Tuesday, November 23, 2010

Techniques To Use When Working With Individuals With Autism

Autism has been difficult for most to understand. It is my belief that all the information that one needs to know is available to understand the phenomenon of autism. It is my belief that individuals with autism cannot reach their potential because those who are working with them do not understand the cause or etiology of autism. Once autism is understood we will see these children grow beyond our wildest dreams. It is my belief that the individual with autism has not benefited from an attachment. I call this an incomplete attachment. Our job is to help the individual to complete the attachment process. Some suggestions on what one might do are recommended below. These ideas are based on Attachment Relational Therapy:

1) First you need to accept that it will be difficult and it will be up to you to encourage the attachment. The child/adolescent cannot be responsible for the awakening of the attachment although the child is ready to complete the attachment process;

2) You will need to go into the child's world (know the particular child) versus demanding that they accept your world. This is an ongoing part of the therapy;

3) Let your client take the lead. In other words, let the client determine what will happen in therapy even though it does not make sense to you;

4) Use every moment with the child to attach;

5) It may not look like the child is attaching;

6) Do not give up on the child;

7) Always talk with the child as if they understand you and hold onto the belief that they can develop.

8) Use projection as a means of communication. This process works with verbal children. Use videos, art projects, toys, play dough, doll house, puppets, etc. to allow the child/adolescent to talk about the other. This technique works because the person with autism cannot be direct and talk by representing himself, but he can talk about what he sees outside of himself. Thus what he sees on the outside of himself is really what is going on inside of him;

9) It is important to fill in the gaps for the autistic child. They live in a unsymbolized world. When you are working with him always speak of what is going on and leave space for an answer from him to respond even if you know he may not respond. This teaches him about interaction (Floortime is based on this same concept);

10) Always act as if there is a person that cannot interact with you, but wants to interact. You might want to say "Is there something you want to tell me?" I would do this even with children who use echolalia or are nonverbal;

11) Theory of mind - the child seems to lack the ability to know that the other has feelings and to also express their own feelings. It is not that the child lacks theory of mind, but instead he is dissociated and thus cannot access and communicate what is on his mind. As mentioned previously, use projective techniques to get the child to talk about feelings;

12) The job of the therapist is to recognize the child. This is done by demonstrating to the child that you can "see" him/her;

13) The job of the child is to "remember" that they exist. This will occur through the relationship between the caregiver/therapist and the child. Our job is to help the child to become conscious of himself especially in relationship to others; and finally

14) Do not give up. The child's development is dependent on you to understand his dilemma and to help him to attach.

Karen Savlov is a psychoanalyst and Marriage and Family Therapist with a private practice in West Los Angeles, California. My specialty is Autism Spectrum Disorders, anger, dissociation, depression, anxiety and relationships. For new and creative ways to think about autism read and follow my blog at http://www.wonderingaboutautism.blogspot.com. I can also be followed on Twitter at Autism Thoughts.

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