Wednesday, September 30, 2009

Playing Outside

Playing outside is one of the core experiences we all remember from childhood, but all too often it doesn’t happen for kids with special needs like Asperger’s, autism and ADHD. And that’s really a shame, because outdoor play is often the easiest way for all sorts of diverse personalities, abilities, and ages to interact.

School politics can get very specific, with each child interacting with only the chosen few in a social clique. Different ages, groups and genders rarely mix at school. But kids aren’t quite so particular when it comes to neighborhood play. A lot of that just comes from opportunity. In neighborhood play, there just aren’t so many kids to choose from. It’s not uncommon for neighbors who’d never talk at school to spend days together at home, having a great time. There’s nothing wrong with this. Schools can be about cliques, but home can be much more open. Not every neighborhood friend has to turn into a best friend at school.
The great thing about outdoor play is that it’s unstructured. There aren’t rules like there might be in team sports, there aren’t even goals or objectives. Kids can just run around, invent new games and be creative. And that’s where kids with ADHD and ASDs can really shine. Their creativity and energy may make these kids the highly sought after playmates.
Why don’t you give it a try? Make sure your children are spending some time in the front yard where the neighbors can find them. Pay attention to where other kids live. Then, maybe your child can take the plunge. Parents have to step back here, but it’s easy to coach your child. Just ring the doorbell, ask for the child and say something really basic like, “Hi, I’m Matthew. Do you want to come out and play?” That’s it. That may be all it take for your child to interact with peers, spend time outside, and probably have a great time.

Friday, September 25, 2009

Getting the Job Done: Creating a Visual Plan

As I discussed in my previous post on managing procrastination and distraction, getting lost in the details can make it very difficult for anyone to finish, or even start, a project. For those with ASDs or ADHD, this can be even more troublesome. One technique I’ve found to be useful for many clients is to create some sort of visual plan of the project. Taking time to think about the goal, organizing the details, and jotting it down on paper will give you something to refer back to while working.

Here’s an example of a simple outline you might use to stay on track while completing a project. I’ve chosen the topic I’m working on right now: writing this post. (I’m typing this for the blog, but I’d only scribble it down in real life.)

Goal: Writing a Blog Post on Procrastination and Distraction

                    1. Reread previous post on this topic
                    2. Consider steps involved
                    3. Create examples:
                    A. Detailed list
                    B. Detail cloud
                     4. Find appropriate pictures to illustrate
                    A. Dog
                    B. Snack
                     5. Copy and paste document into blogging software
                     6. Create links and finalize details on blog
                     7. Publish
Here’s an example of a less structured detail list. You can make the more important steps larger and bolder.

Goal: Writing a Blog Post on Procrastination and Distraction

                    Find Pictures                                     Reread previous post
                                          Create examples   
                                                Publish                 Create links
                    Copy and paste into blogging software           Plan steps involved
That’s it! These are both pretty straightforward and it only took a minute or two to put them together. Now, while you’re working you’ve got a very clear idea of what you should be doing to accomplish the job.
If you decide to pet the dog:

or get a snack:

it’s pretty clear that you’re off topic. But, I think it’s more frequent that people get pulled into the details, and then wander around off topic. Finding a picture of an apple can turn into sorting through all the pictures in the photo library, or wandering from topic to topic in an internet search. That’s where the list helps. You’ve determined the goal: writing a post, and browsing internet photos has nothing to do with that. It’s a clear example of when you need to pull yourself back to work.

If you’re more auditory than visual, recording a list can be helpful. Whatever works for you is fine, just take a few moments to plan, set a goal, and then check back with your plan frequently.

Thursday, September 24, 2009

Using Behavior Charts

Raising a child with special needs like an Autism Spectrum Disorder (ASD), Asperger’s, or Attention Deficit (ADHD or ADD) is a challenge, and too often parents don’t notice all the progress they’re making. Instead the situation seems overwhelming and hopeless, and it’s as if things will never get easier for your family. The reality is that these kids do make progress. But, progress may come slowly, or in a “two steps forward one step
back” pattern that may obscure all the growth.  That’s where behavior
charts can be so helpful.
Behavior charts can be a great tool for keeping track of how your child is doing. They can provide feedback to teachers, doctors or therapists, and most importantly, they’ll tell you, the parents, how things are going. Free behavior charts can be found all over the internet and you can download a basic, easy monthly behavior chart on my website as well. Just find something to suit your needs, one that won’t be too much effort to fill out, but will provide you with the information you need.
If your child is on medication, charting behavior is crucial. Psychiatrists and pediatricians are terribly overloaded and appointments can be brief and infrequent. Track your child’s behavior, sleep, and school results, and make note of any special circumstances. Did your child start a new medication, forget a dose, have a substitute at school? Write that down. Bring the chart to the doctor’s office so they can see exactly what’s going on. Prescribing medication is very difficult and you want your doctor to have all the information possible.
Sometimes it can be very helpful for your child to have a visual measure of his or her own progress. If the chart is being used as a motivator or to track rewards, it’s best to find something bright and colorful. There are many attractive charts online designed specifically for different ages. Teenagers are not too old to benefit from a behavior chart! They provide a visual, concrete image that can be much more meaningful than a generalized comment. Just avoid childish graphics, and consider displaying it in a more private location.
After the chart is filled out, please don’t throw it out! File it away in a drawer and look back at it once in a while. Years from now you may be amazed to see what issues you were dealing with and how far your child has come. (For a few examples of successful individuals with diagnoses of autism, Asperger's or ADHD, check out these earlier blogs. Ari Ne’eman is an autism advocate. John Elder Robison, Blake E. S. Taylor, and Zosia Zaks are all successful authors with various diagnoses. Read the comments from jypsy on her son and his running blog, as well as links to her You Tube videos.)

Friday, September 18, 2009

Getting the Job Done

Many of my clients on the autism/Asperger’s spectrum really struggle with productivity and distraction and the seemingly simple matter of getting things done. Although this is an issue for neurotypicals as well, I find that distraction and procrastination can be a lot more challenging for those on the spectrum.

Frequently, procrastination and distraction can occur when people get caught up in details and lose sight of the big picture.That’s not surprising really, because one of the key traits of both autism and Asperger’s can be, as stated in the DSM IV, a “persistent preoccupation with parts of objects.” Uta Frith refers to this “detail focus” as Weak Central Coherence. While a detail focus can result in amazing achievement and the ability to work creatively and deeply, at the same time, it can lead to lots of activity with little output. Generally, work output does require the leap from detailed focus to a more general viewpoint. Sometimes individuals can afford to take the time to study, learn, delve deeply into an idea and see where the material leads them. But often, this drifting, detailed investigation can be nothing but a waste of time.

So, how do you move from the details to the big picture? With many of my clients I try to take advantage of their strength in visual processing. Create a graphic image of the project, listing all the details. Headline this image of details with a title explaining how all these terms relate. That headline is usually the big picture.The details can be organized in different ways, depending on how you think. If you’re logical and structured try creating a numbered, indented outline, with small details organized into bigger topics. If you’re more artistic than mathematical, a “detail cloud” may be more meaningful. This is similar to those keyword clouds that sometimes appear on the sidebar of blogs.

Whatever you create to explain your project, put it clearly on a piece of paper where you can see it at a glance. Ask yourself frequently, “How does what I'm doing relate to what I'm trying to produce?” and “What am I trying to produce here?” Confused? An example can mean a lot more than an explanation, so please check back for the next blog posting where I'll show some examples of these techniques.

Wednesday, September 16, 2009

An Invitation For My Readers

I’m wondering if my readers who have autistic or Asperger’s children can help me. I’m looking for your stories of success and hope. For years I’ve worked with autistic and Asperger’s kids and teens and their families. A lot of these clients are coming to me because they’re really in crisis. (Nobody goes to a therapist because things feel great!) The kids may be out of control behaviorally or overcome with emotional issues, the family may feel overwhelmed, and things can just feel hopeless.
At the same time, I know that this kind of negative situation is not always the case. Kids with ASDs, autism and Asperger’s can thrive, symptoms can be managed and families can learn to work together and flourish. That’s what I tell the parents I work with: things can get easier, it doesn’t have to always be this tough, your child can make tremendous progress.
I think that a lot of the parents feel better hearing that. But there’s something that would be more comforting and more inspiring than my reassurances - and that’s your reassurances. As parents of kids on the spectrum, you have a wealth of experience, knowledge, and wisdom. You’ve lived with your kids every day, and seen them grow, learn, and develop. And from my experience, parents of kids with special needs seem to be especially generous with their support and sharing their knowledge with each other.
So, if you’d like to share your success stories with other parents, talk about how things have improved for your kids, or just send words of hope to someone who may not be as far along the journey as you are, please do so here. You can email me, comment right here, or attach a trackback to your own blog. Thanks! I’m looking forward to hearing from you.

Thursday, September 10, 2009

Books for Asperger’s and Autism

I’ve added a new side bar to this blog, showing some of my most frequently recommended books for adults with Asperger’s or autism. You can get lots of information online, but for more in depth knowledge, a book might be the solution.

Certainly the most well autistic writer is Temple Grandin. Grandin’s strength is how clearly and personally she describes her own experiences and the creative ways in which she’s built a satisfying and successful life for herself. Grandin is willing to make her own choices about how to balance career and social issues.

If you’re new to Asperger’s, the most complete source of both general and detailed information is probably from Tony Attwood. (Much of his writing applies to autism as well.) Attwood has an easy writing style, and he covers almost any topic you can imagine. The best aspect of his writing is how thoroughly Attwood’s statements are documented. I often use Attwood’s books as a starting point to research a topic further.

Getting a diagnosis as an adult is a complicated issue since the best known measures were created for children. I often send adults to the self test in the back of Simon Baron-Cohen’s The Essential Difference. From there, you can make your own choices on further evaluation. Baron Cohen has published his research extensively and this book is both thorough and interesting.

For information on managing depression, which is very common for those on the spectrum, I recommend David Burns’ The Feeling Good Handbook. This book isn’t a substitute for professional care, but does describe in great detail a Cognitive Behavioral technique for managing depression.

The most troublesome issue for many adults on the ASD spectrum is managing sensory issues. I often send readers and clients to Zosia Zaks’ Life and Love: Positive Strategies for Autistic Adults. Zaks also has a full range of recommendation for everything from  daily life activities to social and romantic issues.

If you’re looking for a more specific book on Asperger’s or autism, a good starting point is the Jessica Kingsley Publisher’s website. They have an extensive list of books on many special needs topics.

Thursday, September 3, 2009

Are You Off to a Good Start with the School Year?

Here in the East Bay, most schools are in the second week of the new school year. It’s a stressful time, because everyone is dealing with a lot of change. This time of year can be especially difficult for kids with ASD’s like Asperger's or autism, or attention issues like ADHD or ADD. Routines are not yet established, teacher expectations are uncertain, and social issues are constantly changing. With all this going on, it really pays off to check in closely with your kids.

I worked with kids for years, both as a therapist and in the schools, and from this I know that the most proactive parents get the best results. It’s a hectic time of year, but a little extra effort now will pay off. In my experience, teachers and principals really are trying. But, budgets are tight, there may be misunderstandings, there are too many kids and not enough time. No one is as motivated to help your child as you are. Here are a few early check-in points.

1. Does Your Child Get the New Systems?

Homework, bringing home books, using the library, getting extra help, lunchtime routines. Every year the rules change a bit. It can be very confusing for any child. But, now is the time to make things clear. Maybe you can run through your child’s day and make sure there’s no confusion.

2. Are Friendships Starting Up?

I can’t stress enough that the beginning of the school year is when most kids shift friendships. It happens gradually, but the groundwork is being laid now. Help your child maneuver through these confusing changes. Just talking about it can help make things clear. Teachers can be a great resource when there are problems.

3. Monitor the Situation

Are there potential issues showing up early? Maybe you won’t want to do anything, but just pay attention to it. Or, if the problem is severe, catching it early can allow you to make a quick fix, like a classroom transfer that won’t be possible in a few months.
Of course, you shouldn’t be combative with the school, after all they are responsible for your child for hours every day. But that doesn’t mean you can’t track things carefully. Jot down private notes if you’re uneasy about a school situation. If things get worse, you’ve got some data, and if the problem goes away, no harm done. Too often, I see parents frustrated by months of difficulties, and only then do they start to document the details. An entire school year can be lost when that happens.
Pretty soon, things will settle into a routine and it's going to be a lot easier!

Tuesday, September 1, 2009

Book Review: ADD-Friendly Ways to Organize Your Life

Adults with ADHD really struggle with managing the daily aspects of their lives. Those with Asperger’s and ASDs often have issues with ADHD or executive functioning as well. For all these individuals, the tips and strategies in ADD-Friendly Ways To Organize Your Life, by Judith Kolberg and Kathleen Nadeau, Ph.D. (Taylor & Francis Group, 2002) may be useful.

The book attempts to provide strategies, accompanied by what the authors term support and structures, to manage various organizational issues every adult faces. The premise of this book is that those with ADHD may not do well with the intense, detailed organizing ideas presented in many other organizing books, but that simple structures, accompanied by support from friends, family and professionals, can result in effective changes.

The book is broken down into chapters for those who are troubled with different aspects of disorganization, such as overcommitment, waiting until the last minute, dealing with clutter, and managing bills and money. For each area, a simple plan of organization is offered, although it’s probably not a lot different than that of many other systems. The ADHD twist of this book is then in adding support in the form of assistance from friends, family or professionals. Although this could be useful, it may be unrealistic to expect a friend to sit by supportively watching as an adult sorts through monthly paperwork. I wish the book had focused more on helping adults grow and shift from using the support of others to developing independent ways of functioning in the long term.

Still, in spite of these shortcomings, the book does offer many useful tips. I especially like the limit setting tips, such as for every item or activity you add to your life, first you need to subtract one item or activity that you already have. In the chapter on prioritizing, the advice calls for limiting the to do list to 5 items only, and each should be done today.

The authors also are quite clever in utilizing the creative strengths of those with ADHD. Their “muttering” filing system uses file labels such as “Why can’t I find this when I need it?” and “I have got to call these people!” They suggest cleaning the garage to organize it in the same way a hardware store would be organized.

Like most organizing systems, adults with ADHD will not find all the solutions in one place, but they may find a number of useful tips.