by KC Kelly, Ph.D.

Autism: A Case Example of Hope

Alex’s (name has been changed to protect anonymity) mother sat across from me and cried into her hands. “I just don’t know what to do anymore,” she began. “From the moment he gets home from school, he races through the door and right to the couch in the living room where he throws all the pillows onto the floor and begins to run back and forth jumping all over both of the couches. I’ve tried everything to stop him, but he doesn’t even seem to realize that I’m there. He’s in his own world. He climbs on the wall unit, breaking things and one day it almost fell over on him! He will also throw tantrums by screaming and crying at the top of his lungs for hours and I don’t know what he wants!” She stopped talking and continued to cry.

Alex has autism. He is five (5) years old and falls into the lower end of what we call the Autism Spectrum. He does not talk, does not communicate, and exhibits aggressive behaviors such as hitting, biting, pulling hair and scratching when he does not get what he wants.

What is Autism?
The experts define autism, also called autism spectrum disorders (ASD) or autism spectrum conditions (ASC), as a spectrum of psychological brain developmental disorders characterized by widespread abnormalities of social interactions and communication, and often patterns of highly repetitive behavior(s). Just like with any child, or any person with a disorder, symptoms and behaviors can vary greatly amongst those with autism.

The Bad News:
There is no known cure for autism.

The Good News:
No matter how low functioning the child, autism IS treatable and a child with autism CAN grow, learn and change.

The Scenario:
Alex goes to school in an autistic class and follows a schedule throughout his day with his peers. He works with professionals in the field of autism, so his behaviors ARE controlled to some degree. This is a definite indicator that Alex CAN learn at home.

My Challenge:
To help Mom become an expert, not necessarily on autism, but on her son.

How We Started:
Firstly, Mom and I did a home make-over into a child-proof safety zone. Next, we talked for a while about what needed to be done to help change Alex’s behaviors at home. I explained to Mom what Alex needed: Routine, Consistency, and Repetition as I witnessed a complete absence of all three of these imperative factors for change in the home. Sound simple to do? Well, the idea is simple. The execution of the idea? Not so much.

1. Routine: An autistic child needs a steady, consistent and solid daily routine. They also need to know what the routine is in a very visible, clear and easy to understand way. If an autistic child does not have a daily routine, this could be the reasoning behind exacerbated acting out behavior(s). I made Alex a picture schedule including his entire day of activities from the moment he woke up in the morning until bedtime. Introducing the schedule to Alex was not easy, but with repetition he stopped testing us and it became routine. Now the test would be to see if Mom could enforce this consistently everyday.

Note: Schedules can be made using either use words or pictures depending on the academic level of the child. The schedule is usually made from small laminated cut outs containing the words or pictures, and with the use of velcro, are put upon a rectangular shaped piece of colored cardboard. (This is how I do it.) The activities of the day are all present and flipped over to show completion. A child should never start an activity without checking their schedule, and similarly, he/she should never end an activity with flipping the piece over and seeing what is next on the schedule.

2. Consistency: Never break the routine. I understand that “life happens” and we must leave room for flexibility; however, for the most part, the way a child is going to learn best is through consistency. The best way for an autistic child to learn is when they know what to expect. This also helps to reduce anxiety and increase reliability and a comfort level conducive to learning.

3. Repetition: An autistic child needs repetition. In order to learn, things must be done over and over and over again. It is important to have patience and if your child is not “getting it” right away, try not to get upset. Instead, take a deep breath and DO IT AGAIN. Repeat, repeat, repeat. And then praise.

Important: When introducing something new to an autistic child, you want to do so in a soft and gentle, yet firm manner. It may be very frustrating at times; however, use you must use repetition without losing patience. I promise you will be rewarded when manipulation ceases and learning begins. I also showed Mom how Alex learned that FIRST he will do a task and THEN he will get rewarded. I usually like rewarding with verbal praise or a small healthy snack. It all depends on to what the child responds best.

The Terrible Tantrums:
“Alex will SCREAM and cry for HOURS,” said Mom with exasperation. It was indeed a piercing scream that I witnessed myself on many occasions, and when I think of that noise today, my ears start to ring. I made pictures of basic needs, such as bathroom, hungry, thirsty, pain and demonstrated to Mom how to use these with Alex. If none of those things were bothering Alex, we knew he was attempting to manipulate Mom for attention or because he was upset that he didn’t get something that he wanted. Mom needed to stay consistent in not giving in to Alex’s tantrums no matter how heart breaking they were to watch. She needed to allow him to “cry it out” until he was willing to either communicate with us using his pictures or give up his manipulating tactic.

Remember: We need to never get upset at a child who has difficulty communicating, but help them the best we can to let us know what they want/need.

After working for approximately 6 weeks, 2x/week with Mom and Alex, Alex changed his behavior at home dramatically. It was a long road. It was a frustrating road. But it paid off. Now that I’m not there anymore in the home to help, I can only hope that Mom (and I DO understand how difficult it is) will remain consistent with Alex’s home routine and use repetition, patience, and love when teaching him new things.

If you are looking to get some specific questions answered about autism or to help you with an autistic child, whether the child is your own or a student of yours, please feel free to write to me at: www.DOCintheBiz.com. I would love to hear from you.

All my best,
KC Kelly, Ph.D.

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Lucky or unlucky in love? Into which category do you fit? OMG…can it be any tougher or more confusing? Love that is. Whether you’re 16 or 40, heartache can hurt just as much. The game of love can be just as confusing. Feelings are all relative depending on what kind of person you are. I’m not writing this article to tell you the do’s and don’t of love or relationships, but to encourage you that if you haven’t found it yet and you want to, my suggestion is to keep patient and believe that it will happen for you. Stay positive, stay honest, stay real, treat others with the kind of respect that you want for yourself from them, and love will find you. Probably when you least expect it.

And whether you have found it or not, allow honesty, truth, and communication to be your keys to success. Being open (even if the truth hurts) is the best way to help Karma to be on your side when it comes to you finding love or to you keeping it once you have it. Some believe you get what you give and isn’t that what love is all about? So, if you’re interested in someone or not, or confused or hurt or happy, let the other person know. Take the chance. Because holding things in is not the way to be a healthy you. And you want someone to love you for YOU! Sound simple? Well, truthfully, it really can be just that simple.

All my best in luck and love.
Dr. KC
www.DOCintheBiz.com
www.GLCzone.com

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by KC Kelly, Ph.D., LMHC

Questions and Answers by DOCintheBiz.

Question: I received an email from a woman who seems to be in an abusive relationship. She is very torn as she says she is in love with him, however, he can tend to be very harsh, angry, controlling and makes her cry way too often by putting her down or having anger outbursts directed at her. At times, she fears him. I have decided not to share the letter for confidentiality reasons; however, I have shared my response to her.

Answer: I would never tell you what to do. I can’t do that as no one has the answers but you. What I can share with you are some facts I have learned throughout my studies and through experiences working with many different people.

Personality traits don’t change. Controlling behavior does not stop. Abusive patterns are just that; patterns. They do not stop. You’ve seen it before…movies, wherever. Significant others may insult, demean, put down, curse, become belligerent, etc. and often this kind of behavior can become physical. Then, when the dust settles, they may cry, beg, plead, etc telling their partner that it will never happen again. But it does, almost every time.

Personality traits are embedded deep within a person’s genetic makeup. I know you say you want to try to understand him and the kind of behavior that he demonstrates; however, even the experts debate why people abuse. They debate nature vs. nurture as a child, but that’s not even the point here. The point is that he is the person that he is now as an adult, no matter how he got there, and you cannot change that. You shouldn’t have to change it.

The victim of the abusive behavior almost always feels as though they are at fault after they think about it for a while. Just as you said, you rethink the situation and end up blaming yourself. No, you’re not perfect, but you do not EVER deserve the treatment he gives you when he’s angry. There are many ways of fighting. His way is NOT an acceptable way. There are many ways to tell someone that you don’t care for something they are doing, saying, wearing, etc, but by overtly putting them down or yelling/cursing at them is NOT right.

I believe you when you say that your boyfriend can be a good guy, or you would not have fallen for him in the first place. I’m also sure that he does not mean to hurt you, but it’s just his way. He doesn’t know any differently. What he does seem to know; however, is exactly how to control you. He knows that when he cries or begs, it breaks your heart and you respond according to his plan. Again a pattern. You have to decide whether this is the kind of life you want for yourself. Whether or not you want to walk on egg shells, as they say, wondering how he will treat you each day.

The man who truly loves you wipes your tears away, he does not cause them.

All my best,
Dr. KC
www.DOCintheBiz.com

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How many of you have children? How many of you work with children? I thought this was a very interesting view on the difference of behavior labeling for adults and children. Some may be a little severe and not always hold true in all cases, of course, but which ones do you agree with and why? Please share your experiences. I would love to have your input.

If an adult is reinforced for behaving appropriately, we call it recognition.
If a child is reinforced for behaving appropriately, we call it bribery.

If an adult laughs with friends, we call it socializing.
If a child laughs with friends, we call it misbehaving.

If an adult writes in a book, we call it doodling.
If a child writes in a book, we call it destroying property.

If an adult sticks to something, we call it perseverance.
If a child sticks to something, we call it stubbornness.

If an adult seeks out help for something, we call it counseling.
If a child seeks out help for something, we call it whining.

If an adult is not paying attention, we call it preoccupation.
If a child is not paying attention, we call it distractibility.

If an adult forgets something, we call it absent-minded.
If a child forgets something, we call it attention-deficit.

If an adult tells his side of a story, we call it clarification.
If a child tells his side of a story, we call it talking back.

If an adult raises his voice in anger, we call it maintaining control.
If a child raises his voice in anger we call it temper tantrum.

If an adult hits a child, we call it disciplining.
If a child hits another child, we call it fighting.

If an adult behaves in an unusual way we call him unique.
If a child behaves in an unusual way, we refer him for psychological evaluation.

Author Unknown

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Many a day, I have spent hours sitting on the floor in the philosophy section of used book stores, reading some of the most magnificent works of art written. The smell of old books is joyful. The idea that the books I love so dearly are approximately an average of two dollars each is unbelievable being that the material inside those books is priceless. Anything that can change a life for the better is indeed, priceless. I have three copies on my book shelf of one of the most significant and popular books about Existentialism ever written: “Man’s Search for Meaning” by the amazing Father of Existentialism, Dr. Viktor E. Frankl.

How I wish that he was still alive when I was researching his life and his philosophies in order to write my dissertation on existential analysis, a topic that just didn’t make it to the final cut due to its complexity. However, the hours spent reading and learning were something I don’t regret. I learned a whole new epistemology in which I live my life. After “meeting” the works of Dr. Frankl, I quickly became proud to call myself a post-modern Existentialist. All thanks to a man that passed on before I was able to meet him. And believe me, I would have tried.

Dr. Viktor E. Frankl lived through the horrific experiences of the Auschwitz and Dachau concentration camps. Through his agony, this hero never stopped attempting to help many others in the camps to survive the horrid conditions and dehumanizing abuse imposed upon these prisoners. They were starved and worked naked in the snow and freezing temperatures. They were beaten, tortured, and lived with the fear of impending death by gas at any moment. The conditions in which these people were forced to live were ghastly, dreadful, and unspeakable. Through his great will, believes, and ideas that the mind is the strongest force which one can control through his/her own consciousness given the desire and aspiration to do so, Frankl himself survived. It was his will to survive; his belief that one day he would be reunited with his wife and unborn child (who were immediately taken and killed) that helped him through his daily torment. The music that he could hear in his mind, the beauty that he could find in the sunset, the beliefs he held onto were “things” that no one, no matter what, could take away from him. Dr. Viktor E. Frankl reached liberation! Given the worse circumstances imaginable, he survived. In his writings, Dr. Frankl borrowed the brilliant words of Neitzsche, who said, “He who has a why to live for can bear almost any how.”

We can probably all agree that if you are alive, you are going to find yourself in controversy, in pain, and in suffering at some point or another. The discourse may not be as horrific as the unspeakable horror of living in a concentration camp, but it is suffering none-the-less. After all, suffering is relative. The point is, that it is imperative that one finds meaning in existence and in suffering. That is what Dr. Frankl contributed to the world of psychology.

Go ahead, I challenge you to read, “Man’s Search for Meaning” and not shed a tear, not feel hatred for the disgust that mankind can impose upon each other, and not cheer when our hero reaches liberation. Dr. Frankl teaches how to love unconditionally. He teaches how the human spirit has strengths deeper than one could ever believe or imagine having. He is living proof that a person can have everything and everyone stripped away from him/her and still understand that the most important thing that could not be taken away is belief, faith, love. With these in tact, one can survive anything, says Dr. Frankl. To quote this great hero, who believes that we all have the freedom of spirit and faith, “It is this spiritual freedom which can not be taken away that makes life meaningful and purposeful.” He also stated, “Everything can be taken from a man but one thing: the last of the human freedoms, to choose one’s attitude in any given set of circumstances, to choose one’s own way.” We are each responsible for finding our own meaning to our existence and to our suffering. We cannot put that responsibility onto anyone but ourselves. For to do so would not only bring about someone else’s perception leading to THEIR answer to what we are trying to discover, but also unfair.

Dr. Viktor E. Frankl has written many books and I own every one of them. They are in “loved” condition right from the shelves of bookstores where people place what they consider trash into the hands of what others consider treasure. The works of Dr. Frankl are my treasures…along with the meaning that I find in MY life and what helps me to be the kind of therapist and person I am.

Here are just some amazing titles from an incredible psychiatrist, who gave so much to the movement of his time and still gives today.

Man’s Search for Meaning

Man’s Search for Ultimate Meaning

The Unheard Cry for Meaning

The Will to Meaning  

The Unconscious God

Psychotherapy and Existentialism

Thank you for reading about my hero. Who is your hero?

Dr. KC

www.DOCintheBiz.com

www.GLCzone.com

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by KC Kelly, Ph.D., LMHC

Questions and Answers from DOCintheBiz

Question: Can you please give me a definition in plain terms of what Borderline Personality Disorder is? I get so many clinical definitions and to be honest, I am not happy about the answers because not every symptom relates to me and I don’t like being categorized into a “mold” if you will. I just want to know how others you have worked with who have BPD feel and act. I don’t know. Just searching for some answers and some understanding.

Answer: There are many emotional or mental disorders and they all have DSM textbook definitions. Sometimes these definitions are hard to bear because they do tend to lump people into a category and it doesn’t seem fair. I can appreciate what you are saying here and empathize with you about how infuriating it can be to be stigmatized into a “mold” with others.  

We are all unique individuals and most times, no two people experience a disorder in the exact same way. It does help; however, to have a “textbook” explanation, so that it can give a doctor a starting off point to try to properly diagnose and treat a disorder.

After the initial diagnosis, I personally have my clients take the term assigned and throw it away. This is when we can begin to work with dealing with or eliminating the symptoms. It is important to have a doctor who understands that you are unique and different than anyone else and although there may be many commonalities between people with the same disorder, everyone is different. Find a doctor who understands YOU and does not treat you like everyone else, but as the wonderful and unique individual you are.

On the social networking site GLCzone, I found an amazing blog by someone who deals with Borderline Personality Disorder. She added the following video to one of her articles and I personally think it gives amazing insight into BPD. I encourage taking five plus minutes to view this video. Being full of accurate information, compassion, understanding, and warmth, I think it will be well worth it.

All my best,

Dr. KC

www.DOCintheBiz.com

www.GLCzone.com

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by KC Kelly, Ph.D., LMHC

Questions and Answers at www.DOCintheBiz.com

Question: Dear Doc KC,

I’ve been a single woman for over 4 years now after ending a 5 year marriage. I’ve dated since then, but only frogs and I’m really ready to meet my prince. What advice might you have to give me? Anything would be appreciated. Thanks so much. I trust you so much!

1. Loving yourself is the key to accomplishing goals and creating healthy relationships. High self worth gives you the confidence you need to take the right chances and to make the right choices for what is best for you in career, friendships, and love. It also helps you to avoid making the same bad decisions you may have made in the past. High self esteem allows you to feel good about yourself and feel happy. When you’re happy, it often radiates to all those around you. People tend to gravitate towards and like happy and positive people. Smile at someone and watch as they just naturally smile back.

2. After that comes attitude and frame of mind. Your attitude and the way you approach life and treat others will determine the way your life turns out and the people that find their way to you. You can be positive or negative. Try them both and see the outcome. I believe that you’ll find staying positive no matter what obstacles get in your way will take you farther in the game of life. No, no one said it was easy, but just do it anyway. When something or someone annoys you, try to laugh it off. Surround yourself with people who have positive healthy attitudes.

3. Lastly, believing is key. To truly believe that you will accomplish what you set out to do and find the person with whom you were meant to be is so important to seeing it all come true. Patience, persistence and believing will ultimately be what gets you what you want. Keep a good support system around you of people who believe in you and your goals. Don’t let others pull you down or think you’re selfish because there is something that you want for YOUR life. There is room for everything and everyone as long as you make that time. Those that love you unconditionally will understand.

All my best,

Dr. KC

www.DOCintheBiz.com

www.GLCzone.com

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