Counteracting Anxiety, Depression, and Social Withdrawal in College

Success for Autism in Higher Education

Researchers investigated possible predictors of first year success for college students diagnosed with autism spectrum disorders.

college success

Eleven freshmen students enrolled at two universities. Each student received specialized supports for ASD at their respective colleges and participated in periodic assessments of social, emotional, and academic functioning. Investigators examined factors related to academic achievement, levels of anxiety and depression, life satisfaction, college adjustment, and social functioning.

Initial results of this ongoing investigation demonstrated:

  • Adjustment to college was negatively correlated with internalizing symptoms (such as anxiety and depression, and social withdrawal). Students with higher levels of internalizing made poorer adjustments to college
  • Students with higher levels of internalizing symptoms also rated themselves lower in terms of life satisfaction
  • Students with higher levels of anxiety and depression at the beginning of college had lower mid-term GPAs
  • Students who reported better adjustments to college had higher GPAs

Anxiety and depression are highly correlated with a number of negative outcomes in the study (such as lower grades, life satisfaction, and social adjustment). Because of this, investigators identified early “screening for and targeting symptoms of anxiety and depression through therapeutic interventions” as critical to supporting college students with ASD.

Students who struggle to adjust in college may experience internalizing symptoms and academic difficulty. So investigators concluded that college students with ASD may also benefit from specialized supports at the beginning of their transition into college.

Lead investigators presented this information as a poster session at the 2010 International Meeting for Autism Research (IMFAR). This was held during the International Society for Autism Research conference in Philadelphia, PA. Information from the session may be found at this link:

https://imfar.confex.com/imfar/2010/webprogram/Paper7332.html

by Dr. Marc Ellison

The Two Types of Reinforcement for Individuals with Aspergers or HFA

Reinforcement in Applied Behavior Analysis (ABA) focuses on the outcome of the behavior and increasing the likelihood of certain behaviors occurring in the future. There are two types of reinforcement: positive reinforcement and negative reinforcement. Positive reinforcement is when a response is followed immediately by the presentation of a stimulus and, as a result, similar responses occur more frequently in the future.

In other words, positive reinforcement means when a behavior has an increased likelihood of occurring again if something is given after it occurs.

reinforcement

An example of positive reinforcement:

You tell a child if he or she cleans up their room, they can play for 30 minutes on the Wii, an activity they enjoy. The likelihood of the individual cleaning up the room is more likely to occur in the future because they received 30 minutes of playing with something they enjoy. In order for reinforcement to work, you need to make sure that what you are giving them is something that they value.

However, let’s change the reinforcement premise–

You instead tell the child if they clean the room you will go the movies. Your child is sensitive to sounds and does not like being around large crowds, so he will be less likely to clean his room even though you think it would be fun. The purpose is to focus on the child’s likes and dislikes to achieve the desired result.

Negative reinforcement is when a response is followed immediately by the removal of a stimulus and, as a result, similar responses occur more frequently in the future. In other words, negative reinforcement means when a behavior has an increased likelihood of occurring again if something is taken away after it occurs.

An example of negative reinforcement:

You are working on having the child be more independent when doing their chores. You provide a checklist of the chores that needs to be done for the day. He or she independently completes two of the chores on the list. You tell them because they independently completed two chores without any reminders, they do not have to do the rest of the chores. In the future, the individual is more likely to independently complete the chores because the rest of the chores were taken away—assuming he does not like any of the chores that were on the list.

If, however, they really like doing laundry and that was a chore on the checklist that you removed, the negative reinforcement will not have the desired effect on behavior.

You need to always keep in mind what the child likes and does not like. You give him or her things or activities that they enjoy and take away things that they do not like to increase the likelihood of the behavior occurring again in the future. If what you are presenting and taking away is not increasing the likelihood of the behavior in the future, then you are not using reinforcement.

by Adriana Sanchez, MA, BCBA

How do you use reinforcement with your child? What types of reinforcements are most effective, in your experience?

Using a Checklist & Self Evaluation to Avoid Behavioral Difficulties

Combo Strategies for Academic Tasks

Since the inception of this blog, we have explored a variety of specific strategies. I encourage all educators and parents to be creative, and mix and match to best meet the individual needs of your child and/or student. In a previous blog, we learned that mini-maps can help to prevent behavioral difficulties related to academic tasks.

Boy doing homework

Often, teachers note that a common antecedent or trigger to behavioral difficulties is the presentation of academic tasks.

The behaviors can range from a verbal protest to a meltdown when students feel overwhelmed by school work. The first question to ask, of course, is what is there about the work that makes the student feel so overwhelmed? Does the page look too busy? Is too much handwriting involved? Are there too many problems? Is it too difficult or too easy?

Behind the Wheel with Autism: A Personal Perspective

Having lived in several different cities, I can attest that it most certainly is not a regional thing: you’ll run into idiot drivers no matter where you live. It isn’t profound at all; many casual conversations begin with a gripe about traffic on the way to someplace or another, or end up there eventually. Driving is a serious source of stress for many, even under the best circumstances. And for people diagnosed with Autism, they are already functioning under decidedly less than the best of circumstances, and the idea of getting behind the wheel can cause anxiety.

I found that I did not have a great deal of difficulty behind the wheel. Having a nice, large, rarely-traveled stretch of land to practice on, and taking as many opportunities to practice, is the first thing I recommend for those who are diagnosed and want to drive. It certainly helped me. After enough practice, it became second-nature.

Contrary to the assumption that driving is the natural enemy of the Autistic because it demands multi-tasking, it really isn’t so difficult as all that. It has a nice and structured set of regulations, and your task is simple: start at one location, and control the vehicle in order to safely reach the next.

Anyone who has ever played a game, whether analog or digital, can tell you that while rules and setup are intimidating at first, once you see how it’s done and try it for yourself, it isn’t as hard as all that.

To the Autistic person who wants to learn to drive but feels rather intimidated, just think of it as a video game.

Hard Skills with Aspergers: Teachable Abilities and Skill Sets in the Workplace

I have often been asked: What is the hardest part of your job? The majority of the time the answer is discovering what skills my clients have to offer to an employer. As an employment specialist I recognize that prospective employers are talking about hard skills.

Employees with special skills wanted - job interview candidates

So, what are hard skills?

Hard skills are teachable abilities or skill sets that can be quantified.

For example: being able to type so many words per minutes, lifting a certain amount of weight, speaking more than one language, and being able to program computers. Hard skills work in conjunction with the soft skills we briefly addressed in previous posts, and will continue to address through this series.

Throughout my experience, something I have become aware of is: For individuals applying for jobs without a lot of past experience, these hard skills are learned through study, training and practice.

Hard skills can be taught and built upon.

So, where do you go when you have minimal experience, but want to work on your hard skills?

Seeking Help For Depression with Aspergers: The Specifics

If you have: lost interest in your usual activities; trouble sleeping, wake up early or sleep all the time; a change in appetite (more or less); withdrawn from people with a down mood (for Aspies it might be sad, irritable or a sense of hopelessness – whatever negative mood or thoughts you recognize), you have what we call major depression.

Depression, Aspergers, Help, Resources

For this, you probably need professional help. Things are not hopeless but being depressed is like looking through dark glasses. While people with Asperger’s are prone to depression because of challenging life experiences, clinical depression is not part of Asperger’s Syndrome and usually responds to treatment. For those struggling with lower level depression, you might still consider therapy to look at ways to make life changes and feel better.

Professional Help

For finding professional help and other resources, Autismsource.org is a gold mine of resources including lists of local therapists in your area.

Online directories:

Psychologists, social workers, psychiatrists, advanced practice registered nurses (APRN), and other specialties all can provide therapy. Individuals should be licensed providers in their states. You can find this information by looking at their websites.

Only psychiatrists, other MDs (medical doctors), and APRNs can provide medication. Medication has been demonstrated to be effective in treating depression. Often a combination of medication and therapy are most useful. The form of therapy most recommended is CBT (cognitive behavioral therapy). MBCT (mindfulness-based cognitive therapy) has been shown to be effective for depression although there isn’t research on it with people on the spectrum. Most therapists specializing in working with those with ASD know how to modify traditional CBT to best work with those on the spectrum.

It can be very challenging, certainly in parts of the US, to find therapists who take insurance.

The prevailing cost of therapy varies widely across the country. Some therapists (usually psychologists) offer sliding scale fees or have some lower fee slots, so it’s worth calling and asking. Clinics generally take insurance but you want to be sure that the therapist is familiar with ASD. The first thing you should do is call the number for patient or customer service on your insurance card and ask for a list of providers (psychologists/psychiatrists/social workers) in your area. This way you can know all the providers near you who are in network with your insurance plan before you call around clinics. In network providers have more affordable rates than out of network providers. It is important to inform yourself about your insurance plan and coverage before you begin the search.

Also, check providers with Medicaid if you have it. Any MD or APRN will know about treating depression with medication. Some therapists who accept Medicaid might be experienced with ASD even if they’re not on a directory for ASD.

Self Care Strategies

Managing the Crushing Blow of Disappointment & Lies

Aspergers101 for the Parent

As neurotypicals, disappointments come early in life. We learn quickly that all we desire is not all that is intended for us. We learn, through a trail of unrealized dreams, to be content with our lot or find another pathway toward our goal(s).

Having a child on the autism spectrum redefines the above lesson. Managing your ASD child’s crushing blow of disappointment comes with a different manual altogether. When it comes to disappointment through deceivers and manipulators…those with an Autism Spectrum Disorder are susceptible to exploitation. ASD is, at its core, a disorder of social functioning and cognition. Just saying old phrases like, “That’s life” or “Pull yourself up by your bootstraps” or “That’s how the ball bounces” makes no sense to them and sets them off into further confusion and strife. Their brain is wired differently so their expectations and heightened sense of right and wrong may bring on pain when the expected turns unexpected. Knowing how to help them is first to understand that your autistic child is wired differently and being lied to will take more than standard sayings to overcome. In other words, like everything else in parenting a child on the autism spectrum, it may take a well thought out talk but you can relieve your child’s mind….and yours by a few steps.

Their brain is wired differently so their expectations and heightened sense of right and wrong may bring on pain when the expected turns unexpected.

-Jennifer Allen

Manage their Expectations

In looking back on raising a son on the autism spectrum, this was and still is an everyday activity. Managing their expectations takes time, communication and preparation. My part as a parent has waned a bit as our son ages, as I am beginning to see how he attempts to prepare himself for daily potential challenges. This preparation begins with a comforting knowledge of facts. Let me give an simplified example but one that you can plug most any upcoming event into. Remember, this is just about managing the small unknown(s). We will get into the larger scenarios later.

Here is the situation: Church is going to be extra crowded on Sunday because it’s Easter Sunday. We then think of the challenging ramifications that overcrowding may bring and discuss solutions.

The Challenges Discussed:

  1. We may not be able to sit in the same pew/area we usually do
  2. There may be louder sounds with more children in the service
  3. It may take us longer to go eat lunch as crowds are larger during Easter Sunday at restaurants

So we go over the potential challenges and discuss the following choices to avoid disappointment, expectations or meltdowns:

The Solutions Discussed:

  1. Let’s leave extra early to get our usual seating -or- would we take the opportunity to sit elsewhere and see what that is like?
  2. With the onset of more crying babies, would you want to use noise-cancelling headsets? Go to foyer if it gets too loud? Other suggestions?
  3. Since it may take longer to get to a restaurant can you set in your mind it might take 30 minutes longer than usual to eat lunch? Would you rather forego crowded Easter Sunday restaurant crowds and eat at home?

The challenge/solution exercise helps to prepare your child for what disappointments might be just ahead. The less amount of surprises the better for a factual mind. This activity prepared our son throughout his young life and now we are starting to see him work through this for himself as an adult. This practice certainly helps prepare for the unexpected but what happens when they are promised something and it’s never delivered. Or a blatant lie is told to them and they keep trusting the source will do as they say but you realize they never will? In other words, how to you explain to the pure believer that the world is corrupt and sometimes people are going to lie to you. Most deal with this topic when their children are very young, but to the parent of a child with Autism it’s ongoing. You know they take everything literally and hidden meaning or ulterior motives is a concept most difficult to grasp. For the autistic brain it’s confusing, painful and sometimes paralyzing.

Using Art to Facilitate Skill Building in College Students with Aspergers

Eszter Kiss is a Provisionally Licensed Counselor employed by the West Virginia Autism Training Center at Marshall University. Kiss presented “Adding Color to Cognitive Behavior Therapy,” at the WV Counseling Association.

The presentation centered on the use of art as a tool to facilitate communication of thoughts and behavior for individuals with ASD.

Specifically, Kiss uses this technique to support college students diagnosed with Asperger’s Disorder.

Resilience

The autism community has long recognized that many living with ASD can better communicate their inner experience through writing or art. For several reasons, an oral expression of their cognitions or emotions can be extremely difficult for those on the spectrum.

College students diagnosed with ASD often need a process through which to express and receive abstract information. Kiss’ presentation highlighted one such process.

Cognitive Behavior Therapy (CBT) is a theoretical mental health counseling process through which this tool was used. CBT should not be attempted by those without advanced training in counseling psychology, or by those without expertise in this specific approach. However, the use of art as a tool to communicate abstract thought and improve life skills can be used by parents and support staff outside a CBT process.

For example, consider the picture at the beginning of this post drawn by a student on the spectrum after Ms. Kiss asked him to provide a visual representation of “resilience.”

The picture of the knight successfully blocking the arrows being shot at him allows a support professional to discuss the following types of issues:

Is Mindfulness Logical for Asperger’s and Depression?

Mediation and Self-Talk

Mindfulness, meditation and self-talk are important ways of helping yourself when you’re depressed, stressed out, anxious or emotional. They’ve been shown to help handle feelings and are actually often used as components of the most helpful forms of therapy, cognitive therapy.

Why is it important to talk about these three techniques, especially for those with Asperger’s?

Two typical traits for those with Asperger’s are black and white thinking and a tendency to ruminate, to stew thinking about something. With black and white thinking, we see things in extremes, all bad or all good. When we’re depressed, that tends to be all bad.

Mindfulness, Meditation, Self-Talk

All bad isn’t realistic; life is always a mix. Things don’t always go wrong. People aren’t always hostile or rejecting. Ruminating means dwelling on something, usually negative when we’re depressed. As we dwell on our thoughts, they tend to become more dramatic, more overwhelming, more conclusive of our negativity. It’s like a downward spiral.

Both black and white thinking and rumination focus on the past, revisiting what has happened, or in the future, anticipating what might happen. We’re rarely in the present. Most often, at this exact moment, nothing too stressful is happening.

The point of mindfulness as an outlook, a way of being, is that it focuses on the present moment – our awareness of what’s happening right now.

Mindfulness exercises include activities that force us to focus on the here and now. Focus can be on attending to our breath, what we hear, bodily sensations, or what we’re doing, like the feelings of washing dishes, the soap on our hands, the feeling of the water, the texture of the plate and glass. This pulls us out of the past and future into the present, which tends to be calmer.

Meditation is a practice for both the body and mind.

When we’re emotionally aroused or stressed, our entire autonomic nervous system is activated. Blood pressure goes up, breathing changes, stress hormones race through our bodies, and every system is affected.

We can be stressed in this way both by what goes on in the moment and by what goes on in our minds – thinking about something can trigger the same physical stress response as being in that moment. Emotionally we’re at a high level of arousal, regardless of what’s happening in the moment. Meditation turns off the stress response, and teaches our bodies what Herbert Benson of Harvard calls the “relaxation response.” Meditation has actually been scientifically proven to structurally change the brain to be more stress-resilient.