Contents:
- Occupational Therapy
- Cognitive Behavioural Therapy
- Social Stories (Carol Gray)
See also:
1. Occupational Therapy
Buny (a mother of an AC child) on the newsgroup posted this explanation of what kind of work the occupational therapist does with her son:
She is working on strengthening up his fingers, hands, arms, and shoulders. With his sensory integration disorder (mainly tactile) and auditory-defensive, he did not play with play-doh, fingerpaints, mud pies etc., that most toddlers played with. This caused him to have "low motor tone' in these areas, and it affects his handwriting. Stengthening these up, through various exercises (most are in the form of games that use small motor skills), ensure that writing will not be as tiresome or "painful" as has been observed by teachers. Not to mention more legible...
Speaking of tactile-defensivness, she helps with that. There are therapies that help with "desensitizing" hypersensitive skin nerves endings. One of his favorites is to be brushed. We use a surgical scrubbrush, to brush along his arms, legs, back, face-wherever he can tolerate it. I have discovered that, for him, long strokes back and forth (without raising the brush at the end of a pass--just changing directions) works best.
Other sensory input therapies for him include:
- Swaddling--wrapping him up tightly, as we did when he was a baby
- Rolling a big ball along his whole body as he lies on the floor - along the front as well as the back
- Getting a couple of big "floor pillows" and making a "kid sandwhich" with him in the middle of the two pillows
All of these seem to be working to allow him to tolerate people "in his space"(which is bigger than the NT's "personal comfort zone"), as well as tolerate hugs, and other touches."
More information at: Sensory Integration Dysfunction
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2. Cognitive Behavioural Therapy
It is probably true to say that the majority of forms of psychotherapy are not successful with ACs and this is particularly true of psychoanalysis.
However, it is claimed that Cognitive Behavioural Psychotherapy can be useful to some, particularly "High Functioning" individuals with anxiety problems, although the support for this belief is largely anecdotal. At present there does not seem to have been any work to assess the effectiveness of CBT in helping those with Aspergers/HFA.
What is generally agreed within the Autism community is that (with the exception of a few very rare and talented individuals), any form of therapy, including CBT, needs to be done by a practitioner who is specifically trained and well experienced in Autism/Asperger's.
A psychologist friend of mine (Laura) explains the standard definition of Cognitive Behavioural Therapy. [Note the emphasis on anxiety being caused by either irrational beliefs or a negative world-view. Anxiety in ACs is almost invariably caused by sensory integration difficulties and by the stress of trying to "Pretend to be Normal"]:
The central tenet of cognitive behaviorism is that thoughts ("cognitions") are the most important causes of behavior. It is our thoughts, more than any external stimuli that elicit, reward, and punish our actions and thereby control them. Hence if we wish to change a pattern of behavior, we must change the pattern of thoughts underlying it [Note: Problematic if it is that very "pattern of thoughts" that is enabling the AC to function in NT society]. To this end, the cognitive behaviorists have developed a variety of techniques intended to increase coping skills, to develop problem solving, and to change the way people perceive and interpret the world.
Cognitive restructuring involves either Rational Emotive Therapy (Ellis), Cognitive Therapy (Beck) or Self-Instructional Training (Meichenbaum). RET's basic contention is that emotional disturbances are the result not of objective
events but of irrational beliefs [Note: no allowance here for neurology] that guide the interpretation of those events; e.g. it is not failure that causes depression but rather failure filtered through the belief that one should be thoroughly competent, adequate, intelligent, and achieving in all possible respects. To combat such beliefs, the irrationality of the client's thinking is bluntly pointed out, and more realistic evaluations of the client's situation are modeled. They instruct the client to monitor and correct his or her thoughts, rehearse the client in appraising situations realistically and give homework so that new ways of interpreting experience can be strengthened [Note: ACs have difficulty generalising, which would be a big problem here].
Similar in theory if not in tone is Beck's cognitive therapy. Like Ellis, Beck holds that emotional disorders are caused primarily by irrational thoughts [Note: not brain chemistry]. In his view, this disturbance is the result of a "cognitive triad" of
1. self devaluation
2. a negative view of life experiences
3. a pessimistic view of the furture.
To change such cognitions, Beck adopts a less didactic approach than Ellis, questioning patients in such a way that they themselves gradually discover the inappropriateness of their thoughts.
Self instructional training instead concentrates on "self talk" and simply try to change it in such a way that instead of defeating the person, it helps her cope wtih the threatening situations. They voice the self-sentences and then "answer back" in a more constructive way.
The difference from other therapies within psychoanalysis called "insight therapies" is that the behavioral techniques do not delve into the reasons for these cognitions, they just attempt to change them.
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3. Social Stories (Carol Gray)
Carol Gray has developed a technique known as "Social Stories" for helping autistic people learn about social behaviour, based on the ancient idea of telling illustrative stories. Her ideas are in her book of the same name, "Social Stories", and she also gives lectures and has a website.
There is an anecdote from one of her lectures, reported by a group member: Becky and the Plant Sprayer
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