the two-day board retreat feeling like I joined an organization on the brink of greatness.
Former Denver Mayor Federico Pena challenged us to become the most powerful economic organization in Colorado. Then he quoted the state’s current lieutenant governor, Joe Garcia:
Quit thinking about our potential. It’s time to act on what is before us.
Speech of the devil: Words That Work
Imagine: I recommend reading a book by the guy who gave us “death tax,” “energy exploration” and the Contract with America.
Frank Luntz helps Republicans choose words that resonate with Independents. I held my nose and bought his book, Words That Work, hoping to learn the devil’s secrets so I could twist them to good use. I did learn a lot, including that I share many of Luntz’ opinions on words — especially his belief that the word “imagine” is the most powerful. “The word imagine … allows individuals to picture whatever personal vision is in their hearts and minds.”
Luntz’ most important point is contained in the book’s subtitle: “It’s not what you say, it’s what people hear.”
“Once the words leave your lips, they no longer belong to you. … When we open our mouths, we are sharing with the world—and the world inevitably interprets, indeed sometimes shifts and distorts, our original meaning.”
I was fascinated by the “dial sessions” Luntz uses in his research. Subjects hold dials that they turn to reflect their positive and negative reactions to speeches or ads. The result is wavy lines that help ferret out the precise words and phrases that work.
His research leads him to a few points that struck me:
When we in organizational communication construct an internal message, we routinely check off the “what,” the “so what” and “now what.” Luntz recommends we put the “so what” — the context and relevance — first. “You have to give people the “why” of a message before you tell them the “therefore” and the “so that.’”
When trying to demonstrate the concept of “value,” focus on the result rather than the process. For example, Luntz’ research shows taxpayers are moved to “reduce crime” (result) more than to support “law enforcement” (process). Additionally, “VALUE” = price + convenience + reliability.
Women respond more to stories and men more to facts. Men want to speak and women want to be heard.
“Respect is “the most important word related to how employees perceive their treatment and what they think of their employer.”
“In my research into the effectiveness of direct mail, the single most-read portion after the opening paragraph is the postscript.”
Luntz includes “patient-centered” among his words that work — validation for a term we use a lot at Kaiser Permanente. In fact, Luntz uses the Kaiser Permanente website as an exemplar of patient-centered language and imagery.
There isn’t much that separates what Luntz does and what I do. We both use language to advocate for a cause. And despite my headline and lead-in to this post, I don’t think he is evil. To me, his “death tax” is not so much inaccurate as maddeningly brilliant. I would call it the “Paris Hilton tax” and would be equally accurate (though less brilliant).
I think he crosses the line, though, when he dispassionately compares John Kerry’s weak words to the Swiftboat Veterans’ powerful ones. “Betrayal” is an appropriate attack word if the veteran is quarreling with Kerry’s opposition to the war he fought in, but not if the veteran is lying about Kerry’s war record.
I’m all for making words work. I’m against making them lie.
Some of Luntz’ words that work:
Imagine”
“Hassle-free”
“Lifestyle”
“Accountability”
“Results” and the “Can-do-spirit”
“Innovation”
“Renew, Revitalize, Rejuvenate, Restore, Rekindle, Reinvent”
“Efficient” and “Efficiency”
“Investment”
“Casual Elegance”
“Independent”
“Peace of Mind”
“Certified”
Here’s the Colbert Report bit with Luntz that lured me into buying his book.
Do you want to read my book, a chapter at a time?
Molly Barton, VP of digital publishing at Penguin Books, has me resurrecting my whacky idea to write the great American novel in serial form and in collaboration with readers. In a wiki. She writes in Mashable about crowd sourcing books online, giving undiscovered authors the opportunity to build audience and attract publishers.
I don’t know much about book publishing, other than that it’s harder to break into the publishing houses than it is to write a book. And writing a book is so hard that I have never gotten past Chapter 2.
Two drafts of those chapters lurk in an un-public area of this blog. I wrote them a couple years ago, with the idea that once I had four or five chapters finished, I would begin to reveal them a chapter at a time in a wiki, inviting readers to help make each chapter better. Kind of like Armistead Maupin’s Tales of the City, which he first published in serial form in the San Francisco Chronicle.
I would impose some guardrails so that the contributors don’t take the story too far from my vision. I’m sure I would reserve the right to reject changes, but I haven’t figured out how much poetic license I would give to contributors for the sake of the experiment.
A part of me recoils at the thought of putting myself out there over and over again. On the other hand, in the more traditional approach, I put years of blood and sweat on the line with just a handful of book editors. Do I want to be crushed all at once by experts, or tortured drip, drip, drip by readers? At least I would have readers.
Social networks: From campfires to Facebook
It’s alchemy: A group of people is greater than the sum of its parts. A hunting party keeps the tribe fed. A bucket brigade douses the barn fire. Thirteen colonies become mightier when they unite. An assembly line mass produces autos. A tech firm creates dazzling innovation. A Twitter community brings a despot down.
What’s the magic?
The connections, according to Nicholas Christakis and James Fowler, authors of Connected: The Surprising Power of Our Social Networks and How They Shape Our Lives. Study the ties between individuals and between networks, and you learn what makes them tick and how you might influence the individuals within.
The authors say social media technology renders the makeup and transactions within networks more transparent. This is good news if you’re working for a better world. Intractable problems such as obesity, poverty and social injustice may be better understood and addressed from a network connection framework, rather than a “fix the individual” framework.
The authors posit a Three Degrees of Separation Rule:
“Everything we do or say tends to ripple through our network, having an impact on our friends (one degree), our friends’ friends (two degrees), and even our friends’ friends’ friends (three degrees). Our influence gradually dissipates and ceases to have a noticeable effect on people beyond the social frontier that lies at three degrees of separation.”
Among the interesting implications: It may be more effective to influence individuals through their connections two or three degrees removed. Smoking cessation efforts could be targeted at people centrally located in a network, whether or not they smoke. They are more influential on the individual smoker than his/her doctor.
Where you do not have a good picture of the network, you may be more effective randomly targeting people within a network. For example, rather than immunize the weaker people in a network (who may be on the fringes and have less influence), you might ask random people in the network to name acquaintances, then immunize the acquaintances. The people who were identified are likely to be the better connected individuals in the group who would be the most susceptible and most likely to spread contagion.
One study proved that weight loss was 33 percent greater and also more durable when people were part of a group. The Connected construct further suggests an unusual strategy: bind friends of friends in a weight loss effort, rather than the more typical cluster of friends losing weight together. Not only would the network of second-degree connections spread the weight loss “contagion” more broadly, it would encourage long-term success because the participants will not be a small cluster of friends surrounded by a network of large people.
The authors see a direct linkage between the ancestral campfire and Facebook. Even before social media, behaviorists had determined the average individual had about four close connections and a list of 150 people whom they counted as friends (the so-called Dunbar’s Number). Interestingly, the typical Facebook user has six or seven close connections and 110 people on their “friends” list. In non-technical life, networks have three key roles: cooperators, free-riders and punishers – people who contribute to the “work” of the group, others who benefit from it and another set who keep the rules. The same roles are found in the Wikipedia ecosystem: people who post content, those who consume it and the committed band of editors who question statements and erase vandalism.
“We do not cooperate with one another because a state or a central authority forces us to. Instead, our ability to get along emerges spontaneously from the decentralized actions of people who form groups with connected fates and a common purpose. “
How about a Support Our Troops tax?
For the first time in our nation’s history, we went to war AND cut taxes. I propose a Support Our Troops Tax. Figure out the past, present and future costs of the wars in Afghanistan and Iraq and set a tax to pay the tab now instead of passing it on to our kids and grandkids.
I know taxes are really unpopular, but Supporting Our Troops is quite popular. People put yellow ribbons on their cars — magnetic ones so as not to mess up the paint. How can you not support a Support Our Troops Tax? We could tax gasoline, the price of which we control by being the Mideast police (how did all our oil get under their land, anyway?).
Or we could just stick it to the oil companies (who will then pass it on to us).
My favorite signs from Rally for Sanity and/or Fear
I looked at all 300+ signs submitted to the Huffington Post (I couldn’t stop!). Here are my favorites.
Imagine all the people: Living life in health
Four conferences over two weeks … there’s so much swirling in my head that I could write a post for each of eight different topics. But tonight I landed on a central theme after watching the video of Regina Holliday describe the painting she created during the Health 2.0 conference in San Francisco. She captures the most important takeaway from my two weeks of travel: I have joined a movement and I enjoy the company I am keeping.
Regina speaks and draws eloquently about the movement: The growing number of us who are taking charge of our health, our family’s health, our community’s health, and ultimately our country’s health. At the Health 2.0 conference, I met an engineer who also is an MD, an MD who is a geek, a geek who is a healer, and a healer who is a patient.
Alexandra Drane proclaimed: “We signed up to help people be healthy,” which I found remarkable coming from the founder of Eliza, which I thought of only as a robo-call company but now appreciate as a company committed to using technology to promote healthy behavior.
Michel Nadeau confided that his years as a telecomm engineer were nowhere near as fulfilling his new gig as head of a startup that makes an obesity app. “A teenager sent me an email. She was writing at midnight on a Sunday, asking for help because she couldn’t bear to go to school the next morning and face the teasing because of her weight. How can that not affect you? I know what we’re doing has real impact on people.”
Ob/gyn Jeff Livingston is motivating teen girls to take care of themselves by engaging them on FaceBook. Chris Cartter is trying to make health challenges go viral through his Change Reaction program. Physician Richard Wexler was talking to video game designers for insights on patient/doctor communication.
A few days later I was with my brethren at Kaiser Permanente for our annual gathering of communicators and marketers. We saw research that shows the marketplace is ripe for a health movement. Americans know that the health care system is broken, and they don’t trust the industry or the government to fix it. They know that ultimately the solution starts with them.
They just need a nudge.































“The Checklist Manifesto” has a hold on me
My organization has a Leadership Forum every quarter for 300 to 400 managers and supervisors. I’ve helped plan and put on more than 30 of them now. For almost every one, there was drama with the slides. This dates back to when slides really were slides — the kind that went up on overheads.
Let’s leave for another post the issue of Death By PowerPoint. Today, let’s talk about mastering the dumb stuff.
For our most recent Forum, we produced four video vignettes, prepped 13 presenters, including the CEO, the Medical Director and the Labor chief, coached 25 facilitators and lined up technology to videoconference the program to 37 locations. The slides were finalized less than 30 minutes before show time.
Next time, we use a checklist. Not just any checklist. A checklist like pilots and surgeons use.
Atul Gawande, the Boston rock star surgeon, says checklists ensure you don’t miss the dumb stuff — like making sure the cargo door is closed or the patient has had antibiotics within 60 minutes of incision. They help rule out the common mistakes so that we reserve our gray matter and adrenalin for the work we are meant to do.
Fact is, we had a checklist for Leadership Forum. One person tracked it and helplessly watched as more and more people got into the act, last-minute changes were made and the unexpected happened.
Our new checklist will be in front of all planners. It won’t be detailed like a recipe, but instead list those things that commonly foul us up: Has the topic been vetted by the right people? Have key presenters confirmed their availability? Have reminders gone out? Have the darn slides been submitted for review at least a week in advance?
There will be pause points: All planners stop, review the checklist and agree that it’s safe to continue on to the next phase.
These are the best practices described by Gawande in his book The Checklist Manifesto. Military pilots began to develop checklists after test pilots “augered in” with a bit too much regularity. Gawande led a World Health Organization project to try checklists in operating rooms large and small, rich and poor. Every single hospital saw dramatic reductions in infections and other post-op complications.
Mistakes may be rare in the OR, but the number of individual actions is so large that even a 1 percent error rate translates to a high probability that a patient will experience one.
A skyscraper is built by hundreds of engineers, craftsmen, accountants and laborers. They use a checklist, one that has periodic pauses at which the different disciplines get together to talk about variances and the adjustments to be made.
Gawande described the “submittal schedule” he saw posted in a construction trailer:
Gawande learned that checklists need to be tested in the real world. So that’s what we’ll do with our Leadership Forum checklist. I suspect it will evolve and improve as we go. And while we won’t prevent infections or building collapses, we’ll get the dang slides done on time!