Tag Archives: #Neurodiversity

AUTISTIC SOLUTIONS RELATED TO TAKING IN INFORMATION: Direct Instruction of Social Information

Autism and Mental Health, Autistic Mental Health, ,

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)

I would like to tell you a story. It took awhile to sort it out. The support worked because it was in line with the neurology of this client I will call Shelby.

I once worked with a young lady who experiences intense feeling that come on quickly whenever her neurology is hit with a surprise. Remember, a neurological surprise is not necessarily a practical surprise.

This young lady, even though she knew she was soon to leave the house to come see me, when her mom said, “Time to leave. Let’s get in the car,” Shelby’s neurology was hit with this surprise because she hadn’t been tracking the time. This meant Shelby’s fight or flight survival instinct was triggered and she yelled, “No, I’m not going!” while throwing objects and crying. This often made her late to places she was going.

For Shelby, it made sense to teach her how to track time when she needed to leave the house. This prevented the intense feeling from happening. Since Shelby always carried her cell phone with her she received direct instruction along with deliberate practice on setting the timer to go off five minutes ahead of leaving time. When the timer went off she had a few minutes to stop her activity, gather her purse and get to the car.


There are undoubtedly more ways to manage big feelings than there are clients who struggle with them! Our own creativity as clinicians can shine here. I have had many clients who have come to manage their own intense feelings that, in turn, allow them more options in their lives. Some of them learn a few feeling labels along the way and for others the labels that go with their feelings still elude them. Please don’t get stuck on teaching your clients to label their feelings at the expense of helping them learn to manage their feelings.

Direct Instruction of Social Information

Just like autistics often need direct instruction and practice on how to make their own pictures in their heads when reading a book so that they can comprehend what they are reading, they also often need direct instruction and practice when it comes to learning social rules. Because of autistic brain function, no matter how many times an autistic is in a given situation where others would automatically learn the expected social skill, his brain will have great difficulty being able to identify the social skill and to then use it going forward.

For autistics the social information simply doesn’t get automatically uploaded into the brain as it does for neuromajority people. This social information that we expect one another to know is called the hidden curriculum. Most of the time it is the most important information when it comes to getting along in the world. The hidden curriculum social information often needs to be directly taught to individuals with autism.

This has nothing to do with cognitive ability, but instead it has to do with the brain’s inability to consistently pick up and apply social information in such a way that it becomes part of their very being as they go forward in life. For example, most very young children generally learn that if you want to have a friend to play with it is more likely to happen when you are friendly, share your toys, and take turns when playing a game. Autistic children often need direct instruction and many times of practice to learn these socially expected behaviors.

For one example using direct instruction to teach a client how to be a good loser when playing a game please refer to the blog Autism, Direct Instruction and Having Friends.

Selection from: Autistically Thriving: Reading Comprehension,
ConversationalEngagement, and Living a Self-Determined Life
Based on Autistic Neurology, pg. 144-145.

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 Adult. Shawnee 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.

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

autism, Autism and Mental Health, ,

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 Adult. Shawnee 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: When Feelings Are Too Big

Autism and Mental Health, ,

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)

Just like the sensory system information can come in too big for an autistic and then become difficult to manage, so to can emotional feelings get too big too fast, making them difficult to manage. Typically, in a therapy setting neuromajority individuals learn to identify and label their feelings. This knowledge then allows them a way to talk about their feelings and ultimately come to manage them over time.

When this approach is used with autistic clients it too often doesn’t go anywhere. Autistics tend to have difficulty when it comes to labeling feelings and are often left trying to guess the right answer. Additionally, while some autistics may find it helpful to talk about their feelings, it has been my experience that most talk about what another person said or did rather than their resulting feelings about the occurrence.

These concrete happenings are easy to know and repeat and are typically what carries the story line for autistics. Many times the feelings experienced by the autistic telling the literal and concrete aspects of the story are apparent to the listener by observing body language, but may not be apparent to the autistic.

Once the literal and concrete details of the story are in order, trying to understand the social ramifications of how another person acted is typically the next topic of conversation. Finally, once the story is sorted out logically and the understanding of the hidden social information is had, autistics might become aware of their own feelings and if so may want to talk about them. It has been my experience that autistics in therapy usually find it much easier to talk about their behavioral response to something another person said or did rather than their feelings around it.

There is no right or wrong way to talk about your own life stories. I merely outline this to show there are neurologically based differences in the way neuromajority and autistic people tell their stories.

Given all of this, I have learned that it is more helpful for most of my autistic clients, regardless of age, to learn about the size of their feelings rather than to struggle over labeling them. Since the purpose of labeling is to be able to talk about and manage feelings, we can cut to the chase of learning to manage feelings by teaching size of feelings.

The beauty of this is that It does not matter if the too big disregulating feeling is a positive feeling such as excitement over an upcoming event or a negative feeling such as sadness over cancellation of a favorite activity in that the too big feeling is managed in the same way regardless of the what the feeling might be.  Therefore, no assigning of feeling labels are necessary to learn how to manage feelings that are too big. Often, it is more important that a client learn to manage/regulate too-big feelings in a short time rather than spending months (often years) getting stuck on labeling the names of these too-big feelings!

Selection from: Autistically Thriving: Reading Comprehension,
ConversationalEngagement, and Living a Self-Determined Life
Based on Autistic Neurology, pg. 141-142.

(The next blog in this series, Examples Using Paint Chip Visual Supports, details clinical examples of a variety of uses of paint chips as visual supports for showing size of feelings.)

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 Adult. Shawnee 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.

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

autism, ,

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 Adult. Shawnee 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.

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

Autistic Neurology,

The  next 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)

Many autistic readers do well in terms of comprehension when they are younger. I think this is because when a child is read picture books the words he hears match the picture he can see on each page. Furthermore, the picture serves to highlight the words salient to the story. Then, pictures start falling away as the child grows older and starts reading more difficult books. In the United States this happens in third and fourth grades. You can go to any elementary school and look at the textbooks used in second, third, and fourth grades and observe this phenomenon of lots of pictures to support text at the second grade level, significantly fewer pictures to support texts at the third grade level and almost no pictures at all at the fourth grade level.

Most third and fourth graders adjust to this falling away of pictures. Some have become language-based thinkers so their brains do fine without picture support. Others remain visual thinkers, but their brains automatically create pictures from the words they read. Autistics have brains that work differently in that they do not always automatically create pictures from the words they read. They often need to be directly taught to do this.

Direct teaching can be as simple or as involved as need be to match the needs of the student. Simply stopping at the end of a paragraph to draw out the picture of the words is helpful to some students. I use a dry erase board as it allows us to easily make changes to the story picture as the story progresses. After a time of seeing how drawing out the story works students can be encouraged to draw and change the picture in their head. Additionally, the previously discussed strategy of layered thinking has been helpful to many.

The Lindamood-Bell program called Visualizing and Verbalizing teaches students to visualize images when they read and when they hear language. This works well for students who are visual thinkers and need a more formal instructional program. “People with autism are relatively better at visual-spatial processing, and this intervention facilitates the use of such strengths to ultimately improve language comprehension” (Lindamood & Lindamood, 1975).

Selection from: Autistically Thriving: Reading Comprehension,
 ConversationalEngagement, and Living a Self-Determined Life
 Based on Autistic Neurology, pg. 139-140.

(The next blog in this series, Using Words to Describe Pictures, details a clinical example of how supporting one autistic student to get the picture in his head into words to tell me.)

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 Adult. Shawnee 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
Lindamood, C. H. & Lindamood, P. C. 1975. Lindamood Auditory Conceptualization Test. Austin, TX: Pro-Ed.