How To Find Your Strengths When You Aren’t Sure What They Are

By Brian R. King LCSW

This is the third of a ten part series I have decided to put together especially for you. I hope these lessons will serve as a road map of sorts on how to be on the Autism Spectrum and have a successful, happy life. So let’s get started . . .

Step 3: Acknowledge Your Strengths & Live Them Every Day

Are you ready to take a break yet? The first two lessons in this series required a lot of in-depth thinking, they really asked you to take a look at yourself and the way you think. So let’s take a break from that approach and be a little more straightforward for this lesson. This lesson is all about finding your strengths.

Now for those of us on the autism spectrum, we’re so used to being criticized and so used to having difficulty that it’s much easier to think that we have more weaknesses than we ever will have strengths. It doesn’t help that those who are looking to support us also have a tendency to emphasize our challenges instead of our strengths. They do this by emphasizing that we work diligently to overcome our weaknesses instead of living from our strengths. Now before you scream, “I DON’T DO THAT” at your computer screen, please bare with me and I will explain.

The obvious problem with emphasis on reducing or eliminating weaknesses is that you only get to develop the things that you give your time and attention to developing. So how do you learn to discover and develop your strengths with so little encouragement to do so?

What Makes Me Confident?

It is in living from our strengths that we have the greatest likelihood of experiencing a feeling of competence and success more often. It’s the experience of competence that is at the heart of our feeling of self-worth.

So by giving so much attention to our weaknesses you’re reinforcing the experience of incompetence and lack of success over and over each and every day of our lives.

We often talk about the need for balance in life, and this is critical in helping someone on the spectrum develop their self-worth while remediating areas of challenge. There must be equal if not greater opportunity for spectrumites to experience their strengths and the value of those strengths. Our strengths serve the purpose of solving the problems of our own lives as well as helping solve specific problems in the lives of others.

What Makes Something A Strength?

Words matter, so let’s be clear what is meant when I talk about a weakness, challenge, or strength. I think of a weakness as something I’m simply not good at or am unable to do. My penmanship sucks and the physical act of writing is painful to do, so how much time and effort do I put into improving it before I fire up my Dragon Dictate software (which I used to write this article by the way)? Does it make sense to work on the writing or use my gift of speaking?

A challenge can be thought of as a problem that is difficult to solve but is within your ability to solve once you determine the strategy for doing so. A strength is knowledge or skill that you use to solve a problem either for yourself or another person.

In fact, when you get down to it the simplest measure of how independent someone is lies in their ability to solve the everyday problems of their life. The way you measure someone’s contribution to society as a whole, can be measured by their ability to solve problems for others. For example, when a person is hired to do a job they are hired to solve a specific problem for their employer. I hire an accountant every year to do my taxes because my math skills are mediocre at best. Therefore, I enlist the strengths of an accountant to solve that problem for me.

Can You Read This?

If you are presently saying to yourself, “But I don’t seem to be good at anything. I don’t know what my strengths are,” then let me make one thing very clear to you. If you are able to read this then you are literate and that is a strength. One of the reasons we miss the strengths that are so abundant and right before our eyes, is that once we learn how to solve a problem such as tying our shoes, looking both ways before crossing the street, reading, or something more complicated like preparing a meal, it can become routine.

My suggestion to you, starting today, is to bring your routine strengths back into your awareness. Ask yourself, “What problems did I solve today? If you’re having a difficult time determining what problems existed today just make a list of everything you did. If you picked out something to wear then you solved the problem of, “What do I wear today?” In fact, every time you ask a question you are stating a problem and when you answer that question you are offering a solution.

The Strength In The Details?

When it comes to solving problems for others, as always those on the autism spectrum are constantly reminded of the problems they cause others instead of the solutions they provide. Which is why I make an all-out effort with my sons to emphasize how their actions solve problems in my life. When they help around the house I thank them and I thank them specifically. I don’t simply say thank you or thanks for helping. I say, “Thank you so much for helping me put the dishes in the dishwasher so quickly. That saved me so much time that now I’ll be able to play cards with you.”

I help them discover their strengths by pointing out the specific problems they solved and the specific things they did to help me solve it. The specific skill they used is their strength. Whether it be an ability to organize (not my strength by the way), an ability to stick with the project until it’s done, a tremendous eye for detail or any other specific ability. Letting them know that they had the knowledge or ability needed to solve your problem is HUGE.  In doing so you emphasize how they are specifically equipt to solve a problem for another person and expressing gratitude for it.

Did I Miss Something?

How many of your day to day strengths are you becoming more aware of now? Are their strengths that you don’t give yourself credit for? The last question to ask yourself is, “How many of the questions you answered today, and the other problems you solved, were done so to solve a problem for another person?”

It is important to be aware of the solutions we provide and the contributions we make not only to the quality of our own lives but to the quality of the life of others. It is in making our contribution to society that we ultimately feel our self-worth. When we feel that our presence in the world each day solves more problems than it causes, then we feel more worthwhile, then we feel like we are important to this world. To feel   the opposite is to feel worthless, to feel like a burden. That isn’t a feeling anyone deserves to have, so please be very cognizant of whether or not you are encouraging someone in your life to emphasize their challenges and the problems they cause over their strengths and the problems they solve.

Just Do It Already

I am so grateful that over the years I have developed the ability to express myself in written and spoken language. Something I am very aware that differentiates me from many of my fellow spectrumites including one of my own sons. I utilize this strength to the utmost and will continue to explore new ways to use it to its highest degree. Today alone I received two inquiries to speak to different groups on working with those on the Autism Spectrum. Not a coincidence when you live from your strengths.

My many challenges include poor memory; poor organization, poor math skills and I continue to have difficulty in social situations. Seems like a longer list, but because I focus so much on developing the one strength that solves problems for myself and others here we are. I am able to articulate my experiences in a way to help other people gain insight into theirs. By choosing to do that instead of beating myself up over the other things I’m not good at, my life and the lives of those who enjoy what I write are a little better.

There is so much I could say on this subject, but I hope what I have shared gives you enough to seriously reconsider how you view yourself in terms of what you’re good at instead of what you aren’t. Hopefully you realize you have far more to offer yourself and even more to offer this world than you’d ever considered.

We’re all in this together.

Contact:

Phone Number: 630‐778‐3447

Fax: 630‐6893‐9004

Email: Brian@SpectrumMentor.com

Website: http://SpectrumMentor.com

 

Life Skill – Toilet training (For Children with Difficulties)

By Prof Eric Lim, Kits4Kids Foundation, August, 2009

Toilet training is teaching an entire new skill. Teaching new skills to children with autism spectrum disorders works best when the steps to the task are organized into simple pieces. Teaching must also be consistent at all times and become predictable to the child in terms of rewards and consequences. In order for toilet training to be successful, the child must move from depending on reminders (timed trips to the bathroom) to recognizing the signs of a full bladder and taking the necessary actions him/herself.

As parents we look forward to that time when our child is finally toilet trained. We expect our child to learn to use the toilet as part of the growing up process. Not every child is alike, some children are difficult to train and may make toilet training harder on the parent. Learning to use the toilet is part of socialization. Children become interested in training when they become aware that other children and adults use the toilet. They assume that using the toilet is part of being considered a “big boy or girl.”

Most children enjoy the recognition and gratification they receive from adults when using the toilet as well as the rewards that come their way. However, young children with autism have trouble applying the same social interaction reason to toileting. They also are being asked to change set routines and rituals and they also may not be aware of or able to control their bodies just yet.

Signs of Readiness

For children on the autistic spectrum, it’s recommended to look for signs of readiness. Signs may include the following:

• Awareness that he or she has wet or soiled, a desire to remove the wet or soiled diaper (pulling at it, taking it off, digging in it, and or vocalizing displeasure.
• Getting a clean diaper, or taking you to the bathroom
• Ability to imitate actions (sitting on the toilet)
• Responds favorably to some form of positive reinforcement (a learned behavior increases after you reward it with something the child likes)
• Stays dry/clean most nights

When to start toilet training a child with autism:

• Many children with autism train later than the average age. Many succeed at urine training before bowel training. Many take longer to train, some reports suggest up to a year to become dry and two years to become clean.

• Start toilet training when you can be positive and the child is able to: sit comfortably on a potty chair or toilet for a couple of minutes, stay dry for at least 60 minutes, is aware of being wet or dirty, is showing interest in other people going to the toilet, showing some signs of cause and effect, and is willing to cooperate. Be prepared for it may be a long learning process.

Communication Problems with Toilet Training

For children with a communication deficiency visual learning may be an appropriate way to teach toileting skill. Does the child understand language? Does he or she understand “potty”, “diaper”, “dry pants”, “toilet”, “bathroom”, or any other words, signs, or pictures/symbols that may convey the idea of toileting. Children with Autism may have difficulty understanding and associating words with actions and most will at least need more time to process what you say. Can the child express the urge or need to use the toilet? Expressive language is almost always a problem for children with an autistic disorder. It will be important to be able to read their cues and/or teach a way to express the need or urge to use
the toilet.

Special consideration for children with autism:

• A child with autism may not be able to communicate a need to go to the bathroom, therefore body signals from the child, routines, and visuals might be significant aides.

• The child with autism may learn to use the toilet at home and be unable to adapt to a new situation easily.

• A child with autism may have sensory difficulties such as discomfort by the hard toilet seat, being afraid of water splashing, or want to play in or watch the swirling toilet water.

• In public bathrooms children with autism sometimes fear the hand dryers, have problems with the doors, the way the toilet flushes, or any number of challenges.

• Having a bowel movement is often harder and occurs less often. Some children go off alone and squat, some insist on wearing the pull-up or diaper to make a bowel movement, some fear that it hurts, some smear feces, and others want to be clean so much that they react to getting anything dirty on them.

• Rule out any medical problems and account for fears that may have developed due to pain from constipation or urinary tract infections in the past.

Before you begin toileting make sure your child does not have a medical problem which would interfere with making toilet training a success. This can be ruled out by the family physician after a routine physical. Contact your physician if you notice any unusual signs like too much or too little urination, painful urination, urinates frequently or unable to hold urine. The same applies to concerns with stool. Children with Autism have a higher than expected rate of bowel problems (constipation or loose stools or both) and require extra care if this is the case.

Making Toilet Training a Success

• Before starting, keep a record for a few days, charting every 20 – 30 minutes whether your child is dry, wet, or dirty. Some diapers have a strip that changes color to make this easier. Chart periodically, maybe once a day each week after starting training to keep track of progress, problems, and tendencies.

• When you start training, prepare the environment with the needed equipment and remove extra distractions.

• Plan a schedule that will match the report you gathered. If you child usually stays dry for an hour, anticipate to take him/her to the bathroom about 10 minutes before. Try to match the schedule to the natural cycles of the day.

• Plan the routine that you will have your child follow and make a picture chart of that routine so that your child and everyone who helps him can follow it. Change the cue level by decreasing examples as the child achieves the skill.

• Watch for signs of readiness such as when your charting shows being dry for an hour, your child indicates in some way that she is wetting or soiling diapers, indicates in some way that she has soiled or is wet, regular bowel movements, or interest in others going toilet.

• Keep positive, praise attempts, praise being dry and clean, use reinforcement and give your child time.

• When your child has some success with understanding toileting help him/ her learn to indicate that they are going to the toilet with a sign, word, or picture or several of these. Children today often use potty, pee and poop, but signing toilet may work or a picture of the toilet may be helpful. Visual cues as part of your routine helps the child tell you when they have to go potty.

Visual and Verbal Cues in Toilet Training

• Give a visual and verbal cue –such as an auditory giving the child a buzzer or bell. Decide what verbal cue you will use such as go potty, go pee, or go to the bathroom. If you use a signs, pair it with the verbal cues.

• Enter the bathroom with the cue needed (verbal, light touches, taking the child’s hand, or more physical assist).

• Pull pants down to ankles with cue

• Sit down with cue

• Pee or poop or both with cues

• Get toilet tissue and wipe with cue

• Stand up with cue

• Wipe, if needed, and throw tissue in toilet with cue

• Pull up pants with cue

• Flush toilet with cue

• Turn on water and wash hands with cue

• Turn off water and dry hands with cue

Use visuals: For many children, having a picture of a toilet or potty chair as a cue to go helps. You might also make a picture schedule to sequence the major activities of the day adding the toilet pictures before or after these. Children have learned to go on their own in this way. The pictures can be laminated and put on with Velcro or inserted in plastic sleeves so you or your child can take them off or change the order. There are also videotapes about using the potty that some children with autism have reacted well to. Other parents have made videos for their child to watch, some have paired music with the pictures. Model for you child, use books and pictures sequences about going to the toilet. Visuals
help your child know what to do, remember what to do, and learn from the sequence.

Use imitation: Imitation is a type of visual. Many children with autism are delayed in their imitation abilities, but many do watch carefully to what is going on around them even if they don’t seem to immediately imitate. Watching someone close to their size use the potty may be useful, but it is helpful for them to see that going to the bathroom is something everyone does. Some children might respond to the use of a doll to go through the steps.

Teach privacy and modesty: Most young children undress anywhere and don’t care who sees them go potty. However, as they are approaching four years of age, they often begin to want more privacy. Children’s needs must be considered and children have to be taught what society expects. Consider teaching your child to undo and pull down pants only in the bathroom as well as pulling up and fastening pants before leaving the bathroom. Once your child is toilet trained teach him to close the door. Also you might want to consider teaching your child when and where he must
be clothed or covered and not naked. Teach them to ask for ask for help with bathing.

Use words that are appropriate: Some children with autism are constant with the words they heard when very young and will not change to more appropriate words later. However, if you are aware of the need to be age appropriate it usually works to use the words that everyone else of the same age is using.

Ideas for Specific Problems That May Be Encountered:

• Resists sitting or doesn’t sit and relax long enough: Encourage your child to sit with his/her clothes on. Make sure the seat of the potty chair or the toilet is comfortable to your child, maybe it needs to be softer, maybe lined with a diaper, maybe warmer, or maybe your child’s feet need to be more stable. Some children may need to have the hole on the toilet smaller and experimenting with various sizes of seats or even covering the toilet with a towel or cardboard may help. Give your child a reason to sit such as his special reward that he/she gets while sitting. Use modeling by sitting together or having a doll or favorite stuffed animal sit. Give the child a visual or auditory cue about how long to sit by a visual timer or the length of a song. Help your child relax while sitting by providing support for feet and body where needed and rubbing your child’s legs. Sometimes children are so tense that they can’t relax and go.

• Afraid of flushing or excessively interested in flushing: Encourage your child to play in water that swirls in other places than the bathroom and at appropriate times. Always let your child know when you are going to flush the toilet when he/she is in the bathroom. Gradually bring your child closer to the toilet by providing a place for the child to stand while you are flushing. When your child is ready allow him/her to flush and either run or stay and watch. Establish a rule that you only flush once then you are all done.

• Afraid of public bathrooms: stalls, hand dryers, different sinks, toilets that flush automatically: At first, it may be necessary to be aware of the public bathrooms you may frequent to know what is likely to cause your child problems. Some of these can be avoided like being far away from the dryer and not walking under it and practicing with soap dispensers and sinks that go on by themselves in a fun way. Protect your child from toilets that automatically flush since some splash a lot. The more you know about the quirks of the public restroom the more you can prepare you child. The handicap stalls are wider and more accessible many a sink next to the toilet.

• Playing in water or with toilet paper: Take the toilet paper off the roll and put it up until your child can master the use of it. Put safety catches on toilets until your child can understand that toilets are not places to play. Allow lots of water play in appropriate places and even swirling water to watch such as in “tornado bottles”. Lower water toilets aren’t as much of a temptation while sitting. Use tissues that are folded or pre-measured, a box of wipes, and folded toilet paper are helpful.

• Resists being cleaned or not wanting to be dirty: Sometimes smearing of feces begins by the child trying to clean himself. They may try to clean up then make a mess. For whatever reasons your child may be having trouble in this area it is wise to stay as calm as you can. Establish a clean up routine that is not especially rewarding, but is comfortable and quick. Make sure the wipes are big enough and comfortable enough for your child including temperature and texture. If your child gets some feces on his hand and is distraught help the child wipe it as soon as possible. Show the child that they can wash their hands clean with soap and water. Sometimes as children with autism grow older they become upset when something happens like a toilet overflowing or they get their hands dirty and react
out of proportion, so we want to assure them early on that this can be fixed quite easily.

• Fear of having bowel movements or constipation: This is a common problem for many children with autism at some time in their childhood. It may be contributed to by diet, not sitting long enough, not being able to relax, their activity level, or various other factors. It is helpful to help a child recognize that the grunting and squatting he/she is doing helps make a bowel movement and that is good. Many children go and hide in a corner to do their poop and resist a change. Help them move closer to the bathroom and perhaps identify where to squat by using a plastic mat as the spot. Gradually influence the action to the potty or toilet over time the child associates the grunts and pushes as signals.
A child may have to go in the diaper even while sitting for a while so try a diaper-lined toilet seat. If a child experiences constipation on a regular basis bowel movements may be uncomfortable and you may need to seek advice from you doctor.

• Trouble in standing while urinating: When your son is sitting to urinate and completely toilet trained or when he shows an interest in standing he may need help. A visual chart of how boys use the bathroom may be helpful. For example action pictures of a boy putting the seat up, standing while urinating and aiming in into the toilet. Sometimes boys do not want to touch their penis because they may have been told not to touch on some occasion. A male in the family may need to demonstrate how to point and aim. Something may be used for a target like a floating paper, a Cheerio, or colored toilet water.

• Regression in toileting: Sometimes a child who is fully toilet trained will begin to have many accidents. Evaluate changes that have occurred and what information or additional supports may help your child feel comfortable again. Some reasons regression may occur are after an illness, after a parent has been away, after a move, after starting school, after a baby has been born, or when going to the bathroom has been painful. Your child may be in a situation where he doesn’t have the skills to tell someone he needs to go and holds it too long. His supports may not be in place. Sometimes at school there is something about the environment or the schedule that is causing problems for your child.
Go back to all the original supports that worked and put them back into your child’s life while reassuring your child that he/she can and will succeed.

Consistency in Toilet Training

Your child can be toilet trained. However, training your child with autism will likely take more planning, attention to detail, and consistency than training typical children. (Remember that all children with autism are different and some are easy to train.) You have to organize the sequence and provide a schedule and consistency until your child understands how all this relates to his body functions. Keep your expectations realistic and reinforce your child for trying as well as for success, always reassuring the child that he/she will succeed and there is plenty of time to try, and be persistent.

 

Moving Into the World of Employment

Contributed by Cathy Pratt, Ph.D., Director and Chris Filler, Professional and Parent, Ohio from Indiana Institute on Disability and Community

Every three years, the Indiana Resource Center for Autism (IRCA) is legislatively mandated to conduct a needs assessment survey. As part of this survey, families are asked questions about topics such as insurance coverage, Medicaid waivers, impact of educational programs, interactions with the criminal justice system, and other relevant topics. The past two surveys have asked family members with children no longer attending school programs about the employment of their sons/daughters on the autism spectrum.

In 2006, the IRCA survey showed that 61% of individuals (over age 18) represented in the survey were unemployed, 14% worked in sheltered workshops and 25% worked in community jobs. Those who are currently employed work an average of 21 hours per week and have a median annual income of $6,516. This figure is troubling considering the dramatic increase in the number of those receiving educational services under the eligibility category of ASD, and the realization that this population will soon be entering the adult service system en masse. It’s also troubling because it illustrates the misunderstandings among many professionals concerning the realities and range of ASD.

Families advocating on behalf of their sons/daughters on the spectrum will come to realize that many adult providers have not received current and accurate information on autism. This lack of knowledge will impact eligibility and the types of services the person will receive. Below are 10 recommendations of information that adult service providers will need to know.

  1. Adult service providers need a thorough understanding of ASD, the spectrum and the diagnosis. It is not unusual for there to be tremendous misunderstandings about Asperger’s and those at the “upper” end of the spectrum. Often these individuals are perceived as being willful or manipulative. For those with more significant disabilities, there is a misunderstanding about the potential gifts and talents they may possess. Adult service providers must understand the complexity of ASD, and that there are no generalized services that will work for all. They must understand that ASD is neurological and not a mental illness or emotional disorder.
  2. Those with ASD require a creative and careful assessment process. Many people with ASD often have unique skills that are not necessarily obvious during a traditional assessment process. They may possess skills suited for a specific “niche” that could lead to successful supported or competitive employment. Identification of these skills often occurs through careful observation, interviews with those who know the person well (e.g., family members or the individual him/herself) and a longitudinal assessment process. Several hours of traditional assessment or a checklist of vocational skills often misses the person’s unique and most important strengths.
  3. Be willing to think “outside the box.” Traditional vocational programs are not always the most appropriate or successful. Vocational/employment programs, supports and services all too often seem to be offered in terms of available options, instead of what the person needs and is interested in doing. Due to some people’s narrow focus and need for functional routines, there are situations when all of the available/traditional options for employment are equally unsuccessful. Sadly, there are times when a person is forced into an inappropriate setting and fails miserably. Agencies may then conclude the person is unemployable, rather than searching for a job match that acknowledges skills and talents. Do not assume that the person with ASD that struggles with communication and socialization has that same level of challenge in all areas. In fact, assume the opposite! Many areas of skill will be significantly more developed than social-communication skills.
  4. Be aware of sensory processing challenges. These challenges often limit many with ASD if gone unrecognized and un-accommodated. The person with ASD’s perception and ability to tolerate or cope with the sights and sounds of a typical work environment can be quite different than that of their co-workers. Accommodations can be made and coping skills can be developed. However, this does not happen automatically, quickly or under threat of losing a job. In fact, the person will likely shut down or quit rather than deal with the situation or attempt to explain the difficulties. This does not mean that the environment needs to be silent or rigid. It does mean that opportunities to periodically leave a stressful environment should be available and without consequence. Environmental control or accommodation can dramatically change the quality and quantity of the work or product, while presenting the person in the most positive light.
  5. Build on strengths. This should be the philosophy when working with any person. However, the strengths of those with ASD may be less obvious and may be more narrowly focused than those of others that come to the attention of agencies that provide employment services. Rather than addressing deficits, opportunities should acknowledge strengths and interests, when possible.
  6. Prepare, prepare, prepare. Be certain the person understands what is to happen during the assessment, work site trials and work training processes. Some require visual supports to assist in this area. Others may need to visit and explore the environment. In some cases, a verbal description and explanation of the situation, schedule and expectation may be sufficient. However, always err on the side of concrete and visual supports.
  7. Communication should not be all talk. Fewer words often are better. People have a tendency to talk too much to folks on the spectrum, regardless of whether the person is verbal or not. They assume that a verbal person will be able to understand verbal expression equally as well as other employees. This is misleading as some with ASD may use many words, but have limited receptive language. Be prepared to use more written and concrete communication and directions. Develop schedules, visual sequences of tasks, and information about the written and unwritten “rules” of the work culture. Employers and co-workers should be aware that the words they say may not communicate meaning as much as environmental reminders and cues. And finally, realize that many of these individuals do not understand sarcasm, innuendos and double meanings. As a result, the directions that we provide may be confusing or meaningless.
  8. Consider carefully the environment and predictability of the job. Workshop-type settings often are the worst for those on the spectrum. These settings typically contain many people, loud noises, and a lack of privacy or a place to get away. Even the person that seems less capable may perform better in a community setting with support than in a sheltered setting. Intermittent employment may not be a good idea either. Seasonal, ever-changing jobs increase the likelihood of anxiety, stress and behavioral escalation. This does not mean to place the person in a boring or static situation. This does mean that the predictability and stability of the employment will go a long way in creating an efficient and successful employee. If the job is one that offers change, use environmental and organizational supports to create predictability and structure.
  9. Social expectations require instruction. Social challenges are a hallmark of the ASD diagnosis. These challenges extend beyond the school years and can dramatically affect the person’s ability to successfully integrate into a work setting. Be prepared to help the person understand the social expectations (“rules”) of the job. These often are “unwritten” or “hidden” rules of the work culture, and can be critical for acceptance. Do not assume the person will “read” the social climate and adjust. It will not happen. Instead, prepare the person by teaching expectations. Rehearse how to greet, ask for help, “small talk,” compliments, etc. The employer should be aware that if social errors occur on the job, these should be calmly addressed in a very direct manner. Subtle suggestions will not work.
  10. Systems must work together (delays can be deadly!). The traditional “hand-off” between school and adult services over a few weeks or even several months often ends in delays in service or employment, misunderstandings and even failure in achieving a successful outcome. Agencies must work with schools to identify students early, begin to actively work with the school team to get to know the student, and begin to identify adult services and potential employment. Timelines vary from state to state and agency to agency. Funding and eligibility requirements may get in the way of a smooth transition. It goes without saying that funding will always be an issue. However, agencies must begin to create opportunities to work together systematically so that the transition is “seamless,” or at least does not unravel all together.

One final thought for family members: As your son or daughter moves from the public school system, which has clear legislative entitlements, to the adult world of eligibility, it is important to have a vision for your child. Examine the possibilities. An issue of the Autism Advocate highlights stories of success that occurred because family members pushed the system and expected a different type of future for their child. Hopefully, these exceptional stories will become common occurrences someday.


Pratt, C. & Filler, C. (2007). Moving into the world of employment. The Reporter, 12(2), 1-2, 13.

 

Modern Love

by Chantal Sicile-Kira

Editorial Note: This article originally appeared in Spectrum Magazine in the February/March 2010 issue.

My son is pining for a girlfriend. He’s on Facebook.

Relationship Status: Single

Interested In: Women

Looking For: Friendship, Dating,  A Relationship, Networking.

Political Views: Go Obama!

About Me:  I like to listen to music and walk on the beach. I can type with one finger. I have autism.

Jeremy is quite a catch – he’s buff from working out at the gym, has an endearing personality, and he starred in an award-winning episode of the MTV ‘True Life’ series.  Never mind that he is autistic, and needs help with everyday living skills, and probably always will. (In my opinion, he should be looking for a traditional wife who will take care of him, instead of a girlfriend, but I digress).

One night recently I woke up at 3:00 am to find that all the houselights had been turned on. Usually a sound sleeper, Jeremy had been making the rounds.  I heard him downstairs and decided to investigate. He was looking through my husband’s collection of architecture books. He found the one he was looking for, Las Vegas: The Fabulous 50’s, and flipped it open to the section on strip clubs and showgirls. “Why are you up, Jeremy, what’s going on?” I asked. “I’m thinking about girls,” he replied.

Oh, how I miss the prepubescent years when Jeremy was examining the guitars in the music magazines and not the beautiful models holding them. Although Jeremy has been showing an interest in females for some time, he is now communicating that guitar magazines just don’t do it for him anymore. I long for the days when his choice of reading and viewing materials ran along the gamut of Dr. Seuss’s ABC and Sesame Street when he wasn’t occupied with his school work.

The show that finally got his attention away from Big Bird is Entourage, which is basically a show about how four good friends from the East Coast now living in LA try to get laid and avoid relationships in between acting gigs.  There is a lot of eye candy for the guys on here (and the male actors are not so bad-looking either). Dusty, one of Jeremy’s tutors, nicely offered us the DVD of the first season as a gift.  Jeremy got hooked. When asked what he liked about it, Jeremy spelled out, “I like that they are good friends.” So I bought him Friends, which I thought was a little tamer but still dealt with friendships, but after watching two episodes, Jeremy didn’t want to see anymore. Frankly, there isn’t enough female nudity to keep his interest. I guess it wasn’t the male bonding between the main characters on Entourage that he was focusing on.

My main concern for Jeremy up until now has been where will he live, what can he do to earn money, what will happen when my husband and I are no longer alive. Not a week goes by when I don’t think about this and research the possibilities and create possible scenarios in my mind. He is now 20 years old, the same age as the young adults I worked with in a state institution for the developmentally disabled, years before Jeremy was born (I guess you can catch autism by osmosis). It is one thing to help people with autism and their families with the emotional detachment of a professional; it is quite another to be caring for and planning for your precious child. Because at the end of the day, it is the parents who are responsible, and it is difficult emotionally as well as practically to try and create a future for your loved one. Already just thinking of providing the basic necessities of food, shelter and work for your loved one with autism is a constant worry (unless he is a trust fund baby). But loving caresses, physical intimacy, love, and a relationship with someone who is with you because they choose to be, not because they are related to you – are also basic necessities, the kind you can’t pay for even if you have the money.  I am not immune to the sadness embedded in the emails from parents of young adults writing to me for advice, asking for answers; asking me what they should do, how are they going to cope.  I feel their pain, my heart aches as it mirrors my own distress.  We have barely enough energy to make it through an autism –filled day, let alone plan for the tangible – and less tangible – future needs of our children.

My son learned to communicate by spelling out on a letter board and has been doing it now for about 4 years.  The way he describes what autism is like for him, it sounds like a less severe form of  “locked-in syndrome,” similar to what Jean Dominique Bauby, the editor in chief of Elle suffered.  Bauby, had a stroke and lasped into a coma and when he woke up he could move only his left eye.  He wrote his memoir The Diving Bell and the Butterfly, blinking out a code representing the letters of the alphabet presented to him on a letterboard.

Jeremy is clear about what he feels and thinks.  “Being severely autistic means being stuck in a body that doesn’t work well with no way to communicate.  People ask do I feel emotions. Yes I do, I just can’t show them. Like when my mom helps me I am really grateful, but I can’t get my face to move. You know autism is very different from being retarded and the difference is that nothing seems different to me.  I am the same as you inside.  I can’t control my body but I am smart.”

Before my son could communicate his feelings, I had no idea how he felt about people and relationships. To look at his body language, which he can’t really control, you would think he does not want to be around people. Yet, he wants to connect so badly with people his own age and he struggles to find ways to communicate this. His quest to connect with friends was effectively documented on MTV:  Jeremy masters assistive technology in order to have a voice, yet  has difficulty  staying in a room full of noisy people at his own party.

On his 19th birthday, Jeremy let me know for the first time that he was unhappy with his birthday presents. When I asked him why, he spelled, “ I want a cell phone.”  “What do you want with a cell phone? You are nonverbal,” I exclaimed. “I want to text my friends,” he spelled. He sees how adept his younger sister, Rebecca, is at connecting with her friends via text, and he was hoping to do the same. This cell phone business has been difficult. Those little keyboards are not easy considering the visual processing and motor problems my son has. And the only real friends he has (sadly) are his tutors. But, I know he is lonely and wants to connect. So he got a cell phone.

Since Jeremy keeps bringing up girls, I suggested he join Facebook and work on his communication skills, as this is important for any kind of relationship. “Do you think I will really find a girlfriend on Facebook?” he asked. “It’s not that simple, but you will meet people and you can connect with others right from your home and practice communicating,” I told him.  Now, he goes on Facebook about every other day with one of his tutors. He likes to see if he has any friend requests and to comment on what he is doing.  What are you doing right now?  Jeremy is thinking the girls at the gym are hot.

Mark, one of his tutors, suggested that Jeremy start working out. He took Jeremy to check out  different gyms.  Once they had narrowed down their search, Jeremy and I went to discuss membership terms. When it came time to ask questions, mine were the usual, “What is the initial membership fee? What will the monthly payments come to? ” I asked.  Jeremy’s questions at the first place were a bit different. “Are the girls nice here?” he spelled out. “Are they pretty?”

As we arrived at the second place, LA Fitness, the doors flew open and more than a dozen gorgeous, shapely young women came running out. Jeremy was all smiles. We walked in and the receptionist said “You’ve just missed the Charger Girls! They just left.” Jeremy was even happier – a Charger Girls poster is the only athletic memorabilia hanging in his room.   “I like this place! This is where I want to come workout.” commented Jeremy.  Jeremy got straight to the point with the salesman. “Do the Charger Girls really work out here? Are they good at sports? What is their schedule?”

Jeremy joined LA Fitness, and goes regularly there with either Mark or Troy, another tutor. This past Christmas, Jeremy spelled out “I want to buy a calendar with pictures of girls for Troy,”  he spelled. “Uhhh…. OK, ask Janine to take you to the mall,” I replied. Jeremy is, after all, over 18.  Sure enough, Jeremy came back with a calendar aptly titled “Hot Buns.” I’ll leave the rest to your imagination. I’m sure he was inspired by the Charger Girls.

When Troy came over the following Wednesday as usual to take Jeremy to the gym, Jeremy gave him the calendar. Now, Troy is an ex-Navy guy, single dad of an 8-year-old girl, and works in a middle school classroom for students with aggressive behaviors. He is not your shy, withdrawn type. However, he looked perplexed when Jeremy handed him the calendar. “Jeremy, thank you, and I’m honored you thought of me, but why are you giving me this calendar?” Jeremy rocked excitedly back and forth and spelled out, “Because you are the best tutor to help my mom understand she needs to find me a girlfriend.”  “Jeremy, I know you need a girlfriend, the question is how to find one,” I said. “Troy is the best tutor to help,” insisted Jeremy.

I asked Jeremy what he wants in a girlfriend. “When I think about having a girlfriend I am thinking about sex,” he explained.  I asked, “Is sex all you think about?” “That really is not the main thing. I want a relationship. I want to have someone to talk to and laugh with,” he replied.

We have discussed a lot about what it means to have friendships and relationships and the meaning of love and how that is different from just having sex. He is beginning to understand the complexity of how it is not that easy and that, yes, being autistic and all that entails for him, it will be difficult. But that even without autism, having a loving intimate relationship with another person is not a given. “I think finding love is not easy for anyone. What I mean is that most people greatly search for love but do not find true love. I know this because I frankly see that my aunt is not married and she is a great person.”

I ask him, “What does love mean for you?”  “Love for me means that someone likes my way of thinking about life and the same philosophy about living. Love is not a prisoner but it makes you realize that you care about this person more than anyone else.”  I could not have said it better myself.

While Jeremy has his eye on Entourage for inspiration, I have my sights set on Big Love. Having three wives, a 3-house suburban home, an extended family and strong community ties  – it sounds like a better model for what Jeremy’s future should look like. With three wives, Jeremy would have the love and intimacy he craves, and the women would have plenty of respite.  This arrangement would also solve the housing problem and our worries about what will happen when his father and I are no longer alive. For now, I keep searching for ways for him to connect and relate with people, and to keep alive the flame of hope he carries in his heart that one day, he will find true love.

 

 

Making (and Keeping) Friends: A Model for Social Skills Instruction

Contributed by: Dr. Scott Bellini, Associate Director from Indiana Institute on Disability and Community

“I am not asking for my child to be the life of the party, or a social butterfly. I just want her to be happy and have some friends of her own. She is a wonderful kid, and I hope someday others can see that.”

Social Skill Deficits in Autism Spectrum Disorders

Indeed, many parents of children with autism spectrum disorders (ASD) echo this sentiment concerning their child’s social functioning. They know that their child has many wonderful qualities to offer others, but the nature of their disability, or more precisely, their poor social skills, often preclude them from establishing meaningful social relationships. This frustration is amplified when parents know that their children want desperately to have friends, but fail miserably when trying to make friends. Often, their failure is a direct result of ineffectual programs and inadequate resources typically made available for social skills instruction. For most children, basic social skills (e.g., turn taking, initiating conversation) are acquired quickly and easily. For children with ASD, the process is much more difficult. Whereas, many children learn these basic skills simply by exposure to social situations, children with ASD often need to be taught skills explicitly, and as early as possible. The present article addresses social skill deficits in young children with ASD by providing a systematic five-step model for social skills instruction, with particular emphasis placed on an emerging intervention strategy, video self-modeling (VSM).

Lack of “Know-How” Versus Lack of Social Interest

Impairment in social functioning is a central feature of ASD. Typical social skill deficits include: initiating interactions, responding to the initiations of others, maintaining eye contact, sharing enjoyment, reading the non-verbal cues of others, and taking another person’s perspective. The cause of these skill deficits varies, ranging from inherent neurological impairment to lack of opportunity to acquire skills (e.g., social withdrawal). Most important, these social skill deficits make it difficult for the individual to develop, and keep meaningful and fulfilling personal relationships. Although social skill deficits are a central feature of ASD, few young children receive adequate social skills programming (Hume, Bellini, & Pratt, 2005). This is a troubling reality, especially considering that the presence of social impairment may lead to the development of more detrimental outcomes, such as poor academic achievement, social failure and peer rejection, anxiety, depression, and other negative outcomes (Bellini, 2006; Tantam, 2000; Welsh, Park, Widaman, & O’Neil, 2001). And the lack of social skills programming is particularly troubling given that fact that many social skill difficulties can be ameliorated via effective social skills instruction.

The long held notion that children with autism spectrum disorders lack an interest in social interactions is often inaccurate. Many children with ASD do indeed desire social involvement, however, these children typically lack the necessary skills to interact effectively. One young man I worked with illustrates this point quite well. Prior to my visit, the school staff informed me of his inappropriate behaviors and his apparent “lack of interest” in interacting with other children. After spending the morning in a self-contained classroom, Zach was given the opportunity to eat lunch with the general school population (a time and place that produced many of the problem behaviors). As he was eating lunch, a group of children to his right began a discussion about frogs. As soon as the conversation began, he immediately took notice. So too did I. As he was listening to the other children, he began to remove his shoes, followed by his socks. I remember thinking, “Oh boy, here we go!” As soon as the second sock fell to the ground, Zach flopped his feet on the table, looked up at the group of children and proclaimed, “Look, webbed feet!” The other children (including myself) stared in amazement. In this case, Zach was demonstrating a desire to enter and be a part of a social situation, but he was obviously lacking the necessary skills to do so in an appropriate and effective manner.

This lack of “know-how” could also lead to feelings of social anxiety in some children. Many parents and teachers report that social situations typically evoke a great deal of anxiety from their children. Children with ASD often describe an anxiety that resembles what many of us feel when we are forced to speak in public (increased heart rate, sweaty palms, noticeable shaking, difficulties concentrating, etc.). Not only is the speaking stressful, but just the thought of it is enough to produce stomach-gnawing butterflies. Imagine living a life where every social interaction you experience was as anxiety provoking as having to make a speech in front of a large group! The typical coping mechanism for most of us is to reduce the stress and anxiety by avoiding the stressful situation. For children with ASD, it often results in the avoidance of social situations, and subsequently, the development of social skill deficits. When a child continually avoids social encounters, she denies herself the opportunity to acquire social interaction skills. In some children, these social skill deficits lead to negative peer interactions, peer rejection, isolation, anxiety, depression, substance abuse, and even suicidal ideation. For others, it creates a pattern of absorption in solitary activities and hobbies; a pattern that is often difficult to change.

A Five Step Model

  1. Assess Social Functioning
  2. Distinguish Between Skill Acquisition and Performance Deficits
  3. Select Intervention Strategies
  4. Implement Intervention
  5. Evaluate and Monitor Progress

The following section will summarize my five-step model of social skills instruction (Bellini, 2006). Before implementing social skills instruction, it is important to begin with a thorough assessment of the individual’s current level of social skills functioning. Once the assessment is complete, the next step is to discern between skill acquisition deficits and performance deficits. Based on this information, the selection of intervention strategies takes place. Once intervention strategies are implemented, it is then imperative to evaluate and modify the intervention as needed. Although I use the term “Steps,” it is important to note that the model is not perfectly linear. That is, in real-life applications social skills instruction will not follow a lock-step approach from step one to step five. For instance, it is not uncommon for me to identify additional social skill deficits (step one) while I am in the middle of the implementation process (step four). In addition, I am continually assessing and modifying the intervention as additional information and data are accumulated.

Assess Social Functioning

The first step in any social skill training program should consist of conducting a thorough evaluation of the child’s current level of social functioning. The purpose of the assessment is to answer one very basic, yet complicated, question: What is precluding the child from establishing and maintaining social relationships? For most children, the answer takes the form of specific social skill deficits. For others, the answer takes the form of cruel and rejecting peers. And for yet other children, the answer is both.

The evaluation should detail both the strengths and weakness of the individual related to social functioning. The assessment should involve a combination of observation (both naturalistic and structured), interview (e.g., parents, teachers, playground supervisors, the child), and standardized measures (e.g., behavioral checklists, social skills measures). I have developed the Autism Social Skills Profile (ASSP) to assist in the identification of typical social skill deficits in children with ASD, and to measure the progress the child is making in the program. Kathleen Quill (2000) also provides an excellent social skills checklist for parents and professionals in her book, Do-Watch-Listen-Say. It is important for the child’s team to ascertain current level of functioning and effectively intervene at the child’s area of need. For instance, if the evaluation reveals that the child is unable to maintain simple one-on-one interactions with others, then the intervention should begin at this level and not at a more advanced group interaction level. Or, if the evaluation revels that the child does not know how to play symbolically or even functionally with play items, then the intervention will probably begin by teaching play skills prior to teaching specific interaction skills. After a thorough assessment of social functioning is complete, the team should then determine whether the skill deficits identified are the result of skill acquisition deficits or performance deficits.

[Author’s Note: A detailed description of social skills assessment is beyond the scope of this article. More information on this topic, including a copy of the ASSP, can be found in the author’s book, Building Social Relationships]

Distinguish Between Skill Acquisition and Performance Deficits

After a thorough assessment of the child’s social functioning and after identifying the skills that we will teach, it is imperative to determine whether the skill deficits are the result of skill acquisition deficits or performance deficits (Elliott & Gresham, 1991). Simply put, the success of your social skills program hinges on your ability to distinguish between skill acquisition deficits and performance deficits!

A skill acquisition deficit refers to the absence of a particular skill or behavior. For example, a young child with ASD may not know how to effectively join-in activities with peers; therefore, he/she will often fail to participate. If we want this child to join-in activities with peers, we need to teach her the necessary skills to do so.

A performance deficit refers to a skill or behavior that is present, but not demonstrated or performed. To use the same example, a child may have the skill (or ability) to join-in an activity, but for some reason, fails to do so. In this case, if we want the child to participate we would not need to teach the child to do so (since she already has the skill). Instead, we would need to address the factor that is impeding performance of the skill, such as lack of motivation, anxiety, or sensory sensitivities.

A good rule of thumb in discerning between a skill acquisition deficit and a performance deficit is to ask the question, “Can the child perform the task with multiple persons and across multiple settings?” For instance, if the child only initiates interactions with mom at home and not with his peers at school, then you should address the initiation difficulty as a skill acquisition deficit. I hear the statement a lot from school personnel, “The child interacts fine with me, so it must be a performance deficit, right?” Not quite. In my experience, children with ASD tend to interact better and more easily with adults, because adults typically make it easy for them; the adults do most of the conversational “work” for the child. To use a baseball analogy, just because Tommy can hit Dad’s soft, underhand pitches at home, doesn’t mean he has mastered the skill well enough to hit pitches thrown by his peers on the playing field. Sometimes adult interactions with children with ASD are similar to throwing a child a soft, underhand pitch. Although they are positive and well intended, they do not adequately prepare the child for more difficult peer-to-peer interactions.

Too often, social skill deficits and inappropriate behaviors are incorrectly conceptualized as performance deficits. That is, we tend to assume that when a child does not perform a behavior, it is the result of refusal or lack of motivation. In other words, we assume that the child who does not initiate interactions with peers has the ability to initiate, but does not want to initiate (performance deficit). In many cases, this is a faulty assumption. In my experience, the vast majority of social skill deficits in young children with ASD can be attributed to skill acquisition deficits. That is, children with ASD are not performing socially because they lack the necessary skills to perform socially—not because they do not want to be social or refuse to be social. If we want young children to be successful socially, then we have to TEACH them the skills to be successful! Therefore, it is essential to focus on skill development when implementing social skills instruction.

The benefit of using a skill acquisition/performance deficit model is that it guides the selection of intervention strategies. Most intervention strategies are better suited for either skill acquisition or performance deficits. The intervention selected should match the type of deficit present. That is, you would not want to deliver an intervention designed for a performance deficit, if the child was mainly experiencing a skill acquisition deficit. For instance, in the example above, if Tommy has not mastered the skill of hitting (skill acquisition deficit), all the reinforcement in the world (including pizza!) will not help Tommy hit the ball during the game. If we want him to be a skilled hitter, we need to provide Tommy additional instruction on the mechanics of hitting a baseball. The same is true for social skills. If we want a child to be socially fluent, then we need to deliver effective social skills instruction. In contrast, if Tommy does have sufficient hitting skills, but lacks the motivation to “do his best,” then the reward of cheese and pepperoni may be all he needs to excel on the playing field.

Once a thorough social skill assessment is completed and the team is able to attribute the social difficulties to either skill acquisition or performance deficits, social skills instruction is ready to begin. There are a variety of strategies that can be delivered to young children with ASD. The most important thing is that the strategies being delivered are appropriate to the unique needs of the child and that a logical rationale can be provided for using the intervention. The following strategies provide a sampling of techniques that can be implemented to teach successful social interaction skills to children and adolescents with ASD. Other than peer mediated interventions (PMI), the strategies listed below are designed to address skill acquisition deficits. However, some of the strategies (in particular, video self-modeling and social stories) work equally well in addressing performance deficits. In addition, it is imperative that the child be reinforced continually for his effort and participation in the program.

Selecting Intervention Strategies: Accommodation and Assimilation

When selecting intervention strategies, it is important to consider the notion of accommodation versus assimilation. Accommodation, as it relates to social skills instruction, refers to the act of modifying the physical or social environment of the child to promote positive social interactions. Examples of this include: training peer mentors to interact with the child throughout the school day, autism awareness training for classmates, and signing your child up for various group activities, such as little league, or Boy or Girl Scouts. Whereas accommodation addresses changes in the environment, assimilation focuses on changes in the child. Assimilation refers to instruction that facilitates skill development that allows the child to be more successful in social interactions. The key to a successful social skills training program is to address both accommodation and assimilation. Focusing on one and not the other sets the child up for failure. For instance, one family that I worked with did a wonderful job of structuring playgroups for their child, and keeping their child active in social activities. However, they were becoming increasingly frustrated with the fact that their son was not making friends and still having negative peer interactions. The problem was that they were putting the cart before the horse. They provided their child with ample opportunity to interact with others, but they weren’t providing him the skills necessary to be successful in those interactions. Similarly, providing skill instruction (assimilation) without modifying the environment to be more accepting of the child with autism also sets the child up for failure. This happens the moment an eager child with autism tries out a newly learned skill on a group of non-accepting peers. The key is to teach skills and modify the environment. This ensures that the new skill is received by peers with both understanding and acceptance.

Social Skills Strategies

As stated previously, social skills often need to be taught explicitly to children and adolescents with ASD. Traditional social skills strategies (such as board games about friendships and appropriate classroom behavior) tend to be too subtle for many children with ASD. For instance, a school counselor was frustrated with the progress she was making with a student with autism. She stated that the program was showing positive results with “other kids in the group,” but the student with autism didn’t seem to “get it.” Indeed, he was not “getting it!” The reason was quite apparent. The school counselor was attempting to teach the students about the concept of “friendship.” This is acceptable for some children, but for children with ASD it tends to be a too subtle form of instruction. That is, instead of spending countless hours teaching the child about “friendship,” the instruction should have focused on skills the child could use to make and keep friends. Experience tells me that the concept of friendship is much easier to understand once you have a friend or two!

There are number of important questions to consider when selecting social skill strategies. For instance, does the strategy target the skill deficits identified in the social assessment? Does the strategy enhance performance? Does the strategy promote skill acquisition? Is there research to support its use? If not, what is your plan to evaluate its effectiveness with your child? Is it developmentally appropriate for your child? The following is a list of social skill strategies that have demonstrated effectiveness in teaching social interaction skills to children with ASD.

The following section summarizes various social intervention strategies that have been designed to promote social interaction skills in young children with ASD, including peer-mediated instruction, thinking-feeling activities, social stories, role-playing, and video- modeling.

Peer Mediated Interventions

The use of peer mentors is one example of an effective strategy for young children with ASD. Peer mediated interventions (PMI) have been frequently used to promote positive social interactions among preschool aged peers (Strain & Odom, 1986; Odom, McConnell, & McEvoy 1992). Peer mediated instruction allows us to structure the physical and social environment in a manner to promote successful social interactions. In this approach, peers are systematically trained to make social initiations or respond promptly and appropriately to the initiations of children with ASD during the course of their school day. Peer mentors should be classmates of the child with ASD, have age-appropriate social and play skills, have a record of regular attendance, and have a positive (or at least neutral) history of interactions with the child with ASD. Peer mentors should also be made aware of the behaviors associated with autism in a manner that is respectful and developmentally appropriate for the age group. The use of peer mentors allows the teacher and other adults to act as facilitators, rather than participate as active playmates. That is, instead of being a third wheel in child-child interaction, the teacher prompts the peer buddies to initiate and respond appropriately to the child with ASD and then get out of the way!. The use of peer mentors also facilitates generalization of skills by ensuring that newly acquired skills are performed and practiced with peers in the natural environment.

For more information on peer-mediated interventions, see Vanderbilt/Minnesota social interaction project play time/social time: Organizing your classroom to build interaction skills. (Odom & MCConnell, 1993).

Thoughts and Feelings Activities

Recognizing and understanding the feelings and thoughts of self and others is often an area of weakness for children with ASD and is essential to successful social interactions. For instance, we continually modify our behavior based on the non-verbal feedback we receive from other people. We may elaborate on a story if the other person is smiling, looking on intently, or showing other signs of genuine interest. On the other hand, if the other person repeatedly looks at her watch, sighs, or looks otherwise disinterested, we may perhaps cut the story short (I said perhaps!). Children with ASD often have difficulty recognizing and understanding these non-verbal cues. Because of this, they are less able to modify their behavior to meet the emotional and cognitive needs of other people.

The most basic thought and feeling activity involves showing the child pictures of people exhibiting various emotions. Pictures can range from showing basic emotions such as happy, sad, angry, or scared, to more complicated emotions such as embarrassed, ashamed, nervous, or incredulous. Begin by asking the child to point to an emotion (i.e., “point to happy”), then ask the child to identify what the character is feeling (i.e., “how is he feeling.

Many of the young children I work with seem to pick up the ability to identify emotions quite easily. When they do, it is time to move on to more advanced instructional strategies, such as teaching them to understand the meaning or “why” behind emotions. This requires the child to make inferences based on the context and cues provided in the picture. That is, based on the information in the picture, ask “why is the child sad?” The pictures should portray characters participating in various social situations and exhibiting various facial expressions or other nonverbal expressions of emotion. You may cut pictures out of magazines, or download and print them from the Internet. You may also use illustrations from children’s books, which are typically rich in emotional content and contextual cues.

Once mastery is achieved on the pictures, move to television programs or video footage of social situations. Many of the programs that air on Sprout or Noggin, are excellent resources for this procedure because they portray characters in social situations, and display clear emotional expressions. You can use the same procedure as for the pictures, only this time the child is making inferences based on dynamic social cues. Simply ask the child to identify what the characters in the video are feeling and why they are feeling that way. When the scenario moves too quickly for the child, press pause, and ask the question with a still frame. (Make sure your machine has a clear picture when on pause.)

Patricia Howlin’s book Teaching Children with Autism to Mind-Read offers helpful information and resources in this area of instruction. In addition, there are a number of software programs on the market that address both emotions and perspective taking abilities (seeMind-Reading: An Interactive Guide to Emotions by Simon Baron-Cohen).

Social Stories

A Social Story is a frequently used strategy to teach social skills to children with disabilities. A Social Story is a non-coercive approach that presents social concepts and rules to children in the form of a brief story. This strategy could be used to teach a number of social and behavioral concepts, such as making transitions, playing a game, and going on a field trip. Carol Gray (1995; 2000) outlines a number of components that are essential to a successful Social Story, including: the story should be written in response to the child’s personal need; the story should be something the child wants to read on her own (depending upon ability level); the story should be commensurate with ability and comprehension level; and the story should use less directive terms such “can,” or “could,” instead of “will” or “must.” This last component is especially important for children who tend to be oppositional or defiant (i.e., the child who doesn’t decide what to do until you tell him to do something…then he does the opposite!). The Social Story can be paired with pictures and placed on a computer to take advantage of the child’s propensity towards visual instruction and interest in computers. I have found that children with ASD learn best when Social Stories are used in conjunction with Role-Playing and used as a social primer. That is, after reading a Social Story, the child then practices the skill introduced in the story. For instance, immediately after reading a story about joining-in an activity with peers, the child would practice the skill. Then, after reading the story and practicing the skill, the child would be exposed to a social situation where she would have an opportunity to perform the skill. For more comprehensive guidance on creating a Social Story, see Gray, 1995.

Role Playing/Behavioral Rehearsal

Role-playing or behavioral rehearsal is used primarily to teach basic social interaction skills. It is an effective approach to teaching social skills that allows for the positive practice of skills (Gresham, 2002). Role-playing involves acting out situations or activities in a structured environment to practice newly acquired skills and strategies, or previously learned skills that the child is having difficulties performing. Role-plays can be either scripted or spontaneous. In the latter, the child is provided with a scenario (e.g., asking another child to play with him), but not with the specific script. Typically, I combine scripted and unscripted elements to each role-play. For instance, the child might be provided with an opening statement or question, but the rest of the interaction would be spontaneous.

I use role-playing to teach a variety of interaction skills, particularly those involving initiating, responding, and terminating interactions. In one scenario, the child is required to initiate a conversation with another person, who is engaged in a separate task. Consequently, he would have to ask to join in, or ask the other person to join him in an activity. The latter typically proves to be most difficult for children with ASD.

During the first few sessions, it is not uncommon for the child to get “stuck” in conversations and interactions, often for minutes without knowing what to say or how to proceed. During the early sessions, the child should be given ample time to process and respond to the role-play scenarios. As the sessions progress, speed and proficiency should gradually increase.

Video Modeling and Video Self-Modeling (VSM)

Video modeling is without a doubt the most effective social skills intervention strategy that I have used with young children with ASD. A video modeling intervention involves an individual watching a video demonstration of a behavior and then imitating the behavior of the model. Video modeling may be used with peers, adults, or self as a model (video self-modeling). Video self-modeling (VSM) interventions have the added advantage of providing the child with a visual representation of success…their own success! VSM can be used to promote skill acquisition, enhance skill performance, and reduce problem behaviors. It integrates a powerful learning medium for children with ASD (visually cued instruction) with an effective evidence-based intervention modality (modeling).

An emerging body of research demonstrates great promise for the use of video modeling (peer or adult as model), and video self-modeling (VSM), as a therapeutic modality for children with ASD. Bellini and Akullian (in-press) conducted a meta-analysis of video modeling and video-self modeling research across 20 peer-reviewed studies and involving 63 participants with ASD. Results suggest that video modeling and VSM are effective intervention strategies for addressing social-communication skills, behavioral functioning, and functional skills in children and adolescents with ASD. Specifically, these procedures promote skill acquisition and that skills acquired via video modeling and VSM are maintained over time and transferred across person and settings. That is, video modeling and VSM appear to be effective interventions for children across the spectrum of autism from early childhood to adolescence. Interventions produced rapid increases (or decreases in some cases) in targeted skills with a median intervention length of nine video viewings. In addition, the median duration of the video clips shown to participants was only three minutes.

VSM interventions typically fall within two categories, positive self-review (PSR) and video feedforward (Dowrick, 1999).

PSR refers to children viewing themselves successfully engaging in a behavior or activity that is currently in their behavioral repertoire. PSR may be used with low-frequency behaviors or behaviors that were once mastered, but are no longer. In this case, the individual is videotaped while engaging in the low-frequency behavior and then shown a video of the behavior. An example of a PSR intervention for preschoolers would be to video record the child participating with peers (low frequency behavior) and then show the child the video. Buggey and colleagues (1999) used a PSR intervention to increase responding behaviors in young children with ASD. The children in the study viewed videotapes of themselves answering questions while engaging in play activities. Although answering questions was a low frequency behavior for these children, the videos were edited to portray the children as fluent in their responses (i.e., non-responses were edited out of the video). The intervention produced rapid increases in unprompted verbal responding.

Video feedforward, another category of VSM interventions, is typically used when the individual already possesses the necessary skills in her behavioral repertoire, but is unable to put them together to complete an activity. For instance, the child may have the ability to get out of bed, brush her teeth, get dressed, and comb her hair (morning routine), but cannot perform these skills in the proper sequence. A video feedforward intervention would videotape her engaging in each of these tasks and then splice the segments together to form the proper sequence. The same may be done with typical social interaction sequences. For instance, the child could be videotaped demonstrating three different skills: initiating an interaction, maintaining a reciprocal interaction, and appropriately terminating the interaction. The three scenes could then be blended together to portray one successful, and fluent social interaction.

Feedforward is also a good option for children who need additional assistance, or support, to complete tasks successfully. The notion of “hidden supports” is an important component of video feedforward interventions. For instance, the child may be videotaped interacting with peers while an adult provides assistance through cueing and prompting. The adult prompt is edited out (i.e., hidden) so that when the child views the video segment, she sees herself as independent and successful. Feedforward requires additional technological capabilities, as compared to PSR, but it typically requires a smaller quantity of raw video footage.

For additional instruction on conducting VSM intervention, please refer to the Video Futures Project at the University of Alaska, Anchorage, http://www.alaskachd.org/products/video_futures/index.html .

For additional information on editing home movies, check out the helpful website, How Stuff Works, at:http://computer.howstuffworks.com/video-editing.htm

Implement the Intervention

Once you have assessed social skill functioning and identified skills to teach, discerned between skill acquisition and performance deficits, and selected intervention strategies, it is time to implement the strategies. Social skills instruction should be provided in multiple settings (home, classroom, resource room, playground, community, etc.) and by multiple providers. There is no “best” place to teach social skills, though it is important to keep in mind that the purpose of all social skills instruction should be to promote social success with PEERS, in the NATURAL environment. As such, if the child is receiving social skills training in a school resource room (or by a private therapist), it is imperative that a plan be put in place to facilitate transfer of skills from the resource room to the natural environment. Parents and teachers should look for opportunities to prompt and reinforce the skills that are being taught in the resource room or clinic.

Rate of skill development differs greatly from one child to the next. Some children will begin utilizing their new skills after only two or three sessions, while other children may require over three months to before they begin to “get it” and start using their newly learned skills. Of course simply using or trying a skill is just the first step towards social success. The child will take additional time to master the social skills that he is learning and developing. Gresham et al. (2001) recommended that social skills training be implemented more frequently and more intensely than what is typically implemented. They concluded that “thirty hours of instruction, spread over 10-12 weeks is NOT enough” (p. 341). Social skill instruction should be intense (as frequently as possible) and encompassing (in every environment the child enters).

Assess and Modify the Intervention

Although “Assess and Modify” is listed as the last stage in the intervention process, it certainly is not the least important. In addition, it also is not the last thing to think about when designing a social skills program. Typically, as soon as I am able to identify the social skill deficits to be addressed, I begin to develop the methods for evaluating the efficacy of the intervention. To use a basic example, if the target of the intervention is social initiations, then I might take baseline data on the frequency of initiations with peers and adults. I would then continue to collect data on social initiations throughout the implementation stage. Accurate data collection is essential in evaluating the effectiveness of the intervention. It allows us to determine whether the child is benefiting from the instruction, and how to modify the program to best meet the child’s needs. In school settings, accurate data collection is a legal imperative. When I work with school teams, the focus is on integrating the social skills program with the child’s behavioral and social objectives. As such, Stage 5 is typically a very important aspect of IEP development, implementation, and integrity.

Case Example

The following case study illustrates the use of a social skills intervention for a young girl diagnosed with autism. “Kelly,” was a kindergartener with low average verbal ability. Although her vocabulary was in the average range for children her age, she seldom used her language spontaneously with classmates and teachers. She spoke only when asked direct questions and interacted only when others initiated the interactions. Consequently, Kelly spent the majority of her playground time by herself, with little peer interaction. A social skills assessment concluded that she had significant skill deficits in initiating interactions, and maintaining interactions with peers. A social skills intervention was designed to increase the frequency and length of social interactions with peers. Data on peer interactions (initiations and responses to peers) were collected in both a structured playgroup, and during recess. Two peer mentors were selected to participate in a structured playgroup with Kelly. The peers were instructed to initiate and to respond promptly to Kelly’s initiations. The peers were also provided developmentally appropriate information regarding autism and Kelly’s behaviors, which included hand-flapping. Also prior to the playgroup, Kelly was read a social story related to initiating social interactions. Each time the story was read, Kelly was given the opportunity to practice initiation skills via a role-playing procedure. The children participated in a playgroup three days a week for two weeks. During the playgroups, Kelly was prompted to initiate interactions with the peers, and she was prompted to respond promptly and appropriately to the peers when they initiated interactions with her. The playgroups were videotaped over the two-week time period. The video footage was then edited to exclude the continual prompting and coaching provided to Kelly. The edited tapes portrayed Kelly fluently and effectively interacting with her peers. The tapes were shown to Kelly in 5-minute increments for two weeks. For Kelly, the VSM procedure facilitated immediate increases in initiations and responses to peers in both the play setting and on the playground. By the end of the school year, Kelly had developed relationships with two other children, friendships that continue to this day.

The purpose of this article is not to provide an all-inclusive list of social skills strategies available for children with ASD. Instead, the present article presents a social skills training model that assists families and professionals in the delivery of social skills instruction. In addition, not all programs are appropriate for every child. Great care and planning needs to be put forth to ensure that the strategies used in the program meet the individual needs of the child. Therefore, a multi-dimensional intervention strategy that addresses the individual characteristics (both strengths and weaknesses) of the child is imperative. In the example above, Kelly received weekly social skills instruction, in addition to speech and occupational therapy. Kelly needed a full compliment of strategies to be successful socially. As her mother told me, Kelly may never be the life of the party or a “social butterfly.” However, with the delivery of an effective social skills program, Kelly has been given an opportunity to develop the skills necessary to develop meaningful personal relationships. And the rest of us have been given the opportunity to meet a truly wonderful child.

References

Bellini, S. (2006). Building Social Relationships: A Systematic Approach to Teaching Social Interaction Skills to Children and Adolescents with Autism Spectrum Disorders and other Social Difficulties. Shawnee Mission, KS: Autism Asperger Publishing.

Bellini, S. (2006). The development of social anxiety in high functioning adolescents with autism spectrum Disorders. Focus on Autism and Other Developmental Disabilities, 2 (3), 138-145.

Buggey, T., Toombs, K, Gardener, P., & Cervetti, M. (1999). Journal of Positive Behavioral Support, 1, 205-214.

Dowrick, P. W. (1999). A review of self modeling and related interventions. Applied & Preventive Psychology, 8, 23-39.

Elliot, S., & Gresham, F. (1991). Social skills intervention guide. Circle Pines, MN: American Guidance.

Gray, C. A. (1995). Teaching children with autism to read social situations. In A. Quill (Ed.), Teaching Children with Autism: Strategies to Enhance Communication and Socialization (pp. 219-242). New York, NY: Delmar.

Gray. C. (2000).The new social story book: Illustrated edition. Arlington, TX: Future Horizons.

Gresham, F. M. (2002). Best practices in social skills training. In A. Thomas. & J. Grimes (Eds.), Best practices in school psychology (4th ed.). Bethesda, MD: NASP.

Gresham, F. M., Sugai, G., & Horner, R. H. (2001). Interpreting Outcomes of Social Skills Training for Students with High-Incidence Disabilities. Teaching Exceptional Children, 67, 331-344.

Howlin, P., Baron-Cohen, S., & Hadwin, J. (1999). Teaching children with autism to mind-read: A practical guide. New York, NY: Wiley Publishing.

Hume, K., Bellini, S. & Pratt, C. (2005). The usage and perceived outcomes of early intervention and early childhood programs for young children with autism spectrum disorder. Topics in Early Childhood Special Education, 25 (4), 195-207.

Odom, S. & McConnell, S. (Eds.) (1993). Vanderbilt/Minnesota social interaction project play time/social time: Organizing your classroom to build interaction skills. Tucson, AZ: Communication Skill Builders.

Odom, S. L., McConnell, S. R., & McEvoy, M. A. (1992). Social competence of young children with disabilities: Issues and strategies for intervention. Baltimore: Paul H. Brookes.

Quill, K. (2000). DO-WATCH-LISTEN-SAY: Social and communication intervention for children with autism. Baltimore, MD. Brookes Publishing.

Strain, P. S., & Odom, S. L. (1986). Peer social initiations: An effective intervention for social skill deficits of preschool handicapped children. Exceptional Children, 52, 543 552.

Tantam, D. (2000). Psychological disorder in adolescents and adults with Asperger Syndrome. Autism, 4, 47-62.

Welsh, M., Park, R. D., Widaman, K., & O’Neil, R. (2001). Linkages between children’s social and academic competence: A longitudinal analysis Journal of School Psychology, 39(6), 463–481.

Article re-printed with permission from the Indiana Resource Center for Autism, at the Indiana Institute on Disability and Community, Indiana University Bloomington.


Bellini, S. (2009). Making (and keeping) friends: A model for social skills interaction. The Reporter, 8(3), 1-10.

 

Getting a Job with Autism – Preparing for the Real World of Work

by Chantal Sicile-Kira

Editorial Note: This article originally appeared in The Autism File in February 2009 and discusses Chantal’s son, Jeremy Sicile-Kira. Find out more about Jeremy here.

“Jeremy does not like jobs with physical activities but likes to work with ideas and be able to tell others what to do…. As the case manager, I see Jeremy’s strong assets like working data, communicating with people to purchase/buy/manage a business. He is able to do gross motor activities, but often finds fine motor activities difficult and frustrating. Jeremy needs more opportunities exploring jobs and finding out what he would do to have fun and earn money.  These last two ideas are very important to Jeremy.”

— Allan Gustafson, Interview with Jeremy Sicile-Kira
Transition Year 07-08

Like all parents, my husband and I worry  about our son, Jeremy, and what his future will look like. Jeremy is now 20 years old, and with  the economic situation being what it is, we are doubly concerned about the financial aspects of Jeremy’s  life as an adult. But as the saying goes, worry gets you nowhere – fast. Preparing, planning and creative thinking is a better alternative to wringing our hands.

When thinking about employment for your child or student  on the spectrum, there are a few  aspects that need to be focused on:  the life skills he or she needs to learn; a clear understanding of what employers look for in an employee; the interests and strengths of the person on the spectrum; the usefulness of mentors; and the different employment structures currently available.

Necessary Life Skills

In my latest book, Autism Life Skills : From Communication and Safety to Self-Esteem and More – 10 Essential Abilities Every Child Needs and Deserves to Learn, the ten skill areas covered are important for all aspects of life, whether  at school, at home, or in the community. Some of the skills  such as self-regulation, independence, social relationships,  and self-advocacy are  important  for getting and keeping a job. The topic of earning a living is the last chapter in my book, because being able to get and hold a job  is really a culmination of  all the life skills  hopefully learned during the school –age years, whether a person is on or off the spectrum. For example, for someone to be accepted in a workplace, they must be able to control their emotional and sensory meltdowns. A certain amount of independence is needed at most jobs. Understanding that you should speak to your boss differently than you would to  a colleague is important to know in most work situations. Self advocacy skills are  necessary in order to request what you need to get the job done.

Life skills in general  should be broken down and translated into IEP goals and objectives, especially during middle school, high school and  transition years. Obviously, everyone is different and the skill level reached for each of these skills is different depending on the person, but every student needs to learn a minimum in order to live and work in the community.

What Employers Look for When Hiring

Too often,  when  looking for a job placement for  a person on the spectrum, people take the approach of asking for handout, or a favor. We need to  approach this differently. I took a look at the top 10 skills and attributes most employers  look for as identified by the Bureau of Labor (Job Outlook, 2003) and I discovered that many of those attributes are attributes people  on the spectrum have, yet rarely do we sell those attributes to prospective employers. Here’s  the top ten of what  employers look for: honesty and  integrity; a strong work ethic; analytical skills; computer skills; teamwork; time management and organizational skills; communication skills (oral and written); flexibility; interpersonal skills; motivation / initiative.

Now, many of you reading this are probably  focusing on the skills in this list your child or student does not have. Look at it again, and think about what attributes your child does have. For example, most people on the spectrum are honest to a fault – they are usually  the ones in the store saying “yes” when a woman trying on a dress says “Does this make me look fat?”  They are not the employee who will be caught with his hand in the cash till.  That’s a positive point to sell. A strong work ethic applies to most of our guys – the ones who do not like a change in routine and are going to be there rain or shine. They will not be calling in sick because they had one too many martinis the night before, or leave early because they have an event to attend.  Analytical skills are really ‘obsessive attention to detail,’ and many of our children have that. The child who likes to line up blocks and trains probably has good organizational skills. Teamwork and flexibility are difficult areas for many, but we should be teaching flexibility at school (there are ways of doing that), and teamwork can be handled by ensuring the person on the spectrum has one person on the team that he is in contact with for all needed  information. Many of our children with Asperger’s are good communicators, and some have become journalists, speechwriters and professors.

The point is, when people are selling a product and/ or service,  they market the positive attributes,  not the negatives. And that’s precisely what we need to be doing with any prospective employees on the spectrum.

The Child’s Interests and Strengths

It is extremely important to consider what your child or student likes or is passionate (ie obsessed) about and figure out how that can help him earn money. In most cases, people on the spectrum can be difficult to motivate – unless it involves something they are really into. For some, it is quite obvious what they are particularly interested in because they don’t let you forget. The trick is to figure out how to use that interest and turn it into a moneymaker, or to find a career field that can use that particular interest or talent. That’s where mentors come into play (more about that later).

For most on the spectrum, a job will be their one connection to the community, and their main activity. If a neurotypical hates his job, he usually has another aspect of his life that is bringing him pleasure – his family, his church, athletic activities. However, most on the spectrum do not have family or friends or many outside groups they belong to, so it is important to help them find work that will fulfill them in some way.

There are those for whom it is fairly obvious what they are passionate about. For many like my son, Jeremy, it is a much less obvious. There doesn’t seem to be anything he is particularly obsessed about  that could lead to employment.  He used to love to spin tops (physics researcher?), and to follow the patterns in carpets and floor tiles (carpet checker in a rug factory?), now he is mostly focused on communicating about girls with his support people (beauty contest judge?). However, by having different people work with him or observe him in different environments, we have been able to come up with ideas to try out, and jobs  to avoid.

When thinking about Jeremy’s future money- making potential (either in a job, customized employment, or self-employment), we thought about the different strengths and weaknesses Jeremy had.  The questions we asked ourselves  are the same that most people should consider when helping someone on the spectrum who is considering employment. For example, we asked:

  • What is Jeremy usually drawn to?
  • Is there a particular  subject area or skill area that  Jeremy excels in?
  • What, if left to his own devices, does he like to do most?
  • What motivates Jeremy to do what he does?
  • How successful is Jeremy at  self-regulating? Does he need to work in a place with low sensory stimulation?
  • What kind of situations cause Jeremy to feel anxious?
  • What do Jeremy’s organizational or multitasking skills look like?
  • Does Jeremy do better in crowded environments or when there are fewer people around?
  • Does  Jeremy like moving around, or staying in the same place?
  • How many hours a week of work can Jeremy handle? Will he be ok with a 40 hour a week job, or does he need a part time job?
  • Does Jeremy like routine and the stability of  doing the same thing every day, or does he like change?

Jeremy is interested in the concept of self-employment and did well in two self-employment experiences he tried in high school.  He had a lot more control over his environment and what his daily tasks consisted of then he would have had in a regular employment situation. However, if he were to apply for a job, there are  many questions he would need to ask an prospective employer (or someone would have to ask for him)  during the interview process to ensure a good fit between himself and the job as well as the work environment.

The Importance of Mentors

Mentors can help figure out how to turn an interest into a job, or  into a means to earn money. Temple Grandin (Thinking in Pictures; Developing Talents) speaks often about the importance of mentors in helping to turn interests into marketable skills.  That is what helped her become the success she is today.  Temple had mentors  from her science teacher at school to her aunt, from family friends to colleagues who were crucial to her success. If your child appears to have skills or  a real interest in a specific area,  someone  who works in that field   can help  the child  realize the application of his interests.  Parents may realize their child’s talent, but not know all about a certain employment area.

For example,   a child may enjoy spending hours on the computer, but  his parent who is a taxi driver or a school teacher or an attorney, may  not know anything aobut the field of computers and employment possibilities. Someone who works in computers – perhaps a tech guy the family knows-  can give insight to what is  applicable  to someone with  that child’s talents.

Mentors can also help a student feel valued as  that person will be interested in the same topic he is and will enjoy hearing what the child has to say, whereas family members  may be tired of hearing about a topic they have no interest in.

Different Employment Structures

There are different employment structures currently available and by analyzing a person’s strengths and weaknesses, likes and dislikes, and by asking some of the questions above,  a clearer idea of what could be a good match with the person on the spectrum is possible. There is full-time work, part-time employment, seasonal work, year round employment and so on.

Other less traditional structures  are becoming more popular, and this is probably in response to the realization that most adults with disabilities are unemployed. In 2002,  unemployment figures for disabled adults hovered at 70% and had done so for the previous 12 years (2002 Report by the President’s Commission on Excellence in Special Education).   This report showed us that besides needing to do a better job of preparing our students for employment, meant we also had to start looking at other employment structures more conducive to individual employee needs.

One  less traditional structure  is customized employment, which  means that the work is tailored to the individual, not the other way around. It can mean job carving, where one job is carved up into different tasks  and shared by several people, giving each employee the part of the job they enjoy or excel at the most. Another type of customized employment is self-employment, which is sometimes referred to as micro-enterprise and  which basically means having your own business or being self-employed.  This can be a good  option for those who are having a difficult time fitting into  regular paid positions, or when there is no position available. This option is gaining popularity in the US as well as in the UK.  For some examples of self-employment initiatives by people with developmental disabilities,  visit http://www.incomelinks.biz/projects.htm.

Self Employment as an Option

Although I would encourage Jeremy to try  an employment opportunity that seems like a good fit, I am not holding my breath waiting for that job to show up on the horizon. I am not convinced that that much has changed since 2002 in the job market in regards to hiring disabled people, and certainly with all the neurotypicals now jobless, I don’t anticipate a huge rush of employers looking to hire my son.

I became interested in the concept of self-employment or micro-enterprise  when Jeremy was not offered any  work experiences during his first few years of high school, about 5 years ago. The workability person at the time felt that Jeremy was not ready for any of  the job options she had in the community.  His teacher, however, felt everyone, including Jeremy, had potential, and was open to creating a self-employment experience under workability. At that time, Jeremy could not communicate as readily as he can now, and so we had to  come up with ideas based on observations that people who knew  Jeremy made about his strengths and weaknesses, his likes and dislikes, and then ask him yes or no questions.

I had heard of people with developmental disabilities having their own business.  When the opportunity came, I  attended a workshop on the process and how it could work, and it made sense to me for someone like Jeremy.  It was clear that if workability was telling me there was not   a work experience opportunity for  Jeremy, I was going to have to create something for him  to learn “on the job” skills.

Jeremy’s teacher came up with the idea of starting a sandwich delivery service for the teachers, based on Jeremy’s strengths and likes, and the fact that by the end of the week, the teachers were sick of the on-site lunch option, and so there was a need for such a service.  Jeremy’s second experience was providing  a needed product (selling flowers to peers at school where no flowers were available on campus). By actually doing these businesses, Jeremy learned valuable business lessons.  These lessons were complimented by general education classes he took those semesters, such as a class on marketing and another one on economics. For his class projects he had to write papers on how he applied those principles to his job. Some of these lessons were:  the cost of doing business; the difference between a profit and a loss;  how marketing, location and  price affected the numbers of customers he was able to attract and keep. Jeremy also learned that if  he could not do all aspects of his job,  he had to pay someone else to do the parts he could not. In reality, it is these kinds of business lessons all neurotypical teens should be learning in the current economy.

That being said, self-employment is not for everyone and necessitates a business support team. The business support team can be made up of a teacher or parent, a paraprofessional, a mentor , a friend, someone who has business experience. Each person brings their knowledge to the team.   The business team helps to advise in areas the person needs help with, and also does parts of the business the person cannot, just as in all businesses (ie I pay a tech guy to take care of my website because I can’t). There are free resources, available on-line for those who are not experienced in starting up a business.

Looking at   self employment as an option sometimes leads to an actual job. The process of discovering a person’s strengths and weaknesses, can lead to discovering  areas of traditional employment that  had not been considered for that person previously. Sometimes it leads to a job offer  from a business in the local community that  the person had visited  to  get more  information about his area of interest.

Conclusion

Teaching children and teens on the spectrum needed life skills is a necessary  preparation to  life as a money-earning adult. Analyzing the needs of both the potential employee and employer, as well as looking at the different options in employment structures is necessary to ensuring a good match. Finding a mentor can help with a successful  transition to gainful employment.

This year, Jeremy is benefiting from two workability experiences while he is studying to earn his high school diploma. Twice a week he works at the local library (which he has visited on a regular basis for the last 10 years). Once a week he helps develop the business and marketing plans for the micro-enterprise experience that some of the other students are working on through workability. Jeremy  has come a long way thanks to all the different team members along the way who believed in his potential. It takes a village….

Travel Tips for Families with an Individual on the Autism Spectrum

by Chantal Sicile-Kira

Transitions are usually difficult for many on the spectrum, and traveling is really a series of transitions. Preparing the person – child, teenager or adult – as much as possible will make any trip a more enjoyable experience for all involved. Some advance planning of specific steps of the trip can be made ahead of time. Below are tips for both preparing the person (1), and preparing the environment for a better travel experience (2).

1. Preparing the Person

Leaving the security of home for a new place can be off putting for individuals with autism. How you prepare the person on the spectrum depends on his or her age and ability level. Here are some tips:

  • Think of the individual’s daily routine and the items he or she likes or needs and bring them along to make him feel more at home. Bring whatever foods and drinks will keep him happy on the trip, especially if there are dietary restrictions.
  • Buy some small, inexpensive toys or books that he or she can play with during the journey and that if you lose it will not be the end of the world. If he only plays with one favorite item, try to find a duplicate and see if you can “break it in” before the trip.
  • Do not wash any items (including plush toys) before the trip as the individual may feel comfort in the “home” smell of his cherished item.
  • Put up a monthly calendar with the departure date clearly marked, and have the person check off every day until departure. Bring the calendar with you and mark off number of days in one place or on the trip, always having the return date indicated.
  • Put together a picture and word “travel book” of what means of transport you are going to be using to, who you are going to see, where you will sleep, and what you will do or see at your destination. Go over this with the person, like you would a storybook as often as you like in preparation for the trip. Using a three-ring binder is best, as you can add extra pages or insert the calendar mentioned above for use on the trip.
  • Put together a picture or word schedule of the actual journey to take with you on your trip. Add extra pages to the travel book. Add Velcro and attach pictures or words in order of the travel sequence. For example, a picture to represent the car ride to the airport, going through security, getting on the airplane, etc. For car trips, pictures representing different stops on the trip and number of miles to be driven can be used. Add an empty envelope to add the “done” pictures when you have finished one step of the journey.
  • Taking a short trip before attempting long voyages, if possible, is recommended. This will help the person get used to traveling and give you the opportunity to see plan ahead for possible areas of difficulty. Also, if you use the travel book system, it will help the person make a connection between the travel book and any impending travel in the future.
  • Travel environments such as airports and train stations are areas that involve lots of waiting. Teaching the individual the “waiting” skill before traveling (if he or she does not already have it) will make your life and theirs much easier. Make or find a picture or icon that will represent “waiting” to your child, such as a line drawing of a “stick” person sitting in a chair, with the face of a clock next to it. Write “waiting” clearly on the card. Glue to cardboard, laminate it and place a piece of Velcro somewhere on it. Next, make sure you have picture of whatever items your child usually requests or wants immediately (favorite food, toy, ride in the car) backed with Velcro. The next time he or she requests the item, place the corresponding item on the Velcro strip on the Waiting board and say “We’re Waiting” and set a timer for how long you think the person can wait – for some this will be 10 seconds, for others a few minutes. When the timer goes off, immediately give the requested item, and say, “Thank you for waiting.” Do this, lengthening the amount of time the person needs to wait. Eventually, he or she will get the concept.

2. Preparing the Environment

Some preparations can be made ahead of time for the different environments and means of transport you will be using. Most people and companies in the field of tourism are willing to help to ensure a positive environment for all their customers and guests. Here are some tips:

  • When staying in a hotel, it is a good idea to call ahead and ask for a quiet room. You may wish to explain about the person’s behavior if there is a likelihood of him or her exhibiting them in the public part of the hotel. Same with a friend or relative’s home. It can be a bit disconcerting for everyone concerned if your child or adolescent takes his clothes off and races through your friend’s home stark naked.
  • If you are traveling by plane, call the airlines as far in advance as you can, and tell them you will be traveling with someone who has special needs. Some airlines have “special assistance coordinators.” You may wish to explain about the person’s needs and some of the behaviors that may affect other travelers, such as rocking in their seat. If the person is a rocker, asking for bulkhead seats or the last row of seats on the plane will limit the number of fellow travelers that are impacted by the rocking. If you need assistance getting the person and luggage to the gate or to change planes during the trip, call ahead and reserve ‘wheelchair assistance.’ Even if the person does not need a wheelchair, this guarantees that someone will be waiting for you and available to assist you. (This was suggested to me by a special assistance coordinator when I told her that the help I had requested had not been provided on a recent trip). When requesting the wheelchair, you may need to explain about the person’s autism. For example, I have explained in the past that my son with autism had difficulty moving forward in a purposeful manner and we needed help to get to the gate to catch a connecting flight.
  • Persons with autism should always carry identification. Make sure he or she has an id tag attached to him or him somewhere, with a current phone number written on it. You can order medical bracelets, necklaces and tags to attach to shoe laces. Additionally, if the person can carry it in his or her pocket, make an ID card with a current photo, date and phone numbers. Be sure to put any information that is important to know such as allergies and medications, and any special information (i.e. non-verbal).
  • Adult passengers (18 and over) are required to show a U.S. federal or state-issued photo ID that contains the following: name, date of birth, gender, expiration date and a tamper-resistant feature in order to be allowed to go through the checkpoint and onto their flight. Acceptable identification includes: Drivers Licenses or other state photo identity cards issued by Department of Motor Vehicles (or equivalent) that meets REAL ID benchmarks (at time of writing, all states are currently in compliance).

Using many of the tips listed above has made traveling much easier for our family. Now, we look forward to any travel opportunity as we all enjoy the experience. A little planning goes a long way!

Transition to Employment and Independent Living for Individuals with Autism and Aspergers

by Temple Grandin

Successful transition from the structured world of school or college to successful employment requires a lot of hard work. One of the biggest problems I had with trying something new was fear. Long before a student on the ASD spectrum graduates from either high school or college, they need to get work experience while they are still in school. The transition from school to employment should be gradual and not abrupt. I saw one student who graduated successfully from college and he had zero job skills. This is wrong. Teaching job skills should start before the student graduates. Mother was always pushing me to try new things. If she had not pushed me, I would not have developed. Below I will outline the work experiences I had when I was still in school.

13 years old – During the summer I worked two afternoons a week for a seamstress who did freelance sewing. My job was to hand hem dresses and take garments apart. Mother found this job for me and I was really good at the job. I also loved the money I earned.

15 years old – Mother lined up a summer job for me at my aunt’s ranch. I was afraid to go but mother gave me two choices. They were come home in two weeks or stay all summer. I ended up staying all summer. Planning for the trip, which included flying from New York to Arizona, started three months before I left. It was essential that I was allowed to plan ahead. Surprises cause panic.

14-18 years old – Horse Barn – In my high school, I worked cleaning stalls and feeding eight horses. This was a job I found for myself. Even though I was a goof ball student who did not study, I worked hard taking care of the horses. I was learning valuable work skills.

16 to 18 years old – Carpentry Work – At my boarding school I did lots of carpentry projects such as fixing up our ugly ski tow house. I put tongue-and-groove siding on it with white trim. One important work skill I learned from my many projects was to do an assigned task. Decorating the ski tow house with cattle pictures would not be appropriate. I had to decorate in a manner that other people would appreciate.

18 years old – I was still a bad student who did not study. I did not see any point in studying until my science teacher gave me a reason for studying. He got me interested in science and I became interested in becoming a scientist. My teacher told me that if I wanted to become a scientist I would have to study. Almost overnight I decided to study and I got good grades in college.

College Years – During my college years while getting my B.A., I continued to visit the ranch and I had two other summer internships. One summer I worked in a research lab with mice and the next summer I worked with autistic children. Mother helped line up both of these jobs.

Master’s Degree – After four years of college, I spent five years getting my Masters and I was gradually spending more and more time working. I slowly transitioned from the world of school to the world of full-time work. During this period I had a part-time job as livestock editor for the Arizona Farmer Ranchman and I also worked part-time for a company that built cattle feedlots. After this five year period I was no longer a student. I had my M.S. degree and I was now building up my freelance consulting business, one project at a time. One of the things that made my transition successful was that I slowly transitioned from full-time school to slowly weaning myself away from the structured world of school.

Ph.D. Program – After five years of full-time consulting, I went back to school to get my Ph.D. when there was an economic recession in the 1980’s. I spent nine years getting my Ph.D. on a part-time basis and I still worked. I still designed equipment and did seminars on livestock handling, while I was working on my Ph.D.

Sell Your Work – One of the things I figured out is that I had to sell my work and not my personality. I avoided job interviews and I showed prospective clients a portfolio of my drawings and photos of completed livestock handling facilities. Many people thought I was weird but they respected me when they saw my design drawings. Many people made the mistake of putting too much stuff in their portfolio. It is best to put relatively few examples of the very best work. In my book, Developing Talents, I provide a lot more tips for making portfolios.

It Takes Time to Develop a Skill – I am a visual thinker and I used my visual thinking ability in my work designing cattle facilities. Half the cattle in North America are handled in my designs. While I was working on my Master’s, I spent three years learning all about cattle handling and different facility designs. I went to every feedlot in Arizona and I worked cattle. It was an obsession but it was an obsession I turned into a career. I had to work hard to develop my designs.

Types of Minds – I have observed that there are three basic types of specialized minds on the autism spectrum.

Visual Thinker

This is my type. I think in photo realistic pictures like Google for images. Algebra was impossible for me. Unfortunately I was never allowed to try geometry or trig. This was a big mistake. Some individuals who cannot do algebra can do geometry. Visual thinkers are good at the following occupations:

  • Artist and Graphic Design
  • Industrial Design
  • Architecture
  • Auto Mechanics
  • Drafting
  • Photography
  • Animal Trainer

Pattern Thinkers

These are the individuals who are often good at math and music. Reading may be their area of weakness. Pattern thinking is a more abstract form of visual thinking. They think in patterns instead of pictures. Some good occupations for pattern thinkers are:

  • Scientific Researcher
  • Statistics – data mining
  • Engineering
  • Music
  • Mathematics
  • Computer Programming
  • Chemistry

Word Fact Thinkers

  • Journalist – Blogger
  • Librarian
  • Record Keeping Jobs
  • Special Education Teacher
  • Bookkeeping
  • Speech Therapist

These are the individuals who know all the facts about their favorite things such as movie stars or baseball players. History is often a favorite subject. They are NOT visual thinkers and they are often poor in art. The following careers would be good choices:

Never Too Late to Start – I have had parents, teachers, and individuals on the spectrum ask me, “How can an individual who is 30 and has never worked get started?” It is never too late to start. They need to start one small job at a time. The first task is learning time management and showing up for work on time. The individual will have to make some changes. When I was hired by the construction company, my new boss scolded me on hygiene. I was very upset but I complied because I wanted to keep the job. As a person on the spectrum, I have never stopped learning. Every day I keep learning.

How does visual thinking work in the mind of a person with autism? A personal account

by Temple Grandin

1. INTRODUCTION

My mind works similar to an Internet search engine, set to locate photos. All my thoughts are in photo-realistic pictures, which flash up on the ‘computer monitor’ in my imagination. Words just narrate the picture. When I design livestock facilities, I can test run the equipment in my imagination similar to a virtual reality computer program. I did not know that this was a special skill until I started interviewing other people about how they think. I was surprised to discover that the other nonautistic equipment designers could not do full motion test runs of equipment in their minds.

My mind is associative and does not think in a linear manner. If you say the word ‘butterfly’, the first picture I see is butterflies in my childhood backyard. The next image is metal decorative butterflies that people decorate the outside of their houses with and the third image is some butterflies I painted on a piece of plywood when I was in graduate school. Then my mind gets off the subject and I see a butterfly cut of chicken that was served at a fancy restaurant approximately 3 days ago. The memories that come up first tend to be either early childhood or something that happened within the last week. A teacher working with a child with autism may not understand the connection when the child suddenly switches from talking about butterflies to talking about chicken. If the teacher thinks about it visually, a butterfly cut of chicken looks like a butterfly.

2. PUTTING LITTLE PIECES TOGETHER

When I design equipment, I take bits and pieces of other equipment I have seen in the past and combine them to create a new system. All my thinking is bottom-up instead of top-down. I find lots of little details and put them together to form concepts and theories.

During the last 5 years, I successfully used this method to fix some of my health problems. Most people have to have a theory first, and then they try to make the data conform to it. My mind works the opposite way, I put lots of little pieces of data together to form a new theory. I read lots of journal papers and I take little pieces of information and put them together as if completing a jigsaw puzzle. Imagine if you had a thousand-piece jigsaw puzzle in a paper bag and you had no idea what the picture on the box is. When you start to put the puzzle together, you will be able to see what the picture is when it is approximately one-third or one-quarter of the way completed, When I solve the problem, it is not top-down and theory driven. Instead, I look at how all the little pieces fit together to form a bigger picture.

When I was in college, I called this finding the basic principle. On everything in life, I was overwhelmed with a mass of details and I realized that I had to group them together and try to figure out unifying principles for masses of data.

3. FINDING A UNIFYING PRINCIPLE IN SCIENTIFIC LITERATURE

I have recently started to lose my hearing. The ear specialist said that there was nothing I could do. I did not accept this; so I spent two weeks at the computer reading journal papers on sudden sensorial hearing loss, Meniere’s disease and other disorders. I had to read hundreds of abstracts and journal papers just to get the background information so that I could find the answer that would save my hearing. I was looking for a unifying principle that would explain all the research results. One study reported that steroids such as Prednisone could save my hearing and another study reported that steroids do not work. How did I sort the data out? The first clue was that many studies were published in arthritis journals instead of ear and nose journals. The reason for this is that arthritis doctors really understand autoimmune disorders where the immune system attacks a person’s body. In my mind, I pictured wrecked, deformed arthritic joints. For a treatment to be successful, the drug has to be given before the immune system has destroyed the joints. I then had a flash of visual thinking insight. I imagined that the immune system attacking my inner ear was such as a house on fire. This is what I call a visual symbol picture. If the fire is put out when it is confined to a waste basket, the house can be saved. If the whole house starts burning, it will be destroyed. The explanation for all the conflicting studies in the medical journals was really simple. Steroid drugs such as Prednisone put out the fire of autoimmune inflammation, but they do not repair the damage. Treatment has to be started before the ear is wrecked. The explanation for all the conflicting scientific studies was a simple basic principle. I had to get a prescription for Prednisone before the autoimmune inflammation destroyed my inner ear. I looked up a second ear specialist in the phone book and he immediately gave me the prescription that saved my hearing.

4. FILLING UP THE INTERNET IN MY MIND

The method of bottom-up thinking really works well for me in problem solving where a basic principle has to be determined from masses of conflicting data. One disadvantage of my kind of thinking is that huge amounts of data are required to find the answers. Since my mind works similar to an Internet search engine, my ability to solve problems got better and better as I had more and more experiences and read more and more books and journal papers. This provided lots of images in my memory for the search engine in my mind to search. Many people have told me that my talks have improved between the ages of 40 and 60. My ability to think in a less rigid way keeps getting better as I fill up the Internet in my mind with more and more information. I greatly improved socially in my 40s and 50s compared with my 20s. This was due to having more experiences in my memory that provided guidance on how to behave.

5. DOOR SYMBOLS

When I was in high school at age 16, many teachers did not understand why I kept talking about going through little doors and thinking in visual symbols. Since my mind stores information as photo-realistic pictures, I do not have true abstract thinking. To visualize the concept of my future after high school, I had to use door symbols. In fact, the first door symbols were real doors I could practice walking through. Today I no longer think in door symbols because I have a huge database in the Internet inside my head. Instead of visualizing doors, I visualize either real past experiences or events I have read about.

6. CATEGORIES ARE THE BEGINNING OF CONCEPT FORMATION

To form a concept from the many specific photo-realistic pictures I have stored in my memory, I sort them into categories. Categorization of my specific visual memories was the beginning of concept formation (Grandin 2000, 2002). When I was a child, I categorized dogs from cats by sorting the animals by size. All the dogs in our neighborhood were large until our neighbors got a Dachshund. I remember looking at the small dog and trying to figure out why she was not a cat. I had to find a visual feature that she shared with big dogs. I had to create a new category in my mind to differentiate. All dogs, no matter how big or small, have the same nose shape. My concept is sensory based, not word based. Other ways of sensory-based categorization would be sound (barking or meowing) or smell.

Researchers have found that people with autism often have difficulty in forming new categories (Minshew et al. 2002). When I was a child, we played lots of games such as Twenty Questions that forced me to get good at thinking in categories. Category formation is a fundamental property of the nervous system. Brains are wired to put visual information into categories (Freedman et al. 200 1). The hippocampus also has the ability to determine whether or not similar photos of objects are the same or different (Bakker et al. 2008). Observations of stroke patients have shown that brain damage can cause them to lose their ability to categorize objects such as tools, but they can still categorize vegetables and animals (e.g. Mummery et al. 1998).

In my case even abstract questions are answered by putting photo-realistic pictures into categories. One time I was asked ‘Is capitalism a good system?’ To answer this question, I put pictures from countries that had different types of governmental systems into the following categories: (i) capitalistic, (ii) capitalistic/ socialistic, (iii) socialistic, (iv) benevolent dictatorship, (v) brutal dictatorship, and (vi) war and chaos. These pictures were taken from my memory and they are from experiences travelling or the news media. My answer was that I absolutely do not want to live in a brutal dictatorship, or war and chaos. Pictures helped me make a choice because in the last two choices I see news photos and TV images of killing and destruction.

My ability to provide a well thought-out answer has greatly improved with age because I have travelled more, and have more pictures both from actual experiences and from reading. They can be sorted into the different categories. When I read, I convert text to images as if watching a movie. The images are then stored in my memory. In college, I photocopied images of my class notes into my brain. When I was a teenager, answering the question about capitalism in an intelligent manner would have been impossible. I simply did not have enough experiences or enough information in my memory to answer it.

7. HOW I DEVELOPED FASTER CATEGORY THINKING

In college, the process of sorting out the basic principles from masses of data was much slower and laborious compared with my abilities today at 60. 1 figured out my ear problem in two weeks. When I was in my 20s, it took me 10 times longer to develop a theory from 100 journal papers.

As an undergraduate, I did an honor’s thesis on the subject of sensory interaction. Here the question was how a stimulus to one sense, such as hearing, affects the sensitivity of other senses. I had over 100 journal papers and I numbered each paper. On small pieces of paper, I typed the major findings of each study. I then pinned hundreds of little slips of paper on a bulletin board. I called it my logic board. Since my thinking is totally non-sequential, I had to develop a way so I could see a display of all the information at the same time on the bulletin board. To discover the categories and concepts, I started pinning the slips of paper into different categories. It was very time-consuming. As I gained more experience with sifting through scientific research, I no longer needed the bulletin board. I became better and better at finding unexpected clues, such as many deafness treatment papers being in arthritis journals. From my previous scientific knowledge, I made the association of rheumatoid arthritis to autoimmune, and therefore saw that ear damage would work the same way as joint damage.

When I was young, my thinking process was extremely slow because I was less skilled at finding the basic principle from the masses of data. But skills in people on the autism spectrum still develop when they are adults. The more research I did analyzing the results of scientific studies, the better I got at it. I always read the methods section of a paper carefully so I can visualize how the experiment was done. Differences in methods often explain conflicting results of scientific studies.

8. DIFFERENT WAYS OF THINKING

For many years I thought everybody else thought in pictures the same way as I do. When I wrote Thinking in Pictures, I started interviewing people about how they think. I was shocked to learn that most people processed information differently to how I did. Most people are able to visualize their own car or visualize walking through their own house. They can do it because they are very familiar with it. I discovered the differences in thinking when I asked other people about objects they were less familiar with. I asked them about an object that everybody sees really often, but it was not visible when I asked the question. I always ask the question in the exact way so I do not bias the answer. ‘Access your memory of church steeples. How do they come into your mind?’ I was shocked to discover that many people saw a vague generalized steeple and sometimes it was a stick figure. They saw a generalized steeple where I saw only a whole lot of photo-realistic pictures of specific ones that I could identify. Research by Nancy Minshew and her colleagues has shown that in people with autism, word based tasks are processed in the visual parts of the brain. Functional magnetic resonance imaging scanning indicated that sentences with both high and low visual imageries were processed in the visual parts of the brain in the autistic subjects and that low visual imagery sentences were processed in the language parts of the brain in normal subjects (Kana et al. 2006). The sentences with high visual imagery were about animals and plants. One of the low visual imagery sentences was about arithmetic. When I did the experiment, I instantly saw my third-grade teacher writing on the blackboard and explaining borrowing in subtraction.

9. AUTISTIC THINKING IS SPECIALIZED

When I wrote Thinking in Pictures (Grandin 1995), I thought everybody on the autism/Asperger spectrum was a visual thinker. People with autism and Asperger’s are specialist thinkers. They are good at one thing and bad at other things. From both books and interviews, I have concluded that there are three principal types of specialist thinking.

  1. Photo-realistic visual thinkers–such as I. All my thoughts are in photo-realistic pictures (Grandin & Johnson 2005). My area of weakness is in algebra because there is no way to visualize it. Visual thinkers can do geometry and trigonometry, but not algebra. For my work, visual thinking is very important. I can see everything in my head and then draw it on paper. Figures 1 and 2 show two of my drawings, done by hand, of livestock handling facilities. They date from the mid-1980s when I did much of my best work.
  2. Pattern thinking–music and math mind. This is a more abstract form of visual thinking. Thoughts are in patterns instead of photo-realistic pictures. Pattern thinkers see patterns and relationships between numbers. Some of the best descriptions are in Daniel Tammet’s book Born on a Blue Day (Tammet 2006) and in Jerry Newport’s book Mozart and the Whale (Newport et al. 2007) The weak area in pattern thinkers is usually reading and writing composition.
  3. Word-fact thinkers. These individuals have a huge memory for verbal facts on all kinds of things such as film stars and sporting events. They are often poor at drawing and other visual thinking skills.

Figure 1: Drawings of livestock handling facilities by Temple Grandin dated May 13, 1985.

Figure 2: Drawings of livestock handling facilities by Temple Grandin dated November 2, 1987.

10. DIFFERENT KINDS OF BRAINS

Recent research on the white matter in the brain may provide an explanation for the uneven profile of abilities that is found in many individuals with autism. There are defects in the white matter interconnections between different localized brain regions. Courchesne et al. (2004) called these connections the ‘computer cables’ that wire different parts of the brain together. The frontal cortex gets less connections than other parts of the brain, but some local areas in the brain may get extra connections (Minshew & Williams 2007). Casanova and colleagues (2006, 2007; Casanova & Trippe 2009) found that the brain of both famous neuroscientists and people on the autism spectrum have more circuits (mini-columns) per square centimeter of brain. They suggest that this may explain savant-like skills. The disadvantage of this type of brain construction is that these small circuits have fewer long-distance connections between distant brain regions that facilitate complex social behaviors.

There is a wide range of brains that should be considered part of normal variation. A brain can be built with larger fast circuits that facilitate social communication or smaller, slower circuits that improve cognition in a specialized area.

In any information processing system, there are always trade-offs. Brains with high-speed connections to many distant areas will be fast and details will be missed. Research shows that normal brains fail to process details that the autistic person perceives (see Happe & Frith 2009; Happe & Vital 2009). My model for visualizing the different types of brains is a large corporate office building. The president (frontal cortex) is located at the top and he has telephone and computer connections (white matter) to offices throughout the building. I hypothesize that in a highly social brain, the frontal cortex has high-speed connections that go mainly to the department heads in the building. The network is fast and details are omitted. In the autistic/Asperger brain, the frontal cortex is poorly connected, but the visual and auditory parts of the brain (technical nerd departments) have lots of extra local connections providing better processing of detailed information.

11. AUTISTIC INTELLIGENCE

Michelle Dawson, a woman with autism, has teamed up with Laurent Mottron, a researcher in Canada, to show that autistic intelligence goes beyond just rote memorization. Instead of using just the Wechsler IQ tests, they tested both normal and autistic children with Raven’s Progressive Matrices (Dawson et al. 2007). In this test, the person is shown complicated patterns and he/she has to choose the pattern that will complete a series of patterns. Dawson and colleagues found that the IQ scores for the autistic children were 30-70 percentile points higher on the Raven’s compared with the Wechsler Intelligence Scale for Children (WISC), while normal children have similar IQ scores when given the Raven’s and the WISC. Scheuffgen et al. (2000) found that children with autism can show fast information processing despite poor measured IQ. These results show that autistic intelligence is truly different.

In 2006, Nancy Minshew and her colleagues performed a method called diffusion tensor imaging on me. They found a huge white fiber tract that runs from deep in my visual cortex up to my frontal cortex. It is located in the brain slice made at the level of my eyes. It is almost twice as large as my sex- and age-matched controls. I used to joke about having a big high-speed Internet line deep in my visual cortex. It has turned out that I really do have one. This may explain my ability to read massive amounts of detailed literature and sort out the details. In my case, abstract thought based on language has been replaced with high-speed handling of hundreds of ‘graphics’ files. Studies of patients with fronto-temporal dementia show that language-based thinking can cover up detailed visual thinking and music. As the disease destroys the frontal lobe and the language parts of the brain, art and music talent can emerge in people who had no previous interest in art or music (Miller et al. 1998, 2000; see also Snyder 2009).

12. HARNESSING AUTISTIC CREATIVITY AND ASPERGER’S SYNDROME

I am concerned that people with mild Asperger’s syndrome may be held back by the diagnosis because people may perceive them as not capable. Simon Baron-Cohen asks ‘is Asperger’s syndrome a disability?’ (Baron-Cohen 2000; see also Baron-Cohen et al. 2009). Many famous musicians, scientists, artists and politicians would probably be diagnosed with Asperger’s syndrome if they were children today (Ledgin 2002; Fitzgerald & O’Brien 2007). What would happen to them in today’s system? In the USA, the lucky ones get apprenticed into the Silicon Valley technical world by their parents. Many parents in technical fields teach their children their jobs at a young age. The unlucky ones do not have somebody to help them develop their skills. In countries such as China or India, a person with mild Asperger’s syndrome would go to engineering or computer science school. I have discussed this with parents from India or East Asia and they stress working with the child from a young age in career-relevant skills. We need to be working to develop the unique abilities of these individuals. I am worried about them getting ‘stuck in a rut’ and their creative skills will not be used.

Department of Animal Sciences, Colorado State University, Fort Collins, CO 80523, USA 

Philosophical Transactions of the Royal Society(2009) 364, 1437-1442
doi: 10.1098/rstb.2008.0297

Reprinted from http://www.grandin.com/inc/visual.thinking.mind.autistic.person.html with permission.

REFERENCES

Bakker, A., Kirwan, C. B., Miller, M. & Stark, C. E. L. 2008. Pattern separation in the human hippocampal CA3 and dentate gyrus. Science 319, 1623-1624. (doi:10.1126/science. 1152882)

Baron-Cohen, S. 2000. Is Asperger’s syndrome and high functioning autism necessarily a disability? Dev. Psychopathol. 12, 489-500. (doi:10.1017/SO954579400003126)

Baron-Cohen, S., Ashwin, E., Ashwin, C., Tavassoli, T. & Chakrabarti, B. 2009. Talent in autism: hyper-systemizing, hyper-attention to detail and sensory hypersensitivity. Phil. Trans. R. Soc. B 364, 1377-1383. (doi:10.1098/rstb.2008.0337)

Casanova, M. & Trippe, J. 2009. Radial cytoarchitecture and patterns of cortical connectivity in autism. Phil. Trans. R. Soc. B 364, 1433-1436. (doi: 10. 1098/rstb.2008.033 1)

Casanova, M. E. et al. 2006. Minicolumnar abnormalities in autism. Acta Neuropathol. 112, 287-303. (doi:10.1007/ s00401-006-0085-5)

Casanova, M. E., Switala, A. E., Tripp, J. & Fitzgerald, M. 2007. Comparative minicolumnar morphomery of three distinguished scientists. Autism 11, 557-569. (doi:10.1177/1362361307083261)

Courchesne, E., Redcay, E. & Kennedy, D. 2004. The autistic brain: birth through adulthood. Curr. Opin. Neurol 17, 489-496. (doi:10.1097/01.wco.0000137542.14610.b4)

Dawson, M., Soulieres, I., Gernsbacher, M. A. & Mottron, L. 2007. The level and nature of autistic intelligence. Psychol. Sci. 18, 657-662. (doi:10.1111/j.1467-9280. 2007.01954.x)

Fitzgerald, M. & O’Brien, B. 2007 Genius genes, how Asperger talents changed the world. Shawnee Mission, KS: Autism Asperger Publishing Co.

Freedman, D. J., Riesenhubert, M., Poggio, T. & Miller, E. X. 2001 Categorical representation of visual stimuli in the primate prefrontal cortex. Science 291, 312-315. (doi: 10.1126/science.291.5502-312)

Grandin, T 1995 Thinking in pictures. New York, NY: Vintage Press Random House. (Expanded version 2006)

Grandin, T 2000 My mind as a web browser–how people with autism think. Cerebrum 9, 13-22.

Grandin, T. 2002. Do animals and people with autism have true consciousness. Evol. Cogn. 8, 241-248.

Grandin, T. & Johnson, C. 2005. Animals in translation. New York, NY: Scribner.

Happe, F. & Frith, U. 2009. The beautiful otherness of the autistic mind. Phil. Trans. R. Soc. B 364, 1345-1350. (doi: 10.1098/rstb.2009.0009)

Happe, F. & Vital, P. 2009. What aspects of autism predispose to talent? Phil. Trans. R. Soc. B 364, 1369-1375. (doi: 10.1098/rstb.2008.0332)

Kana, R. K., Keller, T A., Cherkassky, V. L., Minshew, N. J. & Just, M. A. 2006. Sentence comprehension in autism: thinking in pictures with decreased functional connectivity. Brain 129(Pt 9), 2484-2493. doi: 10. 1093/brain/awl164)

Ledgin, N. 2002. Aspergers and self esteem. Arlington, TX: Future Horizons.

Miller, B. L., Cummings, J., Mishkin, F., Boone, B., Prince, F., Ponton, M. & Cotman, C. 1998. Emergence of artistic talent in fronto-temporal dementia. Neurology 51, 978-981.

Miller, B. L., Boone, K., Cummings, J. L., Read, S. L. & Mishkin, F. 2000. Functional correlates of musical and visual ability in fronto-temporal dementia. Br. J. Psychiatry 176, 458-463. (doi: 10.1192/bjp.176.5.458).

Minshew, N. J. & Williams, D. L. 2007. The new neurobiology of autism: cortex, connectivity, and neuronal organization. Arch. Neurol. 64, 945-950. (doi:10.1001/archneur.64.7.945)

Minshew, N. J., Meyer, J. & Goldstein, G. 2002. Abstract reasoning in autism–a disassociation between concept formation and concept identification. Neuropsychology 16, 327-334. (doi:10.1037/0894-4105.16.3.327)

Mummery, C. J., Patterson, K., Hodges, J. R. & Price, C. J. 1998. Functional neuroanatomy of the semantic system: divisible by what? J. Cogn. Neurosci. 10, 766-777. (doi: 10.1162/089892998563059)

Newport, J., Newport, M. & Dodd, J. 2007. Mozart and the whale. New York, NY: Touchstone.

Scheuffgen, K., Happe, F., Anderson, M. & Frith, U. 2000 High ‘intelligence,’ low ‘IQ’? Speed of processing and measured IQ in children with autism. Dev. Psychopathol. 12, 83-90. (doi:10.1017/SO95457940000105X)

Snyder, A. 2009. Explaining and inducing savant skills: privileged access to lower level, less-processed information. Phil. Trans. R. Soc. B 364, 1399-1405. (doi:10.1098/rstb.2008.0290)

Tammet, D. 2006. Born on a blue day. New York, NY: Free Press.