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Understanding Autism “I feel like I live on the moon and look out to Earth everyday and I don't know how to get there.” ‐ 26 year old undiagnosed Aspie with major depression
Autism Pervasive developmental disorder Affects communication, social intelligence, and processing Autism spectrum disorder: Mild, moderate, and severe Often intellectually advanced but social and emotionally behind Social communication disorder Undiagnosed broader spectrum Autism means “stuck in self”
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Intense World Theory for Autism Autism is a consequence of a supercharged brain that makes the world painfully intense. Symptoms are largely because autistics are forced to develop strategies to actively avoid the intensity and pain. Autistics see, hear, feel, think and remember too much, too deep and process information too completely. The theory predicts that the autistics are retreating into a bubble to protect themselves from this intensity and pain.
Intense World Theory for Autism continued This theory challenges old theories that categorize it within the spectrum of mental retardation. The theory demonstrates from neuroscientific studies that autistic fear memories were so quickly acquired, lasted longer, were difficult to erase and overgeneralized. This puts the neocortex in constant state of alert. This forces the autistic into a bubble: “Defense Mode.” It predicts that all autistic students have exceptional talents that are locked up.
Social Overlap Theory Students exposed to chronic social scrutiny would experience this pain with the same neurology that would not have any difference with physical, emotional or social pain. For autistics, it might drive them further into their world (sometimes dissociative), self‐soothing behavior, which will reinforce neural pathways to release serotonin for a calming effect. The stress‐reward pattern can increase an autistics “odd” behavior leading to more habitual or even compulsivity. Sensory defensiveness, common with autistics, may increase daily stress and trauma can exacerbate it. Research shows that this social pain can produce the same neurological results as from sexual abuse. (Centers for Systems Change: Autism and Trauma: Calming Anxious Brains)
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Defense Mode The mental state caused by overwhelm and trauma that causes someone to mentally or physically shut down which results in a forfeit of higher human functioning in order to survive and to preserve oneself against a perceived threat. Aspergersexperts.com
“Maltreatment in childhood increases risk for virtually every DSM‐IV disorder, from autistic‐spectrum disorders to schizophrenia to ADHD to major depression to substance abuse disorders...” Dr. Bruce Perry
Trauma and the Brain When Threatened: The amygdala signals the brain of danger and floods it with adrenaline, norepinephrine and cortisol. These chemicals activate the needed energy to go into fight, flight and freeze. If this becomes chronic the brain starts to rewire itself and amygdala enlarges while the cortex shrinks. The more it does this the easier and quicker it becomes triggered.
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Research Showing an Autistic's Susceptibility to Trauma Autistics are prone to be socially isolated. They tend to be less accepted and liked by peers. They often lack the buffer of a social support network that has shown to be a protective factor to bullying. They tend to be more reactive to bullying than typical kids which can lead to more targeted aggression directed at them. Bullied kids and their parents reported symptoms consistent with panic disorder, major depression, loneliness and social anxiety.
Research Showing an Autistic's Susceptibility to Trauma Language delays get in the way of them being better reporters. Language‐based approaches addressing traumatic events can be ineffective because of processing issues. It's been shown that all of these factors lead to higher rates of comorbidity with autistic population. As children they are five times more likely to be abused than neurotypical individuals. More accurate assessment and measurement is needed for ASD population in its interaction with trauma.
Trauma Informed Practices
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Key Symptoms to Observe: Barriers to Success Impaired social abilities: Low end of social totem pole, missing social cues, difficulties with social perspective taking Restricted, repetitive behaviors: Increased with stress/trauma Concrete thinking: Over‐identify with objects, confused with abstract thinking or sarcasm Perseverating around certain topics: Doesn't require social interaction, it's comforting to be immersed in that part of their world Motor impairment: Can be clumsy, more suited to individual sports
Key Symptoms to Observe: Barriers to Success Language use is affected but not delayed in its development: Conversation hog, Speaks out abruptly off topic Language production takes ample effort causing fatigue
Auditory defensiveness Inundated with noise
Rigid thinking: Black and white logic Seem oppositional? Very honest, sometimes to a level that confuses others
Low frustration tolerance: Is it anger or anxiety? Made worse by perfectionistic feelings toward self
These Symptoms Create Two Categories of At‐Risk Scenarios 1. The peer‐rejected student 2. The socially neglected student
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List of Comorbidity Common with ASD
Disruptive mood dysregulation disorder ADHD Bipolar disorder Disruptive behavior disorder Major depression Obsessive compulsive disorder Oppositional defiant disorder General anxiety disorder Traumatic stress
Some Thoughts on Autism and Psychosis
Some Thoughts on Autism and Psychosis
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Autism, Anxiety and Obsessive‐Compulsive Behaviors What purpose do these behaviors serve? They function as a way of coping when the environment is unpredictable and as a means of helping to control the unpredictability. Anxiety often develops because of the unpredictability, and it is reduced when an individual engages in repetitive behaviors
Possible Interventions for Obsessive‐Compulsive Behaviors
Working with professionals with autism and behavioral backgrounds Use of an F.B.A CBT approaches like a reinforcement system or replacement activities and behaviors that are more socially appropriate Obsessional index in The Incredible 5 Point Scale Gaming and/or electronic diets or abstinence
Dispelling the Use of High to Low‐Functioning Autism ”It seems to me that a child's purpose in this world is evolving, and it's something they each grow into with time. But when we designate a child's functioning level as high or low, we're assuming that his or her purpose or ability to move through the world is already set in stone. This mindset is dangerous, and it causes more harm than good...” High‐functioning label can often be dismissed. The labels perpetuate fear and negativity around the diagnosis. These labels presume there's a normal that our kids with autism have to get to. http://www.parents.com/health/special‐needs‐now/stop‐calling‐kids‐with‐autism‐high‐or‐low‐ functioning/
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Two Types of Empathy Cognitive Empathy Deficits of Autism: Difficulty understanding what emotions are, trouble interpreting other peoples nonverbal signs.
Emotional Empathy Deficits of Psychopathy: Lack of concern about hurting other people, an inability to share feelings.
Understanding Each Unique Student Through Formal and Informal Assessment Occupational therapy: Assesses sensory issues Speech‐language therapy: Addresses pragmatic language issues related to expressive and receptive delays Identify past teachers and providers to collect data Solid functional behavior analysis with tools that generate antecedents and context to behaviors Identify effective consequences for each individual A.C.E.D. Intervention (Automation & Collaboration Empowering Data‐Driven Intervention), acedintervention.com
Suffering is a Doorway to Awakening If you bring forth that which is within you Then that which is within you Will be your salvation If you do not bring forth that which is within you Then that which is within you will destroy you. ‐ The Gnostic Gospels
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Receptive Language Delays Many students with autism only fully process every third word of something read aloud in the classroom. Can you guess what these come from? and...up...to...pail...Jack...and...crown...came ‐ Nursery Rhyme can...by...early...so...hailed...twilight's...whose...and...through... ‐ Song
John Taylor Ph.D.
Making Events Consistent and Predictable Set predictable daily schedule. Teach tasks as series of simple steps. Use highly structured tasks avoid multitasking. Make beginning and points clear. Use visuals. Do2Learn.com‐free picture cards and visual teaching strategies
Structuring Tasks, Assignments to Promote Success Avoid long sequences of instruction. Give step‐by‐step instructions using concrete language. Don't reword repeated instructions. Use code words or terms ‐ “I don't understand.” Use statements rather than questions to teach whenever possible.
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Thoughts on Transitions
Map it out: Be a step ahead and offer a few choices. Incorporate strengths and interests into daily plan. Stepping down/Voluming down Use a body‐based exercise to release energy: Short exercise Appropriate type of stimming/fidgeting Run an errand for teacher
The Big Goal for the Best Intervention Reduce Anxiety and Reduce Fear
Approaching a Student to Promote Increased Regulation Stay calm, staying courteous and respectful. Establish eye contact before speaking. Use one name (not nickname) exclusively when addressing student. Speak at a rate slow enough to accommodate to the student’s auditory processing challenges. Avoid “be good” or other sweeping generalizations about behaviors desired. Encourage responsibility for specific behavior actions.
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Approaching a Student to Promote Increased Regulation (continued) Let the student know when an inappropriate response has occurred, using clear confrontation of what the student did and how it hurts self or others (now or the future.) Ask yourself when the student acts out: “What skill is missing? What is the missing piece here?” Encourage peer interaction but allow down time. Recruit classmates as occasional partners for activities Autism, Asperger’s, SPD & ADHD – John Taylor, Ph.D. www.ADD‐Plus.com
Be an Anchor & Identify Other Anchors to Keep the Student Grounded Keep it simple: Communicate with few words allowing time for auditory processing. Use comic strip conversations or social stories. Supervise during high risk times: They need to know that you have their back. Reinforce student’s strengths, competencies and self‐ confidence. Take one‐on‐one time periodically:
Lunch Pull aside at times that are appropriate Play a game that student likes Do a home visit
Witness Accept Validate Power
Meg Hanshaw Empowerment Education
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The PEERS Curriculum PEERS is an evidence‐based approach that builds skills and competencies of socially challenged individuals. PEERS addresses the common social errors often committed by those with ASD. PEERS teaches core social skills needed to make friends and keep friends. PEERS focuses on ecologically valid ways in which socially accepted teens handle peer‐ conflict and rejection. https://www.semel.ucla.edu/peers
Other Interventions for Healing Bridges the gap between thinking mind and emotional mind (trauma needs to be “moved”) Gets students out of categorical all or nothing emotions. Helps student with coping skills discerning right and wrong choices. Good visuals to help students rate what they feel and where they feel it.
Deep Breathing: Releasing Endorphins and Regenerating Your Cells 4‐7‐8/For Kids: 3‐5‐6 Breath 4 seconds through your nose. Hold your breath for 8 seconds. Exhale for 8 seconds slowly breathing through a small hole in your mouth.
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Let's Keep Brain Plasticity On Our Mind Plasticity: The ability of the brain to modify its own structure and function following changes within the body or in the external environment. The large outer layer of the brain, known as the cortex is especially able to make such modifications. Brain plasticity underlies normal brain function such as our ability to learn and modify our behavior. It is strongest during childhood — explaining the fast learning abilities of kids — but remains a fundamental and significant lifelong property of the brain. ‐ Society for Neuroscience
“Asperger would often just sit with the children, reading poetry and stories to them from his favorite books. “I don’t want to simply ‘push from outside’ and give instructions, observing coolly and with detachment,” he said. “Rather, I want to play and talk with the child, all the while looking with open eyes both into the child and into myself, observing the emotions that arise in reaction to everything that occurs in the conversation between the two of us.” NeuroTribes: The Legacy of Autism and the Future of Neurodiversity Steve Silberman
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Sources Hoover, Daniel. "The Effects of Psychological Trauma on Children with Autism Spectrum Disorder: A Research Review." Review Journal of Autism and Developmental Disorders 2.3 (2015): 287‐99. Print. Autism and Trauma: Calming Anxious Brain, Centers for Systems and Change. 2012 DuBard, Melanie Ph.D., BCBA‐D, What About Those Obsessive‐Compulsive Behaviors? Kennedy Krieger Schools Autism, Asperger’s, SPD & ADHD – John Taylor, Ph.D. www.ADD‐Plus.com Herbert, Martha. The Autism Revolution: Whole‐Body Strategies for Making Life All It Can Be. New York: Ballentine, 2012. Print. Commentary: Complex Post‐Traumatic Stress Disorder. Implications for Individuals with Autism Spectrum Disorders—Part II; Journal on Developmental Disabilities. 2011 Silberman, Steve. NeuroTribes: The Legacy of Autism and the Future of Neurodiversity. New York: Avery, 2015. Neurotypical. Dir. Adam Larsen. PBS Distribution, 2013. DVD.
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