CHILDREN WITH AUTISM, PART III

This post, the third in a series, is courtesy of Dr. David Jenkins, Sr., a Licensed Specialist in School Psychology and Lead for Psychological Services at Lubbock, TX. Dr. Jenkins has provided psychological services to school districts in Lubbock, Texas and surrounding school districts for over 25 years and has served on the Texas Education Agency statewide networks for autism and behavior.

Identifying a Child as Autistic

How do you know if your child might have Autism? Perhaps the most striking behavioral symptom of the condition involves verbal communication problems. When they occur on a regular basis you should be concerned and investigate further. Keeping in mind the continuum we have described in my previous posts, these language deficits can take a variety of forms. The child may:

Never use spoken language to communicate.

Sound like a parrot, simply repeating everything that is heard.

Repeat your question instead of answering it, or repeat songs they have heard or portions of movies they like.

Use odd word choices when they communicate. I pointed out earlier how one child at Thanksgiving talked about getting to “hack” the turkey.

Talk and talk and talk about favorite topics and interests but never ask you a question about it.

Be able to read but not understand the material.

Say unusual things like, “He likes ice cream,” instead of “I like ice cream.”

Be able to carry on a conversation.

Some additional warning indications, although not definitive signs of autism, should nevertheless raise a red flag in your head. These include things like the following:

The child is not talking by 2 years of age. Or, your child has begun using words and then around 18-24 months stops using those same words.

You notice inattentive behavior on a regular basis and think your child might have a hearing problem.

You find yourself wondering why your child rarely makes eye contact with you.

You wish your child would be more interactive with you and others, such as playing peek-a-boo or smiling back at you.

You notice your child regularly prefers to be off alone, even at his or her birthday party or at other family gatherings.

Your child seems to have exaggerated sensitivities to certain sensory experiences, such as lights or sounds.

You notice on a regular basis that your child has difficulty adjusting to change, such as a new routine. The child definitely prefers sameness and predictability, and repetitious behaviors occur frequently.

To some degree, all children can display any of the above characteristics at any point in time. Generally you hardly notice them. When they are extreme, frequent, and predictable, however, they catch your attention. It is at this point you may want to investigate further. Also keep in mind that any of the above could be indications of something other than autism. The child might have a language deficit. A condition like fetal alcohol syndrome, due to effects of alcohol consumption during pregnancy, can often look the same as autism. Basically, if you are overly concerned there is only one way to know what’s going on and that is to have the child evaluated by trained professionals trained to do such evaluations.

CHILDREN WITH AUTISM, PART II

This post, the second in a series, is courtesy of Dr. David Jenkins, Sr., a Licensed Specialist in School Psychology and Lead for Psychological Services at Lubbock, TX. Dr. Jenkins has provided psychological services to school districts in Lubbock, Texas and surrounding school districts for over 25 years and has served on the Texas Education Agency statewide networks for autism and behavior.

Behavioral Deficits in Autism  

 In my previous post I talked about the continuum and how it applies to sensory reactions shown by children with autism. The same wide variety of characteristics, that is, the continuum, applies when we consider behavioral deficits. Every parent who suspects autism wants to know what deficits to look for. Being aware of difficulties a child may face is certainly the first step in learning to cope with them, and awareness of these deficits can reduce parental concern and anxiety. The reality is, however, that the expression of autism can vary tremendously from child to child. No two children will look the same.  

 Consider verbal ability. Deficits in verbal language skills can include not using spoken language by the time the child is two years old. Or a child around 18-24 months of age may stop using words already learned. Sometimes the child may sound like a parrot, simply repeating everything heard. Mommy says, “Do you want a drink?” and Johnny replies, “Do you want a drink?” Children may repeat songs they have heard or portions of movies they like as they are going about their day to day activities.  

 Some children acquire good vocabulary but may use odd word choices when they communicate.  My friend Jack talked about getting to ‘hack’ the turkey one Thanksgiving. While ‘hack’ can mean cut, it is not the word most people would typically use to describe carving a turkey. Some children may talk and talk and talk about their favorite topics and interests but never ask you a question about it or ask for your input. 

 Jack was an expert on 50’s and 60’s rock and roll music. He could tell me everything about it, such as who wrote the words, who wrote the music, who produced the album, what recording company was involved, what year it was written, etc. I grew up listening to that music and know a little about it.  However, during the course of providing counseling to Jack over 1½ years he never, ever asked me anything about it. Jack also loved stamps. He had multiple five-inch binders full of postage stamps from around the world, and he could tell you everything you ever wanted to know, and more, about them. But he never asked what I knew.

 I evaluated 4-year old Mary who could read everything on the label of the fire extinguisher as we passed by it in the hall on the way to the room used for testing. She couldn’t answer any questions about what she read, but she had no difficulty pronouncing any of the words she saw. Some children may be able to carry on what appears to be a conversation, but they are really just talking on and on about their favorite topic. 

 When thinking about any aspect of autism, think of the continuum. With respect to language, for instance, at one end of the continuum is the child who uses little, if any spoken words, while at the other end of the continuum is the child who uses lots of words.

 

CHILDREN WITH AUTISM, PART I

This post, the first of a series, is courtesy of Dr. David Jenkins, Sr., a Licensed Specialist in School Psychology and Lead for Psychological Services at Lubbock, TX. Dr. Jenkins has provided psychological services to school districts in Lubbock, Texas and surrounding school districts for over 25 years and has served on the Texas Education Agency statewide networks for autism and behavior.

Sensory Reactions in Children With Autism

 When evaluating the presence of autism you should think of various characteristics on a continuum. Children with Autism tend to either be over-stimulated or under-stimulated, to over-react or under-react, be hyper-aroused or under-aroused to a variety of things.  Putting actions on the continuum is especially helpful when you think of autism and the five senses: sight, hearing, touch, taste and smell. Sensory reactions in autism can vary widely in different children. 

Children with autism may be bothered by certain kinds of lights, or they may like to stare at lights while waving their hands or fingers in front of their eyes.  Some may look at things out of the corner of their eyes rather than directly looking at it. Some may like to watch things spin, any object that can spin, such as wheels on cars (real or toy), plates, a frisbee, a ceiling fan, a top, a coin, etc. Children with autism tend to be better visual than auditory learners.  Temple Grandin, a famous woman with autism, talks about how she thinks in pictures rather than words.  

 It is not unusual for parents to tell me they thought their child was deaf because the child did not always respond when their name was called. A 4th grade student I evaluated asked if I could get the teacher to stop “ticking” (as in “tic-toc”) because it was distracting him. The source of the ticking was the teacher’s pacemaker that he was able to hear! Other children, however, completely ignore sounds. One task often used during an evaluation is to ring a bell while the child is engaged in a task.  Many times, children with autism never turn toward the sound; they appear not even to notice it.   

Children with autism can be particular about the clothes they wear.  They may never wear blue jeans, preferring the softer feel of other materials.  I’ve known children who wear the same shirt every day because it is the only type of “feel” they will tolerate.  One little boy liked the feel of nylon stockings, causing his mother to warn visitors about wearing stockings. 

Sometimes children may like to play with water or sand, letting it run through their fingers. Sometimes they may not like the feel of shaving cream or pudding, which is often used in pre-school settings for finger painting.  Sometimes they like the feel of human hair, smooth surfaces, cool feeling objects, carpet, etc., and the list goes on. The continuum is wide.

 It is not unusual for children with autism to be picky eaters. They may prefer only soft foods, or only crunchy foods, or no meat of any kind, or no veggies, or only foods of a certain color. A mother told me her child would eat an apple, but only if it was whole and unpeeled.  Another told me her child would eat an apple, but only if it was whole and peeled.  Others have told me the apple had to be peeled and cut, or cut and unpeeled. Children with autism may only eat a limited number of foods and will only eat those every day, never trying anything new. The food-preference continuum can be extremely varied. 

The last of the senses is smell. Teachers and parents have told me about how their child can detect when a new perfume or deodorant is used and at the same time do not react to the smell of a skunk near the house.

When it comes to sensory sensitivity and reactions, one size does not fit all. Children with autism can fall anywhere along a wide continuum of sensitivity.

 

ARE YOUR BELIEFS AND ACTIONS CONSISTENT?

Syndicated columnist Paula Dockery wrote about her consternation with the seemingly illogical behavior of the American voter in the 2016 election. For instance, polls showed that approval ratings of Congress at election time were around 20%, and yet virtually every Congressional incumbent was re-elected. Crazy, right? If we disapprove of Congress, why do we re-elect them?

Dockery also cited a Quinnipiac poll taken just before the election that showed 67% of Americans agreed with Roe v. Wade; 60% supported allowing illegal immigrants a path to citizenship; 68% were concerned about climate change and 59% supported regulations to curtail it; and 85% of voters felt those on the no-fly list should not be allowed to buy guns. These were sizeable majorities from a respected poll. And yet, the man who disagreed was elected President. Huh?

Dockery raises a very logical question: If we feel government isn’t working for us, why don’t we vote for those who share our views and shun those who hold different positions?

There are explanations and coping lessons from a psychological perspective that we can apply to Dockery’s contradictions. First of all, inconsistencies between beliefs and actions are not limited to voting behavior. Why would an abused woman stay with her abuser? Why does the bullied kid suck up to the bully and seek to join his gang? Why would someone like Jack (11/27 blog) refuse to face a life-threatening health problem? Why would someone waste away in a dead-end job instead of looking for another position? Why would Dad passively ask the family therapist when the anti-depressant for his 17-year old daughter will “kick in” so she will become normal again? Why would a parent hover over a child and protect him or her from failure? These actions appear to make little sense.

To answer these questions let’s note a basic psychological principle: When you commit to a set of beliefs and a course of action, your mind tends to engage in all sorts of questionable thinking to justify your commitment. About 60 years ago Leon Festinger formally developed this idea in his theory of Cognitive Dissonance, and illustrated it with the following case.

In the 1950s a small cult gathered on a hillside on a date specified by their leader as the day the world would end. According to the leader, God would save them and destroy all else. In preparation for this day, these folks sold all their belongings….their houses, cars, clothes, everything. They made an incredibly strong commitment to their belief.

When the end did not come, the group did not turn on their leader as a false prophet. Instead, they joined him in praising God for rewarding them for their great faith and saving the world because of them. Talk about reality distortion! These folks decided the world continued to exist because of them; their faith saved the earth. Extreme self-congratulatory thinking to be sure, but it worked. Faced with the possibility that they were a bunch of knuckleheads who fell under some idiot’s spell, they kept their mental balance with perceptual distortions and irrational thinking, and continued to worship their leader. That’s not a recipe for psychological stability.

Festinger’s theory is based on the belief that the human mind strives for consistency and harmony. Our minds don’t like disharmony resulting from contradictory beliefs and actions. We would add that dissonance kicks motivational forces into gear because dissonance arouses fear. Consider our questions raised earlier: the abused woman and bullied kid fear retaliation unless they stay close to the enemy (the old Stockholm Syndrome); Jack fears abandonment and his inability to confront challenges (symbolically, his father); the job hunt brings fear of rejection; dad and the helicopter parent fear they will be seen as parental failures if their kids fail. Fear, fear, fear……….In each case it drives the irrational behavior.

Fear also plays a role in voter behavior. You hate Congress but you see your representative as fantastic, someone who brings your district lots of money. When things go south it is obviously the fault of the other party. Voting for your guy, is safe, familiar, and shows your wisdom. Congress sucks because of those other members, especially those in the opposition party. Hardly logical or critical thinking, but it makes sense to you.

The coping message here is clear: No matter what beliefs and actions we’re talking about, when they appear illogical, inconsistent, and contradictory, they are often servicing some inner conflict based on fear that makes it difficult to take a hard and honest look in the mirror. And that is why you must be vigilant and willing to face inner conflicts that can lead you to reality distortion and irrational thinking. You simply cannot cope effectively if your mind is otherwise engaged in making your perceptions consistent with your beliefs. That house of cards will eventually fall because it is based on avoidance and fear.

This posting is not about an election or about your political persuasion; it is about coping poorly by failing to confront your fears (whatever they may be), including the ones beneath your consciousness. If you run from your fears you are digging yourself a deep psychological hole. If it gets too deep you may not be able to escape. Again and again, our postings try to make these fundamental points.

 

COPING WITH FERTILITY PROBLEMS, PART III

In Parts I and II of this three-part series, we discussed the difficulties Sue and Dave were having in producing a successful pregnancy. In Part II we focused on specific steps that Sue could take to cope with the various emotions she was facing concerning their, so-far, unsuccessful pregnancies. In Part III we want to shift the focus to Dave, and ask what coping steps he can take to deal with the stress he and Sue are facing.

—-Dave must maintain totally open and honest communication with Sue. The golden rule of any relationship is, when difficulties arise, communication, negotiation, compromise and acceptance are absolutely necessary to facing challenges in constructive ways.

—-Dave must likewise share his viewpoints. They must discuss how they feel about various options they can choose, and work toward finding a common ground from which to proceed.

—-Dave must reassure Sue that her welfare is his primary concern; conceiving and delivering a child is secondary in his mind to her well-being.

—-Dave must also realize that it is Sue’s energy and resources that are more proportionally focused in the direction of having children. It can be quite natural for him to feel that he is in a secondary position in the relationship, and potentially no longer the primary love object. If Dave has these feelings he must voice them, and he and Sue must come to the mutual understanding that Sue’s focus on having a child does not mean replacing Dave in her heart.

—-Dave must assure Sue that she is not to blame for their situation. He must make it clear that he understands and finds it quite natural that she may feel some guilt. He must help her examine this guilt and critically challenge it as without foundation.

When lines of communication and cooperation are open and functioning, true sharing can take place between Sue and Dave. Eventually, that sharing will lead to acceptance of many truths. For instance, Sue and Dave must consider that pregnancy may not be in the cards for them, and that adoption is their best option. Perhaps Sue should concentrate on her career. Both she and Dave have successful careers and maybe they should focus on just being happy with each other. Some folks willingly accept that what they don’t have in life is far less important than what they have and appreciate.

Sue and Dave’s situation shows us that stress can lead either to deterioration or enhancement in a relationship. By pulling together as a team and confronting any anger, guilt, jealousy, and anxiety in positive ways, Sue and Dave can become more loving, cooperative, understanding and helpful with one another. Earlier (Blog of 9/16/16) we discussed the distinction between stress management and stress enhancement. Sue and Dave can focus on stress enhancement to produce outcomes that will lead to increased personal and emotional growth. Such focusing is precisely the strategy any of us must pursue when we face coping challenges.

 

 

           

 

 

COPING WITH FERTILITY PROBLEMS, PART II

From a reader responding to Part I: “I can’t imagine asking someone how old their kids are without first asking if they have kids! How insensitive. As for Sue’s dilemma, if you’re not able to get pregnant maybe it’s not meant to be. I know that sounds uncaring, but there is always adoption. People like Sue and Dave would be wonderful parents for some poor kid without a home or family.”

Another comment: “Sue could concentrate on her career. Maybe Sue and Dave should consider just being happy with each other. Would that be acceptance? Remember, it’s not what you don’t have in life that matters. It’s what you have that you should be happy with and appreciate.”

Here are some coping suggestions from your blog hosts:

It seems the easiest way for Sue to cope across situations is probably also the hardest. If she could learn to be direct, people would probably stop offering suggestions or digging too deeply. Being direct would make it easier for her to interact with her immediate family (who do not know about the miscarriages or that she and Dave have been trying to conceive for years).  Sue has never discussed the issue with her parents. She feels as though she is letting them down; she fears they will judge her. Unfortunately, avoiding a problem is not effective coping because avoiding makes problems bigger.

So, step one for Sue is to come clean, especially with her family and close friends. She also needs to make it clear how their comments make her feel: “What you think are helpful suggestions don’t help me at all and really upset me. I know you’re trying to help, but please wait until I ask for it.”

Other situations might not require being so blunt. Humor or canned responses can be helpful. “We are just enjoying hanging with Dave’s sister’s family – plus no diaper duty!” or “You’ve met Dave – I can only handle one child!” Then she gracefully redirects the conversation to something else, such as asking about their family.

Sue can find strength in numbers. There are many support groups for would-be mothers and fathers. A quick Google search yielded 45,200,000 results for “child loss support forum.” Sue can learn that she is not alone in her struggle, which might help to reduce some of her guilt and self-blame.

Sue is Catholic. She is limited in what she can to avoid her Church’s teaching. She can, however, talk with Priests from her own or another Parish. She may find herself surprised at how sensitive they can be, and the spiritual guidance they can offer.

How about Dave? What can he do to help his wife? Again, we would like to hear from our readers. In a week we will post Part III of this issue and include your comments.

 

 

COPING WITH FERTILITY PROBLEMS, PART I

Recently, over dinner with a long-time friend, we got into a discussion about some not-always-obvious double standards. This friend (I’ll call her “Sue”) has been with her husband (we’ll call him “Dave”) for about 12 years. When the relationship became serious and it looked like they were headed down the aisle, people started asking her when he would be popping the question. She would calmly and humorously refer them to her boyfriend, saying, “Guess you should ask Dave.”

Well, they got married and as soon as they returned from their honeymoon, people started asking Sue if they were trying to conceive. “When are you going to start a family?” Dave, on the other hand, rarely got such questions. If he did they were often in the context of his wife’s wishes, e.g., “So, is Sue about ready to start a family?”

Both Dave and Sue worked at full-time jobs. Over the years, both changed jobs and found themselves with work colleagues who knew little about their personal lives. Most of Sue’s new co-workers seemed to assume she had children because she would often get questions like, “How old are your kids?” Dave’s co-workers, on the other hand, tended to ask, “Do you have kids?”

Fast forward to their tenth wedding anniversary; Sue and Dave still have no children. Sue still gets the “How old are your kids?” and now answers that they do not have children. Almost invariably she sees bewildered uncertain looks and hears comments like, “Why not? Don’t you want kids? You’d be such a good mom.” As for Dave, whenever he tells someone they don’t have kids he usually gets a response like, “Oh.”

The different questions posed to Sue and Dave show a clear double-standard. Dave is treated almost as a bystander waiting for Sue to make the decision; Sue gets the direct attack, with questions implying, “No kids yet? What’s wrong with you, honey?”

Even though people may just be trying to make conversation when they ask Sue about kids, she still gets upset over what she considers very personal questions. The fact is she and Dave have been trying to conceive for years. She has endured three first-trimester miscarriages and one intentional termination for health reasons. She can’t even recall all the invasive procedures and home remedies she has pursued in an effort to get pregnant.

Sue’s gynecologist is stymied, and fertility specialists have no answers. The Psychic Network gives vague platitudes. The few friends and relatives in whom she has confided typically do the same, e.g., “It will happen when it’s time.” Others tell their own hardship-turned-success stories, e.g., “Bob and I were trying for like a year and then one day when we weren’t even planning on it – pregnant!” Many offer suggestions, e.g., “What about adoption? My cousin couldn’t get pregnant but then adopted a kid and suddenly she was pregnant too!” “Have you tried [random ‘miracle’ fix]?”

Dave tries to be supportive and sympathetic toward his wife, but the bottom line is that he just doesn’t understand the physical, emotional, and social anguish she suffers. He can’t quite grasp that Sue is wracked by guilt and shame, and is rapidly losing hope.

Sue has stressors coming at her from various directions: Others upset her by prying into her personal life; well-meaning friends and relatives frustrate her with their advice; she has suffered multiple miscarriages; the medical experts have no answers. What can Sue do to cope?

We invite our readers to offer their comments on coping strategies for Sue. We will post them plus our own suggestions.