Cloak of Competence. Sensory Integration. Autism. Sensation, Stress and Strategies 12/10/2012. Heather M. Brown 1

Transcription

1 Cloak of Competence Heather M. Brown, B.A., B.Ed., M.Ed. Ph.D. candidate, Western University Single mother of a child with special needs President of the CLC for Autism Ontario - London Aspie Driving force = to appear competent Competent = balanced, intelligent and sociable The myth of a mild disability Autism Autism is a neurobiological condition Three main areas of difficulty: 1) Social relationships 2) Communication 3) Behaviour Sensory integration difficulties defined Sensory integration allows us to move purposely through the world without being driven to distraction by the cacophony of sensory experience that bombards us each moment that we are awake. Smith & Gouze, 2004 Sensory Integration Before I can even begin to address my communication problems or my social deficits, I am overwhelmed by sensation simply by existing Sensory Input Working memory and long term memory Metacognition Choice Behavioural Response Use self-talk (metacognition) or rote memory (Long term memory) to compensate for deficient social understanding / communication Stuck in Sensory Overload??? Compensatory system shuts down Heather M. Brown 1

2 Small number of pleasant sensations Unpleasant sensations cause a lot of stress Regular Everyday Stress Frequent Exposure to Unpleasant Sensory Stimulation Frequent Problems Fitting into Social World Crucial skill: How to manage stress Overwhelmed with stress? Few positive coping strategies Co-morbidities Psychosomatic complaints Wackload of Stress Hypersensitivities and sensory overload Hypersensitivities and sensory overload Sensory input can feel overwhelming, painful, and irritating Fight or flight response Repeated flooding => over-arousal Overarousal Potential for meltdowns Unpleasant sensory input Over-arousal feels like agitation Release of More released Irritability Increased sensitivity to sensory input Heather M. Brown 2

3 Hyposensitivities & Sensory deprivation More released Apathy and helplessness Under-arousal feels like boredom Sensory deprivation Frustration Sensory Deprivation and Unstructured Time Unstructured time is the Enemy What is unstructured time? When are common unstructured times? What happens to me during unstructured time? Continued sensory deprivation Release of Sensory Deprivation and Unstructured Time Unstructured time is the Enemy How I deal with unstructured time Creating a schedule of activities which vary in their sensory intensity Some of the scheduled activities must be constraining. Constraining activity defined Overstimulation and Understimulation are both stressful Stress Feeling Overwhelmed Depression Heather M. Brown 3

4 Taste and Texture Sensitivities Sensation, Stress, and Strategies Milk, yogurt, cheese, Cheerios, peanut butter, crackers, pasta Psychological Intervention Pickiness Cubed The princess and the pea Sticker rewards We can t help you Problem with new food: Gag reflex and large quantities of liquid Social events always involve food! Coping Strategies Heather M. Brown 4

5 Sensitivity to Touch Overstimulation causes sensitivity to touch Example 1: He just wants a hug Example 2: Holding hands Sight Enemy #1: Light Enemy #2: Movement Strategies: Sunglasses Darkness Walls Sensitivity to Sound Enemy #3: Sound Sound Strategies Musician s Ears Sniffing is illegal Headphones Quiet Environments Musicians Ears Heather M. Brown 5

6 Coping with very high stress levels Strategic Seating Use breaks to do heavy work Block out all unpleasant sensation D-Day: Thesis Defense Day Specific Ideas Block out all light in room Take a nap Read a fast-paced or engaging book Listen to music with headphones Swing while listening to music Watch a new and engaging movie Fidget Toys Take yourself out of the world that is causing you so much pain and put yourself into a world that is safe Anything new/different Creating new routines Communication Sensory sensitivities Planning and organization Meeting deadlines Managing time Sit still and focus for long periods Doing what we are told Doing things that we don t like Reading minds Making and keeping friends Unpleasant emotions: anxiety, boredom, anger Adapt to a new and different world Create new routines Communicate: group-work, essays Sensory input: loud, a lot of people, bright lights Planning and organization Heavy workload with lots of competing deadlines Hand in assignments and arrive to class on time Sit still for three hour lectures, five times a week Do what your prof says Take courses that are required by your degree Predict what info will be on an exam Make new friends Manage unpleasant emotions Heather M. Brown 6

7 Potential Weaknesses Planning and organization Sensory Sensitivities Social Skills and Communication Academics Manage time: family, friends, academics, self Distracted by noises/movement in lectures/exams Work in groups Learn what I tell you to learn How do I complete this task? Three hour lecture: Sit still and listen! Contribute in class Write essays/exams and DO WELL Heavy workload and competing deadlines The unorganized professor Make friends Coexist with roommates Predicting what the professor wants and what he thinks is important Stress and Emotional Regulation Key to surviving university is learning to manage stress and negative emotions Overarousal More released Potential for meltdowns tantrums aggression & Lost productivity Over-arousal feels like irritation, frustration, anger, powerlessness Increased sensitivity to stressors Release of Irritability Crying Screaming Groaning Inability to speak Hyper-ventilation Hand wringing Rocking Self injurious behaviours Repetitive motions and sounds Feelings of powerlessness and terror What helps me? Not being alone Cold cloth Funny stories Being held Being told: It will be ok Soothing me Writing out what happened Distraction and Time What makes me worse? Staying in my head Telling you what happened Intermittent physical touch Telling me to stop Criticism Being alone Heather M. Brown 7

8 What helps me? What makes me worse? What helps me? What makes me worse? Not being alone Criticism Others ignoring my outburst Criticism Crying intensely Have lots to say Feelings of powerlessness, frustration and anger Talking it through Taking my side Empathy and sympathy Hugs Letting the emotion out Logic Telling me what I should have done to avoid getting upset Telling me that my reaction is unreasonable Trying to problem solve Yelling Cursing Aggression Blaming others Feelings of irritability, anger, and frustration Letting the emotion out Letting the emotion run its course Others and/or myself making jokes Empathy and sympathy Anger from others Telling me that my reaction is unreasonable/inappropriate Telling me to stop yelling at you Arguing or reasoning with me Letting the emotion run its course What makes it worse While experiencing your child s panic, meltdowns and/or tantrums, you are probably wondering, What the heck is all this? Intense Stress Fight or Flight / Over-stimulation Frontal Lobe Shutdown!! Intense Emotional Response Bruel, 2008 According to the book Smith-Myles, B. & Southwick, J. (2005). Asperger Syndrome and Difficult Moments: Practical Solutions for Tantrums, Rage and Meltdowns. Shawnee Mission, Kansas: Autism Asperger Publishing Co. No Frontal Lobe No Planning No Organization No Reasoning No Problem solving No Impulse control Heather M. Brown 8

9 Warning: Do not attempt the following strategies unless you are absolutely sure that I am calm. It is not enough to think that I am calm. It is not enough to believe that I should be calm. It is disastrous to guess that I might be calm. I must actually be calm! Now you can t say that I didn t warn you. Smith-Myles & Southwick, 2005 Eventually, I will calm down and so will your child. Calm Frontal Lobe Online More capable of problem solving, reasoning & planning Teachable Moment Smith-Myles & Southwick, 2005 But what was happening to you while all this was going on? But individuals with ASD tend to have difficulty with executive functions (like problem solving, flexible thinking and planning ) even when they are calm (Joseph, 1999). So how can we make use of the teachable moment??? Green, R. W. (2005). The Explosive Child: A New Approach for Understanding and Parenting Easily Frustrated, Chronically Inflexible Children. New York: HarperCollins Publishers. Empathy (plus Reassurance) Define the problem Invitation Calm Frontal Lobe Online More capable of problem solving, reasoning & planning Surrogate Frontal Lobe Teachable Moment (Green, 2005, p.98) Heather M. Brown 9

10 How do I regulate my own emotions? What is my current level of stress? What stressors are next? Can I reduce my stress? When and how can I calm myself? Planning and Organization Make lists Start early Use a calendar Prepare yourself Specialization in a field Heather M. Brown 10