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Archive for May, 2012

A man recently shared with me that he always wears a baseball cap when playing golf. I assumed that this was to block out the bright sun. He went on to say that when he wears his brimmed hat, which he  pulls down just over his hairline, he is able to focus on his next shot to a much greater degree. Many major league baseball pitchers can be seen with their cap pulled down low over their eyes. It is my understanding that this is done to tune-out as much of the peripheral distraction as possible and focus simply on getting the ball from the mound to the catcher’s mitt.

When we think about the child with autism and his/her hypersensitivity to visual stimulation, it makes sense to think that something as simple as a baseball cap could have much the same effect as it does for the golfer and the pitcher. I suggest that you attempt this simple intervention next time you and your child are going somewhere particularly overstimulating (arcade for a birthday party, county fair, movie theater, etc).

The infamous Pedro Martinez.

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Blind Fold ExerciseEmulating the sensory experience of being out of control.

I begin with something like this: “Sometimes it’s hard to not be in control. It can be scary to trust and accept other’s choices. Today,  using blindfolds, we are going to do an exercise where we each lose control. You are going to give me directions on how to get from one point to another. I will be completely sightless (blindfolded). I will have to trust exactly what you say or else I could fall, trip or get off course. Can I trust that you’ll guide me safely? Okay, lets begin.”

* I usually allow the child to guide me first so that they can see what the experience looks like before trying it themselves.

Why do this?

This is a great trust building exercise for teens. The exercise allows the teen to practice “letting go” and  trusting that other’s can sometimes take the lead (Flexibility!!!).

I did this at a small and rocky park with a  teen with Asperger’s. It was a blast!

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I recently began a Psycho-educational fitness group with some of the teens I work with. One of the teens, John, has Aspergers (the only boy with a spectrum disorder in the group). Today John asked one of the other members “Why are you so short?”. To John, it was a logical question based on an observation and a collection of facts (John had already asked the boy his grade and age). John calculated that this boy, indeed short for his age, was below the 50th percentile in height. The boy did not respond; a surprisingly mature move for an 11-year-old boy.

I, wanting to make peace and avoid early death of an enjoyable group, quickly intervened with a standard “That comment could be taken as hurtful…his face doesn’t look like he liked that”. John pressed on, incessantly trying to make right what he had unintentionally communicated,  “It could  be genetic…”. A peace offering of sorts. In John’s  mind, he was saying “theirs nothing wrong with you…it’s your genes”. Not surprisingly, he was again met with no response….

I asked John to “just drop it”, seeing that the boy was starting to really get annoyed. He couldn’t. “It could just be genetic…I just want to tell him that it could be genetic…hey (grabbing his shoulder) it could be genetic”. At this point, I should have taken the opportunity to ask Cole’s permission to provide some psycho-education around what Asperger’s is and how it can present itself in everyday experiences (stuckness). It would have been a perfect learning opportunity for the others, who probably think “John’s just weird”. John would have welcomed this, i’m sure, and also learned to advocate more openly for himself with others in the future (“I have Asperger’s…It’s a nuerological disorder…sometimes I get stuck and I can’t get unstuck until i’m able to finish my thought”).

Next time…

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Jason, your 14 year old son with Asperger’s, shuts down when it comes to talking about “what happened”. You try and take his perspective and give him the benefit of the doubt, but he still gives you nothing. It may be that Jason simply cannot adequately communicate what happened through words. As we know, words and gestrures can be quite challenging to interpret and muster for the individual with AD. It may be that you’re questions, gestures, and tone of voice seem intimidateing or in some way unwelcoming to your child. Whatever it is, I urge you to try something new.

In many cases, storyboard/cartooning of the event can be very helpful in getting some insight as to what triggered the response, what came before, after, etc (look for this in future posts).

A tool that I have recently incorporated into my practice is  non-verbal processing through writing. This can be done on a white board or even a piece of paper. It goes like this… 

1. “We are going to discuss what happened/what’s bothering you without using our voices.”

Materials: writing utensil, whiteboard,  piece of paper, or even computer.

Activity: It starts with a simple written prompt (by you) – a word, statement, question, or educated assumption like “being a ‘fighter’ is part of your identity”. It can then branch off in a million different directions. In the times I have used this with my teens, I’ve always gained great insight into their internal process, triggers, etc.

Actual Example: The example below was done with a 13-year old boy who has recently begun fighting in school in response to bullying – resulting in suspension. This boy often refuses or is unable to process verbally with his parents, teachers, and therapist. I have a strong rapport with this client at the time this intervention was done.

Therapist: Bold

Client: Italicized.

____________________________________________________________________________________ 

“Fighter is part of your identity

Sometimes.

That is a good thing in school

Yes. At sometimes.

How does it benefit you in school?

No one messing with me.

How else?

People think I’m tough.

What do you think?

I can be.

I think you can control your fists but it’s not worth it for you to do so.

I guess…I think I can.

If you can control your fists…what will change?

No fights.

You’re full of _ _ _ _ (sorry parents…this is often an effective way to engage and attune with a teen)

Yes I am.

You’ve never gotten the respect from others that you’re getting now as a fighter.

Yes.

There’s no other way to get it.

Not really.

You’re face just got serious. You really believe that?

Yes.

I don’t blame you. But when does it stop then?

Now because I’m good.

I don’t understand.

I have enough respect.

But what if things go back to the way they were?

It won’t.

There will always be another (name of the bully).

Yes.

And you’ve only got one way of getting respect.

Yes. But I have a lot of it…respect.

I’m hearing the phrase, “I can’t/don’t want to change?”.

I can and will.

Now we just need to figure out how.

IDK (I don’t know).

Will you work with me to at least try?

YES.”

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Children on the spectrum are not immune from parental separation and divorce. With this reality comes the introduction of at least one new home and a very different schedule (where am I, when, and with whom).

By creating a visual weekly “home schedule” that can be referenced by the child at anytime (and with you), you are helping him/her become accustomed to the new and often confusing shift in routine.

Intervention: The picture says it all.

Materials needed: Color Printer, Picture of both parents homes (4 of each), laminated paper, scizzors.

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