FAQautism

Matter of Degree

Talk@FAQautism.com (Cathy Knoll, MA, MT-BC) — Fri, 12 Mar 2010 04:01:53 +0000

One of the primary characteristics in autism is that of restrictive and repetitive behaviors. At what point do these issues become a problem? Since restrictive behaviors are inherent in autism, is it reasonable to expect people with autism to stop all restrictive behaviors? Is the heart of the issue actually a matter of degree?

Listen Now:

or

continue reading

First, let us take a quick look at different types of obsessive, restrictive, repetitive behaviors. Every individual diagnosed with autism has some difficulty with at least one of these issues to one degree or another.
A. Obsessive rituals
B. Repetitive mannerisms and stimming
C. Inflexible routines
D. Intolerance for change
E. Resistance to transition
F. Extraordinary sensory issues
G. Narrow repertoire of interests

Is the repetitive mannerism, inflexibility, or obsessive interest a problem? Experience teaches us that all issues related to autism are a matter of degree. Although inflexibility and obsessiveness are inherent in autism, we can, in some cases, gradually help a person build tolerance for change. The key to success is to determine which issues must be addressed and to leave the other issues alone.

We learn we cannot micromanage every detail of a person’s life, so we overlook issues that do not cause specific problems. So, for example, we allow our friends with autism to watch a favorite movie over and over or to insist on a certain brand of toilet paper, a daily menu of the same three items at every meal, or watching the same movie for years on end. Restrictive interests and repetitive behaviors are inherent in autism, it is probably counterproductive to try to erase all such perseverative interests.

On the other hand, some obsessions must be shaped. For example, I have several friends with autism who insist on riding in a certain car with just one family member driving. This causes major issues when that person is not available to drive or when the favorite car must be traded in for a different car. In another example, one of my students became extraordinarily attached to a certain pair of shoes. The youngster eventually outgrew the shoes and experienced major trauma for several months when it became absolutely necessary to get new shoes.

TIP FOR THE DAY: All of us are inflexible to some extent about some aspects of our daily lives. The difference with autism is a matter of degree. Life is smoother for all concerned if we follow a two-step plan: (1) to tolerate some obsessive interests and behaviors, (2) to patiently help our friends with autism learn flexibility, tolerance for change, and other key life skills.

We can also benefit from sharpening our skills in being able to systematically address challenging issues that can arise in the lives of our friends with autism. Click on the Toolkit tab on our webiste for great resources; http://FAQautism.com

NOTE TO READERS AND LISTENERS: I am Cathy Knoll, a board certified music therapist and long-time friend of many folks with autism. At FAQautism.com we are committed to providing free, practical, everyday tips for making life better for people with autism. Feel free to send me a confidential email at talk@FAQautism.com with your thoughts or challenging situations or innovative solution. And don’t forget to check out our website for a wealth of ideas and a glimpse into the world of autism. http://FAQautism.com

The following posts may also be helpful:

Matter of Degree Autism does not have a monopoly on challenges and problems....
Crossing the Line When do rituals and repetitive behaviors and transition issues and...
Uneven Behavior Issues We are continuing the discussion about the unpredictable combination of...

Stimming

Talk@FAQautism.com (Cathy Knoll, MA, MT-BC) — Thu, 11 Mar 2010 04:01:09 +0000

We typically think of “stimming” as one of three actions common in autism – rocking, hand posturing, or hand flapping. But, in reality, our friends with autism display dozens of other non-functional, stereotyped, repetitive motor mannerisms. Let us look at some examples of stimming.

Listen Now:

or

continue reading

These are some of the “stimming” incidents I observed during a day last week of music therapy in public school classes for youngsters age 3 to age 22.
+ When given a bit of “down time” in his early childhood class, Nathan pick’s tiny pieces of thread, grass, or other minute items he finds on the floor. Louis is standing, spinning around, and flapping a ribbon.
+ When required to sit still in a school assembly, Matt rocks a bit, hums under his breath, and thumbs through a book incessantly.
+ An elementary student is able to remain calm as long as he is holding a stack of cards in a plastic card box. Sometimes he rocks, hums, and thumbs through the cards, and sometimes he puts them in a box, then flaps them in front of his face.
+ A junior high student occasionally jumps up, flaps his right hand very hard in front of his face, holds his face in a tight, agitated expression, makes a bit of a sound, turns red in the face, then relaxes and sits after about 1 minute.
+ A high school student quietly repeats nonsense phrases and sounds for about 5 minutes at unexpected intervals. He appears disconnected and does not respond to other people.
+ Several students of various ages unexpectedly stop what they are doing in school and start quoting a script of a movie or television show. Some of the youngsters gradually start rocking and talk louder, somewhat as if they are agitated.
+ An elementary age student constantly picks sores on his arms, legs, face, and stomach, sometimes making the sores bleed.
+ A junior high student shakes toilet paper, Kleenex, and any other light paper he can find. He hums and does not respond to other people or reminders to pay attention.
+ A third grader repeats the words of childrens’ songs, beginning under his breath, then increasing in volume and speed, using affective speech that distorts the pronunciation of common words.
+ An articulate high school student in standard classes often rocks and flaps her hands when she is intensely focused on the teacher or other speaker.

Tip for the day: These are just a few examples of the stimming behavior observed in a day of music therapy in the public schools. Questions to consider: When is stimming socially inappropriate? Is it just a matter of degree? Does stimming increase or decrease comfort and calmness? Does stimming interfere with functioning and learning or does it increase focus?

A question for parents, teachers, and therapists: How can we sharpen our skills for systematically addressing challenging issues that arise in the lives of our friends with autism. Click on the Toolkit tab on our website for great resources; http://FAQautism.com

The following posts may also be helpful:

Rocking What is the best response to rocking? Some individuals with...
Inside Snapshots When individuals with autism describe the challenges they encounter and...
Teacher Questions 3 A large group of junior high and high school teachers...

Teacher Attitude part 2

Talk@FAQautism.com (Cathy Knoll, MA, MT-BC) — Wed, 10 Mar 2010 04:01:45 +0000

We are continuing a conversation about teacher attitude – about welcoming students with autism into a typical classroom. In the podcast “Teacher Attitude 1,” we talked about the first of three basic principles for educators to consider when welcoming students with autism into the classroom. In this podcast, we will continue the discussion.

Listen Now:

or

continue reading

You can check out the discussion about the first principle, “Person First,” by clicking on the “Teacher Attitude 1” post on our website: http://FAQautism.com. We will continue that discussion with two more basic principles for teachers to consider.

2. FRAME OF REFERENCE. Autism is very complex, making it difficult to make generalizations. Each person has uneven strengths and deficits in a number of issues that impact their ability to learn, to interact with other people, to communicate, to follow directions, and to tolerate change. For example, one student may appear on the surface to be “higher functioning” than another student with autism in the class because they are on grade-level academically. But, in reality, that academically-typical student may not be toilet trained or may have other issues significantly more challenging than those of the “lower functioning” student. For example, the “lower functioning” student may be much more flexible, cooperative, and attentive. Or, for example, a person with an extraordinary memory for facts and figures may not be able to apply any of that knowledge to daily life. These are just a few examples of the challenges teachers encounter in the face of the inability to place students with autism in neat categories.

3. NATURAL ASSUMPTIONS. It is natural to assume that a person who is unable to talk does not understand language. But the unevenness of autism actually prevents us from following that line of logic. Sometimes our fluent talkers are distracted by their own conversations or are oblivious to other people, while some non-verbal students have age-level abilities to understand conversations around them. Along the same lines, we tend to assume a person with wandering gaze is not interested or not paying attention. But that is not necessarily the case. Or we assume a person who throws an object to the ground is protesting the request to participate in a class learning experience when, actually, they are dealing with some marked sensory issues that make it difficult to hold that object. Over time, we realize the complexity of autism and learn to avoid assumptions, giving each individual the benefit of the doubt in areas such as communication, social interaction, self-help, sensory issues, and restrictive, repetitive interests, behaviors, and activities.

TIP FOR THE DAY: Educators are, of course, sensitive to and responsive to individual differences in all their students. But autism magnifies the issue, making it necessary for even the most experienced teacher to review these principles when students with autism enroll in their classes.

The following posts may also be helpful:

Teacher Attitude Part 1 Every student – whether they have specific disabilities or not...
Teacher Questions 3 A large group of junior high and high school teachers...
Teacher Instructions Many youngsters with autism encounter difficulty in school because of...

Teacher Attitude Part 1

Talk@FAQautism.com (Cathy Knoll, MA, MT-BC) — Tue, 09 Mar 2010 04:01:32 +0000

Every student – whether they have specific disabilities or not – has their own unique learning style and personality. The teacher’s job becomes even more complex when autism is added to that mix of individual differences. We will look at three basic principles for educators to consider when welcoming students with autism into the classroom.

Listen Now:

or

continue reading

1. PERSON FIRST. We do not, of course, define a person by their disability. Instead, we look past their limitations and challenges and view them as a person first. Although we know this principle, it can be difficult to overlook a person’s disability.

Let us put ourselves into a hypothetical situation to explore the issue. If a person we have known a person for many years – a family member, friend, or colleague – our viewpoint of that person immediately turns on its head when they tell us they have just been diagnosed with aggressive, terminal cancer. When we discover a person is going to die within a month, our topics of conversation and our interaction with the person changes noticeably and abruptly.

In the same way, we tend to treat students differently if they have significant physical disabilities or a history of aggressive, hurtful behaviors. The same challenge can arise when a student’s autism results in unusual interests, repetitive sounds, obsessive focus, or unconventional sensory issues.

Granted, it is difficult to look past specific disabilities and limitations. And a good teacher / therapist / parent will take disabilities and limitations into consideration every day. But it is critical that we look deeper and discover the “real person” who can be hidden behind all these issues.

TIP FOR THE DAY: As a teacher, you are, of course, sensitive to and responsive to individual differences in all your students. But autism magnifies the issue, making it necessary to consider three basic principles, the first being to consider “person first.” Click on the second half of this discussion – Teacher Attitude 2 – so we can continue this important discussion.

The following posts may also be helpful:

Teacher Attitude part 2 We are continuing a conversation about teacher attitude – about...
Chaos Reigns part 2 We are looking at some basic principles to consider when...
Dating Parents 2 We are continuing the conversation with a reader who asked...

Classroom Welcome

Talk@FAQautism.com (Cathy Knoll, MA, MT-BC) — Mon, 08 Mar 2010 04:01:55 +0000

Teachers on all grade levels have asked for tips about welcoming a student diagnosed with autism into a “regular education” classroom. The overall topic of helping a youngster with autism function well in school could fill several books. Today we will just look at one tiny issue that can make a world of difference from day one.

Listen Now:

or

continue reading

Although we know better, we tend to use a different tone of voice when greeting individuals with special needs as they enter the classroom. Some of our students with autism may not notice our daily greeting, but most probably prefer to be greeted in the same manner as their more “typical” peers.

VOLUME: For example, we tend to talk louder and more distinctly when addressing students with autism who are non-verbal. I guess we subconsciously rationalize that a person who is non-verbal will understand our conversation if we simply increase the volume. In reality, the impact of autism is very inconsistent, so some non-verbal individuals with autism have much better receptive language than a person who has normal conversational skills.

CONDENSCENDING TONE: Although we recognize the need to avoid singling out our friends, we tend to use a different tone of voice when greeting students with special needs, including those with autism. For example, we might inadvertently talk to pre-teen or high school students as if they are children, using a “baby voice” and saying things like, “Ohhh, I am so glad to see you today,” or “You are so cute.” If a person is non-verbal, we tend to use childish phrases and a condescending tone of voice. Even if they do not seem to notice, it might be more appropriate to welcome students with autism with the same words and tone of voice we use for more typical students.

AUTHORITARIAN TONE: Some students with autism have a history of aggressive, disruptive behavior. Because our guard is always up with these youngsters, we can forget to greet such students in a friendly, welcoming manner. Just a quick, warm hello is all it takes to develop a supportive personal connection with a youngster dealing with significant challenges.

TIP FOR THE DAY: These examples illustrate one of several keys to successfully welcoming students with autism into our classrooms. Greet the youngsters each day, even if they do not acknowledge that greeting, and to use the same tone of voice and words we use with more typical students in the class.

The following posts may also be helpful:

Teacher Attitude part 2 We are continuing a conversation about teacher attitude – about...
Oblivious to Others Although many people with autism are very sociable and communicative,...
Public Announcements Some things should just be kept private, but, for some...

Boring Stories

Talk@FAQautism.com (Cathy Knoll, MA, MT-BC) — Fri, 05 Mar 2010 04:01:33 +0000

Some individuals with autism repeat the same stories over and over or talk endlessly about one topic. How can we help our friends add variety to their conversations?

Listen Now:

or

continue reading

Perseverating on one topic or continually repeating stories can be a natural consequence of autism. One of the diagnostic criteria of autism is stereotyped behaviors, interests, and activities.

“Rehearsed conversations” is a strategy proven successful for several teens and adults with autism. For example, a pre-teen’s irritating habit of repeating the same story over and over again was standing in the way of her making friends at school.

The first step in the “rehearsed conversations” strategy for this youngster was to increase her awareness of the issue. A trusted therapist used a social story to help the youngster understand that her obsession with one topic rubbed the other kids the wrong way. Her awareness of the issue did not lead to more appropriate conversations.

The second phase of this pre-teen’s “rehearsed conversation strategy” involved helping her develop a new repertoire of stories. Her teachers, therapists, and family members helped her develop several three-sentence stories about interesting events at home, at school, or at community events. After rehearsing the stories for families and mentors, she learned to tell friends a story just one time, then to stop talking and listen to other people talk. This young lady also needed coaching to help her understand to wait for an opening in a group conversation rather than abruptly starting a story, interrupting others in the process.

So far, this young lady has not learned to speak extemporaneously, but her new “rehearsed” stories have resulted in her being more readily included in “girl talk” sessions at recess, in the lunchroom, and after school. Family members found they were more patient with the young lady as well not that she does not tell the same boring stories over and over.

QUICK TIP: We depend on your help to spread the word about these podcasts by telling your colleagues and friends to click on our website: http://FAQautism.com. Thanks!

Source: Diagnostic Statistical Manual, American Psychiatric Association, 2000, p. 70.

The following posts may also be helpful:

Girl Talk A pre-teen diagnosed with autism was having some trouble making...
Changing the Subject Some of my friends with autism tend to talk rather...
Repetitive Conversations No matter how patient we are, repetitive conversations about the...

Emergency Food

Talk@FAQautism.com (Cathy Knoll, MA, MT-BC) — Thu, 04 Mar 2010 04:01:05 +0000

Some of my friends with autism and their families are sitting in the dark and cold this week because of a treacherous blizzard that damaged power lines and brought their region to a halt. Weather forecasts allowed advance planning in this case. But situations sometimes arise unexpectedly, making it imperative to keep emergency supplies at hand. Because food can be a breaking point issue for some individuals with autism, let us look at some viable options for stocking an emergency food kit.

Listen Now:

or

continue reading

Special Diets. If your friend with autism has food allergies or requires a special diet, keep a sharp eye out for non-perishable, easy-to-prepare emergency foods that jive with those special needs.

Non-Perishable Foods. Although you can get propane stoves and other non-electric cooking devices, it is probably best to keep a food supply that does not require heating or refrigeration.

Meals. Some foods for “real meals” that so not require refrigeration or cooking include crackers, canned or packaged chicken or tuna, dried meats, olives, pickles, mustard, salsa, and other condiments as well as that old stand-by, peanut butter and jelly. Try the new “all-fruit” jellies with no sugar added.

Fruits and Veggies. When anticipating an emergency, gather a basket filled with apples, oranges, bananas, and other hearty fruits. You might also stock up on dried fruits and veggies that do not require refrigeration or cooking. Some favorites are raisins, dried apples and apricots, and dried veggie chips.

Food to go. Because we never know when an emergency might leave us stranded or without the ability to provide a regular meal to our friends with autism, we might want to keep a stock of nutritious snacks. In addition to some of the non-perishable foods listed above, gather up some cereal bars, snack mix, nutrition bars, pretzels, and other crunchy foods that can substitute for a missed meal if necessary.

TIP FOR THE DAY: Every person, of course, has different food preferences and dietary needs, but autism can magnify those needs. Emergency situations will run smoother if we plan in advance and stock an emergency kit with appropriate food.

Minor emergencies or frustrating situations can arise at unexpected times in our lives. Just click on http://FAQautism.com for a wealth of remedies for any crisis, large or small.

The following posts may also be helpful:

Emergency Supplies Natural disasters around the globe and close to home are...
Be Prepared Tornadoes are spinning in the mid-West and a tropical storm...
Emergency Kit Most of us find it challenging enough just to take...

Basic Job Skills

Talk@FAQautism.com (Cathy Knoll, MA, MT-BC) — Wed, 03 Mar 2010 04:01:42 +0000

What are the basics for getting a job? What skills does an individual with autism want to sharpen before going for that first job interview? Once employed, what skills can help people keep their job? Take a look at four job skills critical for successful employment.

Listen Now:

or

continue reading

(1) Focus. An employee must be able to focus on the task at hand, to listen to directions given by a boss or supervisor, and to turn attention to important announcements or safety drills. Successful employment also requires individuals to maintain focus on a task for an extended period of time.

(2) Follow. Compliance is another critical job skill. Our friends with autism will be much more productive in any job if they can and will follow directions with minimal assistance. If an individual has deficits in processing verbal instructions, she can be taught to use a visual schedule so employers and job coaches can successfully communicate the information she needs to complete a task or a job sequence. Strong-willed or uncooperative individuals will need to develop a willingness to follow directions and job procedures.

(3) Finish. Even when jobs are broken down into a series of smaller tasks, some individuals with autism are unable to complete those tasks without prompting from a supervisor or job coach. A critical job skill to teach early in life is to finish tasks with less prompting.

(4) Flexible. The nature of autism causes some individuals to be intolerant to changes in routine. Our friends with autism will be more likely to succeed on the job if they learn to be flexible and “go with the flow.”

TIP FOR THE DAY: All of us, whether diagnosed with autism or not, can benefit from improving our flexibility, persistence, compliance, and focus. Time spent shaping these basic skills can lead to success not only in the workplace, but also in daily life.

The following posts may also be helpful:

Job-Related Skills “My daughter is entering high school next fall,” wrote the...
On-the-Job Skills An informal conversation with parents, teachers, and business people yielded...
Ready for Work Some individuals with autism are very successful in the working...

Wisdom from Dennis

Talk@FAQautism.com (Cathy Knoll, MA, MT-BC) — Tue, 02 Mar 2010 04:01:35 +0000

A recent Dennis the Menace cartoon by Hank Ketcham has a 12-word caption filled with wise advice for parents, teachers, therapists, and families of kids with autism.

Listen Now:

or

continue reading

In the Dennis the Menace cartoon for February 25, 2010, cartoonist Hank Ketcham draws Dennis sitting in his time-out chair in the corner. His mom is giving him a stern and unyielding look in another futile attempt to eliminate Dennis’s misbehavior and mischief. Dennis peeks out of the corner of his eye and speaks words all parents should consider, “Wouldn’t it be easier just to tell me what I CAN do?”

This clever cartoon brings a chuckle to anyone who has been a teacher or parent, but it has some serious implications for our friends with autism. An inherent characteristic of autism is a deficit in communication skills, including receptive language, expressive language, and processing language. The language issues mixed with occasional inattention result in confusion and misunderstandings. Life runs smoother if we focus on telling our friends with autism exactly what they CAN DO rather than talking to them about what they CANNOT DO.

For example, if we say, “Don’t leave your shoes by the door,” our youngster with autism may become frustrated because they are not certain what we want themto do. So we can say, “Put your shoes in your closet now, please.” More examples:

+ “Read this book now” rather than “Don’t just sit there staring out the window.”
+ “Hands on knees” rather than “Don’t hit your friend.”
+ “Lunch first, please” rather than “Don’t go outside until you’ve cleaned your plate.”
+ “Quiet sounds, please” rather than “Don’t make so much noise.”

TIP FOR THE DAY: Let us consider two new habits. First, let’s get in the habit of telling our friends with autism what they CAN DO rather than focusing on what they CANNOT DO. Secondly, let’s get in the habit of reading daily cartoons like Dennis the Menace – they are filled to the brim with wisdom. Note: Dennis the Menace is the work of cartoonist Hank Ketcham with copyright held by North America Syndicate.

The following posts may also be helpful:

Inappropriate Language Occasionally one of my friends with autism will just suddenly...
Watch Your Words “I can’t believe my son loudly blurted out a graphic...
Do It Now Without meaning to do so, we all spend more time...

Stealthy Veggies

Talk@FAQautism.com (Cathy Knoll, MA, MT-BC) — Mon, 01 Mar 2010 04:01:10 +0000

Research confirms what grandmamma always knew: “Vegetables are good for you.” Of course, veggies have no impact on the health of people who refuse to eat them. Let us look at 3 rules to follow when attempting to sneak healthy vegetables into the diet of individuals with autism.

Listen Now:

or

continue reading

Rule #1 – no fanfare. The simple act of announcing (or, rather, pronouncing) healthy changes often results in resistance. You might consider dropping the word “vegetables” from your vocabulary. Just avoid saying things like, “You’d better eat your vegetables; they are good for you.” Adding more vegetables into the diet of a resistant individual with autism can best be accomplished if the changes are introduced without fanfare and very gradually, just increasing the amount of veggies in tiny, barely noticeable increments.

Rule #2 – blend in. Disguise the taste and texture of selecting one vegetable or a combination of veggies, giving them a whir in the blender, then stirring a bit of the pureed nutritional power mixture into spaghetti sauce, pizza sauce, meatloaf, stew, soup, or other dishes. You can even stir some into catsup or mix with ranch dressing or dip. Zucchini squash, tomatoes, red bell peppers, broccoli, green onions with tops, spinach, summer squash, green beans, green peas, carrots, cucumbers, and other veggies – fresh or cooked – are loaded with vitamins and antioxidants that make a big impact on long-term health.

Rule #3 – add crunch. Some folks who will not touch cooked vegetables love the crunch of raw veggies. The key is to serve the crunchy veggies in fairly small chunks. For example, cut celery into one inch chunks, add a bit of dip, and enjoy! Other good dippers are slices of cucumber, small carrot sticks, a sliver of sweet red pepper, or a thin slice of cauliflower. Another popular crunchy, tasty snack is dehydrated veggie chips, including colorful carrot slices, whole green beans, squash, and other nutritious crunchies.

TIP FOR THE DAY: The key to increasing vegetable consumption by picky eaters is to simply add more vegetables into daily diets, very gradually and without fanfare. Of course, you must take into consideration any food allergies or other dietary restrictions, but use these ideas to get the stealthy veggie attack underway.

The following posts may also be helpful:

Stealth Health: Veggies Questions about health issues are common when talking with parents,...
MORE Undercover Veggies Several parents and other caregivers asked for more ideas for...
Busting Boring Lunches “My daughter seems to have gotten in a rut with...

Do It Anyway

Talk@FAQautism.com (Cathy Knoll, MA, MT-BC) — Fri, 26 Feb 2010 04:01:21 +0000

What are our options when a friend with autism is reluctant about participating in fun, recreational activities? Some individuals with autism require special encouragement or promises such as “First, take a walk with me, then you can watch your DVD.” But in many cases, the best approach is to simply announce an activity and, if met with resistance, do it anyway.

Listen Now:

or

continue reading

MISTAKEN APATHY. Sometimes we fall into the trap of assuming lack of enthusiasm indicates refusal to participate. Some individuals with autism have a flat affect. Their facial expression and tone of voice can be mistaken for indifference. Lots of teenagers, whether they are diagnosed with autism or not, display a nonchalant, less-than-enthusiastic attitude, even when they are looking forward to an activity.

DON’T ASK. When my children were young, I learned to avoid the question, “Do you want to go hiking with me?” We have painted ourselves into a corner when a youngster answers the question, “Do you want to?” with the word “no.” At that point, we only have two choices: (1) give in to their negative response, or (2) jump into a battle of wills by insisting on participation.

EMPTY THREATS. I have also learned to avoid making comments like, “You’d better get some exercise” or “It isn’t good for you to just sit around.” Empty threats rarely yield the desired response since they fly right over the youngster’s head.

DO IT ANYWAY. The approach that most often garners positive results is to simply announce an adventure hike or a bike ride and shoo everyone out the door. As long as we are focusing on the well-being of youngster, we don’t need their permission. So, in many cases, the key to encouraging participation in fun, recreational activities is to ignore the apathy and do it anyway.

TIP FOR THE DAY: There are, of course, times when we need to respect a person’s preference to skip an activity. But, just as is the case with most of us, our friends with autism usually warm up to an activity despite their initial reluctance. So, do it anyway, and enjoy!

The following posts may also be helpful:

Half-Empty or Half-Full We all encounter challenging issues sometime during our life. When...
Nagging and Empty Threats “I often catch myself just nagging my son,” said a...
Circle Time-Part 1 A pre-school teacher of over a dozen young students with...

Winter Blues

Talk@FAQautism.com (Cathy Knoll, MA, MT-BC) — Thu, 25 Feb 2010 04:01:10 +0000

I just heard a weather report forecasting several days of cloudy, windy, cold weather. The meteorologist described the upcoming days as “gloomy.” Many of us are prone to slugishness and low energy in the winter months because of the short days and cold weather. Kids and adults can bust the gloomies by staying active and purposefully planning fun, enriching, outdoor activities every single day.

Listen Now:

or

continue reading

GET OUTSIDE. No matter the weather, get outside frequently. Remember that walking around outside and exposure to natural light – even in cloudy weather – boosts moods and busts gloomies.

KEEP IT SIMPLE. Outdoor activities don’t need to be time-consuming or cumbersome. We can make an impact on physical and emotional health by spending just 15 or 20 minutes moving around outside every day. Spend time with your friend with autism enjoying one or more of these activities: walk around the block, walk out to pick up the newspaper and mail each day, throw sticks for your dog to retrieve, shoot some hoops in the driveway, swing in the sunshine, jump on a trampoline, water the outdoor plants, rake leaves, sweep the sidewalk, tromp in the snow, or throw a soft, squishy ball back and forth.

MAKE IT ROUTINE. Individuals with autism often thrive on routine. Make an outdoor excursion part of your friend’s daily routine. Mention it at bedtime or at breakfast. If he has a daily calendar or schedule, insert “outdoor adventure” in each day. Over time, it will become part of his daily routine, and he will just expect to get outside every day.

LEND A HELPING HAND. One thing that is guaranteed to bust the winter gloomies is to reach out a helping hand to other people. As a family, gather up outgrown coats, sweaters, socks, mittens, and other warm clothing and take them to an agency that provides services to needy children. Or volunteer to help in a soup kitchen on a cold winter evening. Your friend with autism can bake some cookies for a homebound neighbor or volunteer to put her newspaper on her porch every afternoon. The idea is to get off the couch and to go outside with a purpose.

TIP FOR THE DAY. Get out and about during the winter to raise spirits and help everyone not only survive, but enjoy the long winter months. Another way to raise spirits (especially mine) is to share this resource with other people who are interested in the well-being of individuals with autism. ☺ Have them click on http://FAQautism.com. THANKS!

The following posts may also be helpful:

Busting Winter Gloomies Many of us are prone to slugishness and low energy...
Chasing Winter Blues The winter mixture of short days, inclement weather, and lack...
Chasing the Blues Away “Colder weather and shorter days seem to affect the mood...

Jenny & Jeffry, part 2

Talk@FAQautism.com (Cathy Knoll, MA, MT-BC) — Wed, 24 Feb 2010 04:01:49 +0000

Let us take another glimpse into the daily lives of ten-year-old twins Jenny and Jeffry, both of whom are diagnosed with autism. The marked differences in, among other things, their communication, personal interaction, sensory issues, flexibility, and self-sufficiency illustrate the breadth of the spectrum of autism.

Listen Now:

or

continue reading

Part 1 of this discussion about the twins focuses on the diversity of their communication and academic skills. That overview would lead readers to believe that Jeffry is “higher functioning” and Jenny is “lower functioning.” But, depending on your perspective, that conclusion is not necessarily true. Let’s look at some examples from their daily lives.

1. Although Jenny is relatively flexible, Jeffry is very focused on specific routines and rituals, displaying explosive behavior when faced with unexpected changes.

2. Jenny has marked tactile sensitivities. Among other things, it is difficult for her to tolerate wearing shoes and socks. She pulls the arms of her shirts up as close to her shoulders as possible, and the legs of her pants pulled up to her hips. Probably as a result of her tactile sensitivities, Jenny is very resistant to bathing, washing her hair, washing hands, and brushing teeth. Jeffry does not seem to have tactile issues.

3. Jenny was toilet trained at age four. For a variety of reasons, Jeffry is trained to wet in the toilet, but will not use the toilet for a bowel movement. He wears pull-up diapers.

4. Jenny thrives on group activities at school, church, home, and in the community. Jeffry has learned to tolerate group activities, but participates somewhat reluctantly and prefers to be alone.

5. Jenny is relatively compliant and cooperative. Jeffry resists guidance from other people, and often refuses to follow directions.

6. Jeffry takes good care of his possessions and thrives on neatness and cleanliness. Jenny tears, crumples, or breaks nearly anything within arm’s reach.

The contrast between Jeffry and Jenny, 10-year-old twins, is a stark illustration of the fact that autism is a spectrum disorder. Each person diagnosed with autism has unique mixture of strengths and deficits. The key word here is “unique,” as in “vastly different.” No two individuals with autism have the same mixture of abilities and disabilities in the areas of receptive language, expressive language, social interaction, compulsive behaviors, agitation, intolerance for change, sensory sensitivity, cognitive abilities, and daily living skills.

TIP FOR THE DAY: The implication of individual differences is that, because each person has unique needs, no one strategy or approach is going to work across the board. We must pinpoint specific issues and the circumstances surrounding those issues for that specific person, then develop a customized plan for dealing with the issues. Check out our Pinpoint the Problem Toolkit by clicking on the Toolkit tab at our website: http://FAQautism.com

The following posts may also be helpful:

Jenny & Jeffry, part 1 Jenny and Jeffry are ten-year-old twins. They are precious youngsters,...
Toileting Troubles 3 Once we have pinpointed the specific factors contributing to toilet...
Teacher Questions 3 A large group of junior high and high school teachers...

Jenny & Jeffry, part 1

Talk@FAQautism.com (Cathy Knoll, MA, MT-BC) — Tue, 23 Feb 2010 04:01:36 +0000

Jenny and Jeffry are ten-year-old twins. They are precious youngsters, loved by their family, teachers, and friends at school. The twins, of course, were born of the same parents, have grown up in the same home, and have had the same medical care, educational opportunities, and therapy over the years. But the twins, both diagnosed with autism, are as different as night and day.

jenny_&_jeffry_part_1Listen Now:

or

continue reading

Jenny is non-verbal, but is able to make her wishes known by pointing, grabbing, or making a few sounds. She nods her head “yes” at appropriate times, but tends to scream rather than shaking her head “no.” She approximates sign-language for “more” and “please,” but has not yet expanded her sign-language vocabulary beyond those two basic words. Jenny seems to understand what other people are saying, and to comprehend sophisticated conversational topics. She laughs at appropriate times, watches people as they converse, and follows rather complex directions. Over the years, two dedicated speech therapists have worked diligently with Jenny in an effort to help her communicate more effectively. In conjunction with Jenny’s teachers and parents, the therapists have introduced several communication systems, including picture symbols, sign-language, and two different computerized communication systems. Jenny does not seem to focus on or connect with visual cues, and has not yet responded to any of these communication methods.

Her twin brother Jeffry talks fluently, using sophisticated vocabulary and sentence structure. But he is not able to carry on a casual, interactive conversation. Jeffry does not seem to focus on people and happenings, and does not seem to connect to the words and conversations of others. If he does talk to another person, he does not focus on the topic of conversation. Instead, he tends to talk non-stop about a book he has read recently or some interesting facts about the mechanical workings of a car or computer. He cooperates with his speech therapist, but responds mechanically and has not yet generalized the concepts of give-and-take conversations into his daily life.

Jeffry is very bright academically. He can read and write, and he excels in mathematics, science, engineering, and history. He reads books constantly and is able to comprehend and remember facts, figures, and concepts. In the same way he does not connect with the words and actions of people in his life, Jeffry does not show any interest in television, movies, or other action media. He prefers written words. He is fascinated by music notation and the theoretical structure of music, and has enjoys playing the piano and some bass guitar patterns.

Jenny does not read nor write. She tends to throw, break, or tear books, computers, communication board, toys, or any other item within her reach. In spite of the best efforts of teachers, parents, and therapists, Jenny has shown not interest in learning the names of objects, numbers, colors, letters, or any other basic academic concepts. For example, if she is asked to choose between to objects by pointing to a red card or giving the teacher an apple, she just stares or bites her hand. Jenny does pause and begin rocking gently when she hears live music, but she resists attempts to encourage her to strum a guitar on her own or to tap a piano key.

Tune into the second part of this discussion of Jenny and Jeffry to learn more about the diversity of autism, the vastly different ways autism impacts individual lives. Invite your family, friends, and colleagues to join the conversation http://FAQautism.com

The following posts may also be helpful:

Jenny & Jeffry, part 2 Let us take another glimpse into the daily lives of...
Non-Verbal Communication Those of you who are listening to this podcast can...
Language Barriers By definition, individuals with autism have impairments in communication, but...

Arm’s Reach

Talk@FAQautism.com (Cathy Knoll, MA, MT-BC) — Mon, 22 Feb 2010 04:01:18 +0000

How can we prevent injuries when an aggressive youngster with autism participates in a group activity? What can we do to stop a child from biting anyone sitting close during circle time in early childhood? What are our options for dealing with a pre-teen who reaches out to scratch or grab anyone who sits within arm’s reach in the lunchroom, or a young adult who grabs the hair of anyone who gets close to her in the grocery store?

Listen Now:

or

continue reading

When potentially harmful behavior occurs, our first responsibility is to ensure safety. Once we have removed the potential for injury, we can then take systematic steps to develop a plan for decreasing or stopping aggressive behavior. But, first things first.

The key to safety is to remove opportunity. In the case of hitting, grabbing, scratching, or poking, we remove the opportunity for harm by keeping the aggressive person out of arm’s reach of other people. In the case of hurtful behavior, it is not enough to try to keep “a close eye” on a person in an effort to keep the person from hurting others. Safety requires us to physically keep other people completely out of arm’s reach of an aggressive person at all times. Sometimes that takes creative planning.

How do you keep an aggressive person out of arm’s reach while at the same time allowing them to participate in group activities? Always give careful thought to positioning and barriers. Some ideas:

+ In a classroom, lunchroom, or other group setting, space chairs and desks at least an arm’s reach away.
+ Put an empty chair or desk next to an aggressive youngster to add some safety space required to keep other students out of arm’s reach.
+ Rather than isolating an aggressive student by placing them at a separate table in the lunch room, place the youngster at the end of the lunch table with other students just beyond reach. That allows the student a chance to sit with peers without hurting anyone or swiping lunches to the floor.
+ Whether at school, the community, home, a job site, or the grocery store, always position yourself or another adult as a natural safety barrier between the aggressive individual and other people in order to keep everyone safe from harm.
+ A swim coach wrote about a teen in a therapeutic swimming class who tended to reach out and grab the arms of other swimmers, especially in team or partner activities. For safety’s sake, the potentially hurtful swimmer needs to be partnered with the coach or adult assistant and kept out of arm’s reach of other swimmers every single minute.

TIP FOR THE DAY: Once you have resolved the basic safety issues, you can take time to pinpoint the nature and cause of the aggressive behaviors. Once you scout out those factors, you will be able to develop an effective plan to decrease hitting, scratching, biting, or other hurtful behaviors, and increase more positive interaction with other people.

For a treasure of great ideas about practical, easy to implement strategies for pinpointing problems, making changes, and developing effective strategies to address these challenges, check out our FAQautism.com Toolkits. Just click on the Toolkit tab at our website: http://FAQautism.com

The following posts may also be helpful:

Within Arms Reach Some individuals with autism strike out at others, hitting or...
Car Outbursts For a variety of reasons, several of my friends with...
Dangerous Actions 3 What are your options when your friend with autism hits,...

Battle of Wills

Talk@FAQautism.com (Cathy Knoll, MA, MT-BC) — Fri, 19 Feb 2010 04:01:09 +0000

Do you ever feel like you are engaged in a constant battle of wills? Let’s look at a strategy for increasing cooperation and compliance, even with the most strong-willed youngster diagnosed with autism. This proactive process turns a battle of wills into a win-win situation for all involved.

Listen Now:

or

continue reading

With few exceptions, most parents, teachers, and others who spend a great deal of time with individuals with autism can get annoyed when youngsters ignore our instructions or refuse to cooperate. Over time we can become impatient and develop that common condition of “nag-itis.” Our scolding often falls on deaf ears, and nagging can lead to a long-standing battle of wills.

If you find yourself in this situation, you might consider a strategy that involves gentle nudging rather than constant nagging.

1. KEEP YOUR COOL. When met with defiance that cannot be ignored, get on eye level and speak softly but firmly, stating the desired behavior very specifically, e.g., rather than shouting “Don’t hit your brother,” say quietly but emphatically: “Put your hands on your knees, now.”

2. STAND YOUR GROUND. Maintain contact with a firm gaze and close proximity, asking the youngster to respond with “ok” or “sure” if he is able to speak. Give him plenty of time to process the information and to make a decision about following the direction.

3. ENCOURAGE COMPLIANCE. Give the youngster a high five or a big smile or a pat on the back when she follows the instruction or makes a positive response.

4. START AT THE BEGINNING. If the uncooperative behavior continues, patiently repeat the strategy. You may see results in a few hours, or it may take years. But a calm consistent guidance will eventually lead to increased cooperation.

TIP FOR THE DAY. We can turn a battle of wills into a win-win situation if we turn away from impatient nagging, and, instead, give our youngsters with autism nudges every single day toward being pleasant, cooperative, friendly people.

I encourage you to take another pro-active step toward pleasant interaction with your friends with autism: Check out our FAQautism Toolkits – practical, succinct resources filled to the brim with step-by-step details for pinpointing challenging issues and developing a strategy for dealing with those issues. Just click on the Toolkit tab at our website: http://FAQautism.com

The following posts may also be helpful:

Nagging vs Nudging I was talking to a parent and an after-school teacher...
Taming Tantrums part 1 A professional music therapy colleague wrote about a student who...
Teacher Instructions Many youngsters with autism encounter difficulty in school because of...

Totally Opposite

Talk@FAQautism.com (Cathy Knoll, MA, MT-BC) — Thu, 18 Feb 2010 04:01:28 +0000

A mom was puzzling over the differences in the personalities of her two sons with autism. One of the boys responds best to strict, specific instructions, and the other only responds to gentle, sweet coaxing. Mom said, “People who don’t know our family think I speak too harshly our oldest son and that I spoil our younger son.”

Listen Now:

or

continue reading

Teachers have noticed this same phenomenon. All kids, whether they are diagnosed with autism or not, have different personalities and learning styles. Some respond better in a structured environment where they know specifically what to expect and what is expected of them. Others are more cooperative when they are gently guided toward following instructions and encouraged every step of the way. Again, this difference is observable in all children, but it can be more marked in the lives of individuals with autism.

This mom has stumbled on the right approach when facing this difference in personalities. She helps her “literal” son by giving specific, firm instructions, then waiting like a drill sergeant until he follows directions. He turns away from sweet talk and effusive praise. So Mom will say something like, “Brush your teeth now, read one chapter of your book, then go to sleep.” He likes this because he knows exactly what she wants him to do and he isn’t distracted by other conversation or happenings. He hears a direction, finishes the task, then moves on.

Her other son requires a very different approach because of his difficulty in dealing with transition. Abrupt changes and specific instructions can set off a firestorm of screaming, throwing, and refusal to cooperate. As bedtime approaches, Mom gently guides him through very gradual steps that eventually lead to his being tucked into bed for a good night’s sleep. As you can see, the approach this mom takes with one boy is totally opposite of the approach she takes with her other son.

TIP FOR THE DAY. Because of individual differences, it is impossible to develop one strategy or approach for dealing the problems encountered by people with autism The most effective teachers, parents, therapists, and other friends of people with autism are those who take time to know that particular individual, then develop strategies to match their personality and preferences.

The following posts may also be helpful:

Follow the Crowd Most people learn naturally by following the lead of other...
Do Not Do That We all fall in the trap of saying repeatedly, “Do...
Nagging When we are dealing with multiple behavior issues day in...

Be Good

Talk@FAQautism.com (Cathy Knoll, MA, MT-BC) — Wed, 17 Feb 2010 04:01:47 +0000

What exactly do we mean when we tell a youngster we expect them to be good? What does a teacher mean when she reports a student was good in class? How can a person with autism who interprets words and phrases quite literally respond to a stern instruction from an adult to “be good” in the cafeteria, in the car, or at grandmama’s house?

Listen Now:

or

continue reading

Sometimes we use the phrase “be good” sort of as another way to say, “Have a nice day” or “Hope you have fun at school.” But, in reality, our telling children to “be good” can often be translated to mean one of three things:
(1) “Stay out of trouble”
(2) “Don’t do anything to embarrass me”
(3) “My head hurts and I have dozens of things that must be done right now, so don’t bug me.”
Because people with autism interpret phrases literally, we cannot expect them to pick up on these cues and to translate our hidden meanings.

Two thoughts to keep in mind about goodness.
BE SPECIFIC. Rather than using vague terms like “be good,” it is more effective to tell people with autism exactly what we do expect. So, when Terry visits her grandmother, we can say something like, “Keep hands quiet. Listen to Grandmama’s words. Smile!”
TAKE NOTICE. It is important to remember that “good behavior” can also be defined as “lack of bad behavior.” For example, if a youngster immediately pushes his cup and plate off the table when he sits down for a meal, we might say, “Are you going to be good at lunch today?” If he waits 15 seconds before pushing food and drink to the floor, we need to recognize that as a good sign. And as he decides to take a drink before throwing his cup, we need take notice of that action and build on that progress.

TIP FOR THE DAY: Clear, specific communication is helpful in autism, so make certain your friend with autism knows exactly what you mean when you tell them to “be good.”

I also encourage YOU to “be good” by telling your colleagues as well as family and friends of individuals with autism about our daily podcasts and e-mail posts. They can click on http://FAQautism.com Thanks for being good!

The following posts may also be helpful:

Following the Crowd Some individuals with autism are not quick to pick up...
More on Following Directions Parents, teachers, and therapists have sent in more questions about...
Tackling Challenges How do we go about tackling challenges that come up...

Age Differences

Talk@FAQautism.com (Cathy Knoll, MA, MT-BC) — Tue, 16 Feb 2010 04:01:54 +0000

Should teens and young adults participate in group activities with younger kids? For example, at what point do our friends with autism outgrow the need for participating in soccer, swimming, t-ball, and other adaptive recreational activities designed specifically for individuals with special needs?

Listen Now:

or

continue reading

An FAQautism.com follower writes, for example, of an older teen who grabbed and squeezed the arm of an 8-year-old in a therapeutic swim class when the younger swimmer yelled loudly. The swim coach asked about the appropriateness of allowing the teen to participate in the class with younger children, saying the parents are adamant about their daughter’s participation.

There are many factors involved here, but let’s look first at the initial problem – squeezing arms. The teen’s arms are, naturally, longer than the younger kid. And her squeezing – a common behavior in autism – is probably her way of saying, “Don’t yell!” to that 8-year-old. But I’ve also been in situations where the smallest kid in a group was a serious hitter, biter, pincher, or scratcher, sometimes for not perceptible reason. When I find myself in situations like this, where minor or major aggression is involved, I plan all activities so that everyone is always out of reach of a person who is aggressive. And by that, I mean everyone is always out of reach. We’ll look at some effective ways to make that happen in a future podcast.

Now let’s take a look at the issue of age differences. I’ve been working in the same little towns for over 30 years, and my heart always breaks when kids grow up (and they all do!) and services dwindle away for them. I appreciate the parent’s being this teenager’s advocate and encouraging people to allow their daughter to participate in the swim group. At the same time, I also understand the concerns expressed by the swim coach. There are many reasons people of different ages may or may not work well together in a group. This question specifically addresses the issue of aggression by the teenager. Some thoughts:
1. The swim coach might talk to the young lady (even if she doesn’t seem to understand) and to her parents about making the teen an “assistant” in the class or group activity. That allows the coach to have her right by his side (or by the side of another adult assistant) at all times without it looking like he is isolating her from the group. It also helps distract her from yelling and other behavior by the younger kids that causes her aggressiveness.
2. The swim coach could also talk to the parents about the possibility of developing a therapeutic swimming group for older teens and young adults. The parents might be able to help recruit participants. Hmmm…wish this swim group were in my town so I could encourage some of my friends with autism to enroll!

Most importantly, the swim instructor will want to talk to the parents about concerns with their daughter squeezing the younger swimmer. Squeezing arms in an attempt to say “stop!’ is a rather typical behavior among individuals with autism. Talk to the parents in a positive, non-accusatory manner about how you are addressing the issue. Ask if they have other suggestions. When we provide services for individuals with special needs, we have to expect some challenging issues, so we need as many people on our team as possible.

TIP FOR THE DAY: Look carefully at all the contributing factors, then develop an effective plan to help this older teen participate successfully in therapeutic swimming, a plan that includes changing the changeable factors. Click on the Toolkit tab on our website http://FAQautism.com to check out these insightful, practical resources: Pinpoint the Problems Toolkit and Change the Changeable Toolkit.

The following posts may also be helpful:

Arm’s Reach How can we prevent injuries when an aggressive youngster with...
Differing Opinions A teacher wrote asking for some ideas for helping deal...
Baby Toys It can be difficult for children to give up their...

Murmuring, Part 2

Talk@FAQautism.com (Cathy Knoll, MA, MT-BC) — Mon, 15 Feb 2010 16:55:44 +0000

This podcast comes with a warning. Except in a few cases, it is impossible to completely eradicate obsessive murmuring. In fact, our calling attention to the irritating habit can, indeed, escalate the problem. Part 1 of this series describes the issue on continual words, nonsense syllables, scripts, or conversations. Today we will look at some strategies to help minimize murmuring.

Listen Now:

or

continue reading

We’ll start the discussion about murmuring with a technique that definitely does not work – nagging. Few people, whether diagnosed with autism or not, will change a habit if we fuss at them or constantly say things like, “You need to stop murmuring and listen to me,” or “Your constant murmuring is driving me crazy!” From the perspective of others in hearing distance, our nagging can be more irritating and disruptive than the targeted murmuring.

Murmuring is inherent in autism. Among the diagnostic criteria for autism, as stated in the DSM-IV-TR manual (APA, 2000, p. 70-71) are the following characteristics of autism spectrum disorders: “stereotyped and repetitive use of language,” and “encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus.” This can be manifested by ongoing repetition of words, phrases, nonsense syllables, songs, movie scripts, or overheard conversations.

Since, except in a few cases, total silence is unrealistic, our primary goals are to decrease the volume, constancy, or disruptive nature of the murmuring. Let’s take a brief look at four ideas for addressing perseverative speech or continual noises.
1. IGNORE. As long as the chatter is not extraordinarily disruptive, we can learn to ignore the sounds, just as most of us ignore a television, phone conversations, or other scripts in our environment.
2. MY TIME – YOUR TIME. We can use a visual cue card or other cue to help our friend learn that he may talk at will during his free time, but needs to keep his voice silent when requested to do so at certain times of the day or during certain activities. As the length of “my time” gradually increases, the murmuring and chatter of “your time” gets shorter.
3. INTERRUPT. Sometimes a person becomes so involved in their repetitive script that he is not able to focus on the world around him. In this case, we may need to capture their attention and interrupt their murmuring before they notice the “My time – Your time” or the “First work, then free time” cue. We will discuss the “interrupt strategy” in detail in a future podcast, but keep in mind that gentle interruptions and calm but firm reminders can work wonders.
4. CALM. When the volume or intensity of a person’s repetitive sounds causes excessive agitation for them or for others around them, we can focus on helping our friend settle down. Depending on the situation, we can play calming music, turn down the volume of activity in the room, soften lights, and otherwise instill a sense of calm.

TIP FOR THE DAY. Sometimes our murmuring friends are very disconnected and do not respond to our best efforts to help them calm down or to decrease their constant chatter or stream of sounds. When our strategies do not make a dent, the best strategy might be to turn our attention away from the person’s murmuring while at the same time listening carefully for a break in the sounds so we can gently make connections.

Source: American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.-text rev.) Washington, DC: Author.

The following posts may also be helpful:

Murmuring, Part 1 How should we respond to our friends with autism who...
Noisy Kids 2 Among other things, sudden loud noises or constant murmuring can...
Too Much Noise Imagine your reaction if every sound in your environment were...