Wednesday, May 29, 2013


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Saturday, May 25, 2013

Summer Social Skills

Now that school is getting out for the summer, your family’s schedule may be a lot more relaxed.  If your child has special needs, such as an Autism Spectrum Disorder, Asperger’s disorder, ADHD or ADD, organizational and executive functioning issues, or problems with social skills, the school year may have been extremely high stress. It’s great to be able to enjoy this more unstructured time, spend more time together as a family and take it easy. Without the pressures of school and homework, now is also the perfect time to help your child improve social skills for the upcoming school year.

If your child has been struggling with friendships, the summer months can be a great time for unstructured playdates. Many outdoor activities, such as playing in the pool, riding bikes, playing with water balloons or kickballs, are less organized and subtle than more conversational, indoor games. These can be a great opportunity for your child to interact with peers and have fun too.

If your child struggles with basic athletic skills, such as swimming, bike riding, running or kicking, or even climbing on the monkey bars, the summer can be a time to work as a family to improve these abilities. Some kids really dislike sports, and have no interest in doing these types of activities, but school playgrounds do revolve around games. If your child can manage to participate, a new social avenue is opened. Kids who aren’t skilled at sports often don’t join in, and then their skills get even further behind. Playing as a family can remove the pressure that your child experiences in peer play.

For kids who have spent the school year struggling with organization, the summer is the chance to catch up and get ready for next September. Work together to remove all of last year’s papers and books. Clear the desk and drawers so you have room to work in a more organized setting next year. This may seem far removed from social skills, but remember that the faster and more efficiently your child can finish homework, the more time there is left for other activities.

Be sure to keep all these activities light and fun. Kids with special needs have worked hard all year, and so have their parents. You all deserve some time to enjoy each other.

Image attribution:
By Jairo [CC-BY-2.0], via Wikimedia Commons

Book Review: Late, Lost, and Unprepared

Late, Lost, and Unprepared: A Parents' Guide to Helping Children with Executive Functioning ,by Joyce Cooper-Kahn, Ph. D. And Laurie Dietzel, Ph. D. is, yes, another book on helping kids develop executive function. But that’s not necessarily a bad thing. Different books (several of which I’ve reviewed here) on the topic offer similar ideas, but the details vary and one book may work better for your child than another.  The first part of Late Lost, and Unprepared thoroughly explains executive function, breaks executive function down into a list of specific skills, and discusses the developmental aspects of executive function. If this is the first book you’ve read about helping your child, it’s certainly worth the time to read this carefully.

 The second half of the book, “What You Can Do About It”, is of value even to those who have read a number of other books on the topic of executive function. This book’s strength is in breaking issues down methodically. As a former engineer, I know that the best way to get to a solution is to deal with a series of simple issues, rather than one overwhelming problem. This book helpfully lists very concrete, specific issues for each category of executive functioning. For example, one chapter about impulse control addresses specific problems like interrupting others, hitting others, and running off in stores.

A strength of this approach is that the authors present both short term and long term solutions. This is what every parent needs to remember, that executive skills improve with growth and maturity. While short term solutions stop disasters from happening, longer term solutions are what will be truly valuable to maturing individuals.

Another strength of the book is that it discusses how parents can advocate for their child. It’s ideal for every child if all the people dealing with him can be working toward the same solutions.   This book makes that idea straightforward and easy to figure out.

Autism Spectrum and Sex

Sex is a topic that isn't frequently discussed in connection to Autism Spectrum Disorders. There are a few books and several websites, but in general,  sex is often an issue that gets overlooked. In the book Asperger’s From the Inside Out, author Michael John Carley discusses how issues around sex can be difficult for many adults with Asperger’s.  Sensory issues, inadequate sex education, and difficulties with social skills can all contribute to problems in establishing and maintaining a healthy adult sex life. Therefore, I thought this topic would be a good place to turn to an expert.
In this repost of an earlier entry, I’m conversing with Isadora Alman, a Board certified sexologist and a California licensed psychotherapist and counselor. She’s the author of "Ask Isadora," a syndicated advice column on sex and relationships, which appears in newsweeklies nationwide, as well as the Sexuality Forum website.
Patricia Robinson: For starters, can you please explain exactly what a Board certified sexologist is, and how they work with clients?
Isadora Alman: As you know, the state of California licenses people helpers of several sorts: psychologists, social workers, and marriage and family therapists.  All have their areas of expertise in people helping.  There is no licensing for those who make sexuality their specialty so there are several professional organizations such as the American Association of Sex Educators, Counselors and Therapists and The American Board of Sexology who review the professional experience and expertise of those who do specialize and give them certification.
A sex therapist or a sexologist (one who studies sexuality) will be knowledgeable in relationships and in sexuality because one generally takes place within the context of the other.  I might work with clients who have little or no sexual knowledge or experience, making referrals and offering resources to gain know-how and confidence.  If a client's sexual expression is not as satisfying as it might be, I will work with him or her in making suggestions to improve knowledge and skill.  And, since communication is a very important part of finding a partner and enjoying sexual expression, I will also help with that.
Patricia Robinson: I think lack of sexual experience and lack of confidence can be common issues for adults on the autism spectrum, maybe those who didn't get to experience dating and relationships when they were younger. How would you help a client who feels less experienced than peers?
Isadora Alman: For social skills I don't think there's anything better than a mixed (men and women) support or therapy group.  There's is almost always one nearby anywhere in the Bay Area.  There one can get information, support and feedback from others without going on an actual "date" until s/he is ready.
In matters of sexuality I strongly recommend educational explicit films put out by folks like the Sinclair Institute that show and teach all manner of sexual expression.  I recommend a massage course to learn how to touch and be touched.  I recommend weekend workshops such as the Human Awareness Institute's "Love, Sex & Intimacy".  If a client would like, I can also make a referral to a sexual surrogate partner of either sex to learn hands on skills.
Patricia Robinson: There is so much information on sex on the Internet, and there are many different types of people to work with. (Therapists, medical doctors, sexologists, surrogate partners.) How can my readers be sure that they're getting good, educational and ethical information and help, and not just wandering into a misleading or exploitive situation?
Isadora Alman: The Internet is full of misinformation, it's true. Anyone can post anything. Unfortunately, there also exist people with degrees who may act unethically or have their own agendas, but usually membership in an accredited institution such as the American Medical Association or the American Association of Sex Educators, Counselors and Therapists is a fairly reliable endorsement.  The very best endorsement is a referral from someone you know and trust who has used that person's services before.  Ask around.  Ask other professionals you trust to recommend someone. Sometimes the same name comes up as a resource from several sources.  That's a good indication that this person is respected in his or her field.
Patricia Robinson: Isadora, thanks so much for talking to me on this topic. I’m sure this is an article that will be useful to many of my readers.

Dealing with Anxiety

When is anxiety helpful, and when does it tip into that realm of being so distressing that it’s overwhelming? For many individuals, anxiety is too much and it prevents them from making good choices. All they want is for the anxiety to go away.

But the reality is that some anxiety can be a good thing. Anxiety alerts us that something is wrong, that something needs to change. Anxiety catches our attention. The key is knowing how much anxiety is the right amount. Anxiety needs to be managed so we’re focusing on what we need to do, but that it’s not shutting us down completely.

I think of anxiety management as a two pronged approach. Sometimes, it’s important to deal with the emotion, bringing anxiety down so that more rational thinking and behavior is possible. In other cases, the goal is to be practical. Listen to what the anxiety is saying and take steps to remedy the situation.

Frequently, the first step in managing anxiety is simply being aware of it. Once you're is aware of anxiety, simple steps can be taken in an attempt to bring it under control. For many people this involves deep breathing, progressive muscle relaxation, and general awareness of the body. Once the anxiety is at a reasonable level, it makes sense to move into a practical realm. Look at the situation causing anxiety, consider if you're avoiding actions that could improve the situation, and see if simple practical means would be helpful.

For example, if you are worried about your tires, it makes much more sense to have them checked or replaced then to do anxiety reduction techniques. For some people, there can be a lot of anxiety and avoidance around taking these practical steps. That's the time to do an initial anxiety reduction technique, then it's appropriate to move into the problem-solving mode.

The real key to anxiety management is to continually be thinking about what you really need. Do you need to manage your emotions, or do you need to take steps to fix your problems?

Wednesday, May 22, 2013

Passive, Assertive, and Aggressive

I frequently work with clients, both kids and adults, on the theme of passive, assertive and aggressive.This is an easy way to calibrate behavior in tricky situations, and a good way to interpret the behavior of others.

My desktop dictionary defines passive as “accepting or allowing what happens or what others do, without active response or resistance.” Assertive is “having or showing a confident and forceful personality,” and aggressive is “ready or likely to attack or confront.” I like to think of these three words as defining a continuum, with the passive end considering only the needs and desires of others, and the aggressive end as defending one’s own rights solely, at the expense of others. Assertive fits neatly in the middle, standing up for oneself while still considering others.

In most situations, it pays to lean in the direction of assertive behavior. Speak up for yourself, ask for what you want, object to the things you don’t want.

Orion and JFK Transitions Seminar

The transition to adulthood is probably the most uncertain stage in the life of a special needs individual. There are support services and a fairly well defined path available for children and teens, but after high school many young adults flounder. In this post, and my next, I’ll be discussing several good programs to assist in transition planning.

Orion Academy, along with JFK University, is offering their 6th annual ASD Transitions Seminar. The seminar will be held at JFK University, in Pleasant Hill, CA, on Saturday, March 10, 2012, from 10 am to 4 pm. There will be a number of speakers, on various topics of interest to parents of transitioning or soon to transitioning teens, as well as vendors and exhibitors. You can register or get more information at the JFK website. Space is limited!

Book Review: George and Sam

I review many books on this blog, mostly because I love to read, and I want to share those books that I find compelling or interesting. There are many books written by parents, chronicling their personal journeys of raising autistic children, and I’ve read and enjoyed a lot of them. But, after so many examples, I’m now looking for these first person accounts that bring something a bit different to the reader.

George and Sam, Two Boys, One Family, and Autism , by Charlotte Moore, 2006, is just that book. The author discusses her life with her two autistic son, George and Sam. With two sons, there’s plenty of opportunity to explore how one diagnosis can be both the same and different in two individuals. With the addition of Moore’s youngest, neurotypical, son, Moore has even more room to consider just how autism and personality intersect.

One area where Moore excels is in examining how her autistic children play and deal with the world of imagination and fantasy. Her precise attention illuminates just how autistic play can differ from neurotypical play with the same toys. Moore was already an author and journalist before the publication of this book, which is based on her column about her sons. Because of this daily examination, Moore seems to write from a present tense noticing, rather than looking back and trying to remember just how her boys behaved.

Throughout the book, Moore maintains her humor and obvious affection for her sons. We don’t just hear about how she enjoys her children, she clearly demonstrates it on every page.

The GRASP newsletter, one of the best sources of information on any autism topic, recently published an excerpt from the the newest edition of this book, where Moore revisits her life with her now grown sons.

Working for a Boss on the Autism Spectrum

Back in 2008, I posted about working for a boss with Asperger’s. Now, more than three years later, I’m still getting comments on that post, mostly from employees complaining about the difficulties, but also trying to be productive with their boss with Asperger’s.

I like to focus this blog on the positives, and ways to make difficult situations better. The reality is that both neurotypicals and those on the Autism Spectrum are usually trying to do a good job, get along with each other, and communicate effectively. But, differences in expectations, communication style, and social behaviors can mean a lot of frustration on both ends, as well as less than optimal work from the team.

Of course, diversity in the workplace is an advantage to any team, and the Autism Spectrum brings strengths as well as difficulties. Work teams can benefit from the goal directed focus, strong work ethic and loyalty, and straightforward approaches common to those on the spectrum. Neurotypicals can learn to adjust their behavior to those on the spectrum, just as people with autism have been having to adjust to neurotypicals all this time.

Tha's why I’m asking any adults on the autism spectrum to comment here, or send me an email. How can neurotypicals help make the workplace more autism accepting? For bosses on the spectrum, how can your employees work best to fit your needs and make your organizations most effective?

Thanks in advance for your comments!

Saturday, May 18, 2013

Anxiety and Probability

In an earlier post, I talked about a practical and simple technique for dealing with anxiety. In this post I'd like to expand on some of those ideas.

For many individuals on the autism spectrum, anxiety is a constant presence. I find it can be very helpful to view these worries in a more mathematical way. Although many people on the spectrum are very good at math, there's a common belief that math and emotions are two different things. As both an engineer and a therapist, I like to explore the intersection of math and emotion.

You don't need to have an advanced understanding of probability theory to use this technique. Simply think about the general odds that something you worried about will actually happen. Usually, worries are quite specific, and are based on the idea that many specific events will have to occur. To think about probability, it's a simple matter to consider how likely each event is. You don't need a great deal of accuracy, but I find it's helpful to have a number, like 1 in 100, rather than a word such as "unlikely" or "rarely".

Here's an example. Suppose you're worried about a traffic accident making you late to the airport, so that you miss a flight. If this is a valid worry, then it makes sense to take steps to leave earlier. But, so often, the actual worry is unlikely to happen. That's when looking at probability makes sense. How often is there an accident that causes a delay on the roads? Once per day? How likely is it that the delay will be when you're actually on the road? Once per 2 months? How likely is it that the delay will be more than a few minutes? Although I travel busy Bay Area highways, it's rare that the accidents cause delays of more than a few minutes. Maybe the chances are 1 day in 365 that the delay will be so long I would miss the flight. Does that warrent a great deal of worry?

If your worries continue, it can be helpful to do the following tedious yet enlightening exercise. Make a rough estimate of the actual odds of your worry. Create a jar or bowl filled with white pieces of paper, representing everything working out OK, and just enough dark pieces of paper to represent your worry. The chances of one in 1000 could be represented by one piece of blue paper in a sea of 999 pieces of white paper. Although it takes a bit of time, it's not that difficult to cut many scraps of paper by stacking sheets. It's also helpful to see just how long it takes to cut 999 pieces of paper as compared to the one piece of blue paper. I find that the actual exercise of pulling papers from the jar repeatedly helps to illustrate in an experiential way exactly how unlikely many worries are.

Then you get to take the same steps I suggested in the earlier post. Manage the emotion of anxiety, and take the practical steps to deal with the issues as well.

Having a Spouse with an ASD or Asperger's

This is a repost of a popular post that wasn't opening correctly. Rather than spend a lot of time troubleshooting, I'm just moving the post. 

I remember learning in grad school that the very things that attract a couple to each other in the beginning are the things that draw them apart later on. Perhaps nowhere is this more true than the marriages between neurotypicals and those with Asperger’s. In my last post I discussed Gina Pera's Is It You, Me, or Adult ADD, the classic text on marriage to a partner who has ADHD. In my upcoming posts, I’m going to discuss two other books, Loving Someone With Asperger’s Syndrome , by Cindy N. Ariel, Ph.D. and The Journal of Best Practices , by David Finch. Both of these books cover the topic of marriage between a neurotypical and an individual with Asperger’s or an autism spectrum disorder.
The Asperger’s/neurotypical marriage is probably even more challenging than an ADHD/neurotypical marriage. In both cases, the couple is coping with differences in their basic ways of dealing with the world, and differences in neurobiology. However, Asperger’s also, by definition, involves social differences, and marriage is, at its core, our most social relationship.

There’s been a lot of controversy in the autism community about the tendency to scapegoat the Asperger’s partner for all of the relationship difficulties. Maxine Aston put forth her theory, not backed up in the peer reviewed literature, which she calls Affective Deprivation Disorder, where the neurotypical partner suffers due to emotional deprivation. Although, of course there is truth to the idea that the partner may be suffering, the autistic blogging community understandably had a lot of criticism about the idea of the syndrome.  Certainly, in troubled couples, both the neurotypical partner and the ASD partner are suffering.

I think a healthier option toward helping these couples might be to step away from blame and expecting one partner to do all the adapting, and instead focus on improving understanding and communication between both partners. After all, neurotypical partners choose their ASD spouses deliberately, often due to the very strengths that come with the ASD diagnosis.

The two books I’m next reviewing both can help couples move toward that direction, but in very different ways. (Note, check out my earlier posts for Loving Someone with Asperger's and The Journal of Best Practices.)

When the Boss Has Asperger's

This is a repost of a popular post that wasn't opening correctly. Rather than spend a lot of time troubleshooting, I'm just moving the post. 

A reader of this blog recently questioned, “How do I work successfully for a boss who has Asperger’s?” Of course, people with Asperger’s have always worked, frequently in positions of authority and power. What’s new is the public recognition that Asperger’s and autism exist; that the community doesn’t include just children, but adults as well; and that Asperger’s and autism bring strengths and abilities that management values. At the same time, people with Asperger’s and autism tend to be different than neurotypicals, especially in the ways they communicate and interact socially. (Neurotypicals are those without Asperger’s or autism.) 
Let me start with a simple warning. Don’t assume that all engineers and scientists have Asperger’s or that all people with Asperger’s or autism are the same. These conditions are tough to diagnose, they have a wide range of characteristics, and individuals with the condition have varying strengths, abilities, and weaknesses. So, whether or not your boss has a formal Asperger’s diagnosis, or even if you’re just guessing about it, pay attention to the individual, and try to adapt your work to what your boss specifically wants.
That said, there are typical characteristics of individuals with Asperger’s. Many individuals with Asperger’s struggle with figuring out social situations, like how to manage small talk, or the subtleties of interpersonal hierarchies. Making and maintaining traditional eye contact can be uncomfortable or even overwhelming. There may be extreme sensitivities to things like perfume or fluorescent light. A person with Asperger’s may not organize things in the same way as coworkers. Many individuals with Asperger’s have a strong and intense knowledge and interest in some specific area, often the very area where you are both employed. Their knowledge level and speed of absorbing new material may be well beyond your abilities. Frequently, these individuals are straightforward and direct.
The social differences can be the most difficult for neurotypicals to deal with. We neurotypicals value small talk and what may seem like meaningless social interactions. Without them, we can start to question if there’s something wrong, if we’re missing something, or if the boss is unhappy with our performance. Eye contact comes into play here too. Neurotypicals expect eye contact, and it’s very subtly choreographed.  Without that typical interaction, we can feel ignored, misunderstood, or disrespected. But, it’s important to remember that the differences due to Asperger’s may mean that we’re reading a lot into a friendly situation.
Rather than speak for an individual with Asperger’s, I went to an expert. Joel Smith works as an IT supervisor for a government agency and he’s been diagnosed as being on the Asperger's/autism spectrum.   I posed the question to him about how best to work for a boss with Asperger’s, and got this response:
“I work best when people working for me will tell me in black and white terms what they need to do their job - I'll miss subtle hints,  I'd prefer someone to just come out and say what they are looking  for.  Similarly with interpersonal issues or conflicts among  subordinates - I need to know what is going on, and I might not "just pick up on it". I don't talk differently to upper management or subordinates - I  don't "translate" between the languages. I suspect a lot of autistic bosses got where they were not through social networking but rather through ability.  So don't feed them  bull about their area of expertise.”
Thanks for your question, and I hope this has been helpful to you in working productively with your boss. I’d love to get comments from other professionals with Asperger’s or autism about how you’d like to interact with neurotypical coworkers, bosses or employees. Please send me an email, list a trackback, or post a comment.