Event: Take off.

Calming technique: Deep, slow belly breathing (in through the nose all the way down to the belly button, slowly out through mouth). Eyes closed.

Visual imagery: Imagining plane slowly pulling up from the run way to the sky and leveling out.

Negative Automatic thoughts (NATs): Thoughts and image of plane crash occur in the midst of visual imagery and breathing.

Calming technique: Continue deep, slow belly breathing. Eyes closed. Allowed NATs to come in, and go out. Did not question whether this would occur. Just accepted that the NAT was present, continued breathing, continued positive imagery.

Reality/Outcome: Smooth leveling occurs within 20 seconds to 1 minute.

Eyes open.

Normal breathing begins.

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The above visual is one I made to explain how awareness is the key to insight which leads to change. 

It’s no surprise to those who work with me that my favorite tool for trying new things, battling anxious thoughts, and pushing (gradually) to overcome worries, is AWARENESS. I feel this way because awareness of our environment, our bodies, our thoughts, our triggers (those things that set off the cascade of worries), and our behaviors are really the only true control we have. We can’t control what is outside of ourselves (as much as we may try). The nice part about becoming more aware or mindful of yourself is that it allows you to prepare or plan. “What will I do if i start to feel this way? If i start to feel X in my body, i know it’s likely my worries activating my physical system. If i’m aware that this is a normal part of anxiety and I am safe/not in danger, I can find a way to override this feeling, completely remove myself from the trigger, or take a break and return when I’ve regained control.”

In other words:

IF WE ARE AWARE, WE CAN PREPARE. 

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There is no-play-by play manual to parenting. You set the ground work with clear expectations and predetermined consequences (not in the moment reactive ones). You praise and reward, with tangibles and intangibles, mostly with love. You validate feelings and put language to when your child is overwhelmed and cannot express why. You console and love.
You remain steadfast and consistent with what you say and do, to the best of your ability. This requires you to battle some major waves of opposition at first.
You make calculated predictions based on history of behaviors in certain settings, with certain people, under certain conditions. You try your best to prepare your child beforehand to succeed in these setting with these people, in these conditions.
You discuss with them afterwards on whether the prediction was correct, how they handled it, how you handled it,and possibly any alternative ways to try next time around. You do this all with a hug, with reassurance and love, with a stern but patient tone.

Just some thoughts I wanted to write down. Please add your own in the comments section.

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A while back I bought a heart rate monitor. I wanted to see if there was any correlation between the physiological response that one has when feeling anxious and heart rate elevation. I was excited to have a possible tool that would help those with anxiety self-regulate. In my case, it turned out that the correlation was not very strong. On several occasions over a period of months, I strapped myself up when feeling uneasy or anxious and saw heart rates similar to that of a Yogi. The heart rate clearly did not match the feeling I was having and was therefore a poor tool for detection.

I was bummed, because I felt like this would’ve been a great tool to help others (especially the kids I work with who were not so aware of the cues their bodies often send) have a way to self-monitor anxiety. Imagine an alarm going off on your wrist that tells you, take a break, with concrete numerical data (not parents or teachers) to back it up.

Instead of giving up, I tried something else. I began testing what it would be like if I matched my heart rate to my feeling. For example, if I was feeling anxious, I’d sprint or climb stairs rapidly in order to get my heart rate up. If I could do this, maybe I could then control/bring the heart rate back down, and in doing so find a sense of self-regulation (taking back control of my body’s ascending and descending heart rate). A feeling of control is what is often lost when anxious thoughts and feelings arise.
This is still an experiment in progress but it seems to have some legs. I’ve noticed that by increasing my heart rate to fit my level of anxiety or nervousness, I am then forced to sit back, breath deeply, and let my heart, my lungs, and my muscles come back down to regulation.

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The following is a post from a very good blog I follow called “Life with Aspergers”. The writer speaks with clear language and examples about how executive functioning challenges effect the lives of kids, teens and adults on the spectrum.

Here’s the link to his post:

http://life-with-aspergers.blogspot.com/2011/11/how-lack-of-executive-functioning-may.html

The question becomes, how do we recongize this deficit area and change our strategy? For one idea, view my last post on Chunking.

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My major chore in the home is dishes. I do them every night and after breakfast in the morning. Here is my sink with a pretty representative amount of morning dishes (theres only 2 of us). To me, this looks chaotic, not contained, and disorganized. It makes me want to clean it but it also makes me wonder where to start.

So, to begin, before I turn on any water at all, I always organize. Cups with cups, bowls with bowls, flat surfaced things with flat surface things.

Then I begin to tackle one category at a time. First comes the flats. I wash them in a basin of soapy water and then rinse them and put them on the dish rack.

One category down, two to go.

Then comes the bowls.

Lastly, the cups.

Nothing left on that messy counter.

All drying on the rack.

Except for the silverware. I hate doing silverware.

Luckily, my wife accepts this annoying eccentricity 🙂

Why am I showing you this? Well, because when we speak about kids with executive functioning challenges (many kids with autism and ADHD for example), we are told to help them “chunk” large tasks into manageable and more contained steps. Why? One, because it takes some of the chaos and disorienting feeling out of starting a task (“Where do I even begin? It’s too much. Oh, forget it”). Two, because it gives intermediate goals/steps/or chunks to achieve (“I’m done with the bowls, now i’ll do the cups”). It feels less all or nothing.

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I’ve been working with kids lately on recognizing their brain and bodies response to WHEN THINGS DONT GO JUST RIGHT. In session I always use a whiteboard and draw a visual schedule. I have been drawing the picture you see marked “2” to prompt discussion around this common phenomenon:

A boy walking down the street happy as a clam with his ice cream. It suddenly falls. This is unexpected and NOT JUST RIGHT. I use this prompt to give kids an example to go off of. Within the last few weeks, I’ve gotten some amazing responses from kids about their own experiences of when things don’t go JUST RIGHT. We draw these situations out, talk about how their brain is wired to expect things to go as planned and how when things do not, their brain struggles to know how to respond appropriately. This allows for both education, processing upsetting events, and also working towards some concrete ways of managing this feeling when it arises in the future. I ask that parents help their children begin to identify examples throughout the week of “When things don’t go JUST RIGHT” and write them down. In doing this, we are helping the child better understand themselves, their triggers, and the thoughts and feelings associated with these triggers. The goal is that with greater awareness, we can help kids to learn to recognize the feeling before it gets too big and too explosive.

Just today, I came across this wonderful Dr. Seuss picture and text and thought it worth sharing:

What a great mantra for all of us.

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We all have patterns we seem to repeat often, sometimes daily. By drawing these patterns out and filling in the problematic thoughts, we become aware and can set goals to break them. In this example, the young man has allowed his room to get so cluttered that the job seems daunting. His mother expects him to “clean it” completely everyday. However, this has not been enforced with any clear plan.
In the visual we created recently, he walks into the room and instantly feels overwhelmed. He then gives up and falls back to something comforting, watching videos on his tablet. This pattern occurs everyday for the last two months. We all sat down recently to discuss how to break down the daunting task of cleaning this room into manageable steps. We came up with the following:

What does it mean to clean your room (being explicit with expectations)?

A large part of me believes that this child needs a fresh start. If mom either helps or completely cleans the entire room and then follows through with the clearly stated expectations (upkeep of your room daily), then I believe the child will develop a positive pattern of maintaining his room. However, if she continues to expect the boy to overcome this self-created mountain, I don’t know if this pattern will be broken. That is why we wrote the statement “If you don’t clean your room, I will. If I do, you lose your tablet for 1 day because I had to spend my free time doing your chore”. This lets the child know that keeping the room in its current state is not an option. This is important, even if it means that the parent has to do something that the child “should have done” themselves.

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Dear Parents,

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Inflexibility in teens with autism is hard wired. You can read about it in every book, article, memoir, and blog out there. It’s not driven by the same kind of “choice” or intentionality we give to a typically developing teen. This seems obvious to most and yet we often forget to carry this knowledge with us into challenging situations. We demand, “he knew exactly what he was doing and did it anyway”. Well, hear me out and see if you buy what I’m selling.

Let’s use a very familiar example.
A typically developing teen is refusing to turn off the computer and start homework. With their refusal comes a quick weighing of options on their part:
‘How is my parent going to react if I don’t listen?’
‘What will the consequences of my actions be?’
‘How much do they really need me to listen and how much of this is over-parenting/posturing?’
‘How far can I push this before it’s really an issue?’
‘Am I really willing to fight for this? Is it worth it?’
‘I wonder if they’ll actually follow through?’

When a teen with autism is acting inflexibly (same scenario), this weighing of perspectives, possibilities, outcomes IS NOT HAPPENING. This means they are not asking the vital questions that make the teen in the first example reconsider or not (choice).
This is an important distinction because it changes the way we speak about “choice” and what influences choice. The teen with ASD is largely unable to reach these conclusions on their own. Unable to ask the questions and weigh the options before making an informed, intentional decision.
Instead, he or she is stuck in the NOW – responding to feelings that loudly tell them, “I’m not ready”, “I don’t want to stop”, “I’m not done yet”, “Must finish.finish. finish”. This “I” mindset means that I cannot consider “you” or the after. He is not hard wired to consider how his actions are effecting you.
As practitioners who work to aid this individual in their social and emotional development, we need to recognize this. Once we do, we will work much harder to make expectations crystal clear, always review daily schedules , and make +/- consequences to specific actions consistent.

I’m sure many reading this thought, ‘Anthony’s giving typically developing teens way too much credit’. You might be right:)

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