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8 months ago

978-1572305441

autism

William 89 shoes, see

William 89 shoes, see the world from his perspective, be aware of the child’s interests, concerns, and recent experiences. With this knowledge, an understanding of behavior and communications is much easier. Without it, the potential for misunderstanding grows and can lead to conflict, to challenging behavior, aggression, and “being stuck” in maladaptive and repeated responses. A simple but common example illustrates this paradigm. A child drags his mother by the hand to the fridge but does not say what he wants or even point to the fridge. If the mother does not infer the child’s motivation (that he wants something to eat or drink), the child becomes upset, may start to cry or even hit his mother or himself. Once the mother opens the fridge, having “read” the child’s mind, she has to infer again what it is he wants. But it can be only a guess since he cannot, or does not, communicate with her. What are his favorite foods? Has it been a while since he had something to drink? Might he be thirsty instead of hungry? The mother again has to infer a desire on behalf of the child who cannot communicate on his own. If her inferences are wrong, temper tantrums, aggressive behavior, and frustration will follow. This simple example can be expanded to include a whole range of other situations, at home, at school, or in the community. The most challenging situations are those where the child is quite verbal and, on the surface at least, can communicate quite well. It’s easy for parents and others to forget that what is being said is often not what is meant, as in the case of William and the subway cars. I remember one child who, when he got mad, would say the most horrible things to his father, like how he was going to cut him up, disembowel him, and feed him to the birds. Of course the parents were terrified, particularly as he got older and bigger. They were worried that he could become violent and might act on these sentiments. But they needed to realize that he was simply angry and had no more appropriate ways of expressing that frustration. There was no middle ground to his emotion; he either sounded “violent” or was placid; there was no in-between. If they reacted with anger or anxiety, that only made him more frustrated and more violent in his threats. The key was to recognize that he did not mean what he said, react calmly, respond to the real message that lay behind the threats, and try to teach him more appropriate ways of expressing his frustration. Once they started calmly ignoring the threats and saying things like “You must be upset. Are you upset? Tell me that you are upset. Now tell my why,” the threats diminished over time. They realized that their anx-

90 A MIND APART iety only increased their son’s frustration, which made matters that much worse. The same thing can happen in school with teachers who don’t know the child as well as the parents. Too often teachers react to the overt behavior or communication of the child and don’t look behind to the context, the recent history, to understand the child. The most effective form of behavior management in schools is to actively “read the mind” of the child with ASD and not assume that what is said or expressed is what is meant. Before the teacher tries to “manage” the behavior, it’s imperative to understand what it means. If the teacher does not know the child well enough, parents can often provide that information quickly and efficiently. That’s why it is so important that parents and teachers work together as a team. Too often, teachers and parents eye each other suspiciously across the table and cannot form a partnership to provide that context for the child’s communications. The parents have to teach the teacher how to read their child’s mind. In that way, understanding becomes possible and the transition to school that much easier. * * * Finding the right context that day with William was a matter of trial and error. I tried out various contexts to understand his kaleidoscope of color and shape but came up empty. On other occasions it was easier, because once William was aware I was having a hard time, he could help me repair the conversation by supplying answers to my questions. With William, once the background was explicitly clarified between us, dissonance could be reduced, and meaningful contradictions might emerge. Then Mr. Pipes seemed quite appropriate as a description of Uncle Bob, the “weekend handyman.” One reason I was having particular trouble that day understanding William was that the references to a shared context were cut and meaning flew where it might, determined only by his interests, independent of the context or the needs of the listener. Even though I had a good appreciation for his interests, his worries, and his recent life experiences that might constitute a context, I suspect his mood was getting in the way of his ability to help me understand the particular context operating in the background of our conversation. * * *

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