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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.  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.  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 Studentis 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. 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. In my last blog post, I introduced the term executive functioning, and now I want to take the idea to a more practical level. Many of the kids I work with as a therapist struggle in the area of executive functioning, and they’ve frequently been diagnosed with specific deficits in this area. This might have been done at their school, by a psychologist or medical doctor, or at a learning center. Diagnosis can be a very helpful tool in setting up a plan to make up for any deficits, so every individual can function at the peak of their abilities.
But for adults with Autistic Spectrum Disorders (ASDs) like autism or Asperger’s, deficits in executive functioning are seldom diagnosed. Many of my adult clients don’t even have a formal ASD diagnosis, much less a specific analysis of their strengths and weaknesses. This isn’t because the deficits aren’t there, just because the diagnostic process is less rigorous and available to adults. So, if you’re an adult diagnosed or suspecting that you have an ASD, you might want to do some research into executive functioning as well. A good place to start is by carefully defining any problems you might be having. A step by step, methodical approach can work wonders. And, by taking tiny steps, the problem, which was vague and huge, becomes more manageable and the solution intuitively obvious. As an example, let’s look at a hypothetical engineer named Ed. Ed was never diagnosed with an ASD, but is pretty sure he fits the criteria for Asperger’s based on his problems with social interaction, unusual communication style, and strong interest in computer technology. Ed is very intelligent and has been quite successful professionally. More recently however, Ed has started to struggle with more work related problems and his boss never seems to be satisfied. Imagine that you’re in a situation like Ed’s. How would you deal with this problem? The first step is to consider specifically what the boss has complained about. Replay the conversations in your head and list the issues if you can. Reread your performance reviews, or any other written comments you’ve gotten. Ask a trusted colleague for input. In Ed’s case, he realized that his boss has complained repeatedly because reports have not been completed on time, he’s missed numerous line item deadlines for his main project at work, and he’s often getting to work too late. Clearly, all these issues fall under the category of deficits in time management. By redefining the problem from, “My boss hates me.” to, “I need the work on time management.” Ed can come up with specific, concrete solutions, and so can you. What can you do if you’re dealing with a similar issue? Lots of things:
And, most important, check back on this blog for more posts on managing executive functioning. How can you solve the problems you’re having at work or in your relationships? One solution might be to consider the concept of executive functioning. Executive functioning is a term that comes up frequently in discussions of the characteristics of autism, Autistic Spectrum Disorders (ASDs) and Asperger’s Syndrome. In general, many individuals with an ASD struggle with specific deficits in executive functioning as well. I don’t want to go into the details of measurement of executive functions or review the research on correlations between autism or Asperger’s and executive functioning in this posting, but I do want to introduce the basics.  A good definition of “executive function” can be found in Simon Baron-Cohen’s The Essential Difference (Basic Books, 2003, p. 176). Baron-Cohen defines executive function as “shorthand for the control centers of the brain that allow not just planning but also attention-switching and the inhibition of impulsive action.”  Tony Attwood discusses executive functioning in The Complete Guide to Asperger’s Syndrome (Jessica Kingsley Publishers, 2007, p. 234) and lists “organizational and planning abilities, working memory, inhibition and impulse control, self reflection and self-monitoring, time management and prioritizing, understanding complex or abstract concepts, using new strategies.” Other researchers may classify executive functions differently, but the general concept is the same.
The research on the correlation of executive functioning deficits and autism or Asperger’s can get very complex, due to the difference of ability levels along the autism spectrum, as well as the many measures of specific types of executive functions. It’s not surprising that different studies measuring executive function in individuals with autism get different results. What is clear is that individuals, both those with autism and neurotypicals, can vary in their abilities in each of the different executive functions. What’s probably of more immediate value to those with ASDs, is to individually consider the specific executive functions as Attwood lists them. For individuals who are struggling professionally or in relationships, this can be helpful as a first step in problem solving. Check back on this blog over the next few weeks. Further posts will give some examples and specific suggestions for managing problems with executive functioning. It’s exciting to find researchers focusing on all the strengths that go along with autism and Asperger’s, the enhanced abilities and skills, and not just studying deficits and difficulties. On that topic just this month, there was an interesting study published in the journal Human Brain Mapping.
The study compares autistic and non-autistic individuals’ performance on a standard assessment tool called Raven's Standard Progressive Matrices (RSPM). What’s perhaps most interesting about the study is that the autistic subjects performed better than would have been predicted by the results of their IQ tests, and that the autistic subjects, while as accurate as their non-autistic counterparts, performed the test more rapidly. There were also differences in which areas of the brain were active, indicating that the autistic subjects used more visual processing in their reasoning. Lead author Isabelle Soulières, a post-doctoral fellow at Harvard University who completed the experiment at the Université de Montréal, commented, "Some critics argued that autistics would be unable to complete the RSPM because of its complexity, yet our study shows autistics complete it as efficiently and have a more highly developed perception than non-autistics." Per the test publisher, “Raven’s SPM is a nonverbal assessment tool designed to measure an individual’s ability to perceive and think clearly, make meaning out of confusion, and formulate new concepts when faced with novel information. It has been used world-wide for more than 70 years.” The article, Enhanced visual processing contributes to matrix reasoning in autism, by Isabelle Soulières, Michelle Dawson, Fabienne Samson, Elise B. Barbeau, Chérif P. Sahyoun, Gary E. Strangman, Thomas A. Zeffiro, Laurent Mottron, was published online on 15 Jun 2009. You can find a review at Autism News or read the abstract for the study online. Organization can be a big problem for kids with Asperger’s, autism and ADHD. Executive functioning difficulties can be a factor in all of these diagnoses, making it difficult for children to plan, pay attention, organize details, and manage their time.
I sat down recently with Nancy Chin of Step By Step. Nancy Chin is the developer of the Step By Step program for academic coaching. Nancy works with school age children who are typically very bright, but still struggling in school. Many of her clients have diagnoses of Asperger’s, autism and ADHD. I asked Nancy for her tips on helping kids succeed in the classroom. Nancy described how she often works with young students, those from kindergarten through third grade, directly in the classroom. After consulting with the parents and teachers, and observing her students in class, Nancy works to create detailed instructions for these children. Typically, she would start working only on one goal at a time, for example, dealing with transitions during the school day. With the student, she works to create a check list with all the steps necessary. She also explains that the routine will be the same everyday, something that these students may not realize. An example might be: When the bell rings, put your books back on the shelf, put your pencils in your backpack and get in line with the other children, trying to be in the first half of the line. Although her students are very bright, executive functioning issues mean that it can be difficult for them to figure this out without instruction. She’s found that, too often, the teacher can misunderstand and view the child as being defiant or distracted, when actually they’re just unsure what to do next. Often, with younger students she’ll create a sticker chart, sometimes using tiny prizes to help reward successes. Nancy said that her plan is to set the goals so that the students can be successful, and then to focus on the successes. She stressed that learning these skills can take time, and she likes to start working with children when they’re very young, when it can be easier for them to learn these new skills. Each small success can lead to success in other areas, for example successful transitioning from the playground gets the student to the classroom on time, which can then lead to more time for learning, and greater academic success. After achieving this first goal, Nancy said they’ll move on to another, small goal, for example, completing classroom work. This doesn’t mean that the work is all correct, but just that the student is actually doing it. By setting small goals, and focusing on the successes, the student starts to feel successful, learns how to organize and plan, and often academic performance improves. I think many children could benefit from an approach like this. It’s straightforward and simple, creates a visual plan, which is ideal for many individuals on the Autism Spectrum, and most importantly, allows the student to succeed. Nancy and I also discussed her tips for organizing homework, which I’ll be talking about in a later post.  Zosia Zaks has written a number of insightful and informative pieces on the topics of autism and Asperger’s, and you can find some of her work on the GRASP website, as well as in Autism Asperger’s Digest magazine. Recently, I wrote about her essay on empathy in my blog Social Skills for Kids, which I write to parents of children on the autism spectrum. Her most comprehensive work to date is the book Life and Love: Positive Strategies for Autistic Adults (2006, Autism Asperger Publishing Co.).
Life and Love: Positive Strategies for Autistic Adults is an insider’s guide to many aspects of life on the autism spectrum. Zosia Zaks has a master’s degree in Technical Journalism, and, like many adults with Asperger’s Syndrome, was not diagnosed with Asperger’s until the age of 31. In the first half of the book, entitled, "Life", Zaks takes on concrete and straightforward topics such as the practicalities of managing sensory issues, household chores, shopping, travel and healthcare. From her insider perspective, the author gives step by step instructions and detailed tips for a number of situations, like putting together a sensory emergency kit of items such as sunglasses and headphones, or sample schedules for managing clutter and organizing the home. This is the kind of practical, step-by-step information that will be useful for those who are struggling with the details of daily life. There’s also some brief but concrete and specific advice for attaining career success, including choosing an appropriate job and managing social issues at the office. The second half of the book, entitled, "Love", is where Zaks shows her full range as a writer and the book really comes to life. The "Love" section of the book focuses on relationships, from friendship, to dating, to committed partnerships. Zaks skillfully shifts back and forth from abstract concepts, such as falling in love, to concrete tools like defining acceptable and unacceptable behaviors. The author continues to write in a practical and useful manner, but she discusses more emotional topics, like dealing with conflict, social isolation and the very real differences of life for males and females on the autistic spectrum. There are also sections on internet dating, relationships with non-spectrum partners, and the different levels of friendships. This section also includes extensive materials on how individuals can keep safe while interacting with others, and a discussion of the pros and cons of disclosing an autism diagnosis. I recommend this book to those on the autism spectrum and to those who care about someone on the spectrum. The first half of the book can function as an ongoing, practical reference, almost like an instruction book for adult living. The second half is much more, something to read and consider, and a way to deepen your understanding of relationships, whether you’re on or off the autism spectrum. Check out the latest autism article in the UK’s TimesOnline: Autism genes can add up to genius: Intellectual gifts and certain brain disorders are closely related, by Jonathan Leake. Leake discusses a Cambridge University study by Simon Baron-Cohen which studied mathematicians and their siblings and found a much higher rate of autism among them than in the rest of the population. Baron-Cohen stated, “It seems clear that genes play a significant role in the causes of autism and that those genes are also linked to certain intellectual skills.” This new study seems to agree with some of Baron-Cohen’s earlier work, where he found, “Separate studies have shown that the fathers and grandfathers of children with autism are twice as likely to work in engineering. Science students also have more relatives with autism than those in the humanities.”
In the article, Leake also discusses a study by Patricia Howlin, of the Institute of Psychiatry at King’s College London, which found 39 of 137 people with autism possessed an “exceptional mental skills, such as memory.” Thanks to the Autism Hub blog LeftBrainRightBrain for pointing me in the direction of this article. |
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. Archives
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