Thursday, September 24, 2015

Autism Spectrum: Your emotions overwhelm me!

Whether you are in relationship with a child or adult in the autism spectrum, you may not realize how sensitive they are to other peoples' emotions.  They may misinterpret them, make wrong conclusions about them, not understand where they come from or what they are called, but many individuals with ASD (autism spectrum disorder) experience them quite strongly.  

Consider this, have you ever had the experience of having something really bad happen to you, and many people run over to you and say how horrible it is, how sorry they are, and what can they do?  If so, you probably have a sense of how it feels to have trouble taking in and balancing emotional input from others.  You might think, "Oh great.  Now I have to deal with my own stress and sadness, as well as the sadness of other people!"  Or maybe you watched a sad movie on TV and you have trouble regulating all that emotional input from the program without feeling the impact for hours or days later.  It's a lot of emotion to "take in" and do something with. 

Individuals in the spectrum can be easily overwhelmed by the emotions of others.  If they are having a conversation with someone who is emotional, they may shut down or feel like leaving.  If their family members are fighting and crying, they are likely to feel a real struggle with this (maybe even moreso than the individuals in the argument).  If you are a spouse or parent interacting with these individuals about a difficult topic, they may miss much of the content of your communication because they are overwhelmed trying to regulate the emotion of it.  I recently spoke with someone with ASD who said, "This is so true... 200% true!!"

Here are some tips to recognize and overcome this barrier:

  • Recognize that your need to get your emotions out may be just that... your need.  It may not serve the actual communication or help the person you are connecting with.  If it is your need, but overwhelming to the other person, find other ways to let your emotions out (e.g., journaling, exercising, bubble bath, music) while still communicating thought content to the other person.
  • Recognize that adding emotional content to your communications DOES NOT make them more compelling to the other person, but rather decreases their effectiveness.  If you want to make sure you're getting your point across, decrease your emotional output rather than ramping it up for emphasis. 
  • Commit to a calm home environment as part of the overall picture of helping your loved one balance their experiences (e.g., emotional, sensory, activity, etc). 
  • Give the other person time to settle their emotions before talking through the emotional topic.  They may need space, quiet, and time before feeling ready to continue talking about something.  

Wednesday, September 9, 2015

Teaching Emotional Control Strategies to Kids with Autism

I recently wrote a blog entry about why losing games can be overwhelming to individuals in the autism spectrum.  Now for a few ideas about helping kids gain emotional control.  These strategies are one step toward calming and teaching emotional regulation.  Consider yourself and your child to be a detective about what helps in what types of situations. 

  • Catching the Meltdown Before It Happens
It is often difficult for an individual in the spectrum to know how upset they are becoming or may become in certain situations.  As the parent of a young child, you may need to watch for signs and triggers ahead of time and teach your child more about his triggers and emotions.  You might say "You are angry right now" or "It has been a long day.  You need some quiet time."  You may pay attention to your child's schedule to make sure there are not too many difficult things in one day (e.g., don't schedule a school test and a dentist appointment the same day).  

It can be helpful to use pictures to help your child identify how he is feeling (e.g., he could point to green for good, yellow could be "watch out, getting stressed" and red could be "feeling completely overwhelmed").   
  • Using Sensory Strategies for Calming
Once your child is overwhelmed, using verbal reasoning and requests is often very difficult and unsuccessful.  It is hard for her to think about how to comply with your commands (e.g., "Get a grip, it's not that bad" or "Stop crying, this is embarrassing).  It is also very difficult to attach words to the experience.  She is likely to be unable to verbally explain what is happening (e.g., "Why are you so upset!  What happened?").  Instead, you could use physical strategies that involve the senses to help her body calm.  Some strategies might include using deep pressure (e.g., bear hugs, pillow sandwiches with your child in between for a nice squeeze, or a weighted blanket), vestibular input (e.g., a ride in the car, being pushed in a swing), visual input (e.g., repetitive visual things like a lava lamp), auditory input (e.g., ear phones with nature sounds or favorite music), joint input (e.g., carrying something heavy, pulling on something), or smells (e.g., essential oils like lavender).  This can help with calming, even when the individual can't use thoughts or language.
  • Time Out for Calming Instead of Punishment
You can teach the child that when they begin to feel overwhelmed, they may need to regroup in a quiet space before trying to solve the actual problem.  Having time away from chaos and strong emotions, can help him let go of some of the stress before interacting with others again.  Some separation can be initially helpful.  In fact, for individuals with ASD who are older, I have even seen people decide they do better speaking to others about difficult things using email rather than face to face.  If this is a strategy decided on ahead of time that actually helps introduce helpful distance and prevent loss of emotional control, it may be very helpful. 
  • Have a Calming Strategy that you Practice Ahead of Time
Giving your child direction during a meltdown is often more overwhelming than calming.  However, if there is a calming strategy that the child knows about ahead of time, she can learn to use the strategies piece by piece.  For example, one strategy might be to use the breath for calming, like blowing bubbles or blowing LEGOs across the room with a straw (sometimes blowing out is more calming than deep breathing, especially for anxiety).  The individual may have a basket of things for calming (e.g., squeeze balls, ear phones with music, heavy blanket) or may have a binder with pictures of strategies in it (e.g., pictures of swinging or meditation) that they can then go and participate in.  

You will find that thinking about strategy rather than punishment is more effective and comfortable for you and your child!

Monday, September 7, 2015

Why Losing Can Lead to Meltdowns in Autism

All kids have trouble learning to lose with grace, but for children in the autism spectrum, losing can lead to an all out meltdown.  A meltdown is different from a tantrum in which the child is in control of his behavior but is acting out to achieve a goal or manipulate an outcome.  A meltdown is the moment at which someone is entirely overwhelmed by emotion and decompensates before your eyes.  The emotional moment may last a very long time; children with autism can take even hours to recover.  

Many children with ASD (autism spectrum disorders) have meltdowns in response to losing a game.  Why?  Here are several reasons:
  •  Uncertainty:   Individuals in the spectrum often want things to be routine and predictable.  They have difficulty not knowing the outcome of something ahead of time.  For some kids, if there was a predictable pattern to winning and losing (e.g., I win then you win then I win...), the individual would do better.  But that is the point of the game for most people; the outcome is uncertain and captivates our attention.  What is going to happen?!  For the individual with ASD, the uncertainty is stressful.
  • Concrete: Good vs Bad --Concrete thinking is common in the spectrum as well.  Your child may categorize everything into good or bad, or other black-and-white categories.  As my son was growing, he would ask the same thing of me ("Is that person a good guy or a bad guy" or "Is that a good word or a bad word").  It is difficult for your child to, on the one hand, know that winning is the object of a game (no matter what adults say to the contrary) and also realize she is either a winner or a loser, good or bad.  When she uses all her efforts to get into the "good" category and fails, this is overwhelming.  
  • Fixed Beliefs --Many individuals in spectrum fixed beliefs that have no clear basis in reality.  They may firmly believe with all their being that something makes the team that is playing good or bad.  For example, they may be extremely attached to the blue uniforms of a team on television, and melt down if the blue team doesn't win.  I have heard some kids say, "I don't know why, but I just feel like it is really really important for the blue team to win."  It is common for people in the spectrum to be unable to distinguish what is "really important" and what is not. 

This leads us to the topic of Emotional Control.  You can think of emotional control as part of the overall concept of executive function which is impacted by the center and front of the brain.  For a good description of emotional control, see Dr Dawson and Guare's descriptions in their books at Smart but Scattered Kids.  Executive function is a significant difficulty for individuals in the spectrum, and emotional control is a big part of that challenge. 

People who have emotional control difficulties may have different manifestations.  In the presence of overwhelming situations,  they may:
  • Shut down (withdraw, lose their words, freeze, be unable to act)
  • Act Out, Explode, or Meltdown (pushing someone away, crying, yelling)
  • Become very anxious (significant fear, worry, and upset)
Because they are less able to manage their own emotional and physical experiences, they often become overwhelmed by emotion and unable to function appropriately through the challenges.  

It is important to understand that, for these individuals, the difficulty managing emotion after losing a game has a neurologic base and cannot be generally managed hearing someone say "stop it" or "don't be a cry baby." 

Some ideas for managing these situations coming up in my next post!