Wednesday, December 15, 2010

Raising Asperger's Kids: Generalizing the Specifics

Elise aka aspergers2mom
asd2mom.blogspot.com

A primary issue for children on the autism spectrum is generalization: the ability to take what they learn from one situation and apply it in a totally different scenario. The scenarios may not even be all that different, but introduce a new dynamic or remove a familiar item, and the child can get thrown off kilter and lose the resources they just learned. It's similar to the issues my younger son, HSB, has in math. When given a math formula and the appropriate number equivalents for the algebraic letters, he is able to apply the formula and even understands the reasoning and purpose. But if he is required to take that formula and apply in an unfamiliar word problem or with an unfamiliar set of numbers, he will get lost. He is not able to generalize the specific information that he learned for that math equation. So too, do autistic children have issues being able to understand how certain appropriate behaviors are applied across the board and are general to the entire social paradigm. The question then becomes: how can you help them understand how to accomplish this goal? What can you do to help your child relate their social lessons to each and every situation that they face?

Interestingly, Dr. Temple Grandin accomplishes this task by keeping what she terms a running Rolodex of social situations in her head. She remembers them as if they were social stories, so that she is able to access and filter what she needs to accomplish, how, when, and even why. However, that is not how most of our children will function. It is actually an intriguing idea and concept to use your brain as if it were a social story computer, but that is not going to work for everyone. Especially those like HSB who have a working memory shortfall.

So what do you do? Well to start with, you do teach for the moment. As I always say, you take each moment as it comes. You get them through the challenge of the hour and then when all is calm and all is quiet you sit them down and continue the lesson. You point out to them what happened and how it was dealt with. You talk it through with them what was and was not appropriate. You problem solve how they could have done things better or how they actually did terrifically. You make them understand that certain behaviors that they accomplished at that given moment are actually a general concept and that it should be applied liberally.

For example: How does someone behave in a grocery store? You practice looking for your items. You practice walking appropriately in the aisles. You practice waiting your turn at the check out and you practice asking for help from one of the sales clerks. When they accomplish these goals in navigating the supermarket, you next take them to the toy store. You pre-teach the situation by reminding them of the appropriate behaviors in the supermarket and how they apply in the toy store as well. You can use social stories, flash cards, and even basic children’s books on what happens when their favorite character goes to the toy store. You try to get them to understand that behavior in a public store is the same in every store.

Now without a doubt you do not have to follow the supermarket with a toy store. In fact, since our children do have the hardest time in toy stores, (the choices can overwhelm them and they are unable to choose a toy) I would actually even make that one of the last lessons you teach. But that is something you and you alone are going to have to decide how to handle, and when to challenge your child's learning by testing with a visit to a toy store.

Another important point: if your child is not following the rules, don't be afraid to leave the store.

I can’t tell you how many times I have left a grocery cart full of items because the boys may have been acting up at that moment. If you cannot calm them down, you leave. There may be a myriad of reasons for the meltdown. There can be a sensory overload, which even if you calm them down initially may just erupt again, so be prepared. There may be the tantrum that they want Cocoa Puffs instead of Cheerios for breakfast. This is the tricky part, because our children do have a hard time making choices, but you cannot let them tantrum, you cannot let them melt down, and you above all cannot give into their desire to have both cereals, or give them the cereal you do not want them to have.

You need to be aware of the difference between meltdown and tantrum, whether your child is having issues because of the autism, or issues because they are children and want what they want when they want it. However, in many of these situations your response has to be the same: you must walk away. It breaks your heart, especially when you know that it is a sensory issue or their inability to choose, but they must learn to choose. They must learn to channel their coping skills with sensory issues as well. Again, this is where the pre-teaching comes in. The preparation before the excursion can help with these situations.

It doesn't always work. At some points you may think your child is never ever going to learn how to choose one item from a store, or understand that they just can’t have a certain type of food. I still remember the day I took nursery school-aged HSB to the local candy/toy store. I told him going in that he could only have one toy. We practiced it and we talked about it. So lo and behold he decides he wants two toys. I reminded him that he had to choose one. That was the rule. I even helped him by choosing the toy for him. But he started to tantrum that he wanted both.

I am quite aware that as a child on the spectrum he saw what he saw and he wanted it. That perhaps in many ways he was unable to truly choose and that without both toys his internal systems told him that his life was going to be miserable. However, that is not life. Reality is that you have to make choices. You must choose between toys. We teach this lesson not because we want to be cruel, but because we know that there will come a time in life that your child will have to choose between food and a video game or health insurance and a manga. You cannot begin to teach this coping skill when they are 30 years old. This is a skill that takes a lifetime of teaching. You must begin sometime. They have to understand, as all persons do, that there are limits and those limits are part of the social construct that they will be living in. Yes, as with all things in the social realm this can be harder for them to understand and grasp than for someone who is neurotypical, but they can grasp it. It just may take an inordinate amount of time and make you feel like the Wicked Witch of the West.

Honestly, this also goes for being able to curtail certain habits, or resist the urge to eat junk food, or developing good sleeping habits. Learning limits, whether about toys, candy, spending, or appropriate behavior, leads to a better life and a more successful view of the world. And whether we think so or not, when they are three and crying their eyes out because you didn’t buy them that toy, they just may thank us one day when they are able to live on their own, successfully leading the life they choose for themselves. (OK not thank us, but at least not call us names anymore.)

By the way, the story in the candy/toy store ends with me actually picking HSB up and putting him under my arm and carrying him out of the store. I told him he had to choose and when he threw a fit, refused to choose we left the store. Did it have an immediate impact on his ability or desire to make choices? No. I would be lying if I said it did. It still took time and several more store episodes for him to understand that life is a series of choices, but he learned and even over time he learned that sometimes the choices you make are not the ones you want, but they are the ones you have to deal with.

The reality is that there are basic concepts that our children need to be taught and they can be taught in many ways. Here is a small list of generalized behaviors:
  1. Walking and speaking appropriately in a store.
  2. Finding the item you want in the proper way: looking at markers in the store or asking for help appropriately
  3. Standing in line to pay, and waiting your turn if there is any kind of issue to be addressed.
  4. Making sure that you have the right amount of money to pay for the item (of course this is for older children who may need to even pay for their own lunch at school). However, you can start this process by pointing out to your child how you are paying for the item and that the money is in the bank or even handing over cash when you pay. (It is interesting to note, that persons on the autism spectrum can have very bad relationships with money. Budgeting and money management needs to be reinforced from a young age.)
  5. Using proper etiquette when speaking to someone: thank you, please, you're welcome -- it all goes a long way in gaining acceptance and help in society. Demanding and requiring someone to do something for you generally gets no one anywhere.
Our children need to learn to recognize these social attributes. It's essential. So many of our children, due to their speech issues, auditory processing and language issues, have modulation issues as well and their anxiety comes out in their actions/tone of voice. They may be very anxious in any given social situation and it may come out in the way they address someone in a store. The clerk will think your child is being rude or obnoxious when they are simply anxious. Try to get your child to recognize how their body feels, teach them how to cope with the public/social anxiety.

The truth of the matter is that as with everything that our children do, it is only through practice and more practice and even more practice that they will learn to generalize in social situations. Now as far as math is concerned, it took a lot of work to be able to generalize the formulas and at times HSB still does not get it. But that is OK. We came to the conclusion a long time ago that HSB is not going to be a theoretical physicist or an electrical engineer. But interestingly enough he is able to generalize criticism and attributes of video games and films. It seems that is where his abilities lie, which is a good thing considering that is where he has pinned his future career hopes. Of course, he is still going to have to learn to make choices and you know what, he still doesn’t like that, but luckily he doesn’t throw tantrums anymore, because at almost 6 feet and 200 pounds he is just too big for me to put under my arm and walk out of a store.

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A version of this essay appeared on Elise's blog, asd2mom.blogspot.com.