Thrive On the Autism Spectrum

Adult ADHD Group in Albany, California

The Center of Attention and Learning, in Albany, California, offers ADHD coaching, Executive Function support, and Educational Therapy. The Center, founded last year by Educational Therapist Linda Lawton, is now offering their first working group for adults with ADHD. The group will meet three times per month, and each month will focus on a different issue, starting with procrastination.

Group coaching is an excellent way to get both professional and peer support, and it is more cost effective than individual treatment. If you’re interested in more information, visit the Center’s website, or their Working Group information page.

And, for Middle School and High School Students, check out the Center’s Supervised Study Hall. Author's note: 2/13/12, the Supervised Study Hall is no longer offered, but I will be posting about a new program soon. 

Now's the Time To Pay Attention!

School started a few weeks ago, the novelty is wearing off, and routines are setting in. Although it’s tempting to just settle in and let things run their course, now is really the perfect time to look closely at what’s going well and to uncover those little problems that might get bigger. This is true for all students, from kindergarteners to university students. Little, developing problems are easier to solve and there’s still plenty of time to make up for any lower grades. Habits haven’t set in too much yet and it’s easy to create new routines.

First, it’s important to think about what went well last year, and what you’d like to change this year. Did missing assignments snowball into low grades? Did you get overinvolved as a parent, not allowing your child to develop independent skills? Did you forget to factor in time for social connections with other students?

Second, look closely at how that aspect is going this year. Are you just starting to see one or two missing assignments? Are you jumping in a bit to nag, (help) your child? Are you ducking into the library at lunchtime?

Third, look for those tiny changes you can make to improve the situation. The best results often come from rules or systems. Can you start checking the school website every evening before going to bed, and make sure you’ve completed, and packed up, all your assignments? Can you set up a check list for your child, and then let her be responsible for her own work? Can you promise yourself that just once a week, you’ll take the risk and eat lunch with someone else?

Remember, the earlier in the year you try making changes, the bigger the impact of those changes.

Book Review: Smart but Scattered

Smart but Scattered, by Peg Dawson, EdD, and Richard Guare, PhD, is one of the reasons I combined my two blogs into one. Social Skills For Kids was aimed at parents of children with ASDs and ADHD and Coach for Asperger’s was aimed at adults with these conditions. But, often, resources work for both kids and adults, even when they’re aimed at one or the other, which is why I’m now writing this combined blog. For individuals of all ages, with Asperger's, ADHD, autism, an autism Spectrum disorder, or a combination, executive function can be a real problem.

Smart but Scattered calls itself “the revolutionary ‘Executive Skills’ approach to helping kids reach their potential”, and that the real benefit of this book. Executive function has been discussed a lot recently, and many people understand that deficits in executive functioning can impact all types of achievement. Smart but Scattered takes that rather abstract idea and brings it to a concrete, example and solution packed level.

The book details what the authors consider the 11 skills that make up executive function: response inhibition, working memory, emotional control, sustained attention, task initiation, planning and prioritization, organization, time management, goal-directed persistence, flexibility and metacognition. As an engineer, I learned that any time you can break a problem down into small parts, it’s much easier to solve. This list is probably the best breakdown of the executive skills that I’ve seen in a book for kids or adults.

From my work with clients, I know that individuals struggle with different aspects of these executive skills, and that most people are pretty good at figuring out just where their problems are once they’re given a list like this. Sometimes it takes a bit of coaching, or detailed questions, but generally, both adults and teens can figure out their deficits. Parents usually know their own kids well enough to figure out where they’re struggling as well. Smart but Scattered takes a developmental approach to these skills which I find less practical, since growth at all levels can continue for a lifetime. But, the specific examples and definitions are helpful, and there are questionnaires for different ages, including adults.

The second half of the book lists plans for tackling specific tasks. It seems like parents could just as easily make up their own, more applicable plans, but for adults who struggle, these might be very helpful. Basic skills like cleaning a room or managing open ended tasks are not that easy without strong executive skills and these lists can be helpful. (For other detailed plans for adults, you can refer to Life and Love: Positive Strategies for Autistic Adults, by Zosia Zaks, as reviewed in a previous post.) Overall, Smart but Scattered is an easy read, filled with lists, table and charts to make it straightforward, and it could be very useful for parents, teens and adults.

The Alert Program

The Alert Program for self regulation is a wonderful tool for kids (and adults) who struggle with managing their own level of attention. Throughout the day, kids are expected to adjust to the school schedule. They have to jump into the morning bright and attentive, while still sitting quietly and listening to the teacher, then move into socializing at recess, then sit right back down, up and down, all day long. And the demands don’t end with the school day. Kids today have homework, classes, practices and activities. The pace alone can make it hard for any kid to manage, and it’s especially difficult for those kids with ADHD. (A lot of kids on the autism spectrum fall into this category as well, even if they don’t have an official ADHD diagnosis.

The Alert Program was developed by Mary Sue Williams, OTR/L and Sherry Shellenberger, OTR/L to bring together ideas from sensory integration and present them in a way that’s concrete and easy for children to utilize. It was developed for kids, but has been adapted for teens and adults, and I find it useful for almost any age client.

You can learn more about the Alert program from their website, or the book “How Does Your Engine Run?” : A Leader’s Guide to the Alert Program for Self-Regulation.

Get That Final Paper Written

Now is the time of the school year when those big assignments loom in front of high school and college students. For those who struggle with executive function, such as individuals with Asperger’s, autism or ADHD,  getting the paper written can be especially daunting. Here are a few tips to get the assignment written. Depending on what’s keeping you from completing, or starting, the work, you may want to try just one tip, or all of them.

Organize Your Ideas

Putting things on paper can make your thoughts clearer. Don’t turn this into a big additional project! Grab a scrap of paper and a pencil, and jot down phrases.

Change How You’re Working

Typing and handwriting utilize the brain differently. If you’re stuck in one mode, try switching to the other. Even a different pen, color of paper, or new font can help rejuvenate your work.

Change Your Sensory Inputs

Your surroundings can impact how well you can focus. Sometimes music can distract you just enough that your brain focuses a bit better. Or, try chewing gum or drinking water. A quiet bedroom may be too quiet, and too easy to fall asleep in. Move to the family room, the student lounge or a coffee shop.

Explain Your Paper

Find someone to discuss your paper with. This can be a classmate working on a similar topic, or even a friend who knows nothing about your material. Putting ideas into actual spoken words can be an effective means of getting them in order.

Start with a Shorter Version

Long papers can be intimidating. Just remember that even a PhD thesis is only a group of pages, written one page at a time. If the assignment is for a 20 page paper, try starting with a 5 page paper. As you work on it, new ideas will come to you and the momentum will keep things going.

Another way to do this is to consider your long paper as a series of shorter papers. Devote a few pages to each idea and then put them together.

Start in the Middle

That first line can be the most intimidating of the whole project. You want it to grab attention, hook the reader. That can be a tough challenge when your ideas are still taking shape. So, put off that first line. Remember that you don’t have to write the paper in order. Of course you’re going to read it through to link your ideas and explain things clearly. If it’s easier to start in the middle, that’s fine.

Start With a Rough Draft

Managing spelling, vocabulary, grammar, writing sentences, organizing paragraphs and putting the whole project together into a brilliant composition is a lot to do a one time. It may be easier to break that down into single steps. Organize your ideas, then write the sentences, then tweak the paragraph structure, then punch up the vocabulary. Do a final check for spelling and grammar. Different parts of your brain are called into play in each task so breaking the job up can be more effective.

Just Do It

Finally, the best way to get that paper done is to just start it. Stop reading, stop researching, stop surfing the internet, definitely stop the video games, and just start writing. Right now!

Getting the Job Done: Creating a Visual Plan

As I discussed in my previous post on managing procrastination and distraction, getting lost in the details can make it very difficult for anyone to finish, or even start, a project. For those with ASDs or ADHD, this can be even more troublesome. One technique I’ve found to be useful for many clients is to create some sort of visual plan of the project. Taking time to think about the goal, organizing the details, and jotting it down on paper will give you something to refer back to while working.

Here’s an example of a simple outline you might use to stay on track while completing a project. I’ve chosen the topic I’m working on right now: writing this post. (I’m typing this for the blog, but I’d only scribble it down in real life.)

Goal: Writing a Blog Post on Procrastination and Distraction

                    1. Reread previous post on this topic
                    2. Consider steps involved
                    3. Create examples:

                    A. Detailed list
                    B. Detail cloud

                     4. Find appropriate pictures to illustrate

                    A. Dog
                    B. Snack

                     5. Copy and paste document into blogging software
                     6. Create links and finalize details on blog
                     7. Publish

Here’s an example of a less structured detail list. You can make the more important steps larger and bolder.

Goal: Writing a Blog Post on Procrastination and Distraction

                    Find Pictures                                     Reread previous post
                                          Create examples   

                                                Publish                 Create links

                    Copy and paste into blogging software           Plan steps involved

               

That’s it! These are both pretty straightforward and it only took a minute or two to put them together. Now, while you’re working you’ve got a very clear idea of what you should be doing to accomplish the job.

If you decide to pet the dog:

or get a snack:

it’s pretty clear that you’re off topic. But, I think it’s more frequent that people get pulled into the details, and then wander around off topic. Finding a picture of an apple can turn into sorting through all the pictures in the photo library, or wandering from topic to topic in an internet search. That’s where the list helps. You’ve determined the goal: writing a post, and browsing internet photos has nothing to do with that. It’s a clear example of when you need to pull yourself back to work.

If you’re more auditory than visual, recording a list can be helpful. Whatever works for you is fine, just take a few moments to plan, set a goal, and then check back with your plan frequently.

Getting the Job Done

Many of my clients on the autism/Asperger’s spectrum really struggle with productivity and distraction and the seemingly simple matter of getting things done. Although this is an issue for neurotypicals as well, I find that distraction and procrastination can be a lot more challenging for those on the spectrum.

Frequently, procrastination and distraction can occur when people get caught up in details and lose sight of the big picture.That’s not surprising really, because one of the key traits of both autism and Asperger’s can be, as stated in the DSM IV, a “persistent preoccupation with parts of objects.” Uta Frith refers to this “detail focus” as Weak Central Coherence. While a detail focus can result in amazing achievement and the ability to work creatively and deeply, at the same time, it can lead to lots of activity with little output. Generally, work output does require the leap from detailed focus to a more general viewpoint. Sometimes individuals can afford to take the time to study, learn, delve deeply into an idea and see where the material leads them. But often, this drifting, detailed investigation can be nothing but a waste of time.

So, how do you move from the details to the big picture? With many of my clients I try to take advantage of their strength in visual processing. Create a graphic image of the project, listing all the details. Headline this image of details with a title explaining how all these terms relate. That headline is usually the big picture.The details can be organized in different ways, depending on how you think. If you’re logical and structured try creating a numbered, indented outline, with small details organized into bigger topics. If you’re more artistic than mathematical, a “detail cloud” may be more meaningful. This is similar to those keyword clouds that sometimes appear on the sidebar of blogs.

Whatever you create to explain your project, put it clearly on a piece of paper where you can see it at a glance. Ask yourself frequently, “How does what I'm doing relate to what I'm trying to produce?” and “What am I trying to produce here?” Confused? An example can mean a lot more than an explanation, so please check back for the next blog posting where I'll show some examples of these techniques.

Book Review: ADD-Friendly Ways to Organize Your Life

Adults with ADHD really struggle with managing the daily aspects of their lives. Those with Asperger’s and ASDs often have issues with ADHD or executive functioning as well. For all these individuals, the tips and strategies in ADD-Friendly Ways To Organize Your Life, by Judith Kolberg and Kathleen Nadeau, Ph.D. (Taylor & Francis Group, 2002) may be useful.

The book attempts to provide strategies, accompanied by what the authors term support and structures, to manage various organizational issues every adult faces. The premise of this book is that those with ADHD may not do well with the intense, detailed organizing ideas presented in many other organizing books, but that simple structures, accompanied by support from friends, family and professionals, can result in effective changes.

The book is broken down into chapters for those who are troubled with different aspects of disorganization, such as overcommitment, waiting until the last minute, dealing with clutter, and managing bills and money. For each area, a simple plan of organization is offered, although it’s probably not a lot different than that of many other systems. The ADHD twist of this book is then in adding support in the form of assistance from friends, family or professionals. Although this could be useful, it may be unrealistic to expect a friend to sit by supportively watching as an adult sorts through monthly paperwork. I wish the book had focused more on helping adults grow and shift from using the support of others to developing independent ways of functioning in the long term.

Still, in spite of these shortcomings, the book does offer many useful tips. I especially like the limit setting tips, such as for every item or activity you add to your life, first you need to subtract one item or activity that you already have. In the chapter on prioritizing, the advice calls for limiting the to do list to 5 items only, and each should be done today.

The authors also are quite clever in utilizing the creative strengths of those with ADHD. Their “muttering” filing system uses file labels such as “Why can’t I find this when I need it?” and “I have got to call these people!” They suggest cleaning the garage to organize it in the same way a hardware store would be organized.

Like most organizing systems, adults with ADHD will not find all the solutions in one place, but they may find a number of useful tips.

Book Review: The Organized Student

Disorganization is one of the hallmarks of Attention Deficit/Hyperactivity Disorder and it’s often a key feature of autism, Asperger’s and Autistic Spectrum Disorders (ASDs). But, the good news is that disorganization is one of those issues that can be managed with relative ease. The goal isn’t to turn your child into a filing, cleaning, organizing wunderkind, but instead to teach some systems to help your student develop a level of organization that allows for school success. A great resource for this is The Organized Student: Teaching Children the Skills for Success in School and Beyond, by Donna Goldberg with Jennifer Zwiebel. (Simon and Schuster, 2005)

Although individuals with ASDs may be terribly disorganized, this weakness is frequently offset by strengths in analyzing and what Simon Baron-Cohen terms “systemizing”. The Organized Student is set up in a way that takes advantage of your child’s innate abilities and problem solving skills to develop customized, personal systems for organizing at home and at school. Goldberg runs through the specifics of organizing lockers, backpacks, desktops and all those papers that come home. The strength of the book is the immense detail Goldberg goes into, while at the same time not setting up “one size fits all” solutions. She respects her students needs to have a system that works with their own abilities and that feels appropriate to each individual.

Many of the students I’ve worked with intend to start each new school year off right, organized and structured. But without a strong yet flexible system, the best intentions don’t work, and the students are lost in a sea of papers by October. If this describes your child, it might make sense to pick up this book now. Pay attention to each new teacher’s organizing requirements, adapt the book’s suggestions to fit your child’s own needs, and start the new school year off right.

Dealing with Time Management

Running late? Many people struggle with time management, and they’re always running late. Missing appointments, late for work, racing to get to the meeting on time. Time management is a part of executive function, something that many people struggle with. It can be especially troublesome for individuals with Autistic Spectrum Disorders (ASDs) like autism or Asperger’s, or ADHD.

How can you improve your time management and be on time? Here are some simple tips, tailored especially for individuals with ASDs or ADHD, but anyone can use them.

1. What time is it?

It may seem obvious, but many people don’t know what time it is. If you’re always late, you’ve got to wear a watch, carry a cell phone with a clock, carry a pocket watch, have clocks in your home and office and get an alarm clock. And they have to be accurate, so go online and check to make sure every clock shows an accurate time.

2. What specific problem are you working on?

It’s always best to solve one problem at a time. When is being late most troublesome? Let’s focus on that one situation. I’ll use getting to work on time as an example.

3. A routine can be quicker.

Time management is easiest if you do the same things every day, in the same order. I know that I’m most efficient if I make espresso first, then cut up a bowl of fruit, then heat the milk for my morning latte. If I do the steps out of order I have to think about them more, I’m less efficient and it takes me more time.

4. Step by step

Think about all the steps involved in your morning routine. Waking up, getting dressed, eating breakfast, your commute. You may need to be more specific. Waking up may include the alarm going off, hitting the snooze button, dozing for just nine more minutes, and then getting up for real. The more detailed your steps, the better your results, so think about this in detail.

5. Create a timed list.

Take all these steps in your morning routine and list them in order. Then estimate how long each step will take. Many individuals with time management issues have a real problem here. Some people just don’t have a strong internal clock. What seems like five minutes turns out to be 20, something that should take half an hour seems to drag on all afternoon. This timed list will help you calibrate your internal ideas of time, and discover the truth about your actual morning routine. So don’t worry too much about accuracy at this point, just make your best guess of how long each step takes.

6. Test it out.

Tomorrow, see how accurate your list really is. Carry it with you throughout the morning. Carry a watch as well. Keep checking with your list, noting which step you’re on, and the time. Are there any steps you missed? Don’t spend time analyzing your list right now, just try to record what you doing and what time it is.

7. Fine tune your routine.

The morning rush is over, you completed the day’s work and you have some free time. Now is the time to analyze how accurate your time estimates were. Did it take as long to get dressed as you expected? You might want to repeat this exercise several to improve your accuracy.

8. Work backwards.

What time do you have to be at work? Start there, at the end of your list. Working backward, and using the amounts of time it take to accomplish each task, you can figure out what time you need to start your morning routine.

9. Leave some room for error.

The truth is, there’s a lot of unpredictability in some schedules, especially when you’re not in control, like during your morning commute. Most prompt people are actually a bit early much of the time. You need to consider if you absolutely need to be on time, or if it’s OK to be a bit late on those days the traffic is especially heavy, or if your dog is sick, or you knock over the carton of juice. The more trouble it is to be late, the more you’re going to have to accept getting there early most of the time.

That’s it. Give your new routine a bit of time to fine tune it and see how it’s working and then move on to your next time related issue. The more you work in this way, the better you’ll get at estimating how long things take, and the better you’ll be at being on time.