Thinking Errors: How to Jump in the Deep End of Aspergers Emotions

I've been doing a lot of soul searching the past few weeks, and lots of research, and phone calls, and crying, and more phone calls . . .

This school year we attempted to put Sam back in public school, to allow me to find some part time work and contribute to family finances. No such luck, but inevitably better since I am needed at home right now. Sam did so well for about a month, and then started to deteriorate, both emotionally and academically - this is a first. Being a tween involves so much more social pressure to fit in, and Sam just doesn't. He wants to, but it lasts only so long before kids don't want to play by his rules, or always hear his ideas. And kids can be mean, so friends become enemies with little advanced notice.

By Halloween, it was clear we needed to find an alternative, even if temporarily. After Thanksgiving, and a visit to Vancouver to spend time with his grandmother, we registered Sam in a day treatment program. We hoped that the limited stay in a less stressful environment would allow him to learn, or practice, emerging social skills, and work on his emotional development. After 9 weeks, we saw very little progress, mostly sporadic, and little transfer of skills to the home environment.

Every one of his therapists, and even school administration, recommended a change of placement. But rules are rules, and everything has to be documented and supported by data. And there wasn't enough of either as far as the school district was concerned. So back to school he went, so he could fail again and the district could take data on it. What a completely illogical way of treating special-needs students. And how naive I was, even after 6 years of never getting the resources he needed, to agree to this.

After just one month, and many absences, and suicidal meltdowns at home, we pulled him out permanently. But the meltdowns have yet to stop. They get worse with every one, and we are keeping the crisis line number handy, just in case. It should never have come to this. And I keep asking myself why, and how can I help him? Where do I even begin?

I found an article, inspiring this post I might add, that I will be rereading and sharing ad nauseam, because it explains the errors in thinking that I believe are the entire base to all of Sam's meltdowns. I don't know if understanding them will help me help him, but I hope so.

My Aspergers Child: Helping Aspergers Children Eliminate “Thinking Errors"

In brief, there are five thinking patterns discussed in the article: over-generalizing, minimizing/maximizing, emotional reasoning, fortune telling, and all-or-nothing thinking.

• Over-generalizing is when the child uses one event to assume future outcomes. For example, Sam believes that because his brother Liam (4) refuses to hug him, that Liam must not love him.
• Minimizing or maximizing is essentially "making a mountain out of a molehill" and vice versa. For example, Sam frequently believes he has no talent because of the things he can't do, and minimizes his artistic abilities and skill at building elaborate structures in Minecraft. This also happens with blowing mistakes out of proportion and thinking about the worst possible outcome. We hear this a lot too, like when Sam goes out to find neighbors to play with, and the first one isn't home. He then says that the other kids probably won't or can't play either, and he will be bored all day.
• Emotional reasoning is the confusion between feelings and reality. For example, when Sam plays with his brother, Liam hits him sometimes. Sam feels hurt and angry, and assumes Liam is doing it deliberately.
• Fortune telling is making predictions or assumptions with no supporting evidence. Frequently Sam will have a meltdown in the middle or towards the end of the day. If he has been enjoying privileges, he will often say "I guess this means I won't get ___ today" (like to play the iPad, or a trip to the store) when I have made no comments about what he can or can't do in relation to his behavior.
• Finally, All-or-nothing thinking is, well, thinking in terms of always and never, and is related to minimizing and maximizing - this is the extreme version. So when Sam doesn't get to play with a particular friend, he "never gets to do what he wants," Or when he can't have ice cream, he "never gets anything" and we are "the worst parents in the world."

In many cases, we see all five of these combined into the ultimate meltdown, on top of sensory over-exposure, and anxiety, and it results in Sam believing the only way to stop feeling this way is to not be alive. It's very scary. And yet, I still believe there is a solution out there, there is help, we just haven't found it yet. I hope that's not an error in MY thinking ;)

- Adrienne

There and Back Again

Making dietary changes for one's self is comparatively easier than changing someone else's diet, or a whole household. When I initially began my research on diet changes affecting Autism, it was inspired by some information my sister shared with me about the effects of yeast and sugars on the brain. I am a skeptic, so I tend to be very thorough in investigating any health claims, especially when considering my kids.

After doing heavy internet research (including peer-reviewed articles; I will post some titles in my Books page), and lots of library books, I decided I had nothing to lose by starting with Liam. Even though his doctor was not supportive, I knew it wouldn't hurt him since his diet was so limited already.

I know, it sounds like taking away ingredients would further limit him, but I started by replacing the foods he ate with gluten free versions, or introducing new snacks. So Teddy Grahams became Annie's Snicker Doodle Bunnies, Kix became EnviroKids Gorilla Munch, etc. It took a few weeks to inventory what needed to go, and introduce a few new snacks. Within two weeks however, we were seeing a change.

Liam wasn't eating more per se, and was still having tantrum issues, but his focus increased, his attention span lengthened, and sitting for a few minutes became 10 minutes or more. Even his teachers at Early Intervention noticed a difference in his participation.

And then there were words.

Beautiful, plentiful, yet repetitive. But I heard him finally say "Mommy" with regularity, and he learned his brother's name, and Grandma, and so many more. Most of his speech till now was more sounds with little combining, and mostly random vocal stimming. None of it was functional, and he did not point or gesture. And yet, here he was, as if he had known how to all along.

I was so surprised, and so was Daddy. Daddy had been gone for several weeks, out of town for work. We decided to make the 4 hour trip to spend a night with him, and he couldn't believe the difference. In hindsight, it could have also been because he hadn't seen his son for weeks, but I think it was both. We did notice increased trouble sleeping, though, and more harmful tantrums. So I decided dairy was the next victim.

And out it went. This was more difficult, as some of the gluten-free favorites had to be replaced yet again. And most of Liam's calories were coming from the dairy-based Pediasure, so we had to look for other ways to increase calories (I looked high and low for protein powder, and only found an expensive rice based one to try for a while).

Lo and behold, no more head banging, less screaming, and less night wakings. By Thanksgiving, we thought we were in the home stretch. It was like opening a door that had been nailed shut for almost 3 years. I was so excited, and at that point began changing some foods the whole family ate.

December unfortunately saw a return of some of the tantrums and head banging. I had read in several books that children with dairy sensitivities often reacted similarly to soy once dairy was taken away. I was emailing a TACA mentor at the time, and asked her thoughts on this. She too believed this was a strong possibility. After trying to eliminate any other possibilities, I began removing soy as much as possible. And here again, tantrums and self-harm began to disappear.

Now, I have read dozens of snippets and articles on both sides of the diet intervention debate. There is still mainly anecdotal evidence for its effectiveness, as for so many other treatments parents try. I mean, we desperately want our children to be happy and functional. Who wouldn't try just about anything? Here are my two cents, after using diet briefly (6 months). At least for my children, dietary intervention has worked just as other therapies: the kids thrive on the changes, and make leaps and bounds in development, and then plateau. This is when we stopped, conveniently the same time as I was about to lose my mind over the extra time, effort, and money. And I call it successful because we saw no loss of progress. Just as with Occupational and Speech Therapy, Liam does well, then needs a break.

Now to just get the motivation to try another round :)

- Adrienne

Between a Rock and a Hard Place

I have spent the last few weeks entrenched in my newest research project (research is kind of a hobby of mine) – to find more ways to help my kids be successful, not overlooking anything I might have been reluctant about. This was inspired by conversations with one of my sisters and information she shared with me, for my own perusal, nothing more. My sister is a vegetarian, and has made many diet and lifestyle changes for health reasons. She recently began cutting out foods that contain sugar, or ingredients that can become sugars or yeast in the gut. I had never heard of such a diet, but I have heard of other dietary interventions for a variety of issues, some that she and I share. She also wanted me to read the research behind the diet, as it was shown to help with Autism.

After looking through some of the links and articles, it occurred to me that diet and nutrition might be a puzzle piece I was missing, considering that Liam is not growing well, eating hardly anything, and sleeping very poorly. I’m well aware of how diet affects physical and mental functioning, if only from personal experience. So I cross-linked to other sites, searched out books at the library, and hunkered down (in the precious little time I have to myself each day) to gather information.

I am a skeptic at heart. I need to read or see the science behind things. I usually scoff at anything that has no proof, or at least nothing tangible to back it up. So this is the purpose of my research. What I have found however, is way more than I expected, and almost shocking that I haven’t heard of much of it before. There’s been tons of research done in the last 15 years that supports dietary interventions and nutrition assessments for children with Autism Spectrum Disorders. It makes sense too, that if diet and nutrition are so important for normal growth and physical and mental functioning, this should be a crucial piece for treating children with ASDs. These children (mine for example, but there are hundreds of thousands more) regularly have problems with cognitive functions and communication, GI issues, feeding difficulties, sensory processing problems, and fine and gross motor issues. So why isn’t this addressed by our pediatricians?

Well, Judy Converse, MPH, RD, LD explains it quite well in her book “Special-Needs Kids Eat Right.” (2009, Penguin Group, New York) It’s a combination of history, holes, and controversy.

• History: Unfortunately, some remnants remain of the now defunct theory that Autism is caused by cold, unloving mothers. It was a terrible idea to begin with, but we are still having trouble ridding the world of this.
• Holes: Most doctors don’t receive any training in nutrition during their education. Why? Because of specialization. The medical field now has specialists for every system in the body, but all separately. There is no whole body practice. And, pharmaceutical companies are great marketers, so doctors are encouraged to push prescriptions, and treat symptoms, instead of getting to the root of the problem. I have this complaint all the time, that doctors don’t treat patients, they treat symptoms.
• Controversy: Finally, there’s the sacred cow of vaccines. Most don’t know the whole story, or the science that got misconstrued, so the safety of vaccines is still in hot debate. But the truth is, vaccines are safe (in my opinion), except for a subset of children who may be predisposed to react to a clustered viral exposure. I don’t feel my children were adversely affected by vaccines, but there are children out there who were.

So all this means that traditional doctors are reluctant to venture into treatments that aren’t mainstream, especially in fields of knowledge they are unfamiliar with, like nutrition (that is usually the domain of licensed dietitians and nutritionists).

On Tuesday, at the boys’ physicals, I too found this out the hard way. But I was prepared with the above knowledge, and knew which questions to ask. The pediatrician, as expected, was reluctant to offer any information about dietary interventions or the like. But she recognized my concerns about Liam’s poor growth and nutrition, and referred me to a nutrition clinic that also has a GI department. AND it’s covered by our insurance!

I do feel kind of stuck though, between the immovable rock of traditional medicine, and the hard place of going to the other extreme, territory I’m uncomfortable with unless I can read the science. It’s a tough place to be when I just want my kids to be healthy, and be the best they can be, whatever that turns out to be. This is a place many parents of ASD kids before me have been, and more after will be. But I hope it will be easier for them as time goes on.

Here’s hoping for progress and open minds.

- Adrienne

Zucchini Experience

Our landlord brought us some zucchini yesterday, leftovers from his wife's garden. I hadn't pulled it out of the bag till today, so I had no idea how HUMONGOUS they were. One green, one yellow. I offered them each in turn to Liam to examine, and then to Sam. The differences in the way the boys experience them is so telling.

Liam tried to pick up the green one.

After multiple failures, he decided it was too big.

The yellow one was just right, however.

He proceeded to bang it on its end with much gusto,
because this made such lovely noise.

He also tapped it against his head.

Liam, being the sensory seeker, really enjoyed interacting with the zucchini with his whole body (as much as possible being in his high chair.) He loved touching it, feeling it, smelling it, and making noise with it. Sam however, took an entirely different approach.

The green zucchini immediately became a weapon.
And yes, the crazed look was part of his desired pose.
Sam is not one for candid photos. If he knows there's
a camera, he is posing for it.

Only when I asked him to calm down a little did he
choose to cradle the zucchini like a baby, his idea.

Note that Sam chose to interact with the zucchini in a more limited way, and use it as a tool of his imagination, rather than for its own sake. Not that either way is wrong, just different. And very directly related to how each experiences sensory issues and the Autism Spectrum.

I like observing them in the same activity sometimes, for precisely this reason: to watch how differently they experience life, and yet how similarly; and how I can share it with them. I did, after all, offer them the zucchini to play with, and took pictures. It was fun, for all of us I think.

- Adrienne

Lines of Communication

One of the key features of Liam's PDD-NOS diagnosis is his delayed communication development. At 2 years and 7 months, he has less words he says regularly than I can count on both hands, and most of them can only be interpreted by us. They don't even sound the same every time. He doesn't point to things, or look where we are pointing. He doesn't understand most of what we say, except for limited words, and some signs. And he does not babble or put sounds together or make noises that sound like they could be words, most of the time.

However, we have spent the last year learning to communicate with him, and learning how he communicates with us, through trial and error, and sometimes through sheer luck and happenstance.

Daddy has been away for the last 4 days for work, and was gone for 7 days a week and a half ago. Liam loves Daddy. Not just any kind of love a kid has for his Dad. No, Daddy is the favorite, preferred over all other human beings on the planet. Daddy's absence is felt by all, with a vengeance. Liam has made it clear this week especially how much he misses Daddy, and I have become aware just how deep the connection may be. It also makes me rethink the lines of communication between them.

Twice this week, Liam has led Grandma to our bedroom door, saying Dada (one of his few words), and upon being let in, climbed on the bed and lay down in Daddy's spot with his head on the pillow for a few minutes. I suppose he was breathing in the lingering scent. Then he tried to bring Daddy's clothes out into the living room with him.

Last night, Liam woke at 2:30 AM and had to be brought into bed with me. He fell back to sleep, but then woke for the day at 5:30. Upon informing my husband of this, he told me he too woke up at 2:30, very alert, and did not know why. And his alarm was set for 5:30 this morning.

I'm not usually a big believer in other-worldly things or fate or whatever. However, there does seem to be a deep connection, or bond of communication, that ties my husband to his only son. And perhaps it is indeed related to the fact that Liam has such limited powers of communication. He can't use his words to tell me how much he misses his Daddy. He can't tell his Daddy he loves him on the phone (although he can kiss the phone when I put Cliff on speaker, which he did this evening). He can't even communicate his frustration or anxiety to me in a way I can understand and soothe, except to be cranky and difficult until Daddy comes home on Monday (yes, 9/26, it's forever from now). But it means something, and it plucks at my heart strings.

- Adrienne

A Little Background

In my daily life, the things I find most rewarding, as well as sometimes the most frustrating, are finding every way I can to help my kids live the best lives they can. By “best” I mean getting enjoyment like all kids should, but also fulfillment and development and learning, so they can grow into happy, productive adults. 

This is a challenging task and a full time job. Not only are they 8 years apart, so at very different stages of life, but they both have Autism Spectrum Disorders and Sensory Processing Disorder. But the similarities stop there. My 10 year old has Aspergers and is very bright, has the vocabulary of an adult, reads well beyond his age level, and faster than me. He’s also a sensory avoider, and over-sensitive to just about every sensation. My 2 ½ year old has PDD-NOS, with mainly communication and developmental delays, so he barely speaks at all, and behaves more on level with an 18 month old, except for his activity level. He is also a sensory seeker in almost every area, except for feeding. He has serious food aversions because of his other sensory seeking needs. So one kid talks non-stop, and freaks out at loud noises, smells, crowds, etc. and the other talks very little and makes lots of noise and loves rough housing.

The task is also challenging because Aspergers was only in the DSM-IV (Diagnostic Statistical Manual version 4, basically the Bible for psychologists/psychiatrists) as of 1994, so research and information are still scant. PDD-NOS likewise is such a broad category and is used in so many different ways (like a temporary diagnosis, or a catchall for kids who don’t fit Autism fully) that there is not enough specific information. Sensory Processing Disorder is an even newer field of research (only the last 15 years or so has it been more fully recognized) and many doctors and professionals still don’t know much about the science behind it. So information is not easy to find, nor are resources, at least anywhere not near a rather large city (I live near Salt Lake City, which is a SMALL city) where there are plentiful research schools and other organizations.

BUT, I find the challenge rewarding not only for its results, (like when I find things that work!) but also for the journey. I am very academically inclined, and obtained a useless Bachelor’s degree in History because I loved reading and researching so much, and preferred facts and historical information to fiction or science. And I’m well-versed in using technology, being raised in a techie family (my father was a software developer for many years). I enjoy hunting down information at the library, on websites, through word of mouth, and cross-referencing everything. I have more internet bookmarks than I care to count, on every topic I can think of that might help my kids function better, or enjoy life a little more, or give me a break from it all. 

Every day is a new adventure. I don’t know which child will throw a tantrum about what, or if I’ll have a strategy up my sleeve to deal with it. And new ones pop up all the time, as the children enter new life stages (my oldest is now a tween, and acting much like a teenager with his constant attitude and defiance, and my younger is smack in the middle of terrible twos, despite being behind in a few areas).

Oh, one more thing. To top all this off, I’m a Bipolar Mommy. While I do okay most days regulating my own emotions, and have had 5 years of practice doing so, that’s still only 5 years, and as many with Bipolar Disorder know, it’s always a work in progress to hold your own. So my patience level fluctuates from day to day, and my emotions are tied inextricably to my successes and failures at helping my kids thrive. My husband is a trooper, I can tell you that much.

So bear with me as I "puzzle" through the conundrum that is raising my sweet boys to successful adulthood. And if I can share anything of value or enlighten you in anyway, or at least give you a laugh, awesome. If nothing else, this provides me an outlet, and a record of my failures and triumphs.

- Adrienne