My upstate New York family may be getting snowed on, but here in the Bay Area, it's spring, with daffodils and cherry blossoms, and that means it's not too early to starting thinking about summer activities for your kids. There are many summer camp programs and a lot of them are geared toward kids and teens with special needs, like autism, Asperger’s, ADHD or other social or emotional issues. Many of these programs fill up quickly, especially those for older campers and the counselor in training programs, and some camps offer a discount for early sign up. Here is a list of just a few, those I’ve heard about that might be worth checking into for your child. Please do your own research since I’m only reporting what others have told me, I’m not professionally or personally involved in any of them. And, if you are aware of other East Bay programs for the summer, please let me know. I’ll edit the post to include anything else I hear of.
Thanks to the members of email@example.com for your ideas. If you're ever trying to solve a problem and can’t quite come up with the right resource, this group is the place to go. Someone in this group of very helpful people always knows the answers.
Strawberry Canyon Blue Camp's Social Skills camp, on the UC Berkeley campus offers a program for kids with social skills deficits, grades 3 to 12. Younger kids are in groups with a leader, but take part in their activities along with the typical kids from the larger daycamp. For teenagers with special needs, the camp offers a counselor in training program, with focus on social skills as they relate to job skills.
Quest Camps in Alamo offers programs for campers from ages 6 to 18, with special responsibilities and programs for teen campers. They have daily activities, field trips and therapy.
Trails to Success offers their summer camp programs in Orinda. They also have a counselor in training program for teenagers.
Walnut Creek offers a summer therapeutic program through the city parks and recreation. We Care in Concord has also offered an autism summer camp, although I only found online information on the 2009 program. The Easter Seals Kaleidoscope program in Dublin offers an after school program, and I'm told they extend their schedule to longer days over the summer.
Sarah’s Science “This Land Is Your Land” camp is not designed specifically for special needs children, but the science and nature themes may be of interest to many kids. A mom told me that her son with Asperger’s really enjoyed the camp. Older campers can do more challenging projects, and there is a counselor in training program. The camp is located in San Ramon, Berkeley, and Oakland.
Tech Know How offers camps on computers, Legos and game design. Again, this camp is not designed specifically for kids with special needs, but it does match well with the interests of many kids on the spectrum, and a mom reported her child with Asperger's enjoyed it. They have locations throughout the Bay Area.
One of the most troublesome aspects of autism and Asperger’s can be the tendency toward repetitive thoughts, also referred to as stuck thoughts or ruminations. While this trait is probably tied to the ability toward extreme focus that can be such a strength for those on the spectrum, it’s a problem when individuals can’t shift away from thinking about things that are not of their choosing. Often, individuals get caught up in worries, dwelling on past slights from others or their own mistakes or have problems letting go of past traumas.
Frequently, people will refer to this issue with the term “obsession”, but I don’t like to use obsession in this case. Technically, “obsession” as used in the mental health sense refers to stuck images, thoughts or ideas that are a part of Obsessive Compulsive Disorder. Although some individuals with ASDs also have OCD, that’s not always the case.The content of thoughts in OCD also tend to be different than those found with ASDs. (For an excellent article on this, see McDougle, C. J., Kresch, L. E., Goodman, W. K., et al (1995) A case-controlled study of repetitive thoughts and behaviour in adults with autistic disorder and obsessive-compulsive disorder. American Journal of Psychiatry, 152, 772 -777)
An excellent book for self treatment of OCD is Brain Lock: Free Yourself from Obsessive Compulsive Disorder, by Jeffrey M. Schwartz, M. D. Schwartz presents a four step program involving learning to recognize obsessive thoughts, labelling them as a part of OCD, focusing on something else for at least a brief while, and then finally “revaluing” these obsessive thoughts. You can find a clear explanation of these four steps on the website for the Westwood Institute for Anxiety Disorders, Inc.
Neither the book nor the website talk specifically about the autism spectrum and repetitive thoughts, but Brain Lock does have an interesting chapter on the Four Steps and Other Disorders, and states that they can be applied to “almost any behavior you genuinely want to change.” (p. 187) The ideas in this book are certainly worth considering for those on the autism spectrum dealing with this troublesome issue.
Boy Alone is a gripping, honest, and heartbreaking story of a family caught up in trying to raise a severely autistic child in the 1960s and 70s, told from his now adult brother’s perspective. Karl Taro Greenfeld is two years older than his brother Noah, so he barely remembers life without him. Noah, who spoke for a brief period, regressed at age two and his family began a decades long struggle to find answers. It’s a journey many families go through, first that nagging doubt that something is wrong, then searching for a diagnosis that fits, and seeking just the right treatment, one that might lead to a cure, or an improvement, or finally, sometimes, just hoping their child is safe and cared for. Through it all the Greenfelds, like most of these families, struggle to maintain hope in the face of ever multiplying disappointments. Greenfeld documents these experiences in his family with a haunting clarity.
Beyond the story of the family is a more personal memoir about a sibling’s experience. Greenfeld writes honestly from his own perspective, chronicling his childhood confusion, his adolescent resentment, and his adult despair. Through it all, he maintains what one reviewer called a “ruthless honesty”, owning the hard truths that so many books shy away from.
When I work with the siblings of special needs kids, I’m always struck by the idea of “mixed feelings”. Children love their special needs siblings, bond with them regardless of the difficulties, but too often, they’re expected, or expect themselves, to ignore the uglier aspects of the truth, the feelings of loss and grief, the rivalries, anger, embarrassment, and even hatred they may be feeling.
That’s why Boy Alone can be so valuable for parents, older teens and adult siblings. Karl Greenfeld is not the only sibling to struggle with his feelings toward a disabled brother, but he’s one of the few who is able to step back into his childhood emotions, presenting the truth about his feelings and experiences with a raw substance, even decades later. Siblings often feel very alone in what they're going through. This book can help them feel connected.
There’s a great deal of discussion about the proposed changes to the upcoming DSM-V and their characterization of autism and Asperger’s. There's a good chance that Asperger's will be rolled into the general category of Autism Spectrum Disorders. I think for many readers of this post, as well as adult clients I work with, formal diagnosis has never taken place, so the differentiation between the two disorders is really a moot point, aside from how individuals define their own issues.
Lisa Jo Rudy, on About.com has written a number of articles commenting on how this proposed change is more vague than the existing criteria and merges a very broad spectrum of symptoms and behaviors into one even less specific category. I agree with her points about the range of skills and abilities throughout the spectrum, but I think the reality is that we just don’t have enough understanding of the spectrum variations to warrant a precise and meaningful differentiation between what in reality is probably many different forms of an overall autism diagnosis.
For an excellent discussion of the details of this issue, check out the latest Child-Psych blog, where Nestor L. Lopez-Duran, PhD discusses a range of practical and theoretical issues related to this topic. Of particular interest was his discussion of the Yale University Child Study Center criteria differentiating autism from Asperger’s, including differences in speech as well as differing desires for social interaction.
Social skills get more subtle once kids reach high school, and that’s a time when many teens with autism, Asperger’s and ADHD really start to struggle with friends and peer relationships. Often, these kids have gone through the basic social skills training at school or in a social skills group when they were younger. By now, they want nothing more to do with a formal class, but they’re still missing out on some of the more subtle details.
I thought TV episodes might be a useful, fun way to help teens look at social signals. Although the plots of a lot of teen programs are pretty unrealistic, the situations more mature, and the conversations often more adult and introspective than teens really use, the settings are familiar, and the programs are something teens will relate to. They also tend to use body language, but in a bolder, broader way, which can be easier for teens on the spectrum to pick up on. Finally, because these scenes are online, you can watch and rewatch as many times as you want to catch the details, even muting the dialogue to shift focus to the nonverbals.
This week I’m looking at some personal space and nonverbal communication issues as illustrated by the show Glee. You can see these episodes on Hulu.com for free. Note to parents: some of you may object to the more mature themes in this program. I’ll be looking for other shows to comment on as well, but before banning the program, consider if this is something all the other kids at school are watching. Not having seen a popular show can make it hard for kids to fit in. You can watch together, and discuss issues, such as is this scenario realistic, or appropriate, or does this fit with your own values. (If you have a particular show that’s online that you’d like me to analyze, please comment here, or send me an email.)
In Glee, Season 1 Episode 9, Wheels, the show starts with scenes of cheerleading practice. Sitting alone in the bleachers is blonde Quinn, soon to be joined by tall, dark haired Finn. (If you’re new to this show, it might not be obvious from the ways they’re acting that these two are a couple.) Notice the tense body language. As Finn approaches, he doesn’t greet Quinn, he just sits down, at a distance that’s not typical for a dating couple having a one on one conversation. Quinn doesn’t turn to Finn, she doesn’t lean toward him or adjust her body posture, she barely even looks at him. Before anything is said, and without knowing anything about the plot, it’s clear that this pair is not feeling close and connected. Throughout their scene together, Quinn only turns her eyes or occasionally her face to Finn, never her shoulders or the rest of her body, a clear sign of discord between the pair.
Now look at Season 1, Episode 10, Ballad. The show starts with all the students sitting on the bleachers, spaced evenly with almost mathematical precision. (Your teen may not be aware of this spacing rule, but it’s pretty consistent in our culture. People tend to space themselves out fairly evenly, sitting closer to close friends, but not sitting next to strangers unless the space gets more crowded. Think about a movie theater. If it’s almost empty, sitting in adjacent seats is something only friends do. Strangers space themselves out. As the theater fills, it’s not threatening or inappropriate to sit next to strangers.) The exception to the Glee bleacher spacing, which may not be obvious to kids who don’t pick up on social cues, is Quinn and Finn, sitting together as a couple. Finn’s posture isn’t that different than in the previous episode, but now Quinn is leaning into Finn, almost draped on him. Clearly, she is in a different mood than the previous episode. Notice also that the rest of the students are angled slightly toward the center, indicating some cohesion, and friendship alliances can be gauged just by noting who is sitting together. When the teacher asks, “Who knows what a ballad is?” notice how Rachel immediately thrusts up her hand with too much enthusiasm. Can your child glean information about Rachel’s character from this simple action?
Well, I’ve watched about 5 minutes of TV, and written a full post on the details. What details can you and your teen pick up from body language?
Depression and antidepressants are big news this week with Newsweek’s February 9, 2010 story by Sharon Begley, “The Depressing News About Antidepressants: Studies suggest that the popular drugs are no more effective than a placebo. In fact, they may be worse.” (Sharon Begley also wrote the book Train Your Mind, Change Your Brain, which I discussed in an earlier post.)The article goes on to explain the placebo effect, and what analysis of numerous studies on antidepressants, both those published and not published are showing about the effect of the drugs, and the often superior results of psychotherapy.
Depression is a concern for many on the Autism Spectrum, with almost a third of individuals with autism and Asperger’s also dealing with depression. (Mohammad Ghaziuddin’s Mental Health Aspects of Autism and Asperger Syndrome has a good review on this topic if you’re looking for details.) Social isolation, difficulty managing relationships, chronic stress from sensory issues, and practical matters like underemployment can all be contributing factors. For more info, you can find an earlier article I wrote on "Depression with Asperger's Syndrome and Autism".
Dr. Michael Yapko, a Clinical Psychologist and MFT, has published and spoken extensively on the ideas that depression is the result of many lifestyle and social choices and curing depression does not come from a pill. He is the author of Depression Is Contagious, which I haven’t yet read, but it’s in my stack of books. You can hear an interview of Dr. Yapko, where he discusses his book and theories on the importance of social connections and good problem solving skills in managing depression.
Please note: If you’re currently taking antidepressants and these articles are concerning to you, don’t just stop taking them. Please talk to your prescribing physician. It can be very dangerous to stop taking any prescribed medication, or to alter the dose, and any changes to medications should be made under a doctor’s supervision.
I’ve written on several occasions about Stanley Greenspan, M.D. and the DIR® Floortime™ program. I really like this program for several reasons. DIR® Floortime™ can be done by parents, in the home, it doesn’t have to preclude the use of other therapies, such as ABA, and it is very much a social and relational based model, which makes sense to me as a psychotherapist. Of equal value, parents can get started pretty quickly, by reading books, joining an online group, or taking courses, even if they’re waiting for a diagnosis, or in a long line waiting for services. If money is tight, parents can get training relatively inexpensively, and get started without a huge investment. The model helps parents learn to interact with their children in a more engaging manner, taking the child’s developmental level into account and gently helping the child to progress. For parents hoping to enhance their child's social skills, DIR® Floortime™ can be a great place to start.
Stanley Greenspan, M. D. is presenting the Basic Course on the DIR® Floortime™ Model online for parents and professionals, starting on March 12, 2010. I took this online course a few years ago, and really appreciated the ability to take it from home, review the materials as many times as I wanted, and the chance to see Dr. Greenspan in action with children, as well as the relatively low cost. There are also a few workshops being offers, A Lifespan Approach to Autism, Meltdowns, and Regulatory Sensory Processing Disorders.
Patricia Robinson MFT
I'm a licensed therapist in Danville, California and a coach for Asperger's and ADHD nationwide. I work with individuals of all ages who have special needs, like Autism Spectrum Disorders, ADD, ADHD, and the family members and partners of special needs individuals.