Tuesday, December 28, 2010

WHY? BECAUSE. I SAID SO.....

A few years ago my son, Carl and his friend Charlie, who has Asperger's syndrome, asked for permission to go to the bamboo forest with a group of kids the same age. They were all working on building a fort. The bamboo forest was a small patch of woods that separated our subdivision from the next one over. There was a significant amount of bamboo growing there so the kids named it the bamboo forest.

Charlie's mother and I sat down to have a relaxing conversation over diet cokes and snacks. We were thrilled that the boys were off playing and having a good time so we could visit and enjoy each other's company. Unfortunately, our bliss was short-lived.

The boys burst through the back door. We knew something was wrong. Carl was clearly angry and annoyed with Charlie. Carl's face was bright red and he was sputtering and growling, 'Charlie! What the crap?? Argh!!!!!!' Carl growls like a dog when he is angry. We don't know why. He has done it since he was a baby.

Charlie was saying nothing and we could not tell by his facial expression or lack thereof what he was feeling. So we simultaneously asked: 'What's wrong?' Carl was the one to respond. He was still worked up so he yelled his answer.

'Charlie picked up an axe and said he was going to kill himself! The girls started screaming and crying and ran home to tell their moms. And the guys didn't know what to do. Except Hunter started preaching to him and told him if he killed himself he would have to go to Hell. So we came home.' Carl then turned to Charlie and snarled: 'Charlie! Why do you have to act like such a freak?' Carl then stomped outside and slammed the kitchen door.

One of the older boys came to the house to make sure everything was OK. I asked him what had happened and his story was similar to Carl's but the frustration was replaced with concern. We also learned that the ax was actually a very small hatchet that the older boy was using to cut some wood for the construction of the fort. This was a group of very nice, well intentioned kids but somehow something had still gone terribly wrong. We needed to find out why.

I sat down with Charlie and explained that he was not in trouble and that we were not angry with him. We needed him to tell us what had happened. We then embarked on a lengthy question and answer session that went as follows: I asked the questions and Charlie provided these answers.

Q: What happened?
A: They wouldn't leave me alone.
Q: Who wouldn't leave you alone?
A: Everybody.
Q: What were they doing?
A: They just wouldn't leave me alone.
Q: What were they doing to you?
A: Nothing.
Q: Were they touching you?
A: No.
Q: Were they talking to you?
A: No.
Q: Then what do you mean they wouldn't leave you alone?
A: I don't know. They just wouldn't leave me alone.
 
We were not making much progress because Charlie appeared to be contradicting himself. On one hand, he stated that the kids wouldn't leave him alone, yet he claimed that they were not touching him or talking to him. So what do we do now?

Options:

1.    We could tell Charlie he was being ridiculous. The kids weren't doing anything to him and hand him back the ax and send him out to play. At this point we might pull something a little stronger than diet coke out of the fridge and continue with our previous conversation.
2.    We could give Charlie a snack, brainstorm with each other for a few minutes, then continue our investigation to find the real cause for Charlie's erratic behaviour.

We bravely chose to forge on and went straight for option 2. For every behaviour, there is a cause. We had to find the cause for the anxiety that drove him to such an extreme behaviour. We had to find the 'because'.

I continued to ask questions but started in a different place this time. Apparently I wasn't asking the right type of questions the first time around.

Q: How many kids were with you in the bamboo forest?
A: Seven or eight.
Q: How many kids do you feel comfortable hanging out with at one time?
A: Two. Maybe three.
Q: So do you think there were to many kids around for you to feel comfortable?
A: Yes.
Q: So it made you feel like they wouldn't leave you alone?
A: I think so.
Q: OK. So let's think of a better way to handle that situation. What could you have done instead of picking up the hatchet?
A: I'm not sure.
Q: OK. What if you went to Carl and said, There are too many people here. Let's go back to the house. Do you think that would work?
A: Yeah. I guess so.
Q: OK. Will you try that the next time there are too many people around for you to be comfortable?
A: Yeah

It took some digging but we finally unearthed the root of the problem. There were too many kids around for Charlie to feel comfortable. He was planning to hang out with Carl, but there were several other 'unexpected' kids there. This caused anxiety. He felt crowded and nervous. In an attempt to relieve the anxiety he ended up scaring the other kids.

How many times have you heard a child ask his mother 'Why?' And the frustrated mother say: 'Because I said so!' We have heard it. Some of us have said it. We are now going to give new meaning to the age old phrase Why?  Because I said so... When your child makes a mistake socially or exhibits inappropriate behaviour you need to continue asking questions until you find the real reason for the behaviour.

When looking for the cause for the behaviour, or the 'because', you need to look at the events directly leading up to the behaviour. To find out what was happening just before the behaviour occurred, you have to ask some questions. If you hit a dead end, ask another question. Keep asking questions until you can determine the most likely cause for the behaviour.

Here is an example using the story that we just discussed about the group of kids in the bamboo forest.

Q. Why did you say you were going to kill yourself?
A. They wouldn't leave me alone.   (This gives us a little information)
Q. Who wouldn't leave you alone?
A. Everybody (a little more information)
Q. What were they doing?
A. They just wouldn't leave me alone. (This is a dead end)
Q. What were they doing to you?
A. Nothing (dead end)
Q. Were they touching you?
A. No. (dead end)
Q. Were they talking to you? 
A. No. (dead end)
Q. Then what do you mean they wouldn't leave you alone?
A. I don't know. (dead end)
Q. How many kids were with you?
A. Seven or eight (Useful information)
Q. How many kids do you feel comfortable with?
A. Two. Maybe Three. (now we're getting somewhere)
Q. So do you think there were too many kids around for you to feel comfortable?
A. Yes. (BINGO!)


So there you have it. We finally sorted out what the real problem was. We had to ask ten different questions to get the answer. Of course it won't always take ten questions. Sometimes, it will be less or it may take more. There is no magic formula. But we have to remember that the child isn't evading the issue by forcing us to ask so many questions. He is truly unable to identify and express what the problem is until you ask him the right types of questions.

WHY?   There were too many kids.
BECAUSE    He picked up an axe and threatened to kill himself.
I SAID SO...... Next time you are feeling uncomfortable, you could tell Carl and ask him to come back to the house with you.

The WHY represents the series of questions that you ask and then the answer to those questions. If you are not sure what questions to ask remember your basic question words: WHY, WHAT, WHERE, WHEN, WHO, HOW. Use the question words to formulate as many questions as are needed. The BECAUSE represents the behavior. The I SAID SO....represents the alternative action that you suggest to your child to replace the inappropriate behaviour that he chose.

You can use this method to determine the cause of the behaviour in almost any situation. Unless you can accurately identify the reason behind the behaviour, you won't be able to help him find a more appropriate way of dealing with the situation in the future.  Kids with ASD usually have a logical reason for pretty much everything they do. We just don't always understand what that reason is. You need to prioritize what you are spending time questioning and investigating. You won't find an answer to everything. And there are some things that you can't change. As they say, you have to pick your battles.

If your child insists on using exactly seven napkins each time he eats a meal, but you feel that is wasteful, look at the big picture. First, are there issues that need to be dealt with that are more important? If yes, focus on those. Second, at least he is using napkins instead of his clothing or the tablecloth. It may be in everyone's best interest to stock up on cheap napkins and let it go.

You aren't going to, nor would you want to, change who your child is. But hopefully you will be able to help him be happy, comfortable and able to function in society to the best of his abilities. That is the ultimate goal.








Wednesday, December 22, 2010

WORK WITH ME

      A friend of mine who has a teenage son with Aspergers Syndrome told me that she was having a difficult time getting her son to brush his hair and he practically refused to wash it. So I asked her to tell me more about what was going on. She said that when his hair needs to be combed she tells him to go brush it. So he does. He goes to the bathroom and vigorously scrubs his head back and forth all over his head with the hairbrush. He then emerges from the bathroom with his hair looking like a crazy clown wig and worse than it was before.
     When he did wash his hair, he would often forget to use shampoo and he might not even get all of his hair wet. I spoke with her son and asked him why he brushed his hair the way he did. He told me he liked the way it felt on his head. So I thought, “ What if we could give him the same sensation that he gets from the hair brush when he washes his hair?” I asked his mother to purchase a small plastic brush that you put in the palm of your hand to scrub his hair when he washed it. He LOVED it. He could put shampoo on his hair and scrub and scrub. So now washing his hair feels good and he enjoys doing it more often.
     His mom actually purchased more than one brush and he uses the other one any time he needs to. He then uses his mirror skills and combs his hair neatly using the strategies that are described in the post “Man in the Mirror”.
     Will this work forever? Who knows? But it is working right now. He said to me, “Ms. Pam the idea about the brush was the best idea ever!” By using his sensory needs and working with them rather than against them we found a solution to a problem. So when you are facing an issue try to really investigate all types of solutions. Ask questions, be creative, and keep trying.

Sunday, December 19, 2010

MAN IN THE MIRROR

       What do you see when you look in the mirror? I look to see if my face is clean, my hair is neat, if my clothes are on correctly etc. Most of us use the mirror to make sure we look presentable. Kids with autism may spend a lot of time in front of the mirror, but may not be looking at any of these things. They may be just enjoying spending time with the person in the mirror. They may not care if their face is clean, their hair is a wreck and half their lunch is on their shirt.
     So you may need to teach your child some mirror skills. There is nothing wrong with making faces at yourself in the mirror, but you also need to be able to look at yourself in the mirror and make adjustments to your appearance when needed.
     I like to teach kids to “CHECK” themselves in the mirror.

C – Cheeks and chin. Look at them. Are they clean?
H – Hair. Does it need combed?
E – Ears. Did you wash them?
C – Clothes. Are they dirty or on inside out?
K – Kisser. That's your mouth. Did you brush your teeth?
Is there food on your mouth?

Write this on a piece of paper and tape it to his mirror. Or write it on the mirror with window markers. This helps your child really look at the individual parts of his face and helps him understand what you are asking him to look for.
     You can also take a picture of your child looking the way you want him to look and tape it to the mirror and have him match his image to the picture. The more specific you are about what you expect from your child, the more successful he can be. And that will help you both.


Saturday, December 11, 2010

LATHER, RINSE, REPEAT

      Many children with autism have hygiene issues. They may resist washing, brushing their teeth, combing their hair, etc. This can turn into daily struggles and arguments. As they get older, poor hygiene habits can cause problems socially. It's difficult for anyone to carry on a conversation with someone who has bad breath or body odor. In middle and high school having bad hygiene is social suicide.
     Some of these difficulties may be, in part, due to poor executive function skills. Most of us don't have to think about every step of washing our hair or brushing our teeth. We have done it so many times that we are able to do it without thinking. For individuals with executive function issues these everyday tasks require conscious thought and planning. So these individuals may skip steps or forget to include the basics in their daily hygiene routine.
     It is not unusual for some people to wet their hair, put shampoo on their hair and lather up, but to forget to rinse the shampoo out. This is just one example of skipping a step due to poor executive function skills. Incidents like these can be frustrating to both the parent and the child. If your child has already bathed, chances are, he will not be happy about having to get wet again to rinse his hair.
     When your child is little you do these things for him. But at some point he has to take care of his body's daily needs on his own. Here is one idea you may want to try. Write the steps of bathing on the shower or bathtub wall with a soap crayon. You can purchase these at many department stores and they are inexpensive. Once he has finished a step he can cross it off with a soap crayon or “erase” that step with a wash cloth. If you write the steps in a different place in the tub each day, you may find that your tub gets cleaner as well!
     For activities that take place at the sink such as brushing teeth and washing hands, you can write the steps on your mirror with a window marker. Or you can always tape a paper list to the mirror – whichever works better for you. There are other reasons for having hygiene issues and I will offer more ideas and suggestions in future posts so stay tuned! And please feel free to comment or email with your questions and things that have worked for you.

Take Care!

Saturday, December 4, 2010

HELP FOR THE HOLIDAYS

    This week I decided to incorporate a holiday activity into my social groups. I taught them how to “filter their thoughts” with my Mr. Coffee lesson a few weeks ago, so I thought I would expand on that lesson. If you are not familiar with the Mr. Coffee lesson, scroll down and find my blog post called “Coffee Please”. This is the post that explains this technique.
     For my holiday activity I bought 20 or so inexpensive gift bags. I put random items in each bag, like an ice cream stick, tissue, paper clip, one sock, etc. I gave each student a “present” and we practiced opening presents that we don't necessarily like. The students had to open their present, pretend to like it and politely say, “Thank you.” I also put some items that they would like in a few bags as well such as a bouncy ball, plastic bug, and spinning tops. They were allowed to keep any item they got if they wanted it, but they couldn't tell which items they really liked until the end of our session.
     The kids had a great time with this and they did really well. I chose to use gift bags so that I could reuse the bags for different groups and I could quickly get the activity ready. You could also wrap presents with wrapping paper for this activity. It will just take more time to set it up and clean up afterward.
     This could be a fun game throughout the holiday season for your children and their friends to play at home. You could give them gift bags to use and the children could take turns finding crazy and funny items to put in the bags for the others to open up. This may keep them entertained for a short time so you can do some holiday chores of your own. And with a little luck maybe your precious child will say, “Thank you so much Aunt Martha. I love it!” when he opens a hideous, itchy, purple wool sweater or something equally offensive.
     I will be home for the holidays with my family. If you have any questions or need suggestions please leave a comment or contact me by email at pam@lifecoachingangels.com I am here to help in any way I can. Have a safe and blessed holiday season.

Pam