Tuesday, November 9, 2010

Generalizing the Specifics

One of the main issues that children on the autism spectrum face is the ability to take what they learn from one situation and apply it in a totally different scenario. In fact the scenarios may not even be all that different, except for the introduction of a new dynamic or a removal of a familiar item, and the child becomes totally thrown off kilter and lost without the resources that they just learned. I analogize it to the issues HSB has in math. When given a math formula, and the appropriate number equivalents for the algebraic letters, he is able to apply the formula and even understands the reasoning and purpose. But if he is required to take that formula and apply in an unfamiliar word problem or with an unfamiliar set of numbers he will get lost. He is not able to generalize the specific information that he learned for that math equation. So too, do autistic children have issues being able to understand how certain appropriate behaviors are applied across the board and are general to the entire social paradigm.

So the question then becomes what do you do to help them understand how to accomplish this goal? What can you do for your child to help them relate their social lessons to each and every situation that they face? Interestingly, Dr. Temple Grandin accomplishes this task by keeping what she terms a running Rolodex of social situations in her head. She remembers them as if they were social stories, so that she is able to access and filter what she needs to accomplish, how, when and even why. However, that is not how most of our children will function. It is actually an intriguing idea and concept to use your brain as if it were a social story computer, but that is not going to work for everyone. Especially those like HSB who have a working memory shortfall.

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

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

Now without a doubt you do not have to follow the supermarket with a toy store. In fact, since our children do have the hardest time in toy stores, (the choices can overwhelm them and they are unable to choose a toy) I would actually even make that one of the last lessons you teach. But that is something you and you alone are going to have to decide how to handle and when it becomes a good idea. Something else too, don’t be afraid if your child is not following the rules to leave the store.

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

We have discussed on occasion the difference between meltdown and tantrum. The difference between whether your child is having issues because of the autism or issues because they are children and want what they want, when they want it, is something for which you need to be aware. However, the reality is that in many of these same situations you have to exercise the same outcome. You must walk away. Of course, it breaks your heart, especially when you know that it is a sensory issue or their inability to choose, but they MUST learn to choose. They MUST learn to channel their coping skills with sensory issues as well. Again, this is where the PRE-TEACHING comes in. The preparation before the excursion does help with these situations at times.

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

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

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

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

The reality is that there are basic concepts that our children need to be taught and they can be taught in many ways. Here is a small list of generalized behaviors:

1.     Walking and speaking appropriately in a store.

2.     Finding the item you want in the proper way- looking at markers in the store or asking for help appropriately

 3.     Standing in line to pay and waiting your turn if there is any kind of issue to be addressed.

4.     Making sure that they have the right amount of money to pay for the item (of course this is for older children who may need to even pay for their own lunch at school). However, you can start this process by pointing out to your child how you are paying for the item and that the money is in the bank or even handing over cash when you pay. (It is interesting to note, that persons on the autism spectrum tend to have very bad relationships with money. They need to learn early. Budgeting and money management needs to be reinforced from a young age.)

 5.     They should be taught the proper etiquette when speaking to someone…thank you, please, your welcome…goes along way in gaining acceptance and help in society. Demanding and requiring someone to do something for you generally gets noone anywhere. It is essential that our children learn to recognize these attributes. So many of our children due to their speech issues, auditory processing and language issues, have modulation issues as well and their anxiety comes out in their actions/tone of voice. They may be very anxious in any given social situation and it may come out in the way they address someone in a store. The clerk will think your child is being rude or obnoxious when they are simply anxious. Try to get them to recognize how their body feels and you need to teach them how to cope with the public/social anxiety.

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

Until next time,