Category Archives: autism

AUTISTIC SOLUTIONS RELATED TO TAKING IN INFORMATION: Examples Using Paint Chip Visual Supports

This series of blogs and the release dates are as follows:

AUTISTIC SOLUTIONS RELATED TO TAKING IN INFORMATION
Part One: Using Words to Make Pictures (January 13, 2023)
Part Two: Using Words to Describe Pictures (February 10, 2023)
Part Three: When Feelings Are Too Big (March 10, 2023)
Part Four: Examples Using Paint Chip Visual Supports (April 7, 2023)
Part Five: Direct Instruction of Social Information (May 5, 2023)

This blog continues from the previous blog When Feelings Are Too Big and, as promised, includes several clinical examples of using paint chip visual supports.

I use paint chip samples from the hardware store – the book marker looking samples that show intensity of the paint color you are contemplating painting your walls. Clients choose the color they want to use and it is stapled to a piece of paper.

I usually divide the strip into sections of three by drawing lines and labeling the sections small, medium, large. We start by writing down examples of things since the last appointment that cause the client’s feelings to be small, medium and large. These answers are written into the corresponding place on the visual we are creating. Besides being a way for me to learn about the client’s week, it gives my client’s a structure for their appointment times along with teaching the system of small-medium-large and how to use it to define/plot feelings.

General example of showing the visual system of small/medium/large with paint chips:

The following are specific examples with a variety of autistic clients across the life span. Remember these are just a few examples. Also, for each photo, there is a context of a specific client situation it fit into, i.e. these photos of examples are not random, but apply to specific client contexts. All in all, there are limitless ways to use paint chips to show size of feelings. Sometimes extra words are written on the page and sometimes there is no narrative, depending on what is helpful to the particular client. The examples here were chosen so that there is enough narrative that the reader can understand the use of the paint chip visual.

These sorts of visuals allow for exploring ways to get more intense feelings to become less intense. Sometimes my client can tell me things they did that were helpful in causing an intense feeling to become less intense, but most of the time they need direct instruction. I accomplish this in a variety of ways, matched to the particular client.

Some additional examples include:

    •  For one client who used mindfulness, teaching and implementing three different mindfulness practices, keeping data on their effect on bringing big feelings down was helpful.
    • Teaching and practicing sensory strategies. These strategies can then be implemented both on a regular basis (proactively) so as to keep the sensory sytem more regulated and in response to (reactive) experiencing a big feeling (Mahler, 2016, 2019).
    • Using The Interoception Curriculum: A Step-by-Step Guide to Developing Mindful Self-Regulation (Mahler, 2019) has been significant for a number of clients in supporting the body-emotion connection.

    • Expand the small, medium, large feelings to a 5-Point Scale (Dunn-Burron, 2012).

    • Use the activity A 5 Could Make Me Lose Control (Dunn Buron, 2007). This activity has several cards depicting a variety of situations. The client places the card in one of the pockets numbered 1-5 that replicate the numbered order of the 5-Point Scale. For example, if making a phone call is mildly anxiety provoking a client might put that card in the pocket labeled 1 or 2 and if it causes the most anxiety ever it would be placed in the pocket labeled 5. This activity provides information that allows a client to then be supported in thinking through what to do the next time the item on the card occurs – in this case, making a phone call.

    • Teach Kerry Mataya’s visual problem-solving method  (Mataya & Owens, 2012). This consists of a visual depicting the choices in ways to solve a problem along with protocol to teach and practice the problem-solving choices. Once the skills are learned the client can use the Problem-Solving visual each time feelings get big and keep data showing the number of the feeling on the 5-Point Scale when escalated, which problem-solving strategy was utilized and what number the feeling was on the 5-Point Scale after implementing the problem solving strategy.

The take away point here is that we can teach our clients to successfully manage their big feelings without needing to teach the labeling of these big feelings! Often I invent helpful solutions during client sessions that apply to that one individual.

Selection from: Autistically Thriving: Reading Comprehension,
ConversationalEngagement, and Living a Self-Determined Life
Based on Autistic Neurology, pg. 142-144.

(The next and last blog in this series, Direct Instruction of Social Information, will give yet another clinical example.)

Note: The author is a mental health therapist and is also autistic. She intentionally uses identity-first language (rather than person-first language), and invites the reader, if interested, to do further research on the preference of most autistic adults to refer to themselves using identity-first language.

If you are a clinician and interested in learning more about therapy with the autistic client please join me along with two of my colleagues in an online course.
CLICK HERE for additional information about  Mental Health Therapy with the Autistic Client.

BY JUDY ENDOW

Endow, J. (2021). Executive Function Assessment. McFarland, WI: Judy Endow.

Endow, J. (2012). Learning the Hidden Curriculum: The Odyssey of One Autistic AdultShawnee Mission, KS: AAPC Publishing.

Endow, J. (2006).  Making Lemonade: Hints for Autism’s Helpers. Cambridge, WI: CBR Press.

Endow, J. (2013).  Painted Words: Aspects of Autism Translated. Cambridge, WI: CBR Press.

Endow, J. (2009b).  Paper Words: Discovering and Living With My Autism. Shawnee Mission, KS: AAPC Publishing.

Myles, B. S., Endow, J., & Mayfield, M. (2013).  The Hidden Curriculum of Getting and Keeping a Job: Navigating the Social Landscape of Employment. Shawnee Mission, KS: AAPC Publishing.

REFERENCES

Dunn Buron, K. (2007). A 5 Could Make Me Lose Control! An activity-based method for evaluating and supporting highly anxious students. Shawnee Mission, KS: AAPC Publishing.

Mahler, K. (2019). The Interoception Curriculum: A step-by-step guide to developing mindful self-regulation. Lancaster, PA: Kelly Mahler.

Mahler, K. (2016). Interoception the Eighth Sensory System: Practical solutions for improving self-regulation, self-awareness and social understanding of individuals with autism spectrum and related disorders. Shawnee Mission, KS: AAPC Publishing.

Mataya, K. & Owens, P. (2010). Successful Problem-Solving for High-Functioning Students With Autism Spectrum Disorders. Shawnee Mission, KS: AAPC Publishing.

AUTISTIC SOLUTIONS RELATED TO TAKING IN INFORMATION: Using Words to Describe Pictures

This series of blogs and the release dates are as follows:

AUTISTIC SOLUTIONS RELATED TO TAKING IN INFORMATION
Part One: Using Words to Make Pictures (January 13, 2023)
Part Two: Using Words to Describe Pictures (February 10, 2023)

Part Three: When Feelings Are Too Big (March 10, 2023)
Part Four: Examples Using Paint Chip Visual Supports (April 7, 2023)
Part Five: Direct Instruction of Social Information (May 5, 2023)

We continue where we left off in the previous blog, AUTISTIC SOLUTIONS: Using Words to Make Pictures. Many students, even after they have been directly instructed on how to create pictures from the words they read and hear as described in the previous blog in this series, have difficulty using words to describe that picture now in their head. Here is an example from my clinical practice.

Pertinent Background: Franco, a fifth grader, often got frustrated because I did not understand what he was trying to tell me. I had to frequently remind him that I didn’t have the same picture in my head that he did. Therefore, I asked him to use words to recreate his picture for me. Even after explaining this several times Franco still did not understanding what I was asking him to do.

During this time Franco’s class was reading a mystery. He often commented favorably about mystery stories. Capitalizing on this, I told Franco about the mystery of Flat Stanley. This is a true story that happened at my house and it took several days to figure out. I challenged Franco to solve the mystery.

Strategy Implemented During Therapy Sessions: We began reading the book Flat Stanley (Brown, 2009). Stanley was a boy who became flat after a huge bulletin board fell on him. Each chapter of the book tells another of Stanley’s adventures such as being mailed in an envelope to visit a friend across the country and being tied to a kite string and having his brother fly him as a kite. The mystery involved my once upon a time kindergarten son bringing home his cut out shapes and declaring, “These shapes belong to Flat Stanley. Where are MY shapes?” Back then, it took me a long time to figure out what my son wanted and in the process I learned a lot about supporting his communication!

During each session  Franco and I read another chapter of Flat Stanley, after which he would try to solve the mystery of what shapes belonged to my son. At the conclusion of the Flat Stanley book I brought in models of geometric solids such as a sphere, cube, cone, etc. i.e., shapes that were not flat! I showed Franco the answer to the mystery and invited him to make up words my little boy could have used to explain what the geometric solids looked like. Franco was readily able to use words to accurately describe each item.

We discussed how my son only saying a few words and then repeating them over and over didn’t give enough clues for someone to solve the mystery of what he wanted. Franco agreed to try to give more clues rather than to simply repeat his same few words when others didn’t understand what he was trying to tell them.

Follow Up: A few weeks later Franco asked me if I liked power wheels. I told him I didn’t know what power wheels were. He repeated his question and I repeated my response. Then I said, “This is like the Flat Stanley mystery. Please give me more clues.” Franco began by telling me exactly where in Walmart™ I would find the power wheels. I asked for another clue and he described what they looked like and said little kids drive them on the grass. Then, I knew what he meant as I had seen kids in miniature look alike cars driving around in their yards. Franco was happy I had figured it out, but I told him he was the one who make it possible by giving me clues until I could guess what power cars were.

Selection from: Autistically Thriving: Reading Comprehension,
ConversationalEngagement, and Living a Self-Determined Life
Based on Autistic Neurology, pg. 140-141.

(The next blog in this series, When Feelings Are Too Big, will discuss the idea of teaching the size of a feeling rather than the name of the feeling.)

Note: The author is a mental health therapist and is also autistic. She intentionally uses identity-first language (rather than person-first language), and invites the reader, if interested, to do further research on the preference of most autistic adults to refer to themselves using identity-first language.

If you are a clinician and interested in learning more about therapy with the autistic client please join me along with two of my colleagues in an online course.
CLICK HERE for additional information about  Mental Health Therapy with the Autistic Client.

BY JUDY ENDOW

Endow, J. (2021). Executive Function Assessment. McFarland, WI: Judy Endow.

Endow, J. (2012). Learning the Hidden Curriculum: The Odyssey of One Autistic AdultShawnee Mission, KS: AAPC Publishing.

Endow, J. (2006).  Making Lemonade: Hints for Autism’s Helpers. Cambridge, WI: CBR Press.

Endow, J. (2013).  Painted Words: Aspects of Autism Translated. Cambridge, WI: CBR Press.

Endow, J. (2009b).  Paper Words: Discovering and Living With My Autism. Shawnee Mission, KS: AAPC Publishing.

Myles, B. S., Endow, J., & Mayfield, M. (2013).  The Hidden Curriculum of Getting and Keeping a Job: Navigating the Social Landscape of Employment. Shawnee Mission, KS: AAPC Publishing.

REFERENCE
Brown, J. (2009 – present). Flat Stanley. Wilkinsburg, Pennsylvania: Scholastic Publishing Corporation.

Creating, Changing and Replacing Pictures Conclusion

This is the third part of a blog series with this outline

Part One: Creating Pictures in Layers With Two Take and Make Visual Examples 
Part Two: Changing or Replacing a Layered Picture With One Take and Make Visual Example
Part Three: Creating, Changing and Replacing Pictures Conclusion

In Part One of this blog series the reader was introduced to the autistic friendly method of creating pictures in layers.  Visual examples were given. Each layer of the story is created on see through overhead projector sheets. This allows the elements of the story to be stacked up to make one picture. The story elements looked like this:

Stacked together the elements of THE STORY create one picture that looks like this:

In Part Two of this blog series our story continued.  It rained and going to the beach was no longer possible, continuing with layered overheads stacked on top of this original story, the UNEXPECTED EVENT story looked like this: 

Notice in the third overhead of the above picture of our layered transition story the swimmers left the beach. This is one great reason for the layered pictures! It allows one element of a picture to change without needing to destroy the entire picture. That feeling of “everything changed” is prevented. This often prevents meltdowns.

Next, a TRANSITION STORY was created that allowed the “putting away” of the original story, thus making room for the alternative – the change in plans. There were no new elements added to our existing UNEXPECTED EVENT story. Instead of adding new events the TRANSITION STORY simply solidifies that the ORIGINAL STORY will no longer happen. This allows the autistic neurology to process that there is a change. Notice the picture of the TRANSITION STORY is the same as the ending of the UNEXPECTED EVENT story.

          1. Nobody is at the beach. 
            The beach is closed.

          2. We won’t go to the beach today. 
            The beach is closed. 

          3. We won’t go swimming.

          4. The beach is close

The transition story will need to be repeated until the child is tired of the it and ready to transition to something different. Only then is the child ready for the new activity able to be introduced. Talking about the new activity too soon will hit the neurology as a surprise and may precipitate a meltdown.

And then, when the neurology is ready, the new plans can be introduced such as the story from Part One of this blog series called Playing Indoors.

Creating, Changing and Replacing Pictures Conclusion

Please see Part One and Part Two of this blog series for further discussion of everything mentioned in this blog so far. AND know that any event can be mapped out is similar story fashion than the stories presented. Here is the protocol in words rather than in pictures for those readers who would like them!  The protocol  is  in  the  top  two  horizontal  rows  of  this  chart. The  third  horizontal  row  gives  examples/hints  for  implementation.  The  last  horizontal  row  tracks  the  story  examples  used  in  this  blog  series. Often times when people see this protocol they feel it will take too long. For those who have used it they are surprised that even though it does take some time, it is often considerably less time than the time the child spends in a meltdown and then recovering from the meltdown. Additionally, it is much easier to talk this through (or draw it out for those needing the visual support or for those needing decreased auditory input in the moment) than it is to deal with a meltdown.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

If you are a clinician and interested in learning more about therapy with the autistic client please join me along with two of my colleagues in an online course.
CLICK HERE for additional information about  Mental Health Therapy with the Autistic Client. 

Note: The author is a mental health therapist and is also autistic. She iintentionally uses identity-first language (rather than person-first language), and invites the reader, if interested, to do further research on the preference of most autistic adults to refer to themselves using identity-first language.

This blog series is based on Chapter 9 from Autistically Thriving:Reading Comprehension, Conversational Engagement, and Living a Self-Determined Life Based on Autistic Neurology, pg. 126-133.

BY JUDY ENDOW

Endow, J. (2021). Executive Function Assessment. McFarland, WI: Judy Endow.

Endow, J. (2019).  Autistically Thriving: Reading Comprehension, Conversational Engagement, and Living a Self-Determined Life Based on Autistic Neurology. Lancaster, PA: Judy Endow.

Endow, J. (2012). Learning the Hidden Curriculum: The Odyssey of One Autistic AdultShawnee Mission, KS: AAPC Publishing.

Endow, J. (2006).  Making Lemonade: Hints for Autism’s Helpers. Cambridge, WI: CBR Press.

Endow, J. (2013).  Painted Words: Aspects of Autism Translated. Cambridge, WI: CBR Press.

Endow, J. (2009b).  Paper Words: Discovering and Living With My Autism. Shawnee Mission, KS: AAPC Publishing.

Endow, J. (2009a).  Outsmarting Explosive Behavior: A Visual System of Support and Intervention for Individuals With Autism Spectrum DisordersShawnee Mission, KS: AAPC Publishing.

Endow, J. (2010).  Practical Solutions for Stabilizing Students With Classic Autism to Be Ready to Learn: Getting to Go. Shawnee Mission, KS: AAPC Publishing.

Myles, B. S., Endow, J., & Mayfield, M. (2013).  The Hidden Curriculum of Getting and Keeping a Job: Navigating the Social Landscape of Employment. Shawnee Mission, KS: AAPC Publishing.

Impacts of Autistic Thinking Style

I think in colors. My thinking colors have sound and movement. When I hear spoken words my neurology automatically goes for the match. When I was a girl, I heard the saying, “I got the world by the tail.” Immediately, the matching pictures of tail started popping up in my head. It’s like having a personal version of Google Images.

The initial picture search produced a variety of tails of animals. Then, there came the images of the ground mist I saw each morning when I went outdoors after breakfast. I assigned the world tail words I heard to this literal tail meaning that enabled me to name the pictures that had popped up in my head.

Specifically, I assigned this new tail meaning to the interaction of the sunlight and misty water particles I could see rising up from the earth’s surface whenever I was outside. For most of my life, I thought this literally was the earth’s tail.

Furthermore, I thought that people were somehow able physically to grab onto this tail and when they did so they indeed had the world by the tail! I had often tried to touch these sparkles, but now I had a new mission. I wanted to actually catch this tail so I too might have the world by its tail! I am glad this was the 1950’s because children played outdoors many hours. I was not interrupted in my efforts of trying to catch the earth tails.

Today, this would be called “a behavior” and more specifically could be labeled “stimming.” Unfortunately, today some would try to intervene and stop me from engaging in this behavior. Back then, it was just thought to be my way of playing. I used this environmental phenomenon of ground mist interacting with the sun sparkles to make sense of the progression of time across the day. It allowed me to be able to predict what would happen when (lunch, naptime, setting the table for dinner, etc.). I am glad nobody took my mechanism of sense-making away from me!

I was often labeled stubborn and noncompliant based on other’s interpretation of my behavior.  In reality, I was doing the best I could in the moment to participate and do what was asked of me by the adults.

Because autistics have different operating systems, we are misunderstood in many ways. Our operating system visits different, and yet often intense, experiences of aspects of the world that others never seem to notice at all! I would like to end with a poem illustrating the huge impact mismatched colors have on me.

            Warring Colors

Colors are something her eyes
can readily see
and when colors match
they tend to give back
a comfort to her eyes.

But when colors don’t match
she can get distracted
and sometimes finds it harder to function
when her attention needs to be given
over to inside-her-skin physical senses.

If world-people could see
what happens inside to her body
when colors are clashing outside of her skin
in the world all around her

this is what they’d observe
Her eyes start hurting
as if they are burning.
Sometimes tears form
and leak onto her face.

Her insides
become disjointed
with inside-her-skin molecules
of her very being
trying to move away from each other –

like sisters and brothers
in a family feud –
kin not getting along,
choosing sides
and warring with one another.

This causes a physical aching.
Her muscles get sore and tired.
Over the years she has learned
that for her

it is not a very wise choice
to remain a long time inside of a room
where colors don’t match
together (Endow, 2006, pp. 24-25).

Selection from Autistically Thriving: Reading Comprehension, Conversational Engagement, and Living a Self-Determined Life Based on Autistic Neurology, pgs.40-42.

Note: The author is autistic, intentionally uses identity-first language (rather than person-first language), and invites the reader, if interested, to do further research on the preference of most autistic adults to refer to themselves using identity-first language.

BOOKS BY JUDY ENDOW

Endow, J. (2021). Executive Function Assessment. McFarland, WI: Judy Endow.

Endow, J. (2019).  Autistically Thriving: Reading Comprehension, Conversational Engagement, and Living a Self-Determined Life Based on Autistic Neurology. Lancaster, PA: Judy Endow.

Endow, J. (2012). Learning the Hidden Curriculum: The Odyssey of One Autistic AdultShawnee Mission, KS: AAPC Publishing.

Endow, J. (2006).  Making Lemonade: Hints for Autism’s Helpers. Cambridge, WI: CBR Press.

Endow, J. (2013).  Painted Words: Aspects of Autism Translated. Cambridge, WI: CBR Press.

Endow, J. (2009).  Paper Words: Discovering and Living With My Autism. Shawnee Mission, KS: AAPC Publishing.

Endow, J. (2009).  Outsmarting Explosive Behavior: A Visual System of Support and Intervention for Individuals With Autism Spectrum DisordersShawnee Mission, KS: AAPC Publishing.

Endow, J. (2010).  Practical Solutions for Stabilizing Students With Classic Autism to Be Ready to Learn: Getting to Go. Shawnee Mission, KS: AAPC Publishing.

Myles, B. S., Endow, J., & Mayfield, M. (2013).  The Hidden Curriculum of Getting and Keeping a Job: Navigating the Social Landscape of Employment. Shawnee Mission, KS: AAPC Publishing.

Autistic Style of Thinking and Sensory System Impacts

As a teen living in an institution I learned many things. One thing in particular I figured out was what to do when inside my body I felt a rage brewing. The following is a selection from the first book I wrote in which you will see the how my autistic processing and information retrieval lead to ultimate frustration which in turn led me to problem solve – also using my autistic sense making abilities as seen in the sensory based names of the roads leading out of town as they provided the solutions.

It is interesting to note that at the time a diagnosis of autism had not yet been given to me. Even so, I was using my literal, concrete, think in pictures style to serve me along with my innate need for sensory system regulation. Often we think of autistic sensory needs and think- ing style as problems to be solved only because they are different from the norm. I encourage you to think of the autistic sensory needs and thinking style as a place to look for autistic sense making when interfacing with a world not made for us.

Getting Out of Town

     When the info she needs is somewhere inside her
     and she just can’t find it right then when she needs it

     she calls it Ultimate Inside Frustration.

     When she was a girl she coped by showing an array of behaviors
     that world-people outside her labeled “inappropriate.”

     She learned over time that silence was more acceptable
     to the people in the world outside her

     so she tried it.

     And this is what she did:

     She made a map with a city in the middle named
     Ultimate Inside Frustration
     and then drew a road to take to get herself out of this town.

     After that whenever she found that she was in town
     she knew exactly what to do.

     Instead of staying in town she would turn and run down
     a road with the signs pointing “OUT.”

     Here are the names of the roads on the map leading out
     of the town of Ultimate Inside Frustration:

Silent Road – where she can disengage from the outside world

Kaleidoscope Court
– where she can find comfortable looking
matching colors to see

Grey Square Lookout – where she can see the repeating pattern
of the same speckled grey squares on the floors

Hummingbird Lane – where she can silently hum the same few bars
of the very same tune over and over and over again

Lake View Drive – where she can watch or listen to moving water
in the lake, the shower, the sink or the toilet

Textile Turn – where she can stroke something very smooth and soft
or something with a repetitive pattern of texture (Endow, 2006)

Selection adapted from Autistically Thriving: Reading Comprehension, Conversational Engagement, and Living a Self-Determined Life Based on Autistic Neurology

Note: The author is autistic, intentionally uses identity-first language (rather than person-first language), and invites the reader, if interested, to do further research on the preference of most autistic adults to refer to themselves using identity-first language.

BOOKS   BY JUDY ENDOW

Endow, J. (2019).  Autistically Thriving: Reading Comprehension, Conversational Engagement, and Living a Self-Determined Life Based on Autistic Neurology.  Lancaster, PA: Judy Endow.

Endow, J. (2012).  Learning the Hidden Curriculum: The Odyssey of One Autistic AdultShawnee Mission, KS: AAPC Publishing.

Endow, J. (2006).  Making Lemonade: Hints for Autism’s Helpers. Cambridge, WI: CBR Press.

Endow, J. (2013).  Painted Words: Aspects of Autism Translated. Cambridge, WI: CBR Press.

Endow, J. (2009).  Paper Words: Discovering and Living With My Autism. Shawnee Mission, KS: AAPC Publishing.

Endow, J. (2009).  Outsmarting Explosive Behavior: A Visual System of Support and Intervention for Individuals With Autism Spectrum Disorders. Shawnee Mission, KS: AAPC Publishing.

Endow, J. (2010).  Practical Solutions for Stabilizing Students With Classic Autism to Be Ready to Learn: Getting to Go. Shawnee Mission, KS: AAPC Publishing.

Myles, B. S., Endow, J., & Mayfield, M. (2013).  The Hidden Curriculum of Getting and Keeping a Job: Navigating the Social Landscape of Employment. Shawnee Mission, KS: AAPC Publishing.