Wednesday, August 27, 2008

Empathy, Social Skills and the Autism Spectrum

I read a great article a while back, written by Zosia Zaks, who was diagnosed with Asperger’s Disorder and writes extensively. You can check out her website at http://www.autismability.com/ but this article was published on the GRASP website at http://www.grasp.org/new_art.htm.  The article is “Myth: Autistic People Lack Empathy” I’m not sure when it was originally written, or where it was first published, and many people have commented on it at various places online. I’m adding my comments on it because the article raises some important, thought provoking issues.


I write this blog mainly for parents of kids with Asperger’s or autism who are trying to help their child with social skills, and more importantly, to help their child develop good relationships. It’s important to remember these basic goals when working with anyone, because the point isn’t to change someone or to define one way as right or preferred. Social skills are useful to help people interact with each other, understand others and to be understood, and at the core, to help us all feel connected to each other. For parents of kids on the autistic spectrum, understanding your child’s world can really help in knowing how to teach them social skills, and that’s why I like this article so much.


Zosia Zak’s article discusses two important topics. First is an exploration of the difference between empathy and the ability to follow the rules of social skills. She asks the question of whether or not she is lacking in empathy, or instead is missing  “the social and linguistic skills to navigate an alien social world successfully.” She describes in detail several experiences where she misses the point of a conversation and the resulting interpersonal disconnect. She clearly states her intentions: “I deeply wanted to get along with my co-workers and I wanted to be friends too!” For parents working with their children, it’s important to keep this distinction in mind. Social skills, reading others’ messages, sending the right signals, all these are important, but they’re basically the mechanics behind relationships, and completely different than your child’s feelings, intentions and desires for interaction.


I think it’s important to return to the source here, which would be the DSM IV-TR™. (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, published by the American Psychiatric Association in 2000. Officially, it’s the book that lists the symptoms of Autism and Asperger’s, or any other mental disorder.) What’s clear from the DSM is that a diagnosis of Autism or Asperger’s requires an impairment in social interaction, such as nonverbal behaviors, social isolation or even lack of awareness of others. There’s nothing listed about lack of empathy or caring.


There’s also an interesting variation of this discussion on WrongPlanet.net (http://www.wrongplanet.net/postt75459.html) where someone named Amik asks if neurotypicals lack empathy toward people on the autism spectrum.


The second area of interest in Zosia Zak’s article is her discussion of how she tried to set up a series of rules to use in future interactions. I thought of children in social skills groups, and how often they are presented with a list of rules on how to interact. This article vividly illustrates the experience of fitting an everyday interaction to a list of rules, and how difficult and exhausting it can be. I think it’s something for therapists and parents to keep in mind when trying to teach kids about social skills.


Please check out this article, and I’d love to hear your comments on it.


Tuesday, August 19, 2008

Positive Parenting for Kids with Special Needs: Some Great Examples

I’m always looking for examples of positive parenting - parents who are champions of their kids, who look for their strengths and fight to make sure their teachers, doctors, and therapists are working from a strength-based place as well. A great example of positive parenting can be found in three interviews with mothers at the website for ADDitude magazine. (http://www.additudemag.com/adhd/article/1998.html) With the Olympics capturing so much attention, it’s fitting that one interview is with swimmer Michael Phelp’s mother. The others are with the mother of Ty Pennington, of Extreme Makeover: Home Edition, and the third is with the mother of Danielle Fisher, the youngest person to climb all seven of the world’s tallest mountains. All these super-achievers have been diagnosed with ADHD.


ADDitude magazine and website, which focus on issues revolving around ADHD, is one of my favorite resources.  Both the magazine and the website are filled with informative articles on a variety of topics and I find that many are applicable for individuals dealing with issues revolving around the autistic spectrum as well as ADHD. This makes sense, since both kids with ADHD and kids with ASDs often struggle with the same concerns: social skills, depression, anxiety, school and organizational abilities. (One disclaimer, the website has lots of ads for ADHD medications. I’m not a medical doctor, and I’m not trained to prescribe or recommend medications or to tell people not to use them. In any case, whether or not your kids are using medications, the articles are practical and useful.)


What’s so inspiring about these interviews? First of all, the children went on to achieve impressive success not just in spite of their diagnoses, but in some ways because of them. The mothers seem to strike a balance between recognizing and dealing with their kids’ problem areas while at the same time highlighting their strengths. The mothers also exhibit the open-mindedness needed to keep trying out different solutions. I also loved the quote from Ty Pennington’s mother, “I was constantly getting calls from the principal’s office. I felt like the worst mother in the world.” Too often, I hear the parents I work with say the very same thing, and it can be so discouraging to feel blamed for your child’s difficulties.


It’s interesting to note that two of these individuals thrived in a very physical environment, one that really focused their high energy. (Something to keep this in mind next time your kid wants to spend hours watching TV or playing video games!)


Your child probably isn’t going to grow up to be an Olympic champion, a world record holder, or a TV celebrity, but these parenting examples can help any kids achieve their very best.


Tuesday, August 12, 2008

Movie About Social Skills for Teens: American Teen

As your child enters middle school, junior high, or high school, it can get especially difficult for you as a  parent to help with social skills. This can be a problem because older kids are dealing with a more complex social environment than they were when they were younger, and many kids who managed in the early school years really start to struggle as they get older.

One problem is that parents of older kids just aren’t as involved with the school as they used to be. There’s less of an opportunity to volunteer, your kids may no longer want parents around, the kids are coming from a larger geographic area, the school is bigger, there are multiple teachers who may not really know your teenager. For many reasons, it may seem as if you are sending your child off into unknown territory to manage academically and socially, and you can’t understand that world.

That’s why movies, books, or TV can be a useful communication tool for kids and parents. You can watch or read together, enter the same world together, and use that as a way to understand what your child goes through every day. From there, you can help your child figure out and manage all the subtle social things that go on at school every day.

One movie that’s very useful for this purpose is the 2008 Sundance film American Teen. American Teen is a documentary about the 2005 graduation class of tiny, rural Warsaw, Indiana. This film doesn’t tackle the larger issues that may be impacting many teens. There no talk of gangs or violence, and little mention of multicultural issues, drugs, and all the heavy problems facing today’s teens. Instead this film focuses on the same universal issues that teenagers have been dealing with for generations, namely friendships, young love, bullying, and pressure. Peer pressure, social pressure, academic and athletic pressure, pressure from parents, and maybe the biggest pressure of all, that universal concern about what’s going to happen after graduation.

As a first step, go watch this film with your son or daughter. It’s rated PG-13, and contains themes and language some parents may object to.  Kids-in-Mind, (http://www.kids-in-mind.com/a/americanteen.htm), a very useful movie rating website that ranks movies on a scale of 1 to 10 in three categories, Sex and Nudity, Violence and Gore, and Profanity, has given American Teen a score of 3-4-5. (If you’re not comfortable seeing this film with your kids, consider watching it yourself to get back in touch with those memories of high school pressures, cliques and the really cruel way kids can behave. But remember, your kids’ daily world at school would probably be rated at least a PG-13 as well.)

Many teens who struggle with social skills aren’t very skillful at analyzing the social landscape of their school. That’s one area where this movie can help.  All the standard high school stereotypes are represented here: the popular girl, the jock, the outcast, the prom king, the emotional girl. These may be stereotypes, but that doesn’t mean they’re not real, or that these kids don’t exist at your child’s school. It really eases basic social navigation if your child can figure out who plays these roles at his school. Then some of the “rules” become clearer, things like: just because a teen is popular doesn’t mean she’s nice, there’s a lot of pressure to date within your own clique, kids aren’t necessarily nice to their own friends. See if you can come up with your own list of some of the rules at your teenager’s school. How is the film school different from your teen's?


On a more advanced level, this film will allow your teen to view peers with a more balanced vision. At school, you really don’t know why somebody is treating you badly, because you can’t understand the other side of the story. Because this film shows what’s going on for many kids, your teen can get a different perspective. See if you can move beyond the broad strikes. Are the class winners under pressure too? Do bad things happen to them also? Is the outcast left out because he's a bad guy? Learning to view everyone as a full human being, with strengths and weaknesses, triumphs and failures, goes a long way toward developing more mature social skills.


One character in the film is a self proclaimed social outcast. He makes a real effort throughout the film to connect socially, especially with girls. Watching his awkward yet sincere attempts at relationships should give you and your teen plenty of material for discussion. What did he do well, and where did he fumble the situation? Are there times he wasn’t very attuned to his partner?


Finally, just use this film to empathize with your teen’s situation. It seems like everyone in the film is struggling and even the most popular kids are not having a great time. Everyone, even the school’s basketball god, has to deal with the same issues about moving on from high school. Your child spends hours every day dealing with the pressures of school. A few hours with this movie will help you remember what that's like.


Wednesday, August 6, 2008

Helping Your Child Have Great Play Dates: Who’s Coming Over?



Facilitating great play dates for kids who are struggling socially is a complex issue for parents. This post will only cover a small part of this topic, with additional ideas in later posts. It pays to begin at the beginning, so that’s what I’ll do here. The first issue is figuring out which child you’ll invite over for a play date. For many parents, that’s the toughest part.


For children and teens who are developing socially at a standard pace, parents may not have to get too involved with helping their children find friends. For kids who are struggling socially, parents are going to have to get involved. The more trouble your child is having, the more you as a parent will have to step in.


Kids struggle socially for a number of reasons, be it just their personality traits or due to an ASD, Asperger’s or ADHD diagnosis. For kids who don’t do well socially, I find that they have the best play and social interactions with other kids who are functioning socially at about the same ability level. At the same time, kids clearly need to have some interests in common in order to want to interact.


What does this mean in practical terms? Basically, if your child is delayed in social skills, he or she may not get the most out of  a play date with a socially advanced child from the same age group. Too often, the more developed child will either ignore the child with lesser social skills or take on a care-taking, parental role. The goal of the play date is to work on peer relations, and these two types of interactions don’t really count toward that. That doesn’t mean that the play date cannot be fun and useful. I think most social interactions can be, it’s just that they’re not really peer relations.


Having socially delayed kids play with younger children can be one solution, depending on circumstances. With too great an age gap between kids, differences like size, interests, intellectual or athletic abilities may prevent useful peer relations. A chess expert probably won’t want to watch Blue’s Clues on a play date.


That leaves the play date pool considerably smaller, so finding matches takes more work, and parents may need to get creative. Ideally, you’d look for another child of the same gender, same age, and same school, with a similar profile of intellectual and social abilities. That’s a tall order, so you’ll probably have to make some compromises, and enlist a bit of help in searching.


Good teachers and principals can be the best resources here. Talk to the adults at school about your desire to help your child find friends. See if they can introduce you to other parents who may have appropriate children for your child to meet.  Many principals meet with other school leaders on a regular basis, and they may be able to informally search out kids from other schools.  It doesn’t have to be a big deal, just meet the other parents for coffee, see if your kids sound compatible, and set up a meeting for both kids and parents at a park.


The other great resource for finding potential play dates is by attending support groups for families with your child’s particular diagnosis. You can find support groups online, through community agencies, Yahoo groups or meetups.com, and through national and local Autism, Asperger’s and ADHD websites. Often, professionals working with kids will be familiar with the support groups that may be appropriate. (For example, I list resources and support groups for ADHD and ASDs in the East Bay, California area on a page of my website.) At these support groups, don’t be afraid to directly ask other parents if they know of any kids looking for play dates.


All this may sound like a lot of work for parents, just to get a few kids to play together! In my view, it’s worth it. Strong friendships will help your children develop socially, keep them from feeling isolated and different, and will become more and more important as they grow up and less involved with their families. Spending the time now to set up play dates can really improve their quality of life, both now and in the future.


Readers, if you have other ideas for how to find play date partners for special needs children, please leave me a comment. I’d love your input!