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Steven C Altabet, Ph.D
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The Dialogue of Autism #23

9/17/2014

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Mental FlexibilityAn important part of developing coping skills is being able to adapt one's thinking to meet the demands of a situation.  When the behavior, thought or rationale you were using to address a situation is not working then the behavior or thought needs to change in order for coping to take place.  This can be difficult for people with ASD as many people with ASD can only think of one idea or engage in one behavior at a time.  Also, the person may become so invested in that thought or behavior that they cannot conceive of another possibility.  Even when an alternative is introduced, the alternative is often denied or dismissed despite compelling evidence.  Fortunately, the ability to recognize alternatives (referred to as mental flexibility) can be achieved, but it is typically a slow an gradual process.

From a Positive Behavior Support point of view, mental flexibility can be achieved by first establishing a consistent routine/schedule then changing one (and only one) aspect of that schedule each day.  Prior warning/review of any schedule changes should occur before the changes take place to give the person ample time to process the alteration and give them opportunities to find out more information.  There should also be a clear explanation for the change so the person can see the benefit of doing so.  While there may be initial resistance to the daily changes, if they are done consistently then the person will eventually come to expect to minor changes in routine and be more accepting when they occur.       
   

Another way to achieve mental flexibility is to offer choices.  Choices allow the person with ASD to see that there are multiple options available.  Start with two options as too many options may be overwhelming.  Be sure to make the options ones that can be carried out and would not cause distress for the person with ASD or the parent, caregiver, or educator.  Choices can be simple such as what type of snack the person wants or more something complicated like choosing chore assignments.  Choices can also be given when a preferred item or activity is not available, informing the person of what they can do or have instead.  

For individuals with more language, once the person becomes comfortable with making choices, the next step would be for the person to generate their own options for choice.  This can be achieved by asking the person to think of alternatives.  This is typically a foreign activity for many people with ASD so it could be helpful to start this activity by using an area of interest or expertise.  For example if the person's interest is sports, after watching a specific play during the game, you could ask them, what else could the player or coach done in that situation?  If they suggest an alternative you could follow up by asking how that idea cold work better or what could go wrong with that plan.  This ensures a logical thought process to the alternative.  If the person cannot come up wit an alternative, options could be suggested and the person can discuss why or why not they would work.  The important aspect of this is to help the realiz          
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The Dialogue of Autism #22

9/3/2014

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What to Do after Calming

While previous posts have concentrated on how to help someone with ASD become calm once they are upset, this next series of post will discuss what to do once calming is achieved.  The upsetting situation does not go away just because the person has become calm and often times redirection to another thought or activity is only a temporary fix.  What has led to the person becoming upset will eventually resurface and needs to be dealt with an appropriate coping response. 

When an upsetting situation occurs there are typically a few ways to respond.  The first is acting on impulse or first thought.  This type of response can be helpful if the person has a broad range of experience with the situation and has a strong knowledge base of how to proceed in these situations.  Unfortunately, many people with ASD have limited experience in the social and life situations that are most upsetting for them and would have few appropriate responses to draw upon.  Therefore reacting on impulse often leads responses that are either random or designed for immediate emotional relief without long term benefit.  This type of approach should be discouraged for people with ASD, unless it is a situation where the person has a great deal of familiarity, like a special interest or regularly occurring activity.

When an immediate response may not be helpful.  The next option would be to think of multiple possible responses then, after weighing the pros and cons of each, decide on the approach that you think will work best.  This may also be difficult for people with ASD because of difficulty processing multiple thoughts simultaneously.  For this approach to be successful for a person with ASD, they would likely have to think of a single response and evaluate its potential outcome.  If the potential outcome was not pleasant then other responses could be generated until a response with a beneficial outcome was found.  Some people with ASD may be able to perform this process independently, but others may need a visual outline to guide them along a decision tree.   Still others may need to be verbally prompted to think of alternative responses and potential consequences.  If the person is unable to think of alternatives and consequences, those can be suggested by others.  the important aspects for the person with ASD to remember is that there is always a consequence for an action and there is always more than one way to solve a problem. 

Finally, there are sometimes when the person cannot think of a reasonable response to a situation.  In that case the person needs to talk to someone else about the situation.  When with the other person, they can either ask for help in a situation or at least relate their feelings about what is upsetting them.  Often just telling someone how you feel can lead to getting assistance, if not emotional support.  Asking for help and discussing feelings are also difficult for people with ASD.  People with ASD can be encouraged to discuss feelings by providing them a simple and direct way of doing so such as using 'I feel' statements.  An example would be " I feel sad when I have to stop playing my favorite game."  For those with less verbal skills, pointing to pictures depicting different emotions and situations may be helpful.  The idea is to help the person with ASD connect a feeling word to the upsetting situation and thus be in a position to elicit emotional support and help.  To encourage asking for help, explain how everyone needs help with some things and that it is ok to do so when needed.  You may need to model asking for assistance by asking the person with ASD for help in an area of their expertise. 

Hopefully these strategies will help.  I often use the following cue words with clients to help with remembering:  Slow down, Stop, Calm, Think, Talk.

Steven C. Altabet, Ph.D.               



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    Steven C. Altabet, Ph.D. Licensed Clinical Psychologist with a specialty in Autism Spectrum Disorders  

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