Emotional Development and Autism

1. Emotional Development and Autism It is real, it is ongoing, and it controls the adaptive response in the child. Do not use or distribute without written permission.

2. Emotional self-regulation • Ability to respond to the ongoing demands of experience with a range of emotions • Socially tolerable and sufficiently flexible to permit spontaneous reactions • Ability to delay spontaneous reactions as needed. • Also defined as extrinsic and intrinsic processes responsible for monitoring, evaluating, and modifying emotional reactions. Do not use or distribute without written permission.

3. Emotional Self- Regulation • Complex process involves: • Initiating, inhibiting, or modulating one's state or behavior in a given situation • The subjective experience of: • Feelings • Cognitive responses (thoughts) • Emotion-related physiological responses (for example heart rate or hormonal activity) • Emotion-related behavior (bodily actions or expressions). Do not use or distribute without written permission.

4. Emotional Regulation • Also refer to processes such as: • The tendency to focus one's attention to a task • The ability to suppress inappropriate behavior under instruction. • Emotional regulation is a highly significant function in the life of a child on the Autism Spectrum. Do not use or distribute without written permission.

5. Behavior • Range of actions and mannerisms made by organisms, systems, or artificial entities in conjunction with their environment • Response of the system or organism to various stimuli or inputs, whether internal or external, conscious or subconscious, overt or covert, and voluntary or involuntary. • What we can see of a child in a certain situation and not what is underlying the situation • Behavior is the child’s communication to us about how he/she feels about a situation. Do not use or distribute without written permission.

6. Discipline • A systematic instruction intended to train a person, sometimes literally called a disciple, in a craft, trade or other activity, or to follow a particular code of conduct or "order". • Often, the phrase "to discipline" carries a negative connotation. • This is because enforcement of order–that is, ensuring instructions are carried out–is often regulated through punishment.” Do not use or distribute without written permission.

7. Dr. T. Berry Brazelton ( Touchpoints 0-3, page 41) • Discipline means teaching, not to be confused with punishment. • Discipline is aimed at the goal of self discipline. • The goal is to teach the child to stop himself. • A child who can recognize and can act on his/her own limits is already a secure child. • Children learn most about self control from modeling on their parent’s behavior. • A child needs limits and nurturance; neither one alone is sufficient for a child to grow. Do not use or distribute without written permission.

8. Influence of Past Experience • We are now the sum total of our past experiences • Each new event is compared with events from the past • These comparisons are mostly limbic – emotional in nature • Assists us in feeling either secure to move forward or insecure and we need to flee or fight or freeze • Children on the spectrum have amazing long term memories and these memories are retrieved when they encounter experiences that remind them of similar occasions before. This allows them to pre-anticipate their future experiences and enact the possibility of fight and flight before the activity has even started. Do not use or distribute without written permission.

9. Dr. Joseph LeDoux • A mind is not, as cognitive science has traditionally suggested, just a thinking device. • It’s an integrated system that includes, in the broadest possible terms, synaptic networks devoted to cognitive, emotional, and motivational functions. • More important, it involves interactions between networks involved in different aspects of mental life.” Do not use or distribute without written permission.

10. Intrinsic and Extrinsic Motivation • Extrinsic would be our “reward chart” , the positive and negative consequences that we can figure out with our cognitive brain that might be motivating or de-motivating for a child. • Intrinsic motivation is the child’s own inner drive to want to adapt responsibly by their own expectance of their own behavior, not driven by someone else. Do not use or distribute without written permission.

11. Gaining Longer Term Effect • Long term success would be far more feasible if we could facilitate the child’s own resources of intrinsic motivation combined with feeling successful in using what he has. • Extrinsic motivation depends largely on the innovation of the adult and it can only take us so far. • The child’s inner drive to change his adaptive response into something more pleasing, more “whole” and more gratifying, is what our goal should be. • When a child feels successful, he will do the activity again and again. • When he feels unsuccessful, the task will be avoided. • It has much more to do with the emotional adaptive response, than with the cognitive experience. Do not use or distribute without written permission.

12. Driven by FearDr. T. Berry Brazelton • All children go through periods of fear and children on the autism spectrum even more. Their emotional experiences make no sense to them and they cannot figure out the complexity of it to adapt adequately in their responses. • Fears are normal, and they help children solve developmental issues. • They also call parent’s attention to the child’s struggle. • They generate support from parents at a time when children need it • Fears inevitably crop up at periods of new and rapid learning. • Fears call up the energy needed to readjust • Frustration is a healthy force for learning as long as the child is given opportunities to master the frustration. • It is difficult for a parent to watch a frustrated child; it sets off the parent’s own frustration, which the child is likely to feel and respond to. • An overwhelming punishment will leave a child focused on the hurt and resentment, with no interest in the lesson to be learned, and no motivation to do better next time Do not use or distribute without written permission.

13. Dr. Daniel Siegel Handmodel Do not use or distribute without written permission.

14. Attachment • Attachment is the emotional bond that is formed between an infant and its primary caretaker. • Attachment is integral because it has direct effects on the infants developing brain. • When the attachment bond between infant and caregiver is healthy, it leads to feelings of safety, appreciation, joy and pleasure in the infant. • Children on the spectrum have great difficulty forming secure attachments as they tend to withdraw from the complexity of diverse emotions due to their bodies not being able to process this complexity at a level of functional adaptive response Do not use or distribute without written permission.

15. The Infant World • An infant encounters new information constantly. • It is bombarded with new objects, smells, and sights, and needs to make sense of these to grow. • When the infant experiences these sources of stimulation, it can feel many things, such as excitement or fear. • It is when the infant experiences emotions such as a fear or concern that the attachment bond is what helps the infant to cope with the stress. • Parent and child is frequently left frustrated with regards to the limited understanding of each other due to the strong developmental delays and this disrupts the usual relational pattern of seeking comfort, gaining comfort and then building security. Do not use or distribute without written permission.

16. Theory of Innate Intersubjectivity – Colwyn Trewarthon • Infant is born with awareness specifically receptive to subjective states in other persons • This natural sociability of infants, engaging the interest, purposes, and feelings of willing and affectionate parents, serves to intrinsically motivate companionship, or cooperative awareness • Caregivers use verbal and gestural communication in natural social situations. • This innate bonding that needs to occur is quite delayed in children on the spectrum. Researchers say it might be due to the lack of mirror neurons, but that innate mutuality of simply being with each other and “feeling” the other is disrupted in Autism Do not use or distribute without written permission.

17. Intersubjectivity – 3 parts • Attunement – Matching of Affect with rhythm and intensity • Awareness of the same aspects between two persons • Similar natures with agreement on agenda, reason and cooperation Do not use or distribute without written permission.

18. Margaret S. Mahler • Separation – individuation process • Psychological birth of the individual • Sense of separateness, from and in relation to a world of reality • Experiences of one’s own body in relationship with the primary love object • Typically develops from fourth or fifth month to 30th or 36th month Do not use or distribute without written permission.

19. First subphase • Differentiation and the development of the body image • Hatching – perceptual-conscious system – alert • Transitional objects, situations – reminder of Mother • Checking back pattern – comparing mother is frequently lacking in Autism • Stranger reactions / anxiety – linked to the unfamiliarity, new and novel, which can be frightning for the child on the spectrum Do not use or distribute without written permission.

20. Second Subphase • The early practicing period – the infant’s earliest ability to move away physically from mother – crawling, climbing, righting himself • Practicing period proper – characterized by free, upright locomotion, which is strongly compromized in Autism due to their nervous system delays in sensory processing • Body differentiation from mother looks very different in Autism. The less severely affected may need the closeness of the parent figure far more than should be typical. The more severely affected would appear as if in own world with no observable need of being with anyone. This should not be equated as the child individuating. His emotional experiences become “locked up” as they focus entirely on their own body experiences in an extreme response to fight / flight/ Steven Porges equates this them experiencing immobilization Do not use or distribute without written permission.

21. Third subphase • Rapprochemont • Constant concern for mother’s whereabouts • Awareness of separateness grows – This is difficult for children on the spectrum as they have to be able to build a sense of self, theory of mind and empathy in order to individuate • Typical children show a great need for mother’s love, which is frequently misunderstood in children on the spectrum. They do want this security, but have no way of mobilizing their need in expression. • The beginning of gender identity Do not use or distribute without written permission.

22. Fourth subphase • Consolidation of individuality, very difficult for children on the spectrum to attain. It is a life long quest for them • Unifying of the “good” and the “bad” object into one whole representation. • Depends on trust and confidence • And on cognitive acquisition of the symbolic inner representation of the permanent object Do not use or distribute without written permission.

23. Lev Vygotsky • “Learning and development are interrelated from the child’s very first day of life” Do not use or distribute without written permission.

24. Zone of Proximal Development • The distance between the most difficult task a child can do alone and the most difficult task a child can do with help. • New learning is enhanced by interaction • The assistance of teacher, therapist or peer is referred to as scaffolding – have to observe! • Personal and social experiences can not be separated Do not use or distribute without written permission.

25. What do we do? • Be equipped with knowledge that the child on the spectrum needs the same emotional bonding we naturally crave • Find balance between extrinsic and intrinsic reward in terms of looking at discipline and behavior. • Find respect for each child on the spectrum so that they are seen as having intelligence and it is our responsibility to see this exercised more fully • Join the child in his world in order to pull the child into our world • DIR/Floortime Do not use or distribute without written permission.

26. Dr. Stuart Shanker • “The more aware we are of when we’re becoming overstressed, and know how to break the cycle. The better we self-regulate. • The greater our stress, the more constrained is our recovery process • Leads to having fewer resources to exercise self-control • Driving more intensity towards impulsivity • Under the Boab Tree: 5 domain model for self-regulation Do not use or distribute without written permission.

27. Eat, Play Sleep: The Biological Domain • Nervous system and physiological processes • Burning energy and restoring it • Triggering bio-chemical responses • Includes: nutrition, sleep, exercise, sensorimotor challenges, noise, sights, touch, smells, pollution, allergens, extreme heat and cold • Stress includes: lethargy, hyperactivity, transitions, somatic complaints, chronic stomach pain / headaches, sensory sensitivity, sitting still, clumsiness, threshold lower for feeling overwhelmed Do not use or distribute without written permission.

28. The Emotion Domain • Understanding and managing big emotions • Learning to deal with feeling overwhelmed • Developing language to express freely • Can effect the intensity of physical sensations such as pain – more or less sensitive • Temperament plays a role • Stressors: intense emotions, new or confusing emotions, emotional entanglements • Intense negative emotions: drain energy • Positive emotions: energizing, though can also overwhelm Do not use or distribute without written permission.

29. The Cognitive Domain • Thinking and learning • Mental processes: memory, attention, information processing, reasoning, problem-solving, and self awareness • Requires good attention: ignore distractions, sustain attention, shift, sequence thoughts, working memory, plan and carry out steps to achieve a goal. • Cognitive stressors: limited awareness of internal / external stimuli, sensory information, too much information to handle, information too abstract, performance expectations too high, sustained attention Do not use or distribute without written permission.

30. The Social Domain • Adapt to behavior / thinking in social situations • Includes social intelligence, relationship skills, socially accepted behaviors • Good: pick up on social cues, including non-verbal, understand those cues, respond appropriately, take turns in conversation, “repair” communication breakdowns, understand how emotion affect other people’s behavior • Stressors: confusing or demanding social situations, interpersonal conflicts, being the victim / witness acts of aggression, social conflicts, not understanding impact of utterances on others Do not use or distribute without written permission.

31. The Prosocial Domain • Includes: empathy, selflessness, internal standards and values, collective engagement and behavior, social responsibility, ability to put needs of others ahead of self. • Optimal: ability to shift smoothly from a me-centered moment to a we-centered one, connect with others, read cues, recognize their needs, delay gratification from personal desires, awareness of group dynamic, ability to compromise, collaborate, contribute, learn and benefit in collective environment. Can also include: spiritual, aesthetic, humanitarian, and intellectual development • Stressors: dealing with other’s strong emotions, being asked to put other’s needs before self, tension between peer and personal values, moral ambiguity, guilt Do not use or distribute without written permission.

32. 9 Lacrue Avenue, Suite 103 Glen Mills, PA 19342 Maude Le Roux, OTR/L, SIPT, IMC Website www.atotalapproach.com Facebook https://www.facebook.com/ATAMaudeLerouxOT/ LinkedIn https://www.linkedin.com/company/a-total-approach Blog http://www.maude-leroux.com/ Do not use or distribute without written permission.