Upload
newleavesclinic
View
164
Download
0
Tags:
Embed Size (px)
Citation preview
ASD Speaker Accommodations:Silence
• Be very quiet during presentation (e.g., chit chat is distracting)
• Please hold questions...• Q&A at the end• Unanswered Q’s to Karla’s FB page
Personal Space• Do not physically corner Karla for questions• Allow Karla to escape when she asks• Do not touch Karla when speaking to her
(c) Copyright - New Leaves Clinic
The Magic of Neurospan Profiling
(c) Copyright - New Leaves Clinic
Unleashing the Possibilities
Neurospan Profiling…
ASD – 1 continuum
Neurospans – 5 continuums
This difference is important because:
Neurology is far too complicated to create a single span that adequately summarizes Autism.
Multiple spans allow a care giver to understand the whole person, not just the autistic person.
(c) Copyright - New Leaves Clinic
ASD Neurospans
• The amount of data in permanent storage.Cognitive Capacity
• Information not based on fact.
• Eg. Social skills, Emotional understanding, ImaginationAbstraction
• Intake of data
• Eg. Sight, Sound, Touch, Taste, SmellSensory Integration
• Regulation of all information
Eg. Attention, inhibition, emotional regulation, Processing SpeedExecutive Functioning
• Anxiety: Can’t predict what happens next that creates helplessness
• Depression: Chronic helplessness creates hiding/apathy
Comorbid
Anxiety & Depression
(c) Copyright - New Leaves Clinic
“Personality” is a result of the interaction of an Individual’s Neurospan Profile interplaying with environmental factors
Cognitive Capacity
Abstraction
Sensory
Executive Functioning
Comorbid Anxiety &
Depression
Learned Behavior
(c) Copyright - New Leaves Clinic
Assessments As a Tool…
130
115
100
85
(c) Copyright - New Leaves Clinic
Testing /assessment (and observation) allow us to assess each of these areas to develop a Neurospan Profile for each individual based on their specific abilities
The “Perfectly” Average Neurospan Profile
70
80
90
100
110
120
130
Cognitive Capacity
Abstraction Sensory Integration
Executive Function
Standard Scores
----------------------------------------------------------------------AVERAGE
Incr
ea
sed
Sk
ill
(c) Copyright - New Leaves Clinic
Anxiety /depression are not typically present in a “NT” person’s profile
Karla’s Neurospan Profile (at home)
70
80
90
100
110
120
130
Cognitive Capacity
Abstraction Sensory Integration
Executive Function
Standard Scores
----------------------------------------------------------------------AVERAGE
Incr
ea
sed
Sk
ill
(c) Copyright - New Leaves Clinic
Anxiety, Depression
Anxiety /depression (long term anxiety) are always threatening but are less a threat to overall
functioning in a “known” environment
But Wait… It Get’s Better… Neurospan Profiling can be done across some or even many
situations to really give caregivers and the ASD person reasons for otherwise strange behaviours.
Gives insight into the big question of, “Why does my (or my kids) functioning levels fluctuate so much?” “Why is everything so situational?”
It explains the commonly heard problem, “He is so smart at home but does really dumb things when we are out.”
It helps guide the decision of where to focus efforts on helping an ASD person integrate and how to best accommodate their needs.
(c) Copyright - New Leaves Clinic
An
xie
ty,
De
pre
ssio
n
Karla’s Neurospan Profile (unknown place or unhealthy)
70
80
90
100
110
120
130
Cognitive Capacity
Abstraction Sensory Integration
Executive Function
Standard Scores
----------------------------------------------------------------------AVERAGE
Incr
ea
sed
Sk
ill
(c) Copyright - New Leaves Clinic
Anxiety /depression (long term anxiety) are active and
decreasing overall functioning abilities. The higher the Anxiety, the lower the
abilities…
Fix or Advocate?
70
80
90
100
Average Nuance Moderate Severe
Prime for learning and
using new skills
Will be hard but can make
some progress if
handled carefully
Risk is not worth the benefits
(c) Copyright - New Leaves Clinic
** Understanding individual Neurospan Profiles give guidance on where to focus efforts
Lack of using Neurospans creates: Frustrated kids & parents
ASD people feel they are broken beyond repair
ASD people become anxious, depressed – fight or flight or avoidance
ASD people learn not to trust authority
Refusal to go to public school
Optimize their skills.
Do not try to create NT skills.
(c) Copyright - New Leaves Clinic
Unleashing the PossibilitiesKarla’s Personal Insights on Possibilities and ASD…
(c) Copyright - New Leaves Clinic
‘Inside of every block of stone or marble dwells a beautiful statue”Michelangelo
“Performance = Potential – Interference”Timothy Galloway (“The Inner Game…”)
How we measure is EVERYTHING!!! Einstein… “Everybody is a genius. But if you judge a fish by its
ability to climb a tree, it will live its whole life believing that it is stupid.”
“In the measurement world, you set a goal and strive for it. In the universe of possibility, you set the context and let life unfold.”
“How often do we stand convinced of the truth of our early memories, forgetting that they are assessments made by a child? We can replace the narratives that hold us back by inventing wiser stories, free from childish fears, and, in doing so, disperse long-held psychological stumbling blocks.” ― Benjamin Zander, The Art of Possibility: Transforming Professional and Personal Life
(c) Copyright - New Leaves Clinic
Karla FisherBio
Vive La Differences…
Kids are like a box of chocolate. You never know what you are
going to get…
SCARY HOPELESS DEATH MELTDOWNS BANKRUPTCY ANTI-SOCIAL
JOBLESS INCAPABLE NON-VERBAL LOST HUMORLESS ANXIETY
DISABILITY FRIENDLESS CONFUSION ANGER LOST DREAMS EVIL ETC…
TEACHER DOCTOR MOTHER FATHER ENGINEER ATHLETE
STUDENT RESEARCHER DAUGHTER SON CHEF CASHIER
ADULT CHILD WRITER ARTIST ADVOCATE FRIEND ETC…
Label Game Part I (Define it)
High /Low Functioning….
Asperger’s is high functioning
Non-verbal is low functioning
Living Independently is high functioning
Define High and Low Functioning and apply these labels to the following profiles…
(c) Copyright - New Leaves Clinic
Label Game Part II
(c) Copyright - New Leaves Clinic
Profile Person (s) Accomplishments
Needs 24 hour nursing Care. Can do literally no self-care tasks without an aid. Is non-verbal without the use of many technical devices.
StephenHawkings
CH, CBE, FRS, FRSA (born 8 January 1942) is a British theoretical physicist and cosmologist, whose scientific books and public appearances have made him an academic celebrity. He is an Honorary Fellow of the Royal Society of Arts, a lifetime member of the Pontifical Academy of Sciences, and in 2009 was awarded the Presidential Medal of Freedom, the highest civilian award in the United States.
Completely Non Verbal (started typing on computer at 11). Defined as cognitively delayed. Self injurious much of her life. Required 1:1 intervention and services 40 hours a week for self care and cognitive training. She will likely never live independently and always require some supports.
CarlyFleishmann
Just co-authored her first book (available for purchase) at 13 years of age. Now in gifted classes in high school.
Spoke first words at the age of 4. Diagnosed by Doctors at the time as being too autistic to respond to therapies and recommended to institutionalization. Various troubles during the school years with aggression, fitting in, self care, etc.
Dr. Stephen Shore and Temple Grandin
Both with accomplishments too numerous to list
Living independently as adult. Can do basic self care most of the time. Lives modestly doing their obsession as a pastime.
Approximately 80% of AS adults
Varying degrees of accomplishments. Un-employed or under employed living on SSI or with support from others. Many are in jail or in and out of psych. hospitals for a variety of behavioral issues as a result of being misunderstood or not having proper supports or as a result of their unique Neurospanprofile.
IQ ASD versus IQ NTImportant points to consider about this chart*found in a great article about perceptions of autistic people…
Note how much lower overall autistic IQ is to NT IQ based on Wechsler’s tests (the gold standard today). This is especially large gap in children.
Note how NT children perform on both tests similarly as they do as adults (smaller spread) versus the autistic person who gains significantly more in skill as an adult . (THIS Is what I mean when I say that autistic people grow more slowly than NT people. You cannot compare where your ASD kid is today to where he is going to be as an adult by the same markers that you use for NT people. They are different. We take longer to connect some areas. Think of the tortoise and hare story here… Many of us are tortoise. Slow doesn’t mean we are not in the race and certainly doesn’t mean that we cannot win the race. )
* http://www.nature.com/nature/journal/v479/n7371/full/479033a.html
(c) Copyright - New Leaves Clinic
High Functioning is…
(c) Copyright - New Leaves Clinic
Nature Nurture
The best thing any parent can do for their child is to provide a supportive, positive, loving environment that assures that child will grow up to reach their full potential
Living perpetually to my performance potential by eliminating the interferences that cause me to falter. “Performance = Potential – Interference”
Vive La Differences……except it is very different
because even when they are all grown up, they still surprise you with all the amazing things they
are learning and being every day…
You literally NEVER know…
Fixing Autism… (Parents Vs ASD Adults)
Autistic Civil Rights facts At the beginning stages right now (similar to gay rights)
Includes autistics of various abilities (not just “high functioning” by however you are using that word)
Extremely sensitive to disrespect
“The healthy desire is for our children (or clients or friends) to live happy and fulfilling lives. The irreconcilable flaw is that autism cannot be “extracted” from a theoretical person to enable some “other” person to emerge. There is no other person. The only, and best, person is already there: an Autistic person.”
--Robb Gross (Father of an adult autistic daughter)
(c) Copyright - New Leaves Clinic
Unleashing the PossibilitiesKarla’s Core Philosophy on ASD Approach…
(c) Copyright - New Leaves Clinic
‘Inside of every block of stone or marble dwells a beautiful statue”Michelangelo
“Performance = Potential – Interference”Timothy Galloway (“The Inner Game…”)
Meltdowns and Shutdowns hurt.
Hurt me emotionally as well as physically
Hurt others
Leads to GAD/Depression and other related health issues
Pushing into this “zone” feels like having flu where every muscle in the body hurts. The brain is fuzzy and energy is gone. This can last for hours or days.
Long term meltdown mode can result in Anxiety/Depression which may lead to many physical health related problems
Panic attacks
High blood pressure, etc
ASD = Whole Body DisorderPervasive Developmental Disorder
Meltdowns and Shutdowns are a “MIS-Management” issue
(c) Copyright - New Leaves Clinic
Pervasive – Energy Out I use energy in social situations The more chaotic the situation, the more energy used When Energy is depleted a shutdown or meltdown may occur.
These can last for hours, days, weeks or longer. Continued meltdowns can result in anxiety and other health
problems
ASD BunnyBattery = Energy
© copyright 2011 Karla FisherAll rights reserved. Use with permission only
Contact: [email protected]
Pervasive – Energy In I gain energy in my alone time doing my special interests I often treasure things over people for this reason With careful balance of overall energy I can spend time with people
and even go to big events This is why I have only a few “close” friends at any given time
ASD BunnyBattery = Energy
© copyright 2011 Karla FisherAll rights reserved. Use with permission only
Contact: [email protected]
Reduced
Symptoms
Advocacy Via Awareness
Confidence via Empowerment
Health
Hierarchy of ASD Needs Social
Skills Type Training
Poor Health, low confidence and poor environments directly and dramatically affect my abilities/ symptoms so I have learned to prioritize
these areas in my life.
Social Skills (Type) training is hard on my confidence and must be given on a “risk versus benefit” basis. Best results will happen only
once other foundational areas are addressed and managed.
Reduced Symptoms MUST happen for me to absorb training and to reach my baseline for learning
Newsflash!!!Social Skills and
Flexibility Skills are situational!!!
Confidence/Self Esteem is the opposite of Anxiety
(c) Copyright - New Leaves Clinic
Karla’s Neurospan Profile (unknown place)
70
80
90
100
110
120
130
Cognitive Capacity
Abstraction Sensory Integration
Executive Function
Standard Scores
----------------------------------------------------------------------AVERAGE
Incr
ea
sed
Sk
ill
(c) Copyright - New Leaves Clinic
An
xie
ty,
De
pre
ssio
n
Anxiety /depression (long term anxiety) are active and
decreasing overall functioning abilities. The higher the Anxiety, the lower the
abilities…
Focus on Physical Health as priority #1 Nutrition Rest Exercise
Hone Confidence Provide ASD role models Teach to the student’s strengths (Neurospan Profile)
Advocate! Hone Self Awareness Teach Basic Disability Rights Stop Problem Solving
Realistically Balance Activities All ASD people need to know their own limits
Focus on Symptom Management
© copyright 2011 Karla FisherAll rights reserved. Use with permission only
Contact: [email protected]
Unleashing the PossibilitiesParenting Styles and Logic…
(c) Copyright - New Leaves Clinic
‘Inside of every block of stone or marble dwells a beautiful statue”Michelangelo
“Performance = Potential – Interference”Timothy Galloway (“The Inner Game…”)
Parenting Styles… (what works) Permissive parents : are reluctant to impose rules and
standards, preferring to let their kids regulate themselves. Authoritarian parents : demand a sort of blind obedience
from their children. Authoritative parents : take a different, more moderate
approach that emphasizes setting high standards, being nurturing and responsive, and showing respect for children as independent, rational beings. The authoritative parent expects maturity and cooperation, and offers children lots of emotional support.
http://www.parentingscience.com/
(c) Copyright - New Leaves Clinic
AND not OR logic (Black/White)
(c) Copyright - New Leaves Clinic
Unleashing the PossibilitiesADVOCATING…
(c) Copyright - New Leaves Clinic
‘Inside of every block of stone or marble dwells a beautiful statue”Michelangelo
“Performance = Potential – Interference”Timothy Galloway (“The Inner Game…”)
Advocating
(c) Copyright - New Leaves Clinic
Advocacy: The “art” of finding alternative acceptable ways towards a goal using abilities instead of “problem solving”.
Problem Solving Versus Advocating…
Problem StatementIEP Viewpoint
Tone of voice
Inappropriate Language
Lack of social reciprocation
Hitting or physical aggression
Lack of friends
Lack of eye contact
Other social skills issues ad naseum
ASD Viewpoint
Meltdowns4 times a week
Anxiety*Sensory * People
Lack of EmpowermentNo clear options
The only thing that matters on this side is
the physical aggression. Implement
a ZERO tolerance policy
Measureable Goals: •Meltdowns from 4 a week average to 2 or less a week average•Stretch goal = 0 a week•Physical Aggression: 0 times or NEVER (AKA: No tolerance)
Remove the BIG Triggers to achieve goals (20/80 rule)
Besides eliminating physical aggression the
team will focus on reducing meltdowns in
general ignoring all the other “stuff”
(c) Copyright - New Leaves Clinic
Meltdowns and Shutdowns hurt.
Hurt me emotionally as well as physically
Hurt others
Leads to GAD/Depression and other related health issues
Pushing into this “zone” feels like having flu where every muscle in the body hurts. The brain is fuzzy and energy is gone. This can last for hours or days.
Long term meltdown mode can result in Anxiety/Depression which may lead to many physical health related problems
Panic attacks
High blood pressure, etc
ASD = Whole Body DisorderPervasive Developmental Disorder
Meltdowns and Shutdowns are a “MIS-Management” issue
(c) Copyright - New Leaves Clinic
Jackie and Johnny are brothers. Johnny has ASD so his nervous system is on high alert either on a low idle or high spin. The boys get up and get ready for school. Jackie executes his “getting ready” tasks without thinking about it. Johnny
has a task list and when something changes it causes anxiety to rise even more… but he holds on. The bus comes and Jackie sits with his friends to chat enjoying the nice relaxing ride to school and the socialization.
Johnny is bombarded by sensory information and bullying. He fights meltdown the whole way. Johnny holds on and makes it to class without losing control. He is proud of himself.
Let the school day begin!!!!
Jackie NT and Johnny ASD go to school
(c) Copyright - New Leaves Clinic
Our Breaks Aren’t Like Your BreaksNT Break
Recess Hallway chats Lunch “Getting to know you
activities…” Parties Labs Group work Field Trips Assemblies Gym
The sad irony here is that every one of these things that typical people call breaks can and most often does cause even more stress to your ASD students. Remember that they have more anxiety when they start school due to their neurology so actually need breaks (their kind) even more and should be exposed as little as possible to the NT type of breaks.
ASD Breako Alone time
o Library
o Time doing obsession (reading, computers, etc)
o Getting AWAY from people and sensory input is almost always a “safe” break…
o Alone exercise may also be a good option for some. Quiet walk, boxing, jumping, etc…
(c) Copyright - New Leaves Clinic
Behavior Identify the 1 or 2 things that are problems
Create a clear problem statement that include those 2 issues If you cannot articulate the problem, you cannot fix it Think hard.. Is this REALLY important?
STOP problem solving! Think Advocate instead Empower the child to advocate by providing tools and clear
steps. Create a clear BSP. Make sure student/child understands the
BSP Remember that BSP must be black/white (100% consistent)
AKA: AND logic not OR logic
(c) Copyright - New Leaves Clinic
Key Points to Remember… You cannot really know the future, so why limit it?
ASD is pervasive. Tokens are limited… Spend wisely.
Categorize Problems. Carefully pick the BIG ones to work on. (Spend wisely)
STOP problem solving! Think Advocate! (cater to abilities)
Use Neurospan Profiling to help make decisions about where to spend efforts/tokens.
(c) Copyright - New Leaves Clinic
Contacting Karla and Cynthia: Follow us on Facebook Karla’s ASD Page (Karla’s personal experience and research)
New Leaves Clinic (Info on ASD, ADHD, Dyslexia, funky brains )
Oregon RISE Conference Oregon Parent Training Institute 23rd Annual Conference
April 27-28
Sheraton - Portland Airport
OregonRiseCenter.org
888.505.2673
(c) Copyright - New Leaves Clinic
Backup
(c) Copyright - New Leaves Clinic
Unleashing the PossibilitiesKarla’s Uses Neurospan Profile to Socially Advocate…
(c) Copyright - New Leaves Clinic
‘Inside of every block of stone or marble dwells a beautiful statue”Michelangelo
“Performance = Potential – Interference”Timothy Galloway (“The Inner Game…”)
Karla’s Problem Statement
“People are Idiots” is triggered
Me: Rude
Them: Bad, Angry
Working in high tech as a senior leader puts me in social situations
where I often fail to make good impressions. This happens because I am no longer in an environment with purely logical minded people who can discuss technical details with me to keep me in my social “comfort zone”.
The most common scenario is that I will be approached by a wife of a
colleague or boss and something they say will trigger a “People are Idiots” reaction in me. (This is not really
their fault as I have so little understanding of people overall
outside of my circles) I will react by being rude and am completely
justified in that rudeness because of my understanding of the context.
This results in me having to clean up messes later on if it is even possible.
Notice how this model… (“Fatal” flaws)
1) Does not recognize responsibility on my part of misunderstanding context…
2) Does not see emotion in my actions. (unaware)..
3) Does not have an “inhibit” button…
4) Gives the same result every time…
Me:Confused, just
ified
NT Social Skills Model for me
“People are Idiots” is triggered
Inhibit?
RudeAct NT –
Social Fake
No
Yes
Bad, AngryNeutral,
Good, Weird
Typical Social Skills books teach us that our way is the wrong way. They tell us that we must develop the skills to be proficient at their game. There is no discussion of how abilities are
sometimes affected due to sensory or if there is what to do about it.
Being rude is never considered as an option. Additionally there is little
discussion on the inhibiting part or how that is the crucial part to this entire game . This is mentioned in
social skills type training so I know it is part of someone's picture
somewhere. I just had to put this together myself as I did not see it in the material I have been exposed to
like this.
Socially Advocating Skills!
“People are Idiots” is triggered
Inhibit?
RudeAdvocate
and ExcuseAct NT –
Social Fake
No
Yes
Yes
Yes
Bad, AngryNeutral,
Good, WeirdNeutral,
Good, Weird
The “secret” to having good interactions is to recognize when
“anger” is starting early enough to inhibit the natural response (Path 1).
If that is possible, a choice can be made (AKA: I am empowered) how to proceed. In many cases Path 3 will be impossible due to the environment or
my abilities in the moment.
In my case implementing Path 2 or Path 3 will likely result in the same outcome. Path 2 is the option that
will be easier/more true to me so I will practice scripts for this versus try to learn NT social fakes and NT scripts.