Autism Therapy: cognition

I spent the day at an incredible seminar given by Dr. Ross Greene from Harvard. Dr. Greene is an incredible speaker and he goes on tour occasionally. He has also written a book entitled "Explosive Noncompliant Children and Adolescents: Implementing the Collaborative Problem Solving Approach." And, he has a video of his presentation is available from the web site at http://www.ccps.info.

I feel that he has given me the tools to teach my son techniques to overcome any deficiencies that may contribute to behavioral problems. I really want to share a bit of what I learned because I was so impressed by it. This presentation gave me so much hope, because I feel that I was given an early intervention program for the behavioral issues. Older parents will probably have more perspective to offer here, but I thought this was phenomenal. Some of my notes follow.

His plan involves teaching the children empathy and consensus building and problem solving as opposed to training them to behave.

He believes that children who have outbursts are "Delayed in the development of the skills of flexibility/adaptability and frustration tolerance, or have significant difficulty applying these skills where they are most needed."

Therefore, the logical intervention is to "Teach the skills of flexibility and frustration tolerance and reduce the likelihood of explosive outbursts, while maintaining adults as authority figures."

He argues that children/adults who have these problems have a deficiency in one or more of the following pathways: executive skills, language processing skills, emotion regulation skills, cognitive flexibility skills, and social skills.

For example, one of the executive skills is separation of affect which means separating emotions form thinking. The goal of intervention would be to teach the child how to think clearly in the midst of frustration. (As opposed to punishing the child for not thinking clearly in the midst of frustration).

One of the language processing skills is identifying and articulating problems and so you would teach the child how to find words to articulate moods and needs and concerns.

Cognitive flexibility (idea gets stuck in head and won't change) is another deficiency that can be assessed and trained.

He argues that explosive outbursts are highly predictable and that predicting them requires identifying the child's processing limits as well as the triggers.

Compliance is a cognitive skill that not all children are born having.

Parenting these children (and all children) should involve solving the problem together - as opposed to letting the adult dictate the solution or letting the child dictate the solution.

He believes that many outbursts can be avoided by successfully thinking through solutions with the child before the trigger presents itself. For example, if you know that your child freaks out when he has to brush his teeth, you work through a plan with him in advance so that he does not freak out.

Key steps are: 1) empathy, 2) define the problem, 3) invitation to create a solution.

Above all, though, parents must ask themselves if they truly have a concern. If the parent doesn't have a concern to set on the table then there is no need to say no to the child.

If your child has trouble shifting gears, you could help him to identify when a shift is going to be required, anticipate the shift, and do what is necessary to achieve the shift so that he is not always surprised.

Dr. Greene argues that explosive kids are often bad using past problems to resolve similar problems. If the problem is not precisely identical to a problem that they have seen before, they can't apply it. So, you have to teach them how to do cross apply situations. It may take 30 or 40 times, but he believes that you can teach them how to access past solutions.

Or, if the child has cognitive distortions (I am stupid) you can provide disconfirming evidence to refute the distorted cognition.

His philosophy is that "Children do well if they can"

One of his messages is that it is important to teach your child to think and to do it at age 2-3, so that they don't get stuck in 2-3 year old behavioral issues.

"If you teach a child that someone always has to win and someone always has to lose, when does s/he learn the important skills of solving problems in a mutually satisfactory manner (win/win)?"

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