Adding Theraplay to the Autism Spectrum Toolbox

At Kids Cooperate, we believe that play based therapy is the most effective way to learn, integrate, and generalize new tools and strategies for coping with the emotional and sensory stresses faced by many children on the Autism Spectrum.​

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Raising a Confident Child, Locus of Control

​As parents, a common hope for our children is that they will make good, confident decisions and think ​for themselves. Your child's perception of whether the course of their lives are controlled primarily by their own thoughts and actions, or external circumstances is referred to by developmental psychologists as "locus of control".

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Understanding Autism Part 2: Theory of Mind

The two main concepts related to understanding Autism are Executive Function and Theory of Mind. This post will focus on Theory of Mind which is the ability to intuit the thoughts, feelings, and intentions of others. Social skills coaching leans heavily on this model of understanding Autism, and brings resources to bear on helping people to modify their behavior for situational appropriateness. 

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Autism Spectrum and the Philosophy of Paradox

F. Scott Fitzgerald said that "The test of a first-rate intelligence is the ability to hold two opposed ideas in the mind at the same time, and still retain the ability to function."  

Paradox is everywhere in the world of Autism.  It is embedded in the name Autism Spectrum itself. A diagnosis, autism, coupled to spectrum, a fierce rejection of the very idea that a diagnosis can define or describe.

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Understanding Autism Part 1: Executive Function Theory

The two main concepts related to understanding Autism are Executive Function and Theory of Mind. This post will focus on executive function which includes the cognitive tasks related to planning, focus, organizing, error correction, recognizing danger, and impulse control.

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Understanding Attachment

There has been a lot of back and forth about the merit of attachment parenting, a style of parenting that emphasizes the importance of a secure and close relationship between the parent and child. 

It seems like there is value in understanding the fundamentals of attachment theory, first articulated by John Bowlby in the 1940s and expanded on by Mary Ainsworth in the 1960s and 1970s​. ​

I typically blog about issues specific to parenting a child on the Autism Spectrum, but I believe that there is value in having a base of knowledge of important concepts in developmental psychology, and that good parenting is good parenting, regardless of diagnosis.

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A RADICAL VIEW OF AUTISM

While we may not be able to control the surprise curve balls life throws our way, we do have a choice as to whether we perceive difficult situations as disasters, or opportunities for growth.

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Play is a Child's Work

Play is a child's work. It is through imaginative play that children process and integrate the social and cultural information that they experience. The social learning that happens during play lays the foundation for social communication and emotional regulation skills that become important for getting and keeping a job, and maintaining close healthy relationships throughout life. 

The imaginative games that children play equip them to read and intuit the feelings of others, laying the groundwork for the development of authentic empathy. For children on the autism spectrum, the ability to take the perspective of another is one of the most important challenges.

Cognitive development progresses through stages of grouping information, or schemas. As new information is encountered, it must be fit into an existing schema or a new schema can be developed. For example, the "cat" schema may include house cats, lions, and tigers, but when your child sees a weasel with catlike paws and whiskers, they must process and integrate that it does not fit into the "cat" category.

April is Autism Awareness Month, so it is worth mentioning that for children on the autism spectrum, imaginative and cooperative play may not come naturally. Adults can scaffold play by including neuro-typical children, interactive manipulatives, a well organized environment, visual supports, and a consistent routine.

An example of how prosocial behavior is supported by cooperative play can be seen in a simple game of "hot and cold". One child must hide an object and then encourage the other child to locate it by encouraging them with "hot"as they get closer to discovering it and "cold" as they get further away. This interaction requires perspective taking (I know something my friend does not), social exchange (I offer verbal prompts which affect my friends movements), and central coherence or situational appropriateness (I can give hints but should not reveal the answer because it would ruin the game).

Children process their experiences through imaginative play. You can support your child's development by engaging them in make believe! Remember to let your child take the lead in setting up the scenario and be flexible about rapidly shifting rules and roles.

Aaron Weintraub, MS runs child-centered social skills groups with a focus on children and teenagers withPervasive Developmental DisorderAsperger Syndrome, High Functioning Autism, Attention Deficit Hyperactivity Disorder, and Shyness. Strengths-based approach in a community based setting. Groups available in Tolland, Mansfield, Willimantic, Hartford, Vernon and Coventry Connecticut. 
http://kidscooperate.com
860-576-9506

We Are The 1.01%

We are the 1.01%. According to the New York Times, a new report out last Thursday from the CDC " ...estimates that in 2008 one child in 88 received one of these diagnoses, known as autism spectrum disorders, by age 8, compared with about one in 110 two years earlier. The estimated rate in 2002 was about one in 155." The Times article notes that it is unclear whether this increase in diagnosed cases of Autism Spectrum Disorder has been caused by a nebulas definition of what constitutes the spectrum, greater awareness of the disorder, or some, as of yet unidentified environmental, social, or genetic factors. Changes to the DSM diagnostic manual that will take effect next year will narrow the criteria for a diagnosis and may reduce the number of children who qualify for ASD services. The PPD-NOS and Aspergers diagnoses will disappear entirely, and revised categories for other spectrum disorders will be more clearly defined in a way that the organizers of the DSM say should absorb most of the children already diagnosed. 

It is important to consider that, according to the Times piece, "boys were almost five times as likely as girls to get such a diagnosis - at a rate of one in 54, compared with one in 252 for girls. The sharpest increases appeared among Hispanic and black children, who historically have been less likely to receive an autism spectrum diagnosis than white children." If we unpack this, it means that the increase in diagnosed ASD most likely came from the rise in the traditionally under diagnosed minority communities, and that the proposed changes to the DSMV have the potential to disproportionately effect access to services for these children. This does not mean conspiracy. What it does mean is that families dealing with Autism Spectrum Disorders and their allies must continue to educate themselves and advocate for their children. We are the 1.01%.

Aaron Weintraub, MS runs child-centered social skills groups with a focus on children and teenagers withPervasive Developmental DisorderAsperger Syndrome, High Functioning Autism, Attention Deficit Hyperactivity Disorder, and Shyness. Strengths-based approach in a community based setting. Groups available in Tolland, Mansfield, Willimantic, Hartford, Vernon and Coventry Connecticut. 
http://kidscooperate.com
860-576-9506

A Strengths Based Approach to Social Skills Programming

Many autism interventions are built on a deficit model that begins by identifying the behaviors that are causing the most social difficulty, and then designing a curriculum to address problems. For example, according to Bellini (2006), the six major areas of impairment in social functioning include:

  1. Nonverbal communication
  2. Social initiation
  3. Reciprocity and terminating interactions
  4. Social cognition
  5. Behaviors associated with perspective taking and self-awareness
  6. Social anxiety and social withdrawal

These concerns are real, tangible, and difficult to cope with. The impulse as a parent or educator is to ameliorate problem areas by targeting deficits as quickly and effectively as possible. In the rush to target valuable energy and resources to solve problems, your child's innate strengths and capabilities can be forgotten.

As a pracitioner offering social skills groups in the greater Hartford region, I feel that it is critical to design interventions using a strengths based approach. I propose the following six inherent strengths of children with autism spectrum disorder and ADHD. 

  1. Elasticity: the ability to adapt 
  2. Desire to make social connections
  3. Inherent ability for growth
  4. Individuality: each child has individual interests and motivations
  5. Natural supports: family, faith community, and anyone invested in the child's success
  6. Resiliency: the ability to recover from setbacks

A strengths based approach can be reflected in the language used by the constellation of professionals and informal caregivers supporting your child, and this learned optimism will begin to transform the way that you and your child view growth and progress. A study by Shirvani (2007) found that positive teacher communication improved both students performance and parents attitudes. The growth you are working towards can be scaffolded by acceptance, support, and an unwaivering belief in your child's innate capabilities.

Aaron Weintraub, MS runs child-centered social skills groups with a focus on children and teenagers withPervasive Developmental DisorderAsperger Syndrome, High Functioning Autism, Attention Deficit Hyperactivity Disorder, and Shyness. Strengths-based approach in a community based setting. Groups available in Tolland, Mansfield, Willimantic, Hartford, Vernon and Coventry Connecticut. 

http://kidscooperate.com

860-576-9506

Teaching Social Skills: Polite vs Pragmatic

As parents and professionals caring for children with ADHD or on the autism spectrum, we should be aware of the difference between "social success" and "good behavior".  When parents or educators seek out a social skills group for a child, It is often out of the unspoken desire to foster polite behaviors, but the skills that are considered innapropriate by adults can be functional in peer to peer interactions (Bellini, 2006). 

I remember a child that I worked with who was diagnosed with ADHD. His disruptive behaviors in the classroom were being punished by the teacher, but rewarded by his peers in the form of laughter and attention. The challenge was to redirect his behaviors to be successful in one domain (academics) without diminishing the equally important success he was having in another domain (peer interaction). 

For a child without well developed instinct for social behaviors, stumbling upon an action that provokes a positive response from their peers can trigger a repetitive cycle. One way to interrupt this is to inject a moment of reflection into the cycle of repetition. Encourage your child to take a breath, and a moment to "see into the future" to anticipate the results of their choices for a next action. These are called "choice points". 

If we stretch our own comfort levels, we can encourage children for their social success in a way that redirects impolite behaviors. We should take care not penalize them for the sometimes conflicting goals neccessary to navigate a complicated  and contradictory social landscape.

Aaron Weintraub, MS runs child-centered social skills groups with a focus on children and teenagers withPervasive Developmental DisorderAsperger Syndrome, High Functioning Autism, Attention Deficit Hyperactivity Disorder, and Shyness. Strengths-based approach in a community based setting. Groups available in Tolland, Mansfield, Willimantic, Hartford, Vernon and Coventry Connecticut. 
http://kidscooperate.com
860-576-9506

A Yankee Way of Parenting

Recently, there has been a lot of attention and punditry directed towards international cultural norms of parenting. From the Tiger Mom Manifesto earlier this year to the recent interest in French styles of parenting described in Bringing Up Bebe. It is great that we are thinking about and discussing multiple perspectives on parenting, and I think that the time is right to develop a distinctly New England framework for parenting that goes beyond Ferberization to truly reflect and nurture the values we hold about family, citizenship and human development.

Some of the important issues to consider as we work towards articulating a distinctly New England parenting style are, communication styles, disciplinary boundaries and nurturing expression. In family development literature, there are four generally accepted types of parenting styles, each of which come with their own implicit assumptions about the expectations and nurturance within family structures. The authoritative parent maintains  firm rules and boundaries, but is mindful of the child's emotional needs and agency. The authoritarian parent draws strict behavioral expectations, and tends to be inflexible in the application of discipline. The permissive parent has few expectations  and maintains a democratic family structure with flexible boundaries. Finally, the uninvolved parent is, well, uninvolved with their child and may even stray into neglect. 

The folks of New England have been known for a fierce commitment to independence, emotional stability, and resiliency. So what combination of these parental attributes would support a child's development in a style that is uniquely yankee? 

Based on this, I suggest the following three values as a scaffolding to build a distinctly New England style of parenting.

 

  1. Development is not linear. The pace of children's intellectual and emotional growth varies over time. This should be reflected in flexible expectations about a child's capacity to be the person we wish and work for them to become.
  2. Independence is fostered through clear and consistent boundaries. Secure and healthy attachment is supported by behavioral expectations that are clearly stated and consistently enforced.
  3. Respect is the foundation for a strong sense of self. The human mind is resilient and innately capable. By respecting children as competent and "whole" people, we inspire the self confidence that we respect in others.

 

What would you add to this list?

Aaron Weintraub, MS runs child-centered social skills groups with a focus on children and teenagers withPervasive Developmental DisorderAsperger Syndrome, High Functioning Autism, Attention Deficit Hyperactivity Disorder, and Shyness. Strengths-based approach in a community based setting. Groups available in Tolland, Mansfield, Willimantic, Hartford, Vernon and Coventry Connecticut. 
http://kidscooperate.com
860-576-9506

Why Use an "Emergent Curriculum" in Social Skills Groups?

An emergent curriculum is a best practice based on building a lesson plan on the shifting foundation of a child's interests and developmental needs. It requires flexibility, and the time it takes to get to know each child individually and listen deeply to their interests. 

An emergent curriculum is a natural organizing principle for social skills groups for children on the Autism Spectrum and Attention Deficit Hyperactivity Disorder because the work of learning social thinking happens most easily in the context of real world situations. 

Making the decision to commit to the principal of an emergent curriculum does not mean that you must abandon evidence based practice and tested methods of teaching social skills. A session may start out with a clear objective on the group facilitators end, and then evolve based on information and needs that the children bring to the dynamic. 

So what does an emergent curriculum look like? a group facilitator has taken the time to get to know each child and has a detailed social and recreational profile filled out at home by the child and their parent. The objective for the session is practice "putting yourself in someone else's shoes". The facilitator knows that two group members favor different baseball teams, and that they recently played each other. Rather than building the excercise around something abstract, the facilitator encourages they children to identify the other childs emotions in a context of something tangible and relevant.

The comittment to teach social skills using an emergent curriculum means more planning and requires thinking on ones feet, but the payoff in terms of connecting the skills that a child with Autism or ADHD need to develop to real world relevancy is immense.

Aaron Weintraub, MS runs child-centered social skills groups with a focus on children and teenagers withPervasive Developmental DisorderAsperger Syndrome, High Functioning Autism, Attention Deficit Hyperactivity Disorder, and Shyness. Strengths-based approach in a community based setting. Groups available in Tolland, Mansfield, Willimantic, Hartford, Vernon and Coventry Connecticut. 
http://kidscooperate.com
860-576-9506

Comfort in Our Skin

I've been watching season 3 of the British show Skins, a drama about the lives of a group of teenagers struggling to negotiate conflict and relationships. One of the main characters is a boy with high functioning autism who describes himself as in the 97th percentile with math and language development, but in the bottom five percent for social skills. The interesting aspect of his character is the way in which the writers normalize his autism. It is a piece of who he is, but is not used for comic effect, or to highlight his quirks. His friends, for better or worse, accept him how he is and include him as a full part of their circle without trying to change him.

This leads me to an important point to remember as we look for the most effective ways to teach children on the autism spectrum skills to foster postive social relationships. We must start from a place of unconditional acceptance of who they are and their way of being in the world. Only from here can we nurture the confidence to build rewarding and mutual relationships. It's a paradox. In order to be a part of the process of growth, we first must accept where the child is at, unconditionally. 

Aaron Weintraub, MS runs child-centered social skills groups with a focus on children and teenagers withPervasive Developmental DisorderAsperger Syndrome, High Functioning Autism, Attention Deficit Hyperactivity Disorder, and Shyness. Strengths-based approach in a community based setting. Groups available in Tolland, Mansfield, Willimantic, Hartford, Vernon and Coventry Connecticut. 
http://kidscooperate.com
860-576-9506

In

Why are social skills important?

Each day contains a myriad of social interactions, large and small. These can occur face to face, or digitally using social media. Every encounter is a cascade of action and reaction. Whatever the outcome of the interaction, positive or negative, a flood of chemicals including serotonin and adrenaline are released into the body, coloring and influencing our ability to respond positively and with resilience to the next encounter. Some research (Cohen, 2004) even shows that positive social interaction can make us physically healthier and body immunity. Repeated negative experiences can compound into a "vicious circle" but, conversely, positive interactions can instead create what therapist Albert Ellis called a "delicious circle"!

Aaron Weintraub, MS runs child-centered social skills groups with a focus on children and teenagers withPervasive Developmental DisorderAsperger Syndrome, High Functioning Autism, Attention Deficit Hyperactivity Disorder, and Shyness. Strengths-based approach in a community based setting. Groups available in Tolland, Mansfield, Willimantic, Hartford, Vernon and Coventry Connecticut. 
http://kidscooperate.com
860-576-9506