Wednesday, December 30, 2009

PBS Series: This Emotional Life

PBS is airing a new documentary called This Emotional Life. It’s being shown January 4,5,and 6, 2010, at 8 p.m. I haven’t seen the show, but the previews talk a lot about emotional connection as it impacts our well being.

A portion of the documentary looks specifically at Asperger’s and a young man named Jason who’s dealing with the issues surrounding Asperger’s and connecting socially. For those who follow this blog through the Autism Hub, you’re probably already familiar with Jason, but others might want to check out his blog, Drive Mom Crazy.

Wednesday, December 16, 2009

How Sound Impacts Humans

TED is a website that presents fascinating short talks by experts on many different topics. I like to go there and browse around and see what interesting ideas come up, as well as to look for presentations on topics I’m especially interested in.
Julian Treasure, who advises businesses on how sound effects people, gives a brief but interesting discussion on the Four Ways Sound Affects Us. Treasure discusses and illustrates how sound impacts our physiology, psychology, cognition and behavior. This is true for all of us, but the impact of sound is even more intense for those on the spectrum, where sensory issues are so much more common. Treasure talks about how the noise level in open plan offices is so distracting that productivity drops tremendously. Not surprising for anyone who spends time in an office cubicle!
I know that sound impacts mood, and I often work with clients on identifying calming sounds. Treasure’s suggestion of listening to bird song is an interesting idea that I’ll have to try out, both for myself and for clients.

Wednesday, December 9, 2009

Get That Final Paper Written

Now is the time of the school year when those big assignments loom in front of high school and college students. For those who struggle with executive function, such as individuals with Asperger’s, autism or ADHD,  getting the paper written can be especially daunting. Here are a few tips to get the assignment written. Depending on what’s keeping you from completing, or starting, the work, you may want to try just one tip, or all of them.

Organize Your Ideas

Putting things on paper can make your thoughts clearer. Don’t turn this into a big additional project! Grab a scrap of paper and a pencil, and jot down phrases.

Change How You’re Working

Typing and handwriting utilize the brain differently. If you’re stuck in one mode, try switching to the other. Even a different pen, color of paper, or new font can help rejuvenate your work.

Change Your Sensory Inputs

Your surroundings can impact how well you can focus. Sometimes music can distract you just enough that your brain focuses a bit better. Or, try chewing gum or drinking water. A quiet bedroom may be too quiet, and too easy to fall asleep in. Move to the family room, the student lounge or a coffee shop.

Explain Your Paper

Find someone to discuss your paper with. This can be a classmate working on a similar topic, or even a friend who knows nothing about your material. Putting ideas into actual spoken words can be an effective means of getting them in order.

Start with a Shorter Version

Long papers can be intimidating. Just remember that even a PhD thesis is only a group of pages, written one page at a time. If the assignment is for a 20 page paper, try starting with a 5 page paper. As you work on it, new ideas will come to you and the momentum will keep things going.

Another way to do this is to consider your long paper as a series of shorter papers. Devote a few pages to each idea and then put them together.

Start in the Middle

That first line can be the most intimidating of the whole project. You want it to grab attention, hook the reader. That can be a tough challenge when your ideas are still taking shape. So, put off that first line. Remember that you don’t have to write the paper in order. Of course you’re going to read it through to link your ideas and explain things clearly. If it’s easier to start in the middle, that’s fine.

Start With a Rough Draft

Managing spelling, vocabulary, grammar, writing sentences, organizing paragraphs and putting the whole project together into a brilliant composition is a lot to do a one time. It may be easier to break that down into single steps. Organize your ideas, then write the sentences, then tweak the paragraph structure, then punch up the vocabulary. Do a final check for spelling and grammar. Different parts of your brain are called into play in each task so breaking the job up can be more effective.
Just Do It
Finally, the best way to get that paper done is to just start it. Stop reading, stop researching, stop surfing the internet, definitely stop the video games, and just start writing. Right now!

Continuing to Grow and Develop

Maturing and learning don’t stop at 18, whether you’re on the autism spectrum or not. As any parent of a college age student can attest, there’s a great deal of maturing that takes place after high school. As we move through adulthood, that continues to be true. I think this continued development is especially true for those with autism and Asperger’s.

Neuroplasticity, the ability of the brain to reorganize and restructure itself both physically and functionally, is now known to be possible at any age. Although young brains seem to be the most capable of gross reorganization, a growing body of research is showing that the brain continues to be plastic throughout life.
An informative, as well as entertaining and very readable, discussion of neuroplasticity and new discoveries surrounding the topic is presented in Train Your Mind, Change Your Brain, by Sharon Begley. Begley, a science writer for Newsweek, and before that, the Wall Street Journal, presents some of the new research and discoveries about neuroscience. The data is presented against the backdrop of Dharamsala, India and the 2004 Mind and Life meeting between Western researchers and the Dalai Lama. Begley explains numerous examples of how animal and human brains are impacted and changed, both in function and structurally, through our experiences, sensations and even thoughts.

The idea of a primate generating new neurons is interesting, but what does it mean in practical terms? Plenty. Right about the time I was reading Begley’s book, the 10th anniversary issue of Autism Asperger’s Digest (November/December 2009) came out. The entire issue is available online, and there are a number of interesting stories from individuals looking at their progress over the years. The one that most elegantly illustrates this idea of lifetime neuroplasticity is Temple Grandin’s The Way I See It column, "Learning Never Stops". Grandin talks about how she and others on the autism spectrum continue to learn how to communicate, behave, and expand their minds, not just as children, but throughout their lives.
When I work with young adults and college students with autism and Asperger’s, I’m continually reminded of this concept. I think parents sometimes worry that their high school age children aren’t on track for transitioning to adult independence. Certainly, in some cases, that’s true, but so often, these young adults are continuing to make rapid advances in their social skills, executive functioning and emotional management. Kids who aren’t ready for a job or college right after high school can continue to mature and learn and be ready a few years later. As Grandin and Begley both illustrate so clearly, the key to this growth is continued exposure to new experiences, new challenges and the opportunity to keep learning.

Monday, November 23, 2009

Managing the Holidays

Holiday gatherings can be wonderful, filled with fun and family, food and laughter. But some people find the holidays more stressful than relaxing. Many individuals on the autism spectrum struggle with sensory overload, especially with extra guests in the house, loads of noise and excitement. For others, the family reunion can bring up all sort of old disappointments and hurt feelings. Everyone wants a great holiday, but you might need to take special care to make sure you have the best time possible.

Plan Time for Yourself

If you find yourself getting overloaded, it’s perfectly acceptable to step aside and spend some time alone. Go for a walk, find an empty spare room, or offer the do all the dishes by yourself. Family members may pressure you to join in the “fun” but it’s fine to say that you just need a bit of time to yourself.

Choose Your Battles

You’re an adult now. It’s OK if your family doesn’t understand you, or if you can’t convince them that you’re right. Agree to disagree. Some battles are just not worth the emotional energy. No one has to get all their needs met by their family, friends can offer support and understanding you can’t get from some of your family members.

If It’s Too Much, Go Home Early

Again, you’re not required to stay with the family on holidays. It’s your job as an adult to take care of yourself. Come late and leave early if that’s the best way for you to take care of yourself.

Look for the Bright Spots

Try to find an activity that’s enjoyable. If the long family conversation is too much, go sit at the kids’ table and be the fun adult. Or, pull out old pictures and reminisce with your sibling about funny childhood times. An older relative may have a lot of interesting memories about their youth and family and this can be a more low pressure way to connect.

Try Giving

Sometimes the best way to manage when you’re not getting what you want is to shift focus on to more positive areas. Think about all the things you’re grateful for this year. Look around and see what you can do to help out.

Above all, remember that as an adult it’s your right and responsibility to take care of yourself. Do what you need to to feel good about this holiday.

Thanks for reading this blog, and Happy Thanksgiving!

Thursday, November 19, 2009

Holiday Advice for Parents

The holidays are coming up and for a lot of people that means getting together with extended family and relatives you haven’t seen in a while. This can be a great chance to connect, feel supported, even show off a bit with all the progress your child has made.
But it can also mean unwanted advice. Your parents, your sister-in-law, your best friend from high school probably mean nothing but the best for you and your family. But they also may not have a special needs child and they may not understand what it is that your family is going through, or what your child needs.
So often I’ve heard the same story from clients. A well-meaning relative says something like, “If only you’d do _________, your kid wouldn’t do _______.” or “Trust me, your kid just needs more __________, and he wouldn’t be so _____________.” You can probably fill in the blanks, there’s a lot of advice out there.
The fact is, and I’ve said it before, some kids are just tougher to parent than others. Your nieces and nephews may just be incredibly easy-going children. It doesn’t mean that you are not also a good parent. Your child may just be wired differently, temperamentally more sensitive,  more strong-willed, or more emotional.
I’ve worked with so many different kids over the years. The truth is, some of them are so easy and low key, they practically parent themselves. Other kids are so difficult, it’s hard to manage them for just a brief while, much less an entire holiday vacation. Add in some travel time, late nights, too much stimulation, and it’s not surprising that things get out of hand.
So this holiday season, I’m asking you to trust yourself and the parenting skills you’ve developed by taking care of your child for all this time. Listen to the advice politely if you want to, but don’t think that any other parent is more capable than you are. Your child is lucky to have you as a parent.
I’m thankful for all my wonderful clients, parents, and readers! Happy Thanksgiving!

Tuesday, November 17, 2009

Contra Costa Country Annual Transition Conference

A few posts ago, I talked about transition planning for teens and how important it is to start planning early. At that time, I wasn’t sure when the Transition Conference for Contra Costa County was being held. But now you can download a copy of the Conference Brochure. It’s being held at Diablo Valley College in Pleasant Hill, California on Tuesday January 5, 2010. This conference is a great resource for adults and parents of teens, with a full day of presentations on living options, employment, financial needs, sexual issues, disability services at community colleges.There is also a resource room for more info about services. Download the Conference Flyer Here

Tuesday, November 10, 2009

Is It Autism or Asperger’s?

It’s all over the news lately: Will the newest DSM revision, DSM-V which is expected in 2012, get rid of the Asperger’s category, merging everything into an autism spectrum disorder? There are good arguments for both sides of the debate, but you can read a very well written opinion from researcher Simon Baron-Cohen, in the New York Times, November 9, 2009.

Wednesday, November 4, 2009

Anger Management and Asperger’s, Part II: The Feeling of Anger

Anger management skills are important for everyone, not just those with Asperger’s and autism. But for those on the spectrum, managing anger may be especially difficult. In my post of 10/1/09, I discussed understanding anger. In today’s post, I’ll be discussing the actual physical sensation of anger.

Like all emotions, anger comes with a physical feeling. And that’s important, because often that physical feeling is the first subtle clue that the emotion is present. Many individuals experience anger as a tightness in the hands, arms, and jaw. Some people may get a stomachache or a headache. What’s of interest is how you specifically experience anger.
For many of my clients on the autism spectrum, they are more comfortable with reason and intellect, and may be less attuned to the sensations in their bodies. For those with sensory issues, the physical sensations in their bodies may be so overwhelming that they try to tune them out. Whatever the reason, disconnecting from the physical may mean that subtle, early signs of anger are not recognized.
It’s possible to re-experience all the feelings of anger just by remembering an upsetting event. This may be the perfect opportunity to tune in to your experience, without feeling as overwhelmed as when you’re actually in an angry situation. The next time you’re remembering something that made you angry, close your eyes and scan your body. Note what feels different. This is how your body reacts to anger.

Recognizing anger is an important step in managing it. Look for upcoming posts for further info on this topic.

Monday, November 2, 2009

What Happens After High School?

The transition from high school to adulthood is a crucial time in the lives of many young adults on the Autism Spectrum, and it requires careful planning. I encourage the families I work with to start the planning process early. Many local resources, schools and supports groups may offer information, but frequently these events are only offered annually, so parents need to start gathering information early in the high school years. Get on those email lists!

As an example, here in San Francisco’s East Bay, The Orion Academy holds a post secondary transition seminar annually in March. The Springstone School has a monthly group for parents of children transitioning from high school, which is open to all families in the community. This year the Alameda County Public Health Department held their Transition Information Faire in March. I believe planning for the next faire is underway, and it is tentatively scheduled for March of 2010. Contra Costa’s Faire was in January, 2009, and I’m not sure what their plans are for next year.

One website that is useful no matter where in the country you live, is Inside’s lists of Very Friendly Schools for Students with Asperger’s, and Friendly Schools for Students with Asperger’s. College is a big step, especially for those who are moving away from mom and dad, and finding an environment that offers extra support may mean the difference between success and failure.

In spite of the budget cuts, there is still some good information available from government agencies. For example, here in California, the Department of Developmental Services has a number of informative and relevant links and downloads.

Good career counseling is crucial for special needs individuals who are making the transition to adulthood. Individuals on the autism spectrum frequently have unique strengths and abilities, and highlighting those areas in career planning cannot be done too early. If your school doesn’t offer career planning, or they don’t seem to understand your child’s specific needs and strengths, you can find a therapist or career professional who can work with your family individually.

The whole transition process requires a lot of work and advance planning, mostly by parents. But I’ve learned from my clients that it’s much tougher to catch up if the steps aren’t taken early. Please consider taking some time now to research your own child’s options.

Thursday, October 22, 2009

Thinking About Other’s Minds

Rebecca Saxe is a neuroscientist at MIT, studying Theory of Mind. Theory of Mind is the understanding about how we think about ourselves and others, or as Simon Baron-Cohen phrased it in Theory of Mind in Normal Development and Autism, (2001), “to be able to reflect on the contents of one’s own and other’s minds.” This is an important concept from the viewpoint of autism and Asperger’s, because many researchers attribute deficits in Theory of Mind to some of the struggles those on the autism spectrum might be having.

Rebecca Saxe has been researching the brain using fMRI, and identified the region, called the Right Temporo-Parietal Junction, that is activated when we’re thinking about other’s thoughts You can hear a brief, but informative and entertaining talk by her on, titled How We Read Each Other’s Minds. She talks about her work and also demonstrates some interviews with children of various stages of development. You have to register, but the site is free, and full of fascinating presentations.

Local Bay Area Special Education Resource

Special education and the legal issues surrounding it are very complex topics. Parents need to know their rights and responsibilities, and what their child is entitled to. For parents in the San Francisco Bay Area, the Leigh Law Group is presenting a workshop for parents and professionals on Special Education: Rights to Related Services in the Public Schools. The training event is November 14th, 2009, in San Francisco, and it’s only $10.00. 
I’ll state right up front that I’m not familiar with this group, and I don’t know the presenters, but the topic is so crucial, I’m guessing this could be a valuable morning. I think they run these regularly, so you might want to get on the mailing list. If you do attend, please send me a note and let me know how the presentation was.

Friday, October 9, 2009

Book Review: Mother in the Middle by Sybil Lockhart

Mother in the Middle is a fascinating book, a moving and personal memoir of a woman’s experience with raising small children while at the same time caring for a parent with Alzheimer’s. But the author is also a neurobiologist, and she beautifully interweaves her own technical perspective into the work. It’s this unique juxtaposition that makes this memoir stand out from others.

Usually, I review books about careers, business, social skills or autism and Asperger’s on this blog. And this is not a book about any of those topics. But I think it’s appropriate for this blog anyway. Human development, mental illness, emotions, thoughts, behavior and personality are all controlled by our nervous systems, but we’re still at the early stages of understanding those systems. For those of us who aren’t neuroscientists, making the connection between the brain structures and human experiences can be especially difficult. This book makes those connections. Life events and biology come together clearly. The fact that the author is also a teacher makes her explanations that much clearer.

As an example, at one point in the book the author narrates an event where her mother completely forgets about an important loan she made. The memoir moves smoothly from discussing the event to describing what’s actually taking place in her mother’s changing brain. The technical explanations are beautifully balanced with the honest and insightful experiences the author and her mother are going through. The growth and development of her children's abilities contrast dramatically with her mother's declines.

I love books that combine the personal with science. Maybe that’s because I’m an engineer as well as a therapist and coach. But, I think examples help all of us understand, and true life examples can really make a technical discussion come to life. That’s what this book does so well.

Thursday, October 8, 2009

Book Review: No More Meltdowns by Jed Baker, Ph.D.

No More Meltdowns by Jed Baker, Ph.D. is an excellent resource for parents trying to deal with their child’s out of control behavior, whether the kids have a diagnosis or not. This book is straightforward, with a simple step by step plan for dealing with tantrums and meltdowns. At the same time, there are plenty of detailed examples that show how to fit the simple plan to complex situations.
Certainly parenting is tougher when children have special needs, like an Autism Spectrum Disorder (ASD), Asperger’s or Attention Deficit (ADHD or ADD). And frequently these parents have to also deal with harsh judgment from the world every time their kids act up. Too often, parents are simply told to be firm, be consistent, take control, and their kids will behave. Well, what should parents do if they are firm and consistent, and it still doesn’t help? This book offers some solutions, and since the author has experience dealing with special needs kids, the ideas are realistic and practical for all families.
Baker acknowledges the basic rule of of child rearing, using consistent rewards and consequences. And that’s a good place for all parents to start. But he quickly moves beyond that to a four step plan of action for when this basic plan just doesn’t work. His model begins with accepting the child, then moves on to de-escalating a meltdown, understanding why the meltdowns are occurring in the first place and preventing future meltdowns.   
The real heart of the book is its detailed analysis to understand why meltdowns are occurring, and the techniques to set up a plan to prevent them in the future. Baker breaks down the different issues that might cause problems, then methodically explains how to change the triggers causing the tantrums, teaching the child skills to deal with the triggers, and how to set up a system of rewards and losses.
One thing I really appreciated in No More Meltdowns was the way that Baker exhibits respect and understanding of the children and parents in his examples. These aren’t presented as bad, out of control kids, with ineffective parents. Instead Baker acknowledges the difficulties of these tough situations and focuses on both short term crisis management and also long term skill building. This is a book I’ll be sure to recommend to my clients.

Thursday, October 1, 2009

Anger Management and Asperger's Part 1: Understanding Anger

Anger management is an problem for many individuals, whether or not they have Asperger’s or an ASD. It’s one of the topics that gets searched for most frequently by readers of this blog. In an earlier post I referenced an Anger Management article I wrote for Autism Asperger’s Digest Magazine, but until now I haven’t written anything on anger management specifically for this blog. Because anger management is such a big topic, I’m not going to attempt to cover it all in one post.

We’ve all had that feeling of anger growing, and getting out of control. Sometimes when we lose our tempers, a part of us may even know it’s happening, but the anger still seems to have taken on a life of its own. Anger management techniques can help us manage before the situation gets out of control.

With my therapy clients who are dealing with ADHD, autism, or Asperger’s and anger, I start by exploring what anger is. Most important: anger is not a bad emotion! Anger is powerful, strong and it drives people to make changes in situations that just aren’t working. So the point is not to eradicate anger, but to control it. To manage it.

Another important fact about anger is that the emotion often exists concurrently with other emotions. People may react with rage when what they’re really feeling is disappointment, shame or guilt, fear, or sadness. All of those other emotion can have an aspect of weakness and powerlessness. It may feel safer and more empowered to shift that helpless feeling over to the power of rage. I often ask clients to reflect on what the emotion behind the anger is. What’s the uncomfortable feeling the anger covers?

Next we’ll explore the physical sensation of anger and how important that knowledge can be for managing it. Please check back for further posts !

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.

Thursday, August 20, 2009

Book Review: The Organized Student

Disorganization is one of the hallmarks of Attention Deficit/Hyperactivity Disorder and it’s often a key feature of autism, Asperger’s and Autistic Spectrum Disorders (ASDs). But, the good news is that disorganization is one of those issues that can be managed with relative ease. The goal isn’t to turn your child into a filing, cleaning, organizing wunderkind, but instead to teach some systems to help your student develop a level of organization that allows for school success. A great resource for this is The Organized Student: Teaching Children the Skills for Success in School and Beyond, by Donna Goldberg with Jennifer Zwiebel. (Simon and Schuster, 2005)
Although individuals with ASDs may be terribly disorganized, this weakness is frequently offset by strengths in analyzing and what Simon Baron-Cohen terms “systemizing”. The Organized Student is set up in a way that takes advantage of your child’s innate abilities and problem solving skills to develop customized, personal systems for organizing at home and at school. Goldberg runs through the specifics of organizing lockers, backpacks, desktops and all those papers that come home. The strength of the book is the immense detail Goldberg goes into, while at the same time not setting up “one size fits all” solutions. She respects her students needs to have a system that works with their own abilities and that feels appropriate to each individual.
Many of the students I’ve worked with intend to start each new school year off right, organized and structured. But without a strong yet flexible system, the best intentions don’t work, and the students are lost in a sea of papers by October. If this describes your child, it might make sense to pick up this book now. Pay attention to each new teacher’s organizing requirements, adapt the book’s suggestions to fit your child’s own needs, and start the new school year off right.

Tuesday, August 18, 2009

A Survival Guide for the First Day of School

Back to school is a stressful time, but it can be especially difficult for kids with ASDs and ADHD. But, now is the time to take a few steps to ensure more success this school year. The beginning of the year is the time to get organized, and to make new friends. Keep these tips in mind before going back to school.
1) The Unknown Can be Scary
Try to familiarize anxious kids with the school environment before the first day. Take a tour, figure out where the classrooms are, stop in to the office or walk by the homeroom.  Some schools might even allow you to meet the teacher. Other schools publish a class list or have an orientation picnic.
2) Take Your Kids to School On the First Day
Most school are packed with parents dropping kids off on the first day. This is your perfect opportunity to meet other parents. Remember, lots of parents are uncomfortable with playdates if they don’t know the other parents. You want to start meeting moms and dads now.
Also, the teachers are looking for volunteers right now. Here’s a perfect opportunity for you to get involved at school and know the parents and teachers better.
3) PTA Events
Many schools have a PTA coffee on the first morning, another chance to get to know people. (Remember, the principal or office staff will probably be there. You want them to know you’re willing to help out and give back.)
4) Be Sure To Go To Back To School Night
Back to School Night is your first opportunity to find out what the teachers expect, how their classroom are organized and to show that you’re a concerned parent. You may not have a chance to hear from your child’s teacher until after the first report cards, so this is an important opportunity.
5) Discuss Lunchtime Plans with your Child
Lunchtime and the daunting cafeteria full of kids at long tables can be the scariest part of the day.  I always suggest kids try to walk into the cafeteria with a friendly classmate if possible. Don’t dawdle or rush there! You child needs to be a part of the crowd now. Some kids bring a small lunch as well as some money so they can either go directly to the table or get in the cafeteria line, depending what their friends are doing.
6) Figure Out How to Communicate with the School
Every school is different. Some have a computerized communication system, others want everything on voice mail or through emails. Set up the system now, so it’s ready when you need it.
7) Plan for PE.
Getting into PE clothes at school can be a stressful experience for shy kids. Find out the requirements at your child’s school and come up with a plan to make your child as comfortable as possible. The teachers may have some tips here, but be discrete. Don’t embarrass your child by discussing this publicly.
8) Back to School Clothes
Clothing makes a statement, and every school has it’s own style. Many kids don’t care what they wear, others want to be dramatic or different. That’s fine, unless your kids have struggled socially. If your child wants to make more friends, it makes sense to dress to fit in. (Don’t do all the back to school shopping early. Get a first day outfit, see what kids are wearing and then shop.) Popular kids set the trends, but less powerful kids may be ostracized merely because they dress too immaturely or oddly.
9) Give some Leeway at Pickup Time
After school is the perfect time for your child to chat with new classmates, or even plan an outing. Try to be there after school, so your child doesn’t have to wait, but set it up that you can wait a few minutes if they want to talk to new friends.

Monday, August 17, 2009

Dealing with Time Management

Running late? Many people struggle with time management, and they’re always running late. Missing appointments, late for work, racing to get to the meeting on time. Time management is a part of executive function, something that many people struggle with. It can be especially troublesome for individuals with Autistic Spectrum Disorders (ASDs) like autism or Asperger’s, or ADHD.
How can you improve your time management and be on time? Here are some simple tips, tailored especially for individuals with ASDs or ADHD, but anyone can use them.
1. What time is it?
It may seem obvious, but many people don’t know what time it is. If you’re always late, you’ve got to wear a watch, carry a cell phone with a clock, carry a pocket watch, have clocks in your home and office and get an alarm clock. And they have to be accurate, so go online and check to make sure every clock shows an accurate time.
2. What specific problem are you working on?
It’s always best to solve one problem at a time. When is being late most troublesome? Let’s focus on that one situation. I’ll use getting to work on time as an example.
3. A routine can be quicker.
Time management is easiest if you do the same things every day, in the same order. I know that I’m most efficient if I make espresso first, then cut up a bowl of fruit, then heat the milk for my morning latte. If I do the steps out of order I have to think about them more, I’m less efficient and it takes me more time.
4. Step by step
Think about all the steps involved in your morning routine. Waking up, getting dressed, eating breakfast, your commute. You may need to be more specific. Waking up may include the alarm going off, hitting the snooze button, dozing for just nine more minutes, and then getting up for real. The more detailed your steps, the better your results, so think about this in detail.
5. Create a timed list.
Take all these steps in your morning routine and list them in order. Then estimate how long each step will take. Many individuals with time management issues have a real problem here. Some people just don’t have a strong internal clock. What seems like five minutes turns out to be 20, something that should take half an hour seems to drag on all afternoon. This timed list will help you calibrate your internal ideas of time, and discover the truth about your actual morning routine. So don’t worry too much about accuracy at this point, just make your best guess of how long each step takes.
6. Test it out.
Tomorrow, see how accurate your list really is. Carry it with you throughout the morning. Carry a watch as well. Keep checking with your list, noting which step you’re on, and the time. Are there any steps you missed? Don’t spend time analyzing your list right now, just try to record what you doing and what time it is.
7. Fine tune your routine.
The morning rush is over, you completed the day’s work and you have some free time. Now is the time to analyze how accurate your time estimates were. Did it take as long to get dressed as you expected? You might want to repeat this exercise several to improve your accuracy.
8. Work backwards.
What time do you have to be at work? Start there, at the end of your list. Working backward, and using the amounts of time it take to accomplish each task, you can figure out what time you need to start your morning routine.
9. Leave some room for error.
The truth is, there’s a lot of unpredictability in some schedules, especially when you’re not in control, like during your morning commute. Most prompt people are actually a bit early much of the time. You need to consider if you absolutely need to be on time, or if it’s OK to be a bit late on those days the traffic is especially heavy, or if your dog is sick, or you knock over the carton of juice. The more trouble it is to be late, the more you’re going to have to accept getting there early most of the time.
That’s it. Give your new routine a bit of time to fine tune it and see how it’s working and then move on to your next time related issue. The more you work in this way, the better you’ll get at estimating how long things take, and the better you’ll be at being on time.

Tuesday, August 11, 2009

Sensory Issues: What It's Like for Your Kids

Many individuals on the autism spectrum struggle with sensory problems: the lights are too bright, the fabric too scratchy, the noise simply overwhelming. Unfortunately, the neurotypical world is often unsympathetic. This can be especially true in school settings, where all kids are expected to fit in to all the same requirements.  Every kids must survive a fluorescent lit classroom, the overly warm, fetid cafeteria, and a screaming, running recess "break". These sensory challenges can make a school day into a marathon of overwhelming and exhausting input. (And leave your kids too exhausted to tackle that pile of homework.)
I think it can be hard for neurotypicals to understand what these sensory issues can feel like. Of course, everyone is different and each person has their own particular issues. But I did want to pass along an interesting article on one individual's experiences of sensory challenges. Brian King is a social worker, as well as someone diagnosed with Asperger's as an adult. Check out the third issue of Brian's Spectrumite magazine to learn about what his experience is like. Talk to your kids about their experiences, and try to understand their own particular sensitivities. Maybe the school can be a little more flexible, or some sensory related modifications can be written into the IEP.
Still not sure these sensory issues are real? Just think about biting on foil or scratching fingers down a chalkboard. Can you imagine trying to learn while that's going on?

Monday, July 27, 2009

ASDs and Video Games

Autism Asperger’s Digest Magazine is one of my favorite publications for all sorts of information. In the latest issue, July-August 2009, page 11, there’s an interesting little news brief about a video game making class.
So many of the kids and teens (and a few of the adults as well) with whom I work love video games. And many kids on the spectrum aspire to a career as a video game designer. As a therapist, I try to focus on my clients’ strengths and interests, and expand them if possible. This class could offer an opportunity to expand an interest beyond just playing the game to learning some new skills.
I’m not opposed to video games in moderation. Playing a video game can be a self soothing activity, or it can fill a crucial role as an emergency babysitter when the parents just have to cook dinner or finish the taxes. Certainly, for school age boys, video games are a part of the culture and they enable social connections and interactions to flow more smoothly.
Of course, becoming a game designer as a career is unlikely, but the skills involved are useful regardless. The organization also offers a Lego engineering class, another common interest. You can get more information on both at All About Learning.

Tuesday, July 21, 2009

Are You Struggling with Executive Functioning?

In my last blog post, I introduced the term executive functioning, and now I want to take the idea to a more practical level. Many of the kids I work with as a therapist struggle in the area of executive functioning, and they’ve frequently been diagnosed with specific deficits in this area. This might have been done at their school, by a psychologist or medical doctor, or at a learning center. Diagnosis can be a very helpful tool in setting up a plan to make up for any deficits, so every individual can function at the peak of their abilities.
But for adults with Autistic Spectrum Disorders (ASDs) like autism or Asperger’s, deficits in executive functioning are seldom diagnosed. Many of my adult clients don’t even have a formal ASD diagnosis, much less a specific analysis of their strengths and weaknesses. This isn’t because the deficits aren’t there, just because the diagnostic process is less rigorous and available to adults. So, if you’re an adult diagnosed or suspecting that you have an ASD, you might want to do some research into executive functioning as well.
A good place to start is by carefully defining any problems you might be having. A step by step, methodical approach can work wonders. And, by taking tiny steps, the problem, which was vague and huge, becomes more manageable and the solution intuitively obvious.
As an example, let’s look at a hypothetical engineer named Ed. Ed was never diagnosed with an ASD, but is pretty sure he fits the criteria for Asperger’s based on his problems with social interaction, unusual communication style, and strong interest in computer technology. Ed is very intelligent and has been quite successful professionally. More recently however, Ed has started to struggle with more work related problems and his boss never seems to be satisfied.
Imagine that you’re in a situation like Ed’s. How would you deal with this problem? The first step is to consider specifically what the boss has complained about. Replay the conversations in your head and list the issues if you can. Reread your performance reviews, or any other written comments you’ve gotten. Ask a trusted colleague for input. In Ed’s case, he realized that his boss has complained repeatedly because reports have not been completed on time, he’s missed numerous line item deadlines for his main project at work, and he’s often getting to work too late.
Clearly, all these issues fall under the category of deficits in time management. By redefining the problem from, “My boss hates me.” to, “I need the work on time management.” Ed can come up with specific, concrete solutions, and so can you.
What can you do if you’re dealing with a similar issue? Lots of things:

  1. Since people on the autism spectrum are frequently visual, lists, timelines and charts can be the best resource.

  2. Make a detailed list of the milestones in your work assignments.

  3. Figure out the order in which the steps need to be carried out, analyze how long they take, consider roadblocks and items that are out of your control.

  4. Factor in some cushion in case everything doesn’t run smoothly.

  5. Talk to your boss about his expectations and requirements for specific deadlines.

  6. List these items on a calendar and check it daily.

  7. It may help to create little checkboxes where you can physically mark your progress.

  8. If you’ve missed a deadline, deal with it immediately. Ignoring the problem does not make it go away.

And, most important, check back on this blog for more posts on managing executive functioning.

Monday, July 13, 2009

How Far Can Your Child Go?

All parents want their child to succeed, personally and professionally. But, if your child is diagnosed with a disorder or syndrome, like ADHD, Asperger's or an autism spectrum disorder, it can be tough to adjust your expectations as a parent. On the one side, your don't want to place unrealistic, potentially damaging goals onto your child. For example, we can all see that not every little dancer is cut out to be a prima ballerina and it would be cruel and pointless to push every kid in the local dance class to train to be a professional. But, on the other side of the expectation equation, it can really be damaging to your child if you give up all your parental hopes and dreams. Too often, I've seen parents come back from their child's diagnosis sessions having heard all about the limitations of Asperger's or ADHD or whatever the diagnosis is, without having a balanced picture of strengths. In the end, I don't think any child achieves great things without someone, usually a parent, believing in him or her. No diagnosis should make a parent lose hope.
So, how do you figure out what's realistic for your child? It's best done in three simple steps.
1) Trust Parental Intuition
You know your child better than any professional can. You've seen your child grow up, and you have a good idea of his or her strengths and weaknesses. To improve the power of that intuition, get educated about your child's diagnosis. Just be careful, because there's a lot of misinformation on the internet. Find sources you can trust and avoid anything that takes a strong "black or white" tone, because that's (usually) wrong. Then, if a professional tells you something that doesn't seem to fit your child, consider getting a second opinion.
2) Take It Step By Step
It's not necessary or even possible to plan your child's entire future. Even before the diagnosis, you weren't able to do that. With any child, it's best to aim for progress, and give up worrying about what the end point will be. Set small, concrete goals and look for ongoing improvement.
3) Pay Attention to Your Child
If your goals are too intense, or your expectations too high, your child will probably let you know. But the signs might be subtle, so you need to pay attention. If your child seems overly nervous, depressed, withdrawn or volatile, consider what might be going on. Are your goals and expectations putting your child under too much pressure? Consider easing up for a while and see if things improve.
As an example, many parents are told that their child with an autism spectrum disorder will not have "good relationships" as an adult. It's okay to question that statement based on what you know about your child specifically. Start with the knowledge that many people on the autism spectrum are happily married, or parents, or in other satisfying relationships. Factor in what you've seen for your child. Has your child been able to get very close to a teacher, friend or family member? That's evidence that the professional opinion may be too limiting.
Then go to the second step and aim to improve your child interpersonal skills. Don't worry about the end goal of what your child will achieve as an adult. Just try to improve current social skills, looking for small progress in things like relating, coping with emotions and being thoughtful.
For step three, see how your child is reacting. Almost everyone loves to achieve and succeed, as long as the pressure isn't too intense. Enjoy the successes and the progress along the way, and don't worry too much about the end point.
The final point to remember is that for many kids, progress comes slowly, but things do keep improving. In Engaging Autism, by Stanley Greenspan, M.D. (De Capo Lifelong Books, 2006), there is an excellent chapter on  working with older children, teens and adults, subtitled "A Lifetime of Learning".  Greenspan, best known for his development of the DIR/Floortime approach, argues that it's important to "overcome the myth that children reach a developmental plateau beyond which improvement can only be minimal. In fact, during the teenage and adult years, the brain and nervous system are still developing."  (p. 212) Give your child lots of time to fail, to try again, and to succeed.

Tuesday, July 7, 2009

Executive Functioning and Autistic Spectrum Disorders

How can you solve the problems you’re having at work or in your relationships? One solution might be to consider the concept of executive functioning.
Executive functioning is a term that comes up frequently in discussions of the characteristics of autism, Autistic Spectrum Disorders (ASDs) and Asperger’s Syndrome. In general, many individuals with an ASD struggle with specific deficits in executive functioning as well. I don’t want to go into the details of measurement of executive functions or review the research on correlations between autism or Asperger’s and executive functioning in this posting, but I do want to introduce the basics.
A good definition of “executive function” can be found in Simon Baron-Cohen’s The Essential Difference (Basic Books, 2003, p. 176). Baron-Cohen defines executive function as “shorthand for the control centers of the brain that allow not just planning but also attention-switching and the inhibition of impulsive action.”
Tony Attwood discusses executive functioning in The Complete Guide to Asperger’s Syndrome (Jessica Kingsley Publishers, 2007, p. 234) and lists “organizational and planning abilities, working memory, inhibition and impulse control, self reflection and self-monitoring, time management and prioritizing, understanding complex or abstract concepts, using new strategies.” Other researchers may classify executive functions differently, but the general concept is the same.
The research on the correlation of executive functioning deficits and autism or Asperger’s can get very complex, due to the difference of ability levels along the autism spectrum, as well as the many measures of specific types of executive functions. It’s not surprising that different studies measuring executive function in individuals with autism get different results. What is clear is that individuals, both those with autism and neurotypicals, can vary in their abilities in each of the different executive functions.
What’s probably of more immediate value to those with ASDs, is to individually consider the specific executive functions as Attwood lists them. For individuals who are struggling professionally or in relationships, this can be helpful as a first step in problem solving.
Check back on this blog over the next few weeks. Further posts will give some examples and specific suggestions for managing problems with executive functioning.

Monday, June 29, 2009

Siblings of Specials Needs Kids

For many of the families who are working so hard to do what's best for their special needs child, there's also a typically-developing sibling who is heavily impacted by the situation as well. Having a special needs brother or sister has both positive and negative facets, and most parents are extremely aware of both.
Because I spent many years working in school settings, I frequently had the opportunity to work with several siblings from one family, including the special needs child and the typically-developing sibling. From this experience, I've developed suggestions that could make life easier for your typically-developing child. Certainly, this is not a comprehensive list in one article, but instead a few tips for what I've found to be most important for the siblings of special needs kids.
1. Acknowledge everyone's mixed feelings.
If you only consider one item, this is the most important. Siblings of special needs children typically struggle with guilt. Of course they love their brother or sister, and may enjoy many aspects of their relationship. Kids with special needs are more than just a diagnosis, and family life can be filled with fun and joyful moments. However, realistically, special needs kids have "special needs" and much of the family energy will revolve around getting those needs met. It's tough for the sibling to be feeling embarrassed or resentful of a brother or sister, when they can see the difficulties they may be having. At the same time, when they look to their friends with more typical families, they are aware of how much easier that family life can be.
As parents, you have mixed feelings about the special needs as well. The best thing you can do for the typical sibling is to acknowledge your own mixed feelings, and give your child permission to feel that way as well.
2. Spend time alone with the typical sibling.
All kids need time alone with their parents, especially in this situation. Time alone will allow you to do activities that may not be possible with the whole family, and allows you to focus on just one child. When fun parent activities aren't possible, even a trip to the grocery store can be special if it's just the two of you.
3. Find kids a neutral person to talk to.
It's especially tough for children to share all these mixed, guilty feelings with their parents, who are far from impartial. It can be a real gift to your typical child to find them a understanding adult to talk to, whether a family friend, a coach or teacher, or a professional. Sibling support groups, if run by skilled leaders, can be useful as well.
4. Don't make your kids responsible for their siblings.
It can be tough to manage all the responsibilities of a special needs family, and the typically developing sibling may be very mature, responsible, and even eager to help. It's easy to fall into the trap of depending on this child to make your life easier and help with a brother or sister, but it can backfire. Children develop best when they are treated like children, not little caretakers. When you want to give your kids responsibilities, it's better to find household chores for them, while you take care of the family members.
5. Remember the advantages.
My intent is not to add a heavier load onto what may already be a very stressed family.  Kids with special needs siblings generally learn to be especially compassionate, thoughtful, and caring adults. The sibling relationship can be much closer and deeper than in other families. And the most important thing any child needs is a loving parent. So do the best you can for everyone in the family, including yourself, and never feel guilty about being less than perfect.

Tuesday, June 23, 2009

Autism and Strengths in Problem Solving

It’s exciting to find researchers focusing on all the strengths that go along with autism and Asperger’s, the enhanced abilities and skills, and not just studying deficits and difficulties. On that topic just this month, there was an interesting study published in the journal Human Brain Mapping.
The study compares autistic and non-autistic individuals’ performance on a standard assessment tool called Raven's Standard Progressive Matrices (RSPM). What’s perhaps most interesting about the study is that the autistic subjects performed better than would have been predicted by the results of their IQ tests, and that the autistic subjects, while as accurate as their non-autistic counterparts, performed the test more rapidly. There were also differences in which areas of the brain were active, indicating that the autistic subjects used more visual processing in their reasoning.
Lead author Isabelle Soulières, a post-doctoral fellow at Harvard University who completed the experiment at the Université de Montréal, commented, "Some critics argued that autistics would be unable to complete the RSPM because of its complexity, yet our study shows autistics complete it as efficiently and have a more highly developed perception than non-autistics."
Per the test publisher, “Raven’s SPM is a nonverbal assessment tool designed to measure an individual’s ability to perceive and think clearly, make meaning out of confusion, and formulate new concepts when faced with novel information. It has been used world-wide for more than 70 years.” The article, Enhanced visual processing contributes to matrix reasoning in autism, by Isabelle Soulières, Michelle Dawson, Fabienne Samson, Elise B. Barbeau, Chérif P. Sahyoun, Gary E. Strangman, Thomas A. Zeffiro, Laurent Mottron, was published online on 15 Jun 2009. You can find a review at Autism News or read the abstract for the study online.

Monday, June 15, 2009

Summertime Boredom

I’m a big fan of unstructured time for kids. And it’s never as easy to schedule as it will be during the summer months.
I think it can be tempting for parents to fill kids’ summer days up with activities, camps, playdates and daytrips. And, I’m not against any of these. Certainly, if child care is needed, or your child needs to catch up in summer school, these structured activities may not even be optional. But, too often, I think parents feel like they have to keep their kids busy, or they’re not being good parents. And that’s just not true.
I hope parents will take some time this summer to allow their kids to do nothing, to putter around in the back yard or the neighborhood, to lie on the hammock and read a book. It’s OK for your child to be bored, children need to learn to entertain themselves, not just to participate in structured activities. Children learn creativity from doing things on their own. They learn to make friends when they’re drawn to interact with the other neighborhood kids.
Notice that I’m not talking about TV or video games here. Again, I’m not against TV or video games. I think they can be an appropriate relaxation activity for some kids, and they are a huge part of children’s cultural world. But, screen time, whether TV, video game or computer, is still a place where your child is being entertained. There’s no need to figure out how to entertain yourself amidst the flashing lights and the laugh track.
Instead, let’s just do nothing. In honor of that, I think I’ll cut back on my summer blog posting schedule, so I have some down time too.

Friday, June 12, 2009

GLBT and on the Autism Spectrum?

A lot of people ask me for info on support groups, social groups or discussion groups. Sometimes I can help them, especially if it’s something fairly common, like locating a parent support group for local parents with kids on the spectrum. But it seems like it gets tougher and tougher to find a group as the potential members get older. There are a lot fewer groups for teens or adults, and if the group is for multiple special issues it can really get difficult. That’s why I was pleased to find that GRASP is starting a new online discussion group for teens and adults within the GLBT community.  
Please check out the GRASP website for info on their latest support group: the GRASP GLBT Network. GRASP defines this group as a “discussion group for adults and teens who are on the autism spectrum and members of the gay, lesbian, bisexual, transgender, queer, or questioning community.”

Friday, June 5, 2009

What Will Your Kids Be Like As Adults?

I’ve worked with a lot of autistic kids who are really struggling. And that’s hard on their parents too, because they worry about the future. Will their children grow up to be safe, happy, productive?
No one can predict the future, but I always want to look toward the positive side. So many successful adults with Asperger’s or autism tell of difficult childhoods. An example I recently read was in the 5/16/2009 Newsweek article on Ari Ne’eman. Ne’eman is a college student, autistic, and the founder of the Autistic Self Advocacy Network.  I think by anyone’s standards he’d be considered quite accomplished. So it was especially interesting to read about his childhood in the article:
Ne'eman battles a strange kind of image problem: his critics accuse him of not really being autistic. His mother, Rina, is particularly sensitive about this. "People who see Ari today have no idea where he's been," she says. As a young child, Ne'eman was verbally precocious but socially challenged. "I didn't understand the people around me, and they didn't understand me," he says. He was bullied and ostracized—back then he didn't look at people; he flapped his hands and paced incessantly (he still does both today); he brought newspapers to elementary school as leisure reading. "I think the word 'freak' may have come up," he says. He was, at one point, segregated from his peers in a special-ed school. That led to struggles with depression and anxiety so severe he would pick at his face until it bled. I asked Ne'eman how he manages all the professional mingling he does today. Small talk makes him uncomfortable, but he's learned to play along. Still, none of it is easy. "You come out of a meeting and you've put on a mask, which involves looking people in the eye, using certain mannerisms, certain phrases," he says. "Even if you learn to do it in a very seamless sort of way, you're still putting on an act. It's a very exhausting act."
And Ari Ne’eman is just one example of so many autistic adults who are thriving, both in spite of and because of their autism. So what will happen with your child? You can’t predict, but neither can the specialists.
I do know that all kids do better with good, supportive parenting, adults who stand up and fight for their kids no matter what, and extra help when they’re really struggling, whether socially, academically, or emotionally. And every child deserves to have a parent who’s optimistic about the future.

Thursday, June 4, 2009

Asperger’s, Autism and Psychotherapy

I’m a therapist, also called a counselor, a psychotherapist, or even a "shrink",  and I work with people who have Asperger’s, autism, or other ASDs. But that doesn’t mean I’m trying to cure someone of their autism. That’s a confusing distinction, but it’s important.
Many individuals on the autism spectrum are struggling with the symptoms from a mental disorder, such as depression, anxiety, or getting caught up in repetitive thoughts. Those are all things that can be treated with psychotherapy, (and sometimes other means), and often “cured” or at least managed so that the symptoms aren’t a problem.
Other individuals on the autism spectrum are trying to deal with issues that go along with their autism, such as difficulties with social signals or managing relationships. Those symptoms can also be managed through psychotherapy.
But the important thing is that in neither of these cases is psychotherapy meant to take the autism away from an individual. It’s not trying, or even wanting, to “cure” autism or Asperger’s.
I think that many autistic people don’t want to be changed. They appreciate and enjoy their cognitive strengths. They derive a great deal of pleasure from their special interests. They relish alone time. And they have no interest in becoming a social, outgoing, maybe even shallow, neurotypical.
The good news is that people can have the best of both worlds. Therapy can manage depression, anxiety, or other symptoms so they’re not a problem. People looking for more satisfying relationships or professional success can learn to adapt in the ways they choose to. And at the same time, all the strengths and special characteristics of ASDs don’t have to be erased.
You can learn more about this topic at my Therapy and Coaching for Asperger's, Autism and ADHD website or in my ezine article on Depression with Asperger’s and Autism.

Friday, May 29, 2009

As the School Year Ends

In my last post, I gave some tips on setting things up so that kids have a fun and social summer. On the flip side of that planning, I think it’s important to think a bit about academics, such as what worked and didn’t work this school year.
Has it been a great year? I hope so. Now is a good time to analyze that success. Was the teacher a great fit? It might make sense to schedule an end of year meeting and get that teacher’s tips for what might work next year. Lot’s of structure, frequent breaks, short term rewards, a buddy system? You child’s teacher has probably put a great deal of time and effort into fine tuning a classroom and homework situation that has been effective. Now is a good time to see what can carry over to the next year. If possible, the teacher could even meet with next year’s teacher to pass on some of these tips.
Has it been a bad year? Thankfully, it’s almost over. Before you breathe a big sign of relief, it will probably pay to consider what the problems were. Compare this bad year to one that worked out better. Was there a big difference in teacher personality, the tone of the classroom, the way homework or discipline was handled?
Remember, you are the expert on dealing with your child. You’ll need to share your expertise with teachers, the principal, and all the specialists who will be working with your child. It’s best if you can be precise, detailed and concrete in discussing how to manage your child’s education. Saying something vague, like, “Ms. Jones was really nice, my son liked her a lot better than Ms. Smith.” will not be very helpful. But, if you put a bit of effort in now, you’ll be able to come up with a very clear statement, like, “My son does best in a structured and quiet classroom, like he had in third grade. In fourth grade, the room was much busier and louder; he reacted badly to that  much stimulation. He also responded very enthusiastically to his first grade teacher’s visual behavior plan.”
See what details you can figure out for your child.

Friday, May 22, 2009

End of the School Year Tips: Plan Now for the Best Summer

Just a few more weeks and you’ve made it through another school year! For kids with special needs like autism, Asperger’s or ADHD, the upcoming break can be a huge relief. But, before you walk out the school door for the summer, there are a few things you should take care of now so you have the best summer ever.

Make Some Social Contacts:

The summer is a great time to relax with family, but your child needs to spend some time with peers as well. It’s a lot easier to connect with some friendly kids and their parents now, while you’re all at school together. See who’s going to be around this summer, get their contact info, make some casual plans.
Think About Camps and Activities:
Now is the time to plan some structured activities for  your child’s summer, and it’s great if there are going to be some school buddies there also. Check with the other parents and see if any activities are going to be especially popular this summer. Shared activities help friendships grow. Next year in school, your child may be best friends with the kids from camp this summer.
Plan on Sports:
Many kids with ASDs are not very athletic. That’s tough, because children’s social lives revolve around sports. Find out from the homeroom teacher or PE coach what the kids play on the playground during recess. It’s probably something that requires ball handling skills, like kicking or dribbling. Jumping rope may also be popular. Whatever the game, the summer offer a great opportunity for your child to practice and catch up with their classmates’ skills.
That’s it! A few simple conversations and you’re ready for a great summer.

Reading Faces: Emotions Revealed, by Paul Ekman

All of us, whether on the autism spectrum or not, could do a better job of reading each other’s emotions. One obvious way is to look at facial expressions. And the expert on facial expression is Dr. Paul Ekman, a psychologist and author who has devoted his career to understanding how humans in many cultures express emotions . Ekman spent 8 years developing a facial expression coding system and studying how we express common emotions like anger, fear, sadness, happiness, surprise and disgust. He’s worked with everyone from police departments to the Dalai Lama, and is one of Time magazine’s 100 most influential people of 2009. The Fox TV show Lie to Me is based on Ekman’s work.
One of the most interesting things about Ekman’s work is that these skills can be learned. In “Emotions Revealed” Ekman uses detailed pictures of his daughter making tiny changes to her face, and explains how this results in vast differences in expression. This is backed up with news photos of people expressing the same emotions. Ekman explains how we can even generate emotions in ourselves just by moving our facial muscles. The back of the book gives a quiz on reading facial expressions, which Ekman suggests taking both before and after reading the book.
You can find more info on Paul Ekman, including extensive interviews with him, on his website.