LVAC for Asperger’s

If you have a child or a spouse with Asperger’s Syndrome, or if you yourself think that you may be an “Aspie”, you may find the following interesting and useful.

One of the major issues and challenges for adults and children with Asperger’s is their inability to accurately interpret and modulate their anxiety and the environment around them. They are often stuck in a vaguely defined distress- or pre-distress-fraught emotional space, trying to identify or make sense of what’s happening around them or to them at any given moment.

LVAC is a Technique I invented to maximize empathetic communication. It was designed to help you meet the other person where they ARE emotionally rather than where you THINK they are.

My point in writing this is that I think that this skill translates very well to communicating with an Aspie, where empathy—or really trying to be accurate about your understanding of where they are emotionally—can be an extreme challenge.

So I am going to briefly explain the LVAC Technique, then I’m going to share some observations I have made, either directly or indirectly, about how the Technique can be adapted for use with a child or adult with Asperger’s. (Note: I am NOT going to get into any neurophysiology, neuropsychiatry, neurochemistry, or neuroimaging, as you can easily read up on these topics these days on the internet. I am also going to stay away from neuroanatomical terminology as it is not necessary for what I want to share with you.)


LVAC stands for Listen, Validate, Ask, Comment.

The gist of it is to hold your Comments for last. These Comments might include: 1) immediate answers or “solutions” to what YOU perceive to be the problem, 2) telling the person what YOU would do, 3) making a judgmental statement, and 4) asking a closed-ended question where the answer is already in the question. (e.g. “You’re not wearing that are you?!”)

Some Examples of the Uniqueness of the Aspie

Okay, now I want to share with you what I’ve learned about a few differences in trying to Listen, Validate, Ask, and Comment with those on the spectrum.

Number One: You are dealing with a human being who is fundamentally wired differently than most of us. Given any stimulus, (noise, color, voices, depth, human emoting), what may occupy YOUR central attention very likely is NOT the main focus for them. So, for example, if you are focused on color, they may very well be focused on shape or height or sound. If you are focused on the calming nature of something, they may be tortured by the anxiety-provoking nature of that very same thing (and vice-versa).

Number Two: Their anxiety, worry, and fear triggers—and how they overcome them—may well be VERY different from what they are for you. Something which you might be able to overcome quite easily or with some soothing words or touch may stick very hard for an Aspie. Worry can become obsessive and extremely threat-laden for someone with Asperger’s, so that when you are trying to soothe them, you have to be cognizant of this heightened vigilance to a threat that you may very well NOT be perceiving. (e.g. A television program in a doctor’s office, a song on the radio, or a smell in the air like a woman’s perfume may trigger an anxiety, worry, or fear  response deep in the emotional-modulation parts of the Aspie’s brain which you may not perceive or understand.)

Number Three: And speaking of the above, what might calm a non-Aspie down may very well further agitate someone with Asperger’s—e.g. Saying “you’re just going to feel a bit of ‘pressure'” may trigger a whole cascade of vague, undefined, and dark worry about what this word ‘pressure’ is supposed to mean in the context of getting an injection, causing a higher threat response. Becoming angry, incredulous, or indignant with their reaction or noncompliance will further agitate them. The more you display how frustrated you are with them or how much you DON’T understand what’s happening to them, the more torturously lost, abandoned, and desperate they are feeling. Given how already tenuous is their hold on feeling connected to you or to their environment in the first place, it doesn’t take much for an Aspie child to escalate verbally or physically once they start falling into the abyss of further disconnect from you and from their environment.

LVAC for Aspies

So then, LVAC for Aspie = more creative, more effort, more inductive and deductive thinking, and, most of all, more heart. Maybe we’ll call it The Ultimate LVAC!

Practicing the LVAC Technique with anyone is difficult enough, because it goes against our nature to Listen first, Validate next, (instead of answering, ‘solving’, or judging—all are Comments), then to Ask open-ended questions that give the person space to talk, and, finally, to save our Comments for last.

With an Aspie, it’s going to take everything you’ve got.

Listening with Your ‘Aspie Ear’

You’re going to need to Listen with both of your ears, plus your third ear, what I call your Aspie ear.

The Aspie ear doesn’t just hear within the context in which you’re used to hearing. It hears on a much, much broader scale.

When Listening to a person with Asperger’s—and this includes observing them even if they’re not actually communicating verbally at the time—you’ve got to think of AS MANY POSSIBILITIES AS YOUCAN about what they are actually saying with their words or their behaviors. It’s kind of like when we physicians make a ‘differential diagnosis’: we list out all the possibilities of what might be causing the patient’s presenting symptoms.

Your Aspie ear doesn’t just ‘hear’ what is said or done; its intention has to be to hear what the Aspie may actually feeling or communicating.

You’re going to Listen like you’ve never listened before. You’re going to be Detective Columbo and your Aspie ear is your tool.

Sometimes you’re going to hear a very concrete, direct question, thought, or feeling, and that’s fine.

But, at other times, what you’re going to hear is actually what I call a ‘derivative’ of what’s really going on. This means, for example, that you may be THINKING that you are hearing happiness or silence, but what you are really hearing is worry, increasing anxiety and disconnect, and a pending outburst.


Validation is very closely related to, and very often produces, both a calming effect and soothing in a person.

For a person with Asperger’s, this is especially important as it can prevent escalation of their anxiety, worry, or fear reactions.

It can also be exceedingly difficult, especially if you haven’t used your Aspie ear to first identify what is really happening for your Aspie.

What can be validating to one person, can be quiet invalidating to another, depending upon how closely we’ve Listened to them and to their heart to begin with.

For someone with Asperger’s, a random, uninformed, hug, touch, or word, may very well cause greater distress.

Asking vs. Commenting

In order to Listen and to Validate the best we can, we often need to Ask one or more open-ended questions in order to learn more about what the other person is going through at the moment.

This can be especially challenging to do with an Aspie, as they may not have a clue themselves as to what they’re feeling or why—they may just be in distress.

This is why asking OPEN ENDED questions is the best approach, because it will hopefully encourage and entice the Aspie to talk more so you can Listen more with your Aspie ear.

Examples of open-ended questions: “What’s up?”, “How are you doing?”, “Can you tell me more?”, and, “What are you thinking about?”

Notice how I’ve stayed away from asking “How are you feeling?” This is generally a very low yield question in general, and especially with someone on the spectrum. Instead, appealing to their thoughts rather than directly to their emotions tends to get the conversation moving more smoothly and productively.

Lastly, try to stay away from too much assuming, random guessing, or direct Commenting with your Aspie, as this can be almost immediately toxic and anxiety provoking for them.

Instead, use the approach I’ve described, which can be used with anyone, not just those with Asperger’s, but tweak it the way I’ve described and observe for yourself the differences in your interactions with your Aspie.

I’d love to hear about your own experiences, so please make comments to this post, on whatever website you may be reading it.

All the best,

Anthony Ferraioli, M.D.

Author, Don’t Get Married! (Unless You Understand A Few Things First)

                LVAC Nation!

                Cobwebs and Ugly Wallpaper


5 thoughts on “LVAC for Asperger’s

  1. You posted this JUST for ME!!! 🙂 I’m sure I’ll have lots more comments in a few but I have to SHARE the heck out of this first and then do a couple projects I have due for MY school and then I’ll come back and read this and let you know my opinions!!!! 🙂 YAY ASPIES!!!

  2. What’s up? works well with my almost twelve year old. I get so much more information and I don’t lead him that way. He told me he was fine when we were filing his nails the other day. He clearly was not fine. He went on to say it was ok, just felt like when someone sharpens the metal end of a pencil…eeeeek! Now I understand the squirming! We got it done quickly. He is a great kid, just wired different. He is one of the most kind and sincere people I have ever known.

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