Girls with ASD_ Masking Mental Health

Teri McGill, Marci Haight, Nicole Heller, Jen Johnson, Beth Klootwyk Author

03/16/2021 Added

16 Plays

Description

Girls with ASD - Masking and Mental Health

Searchable Transcript

Search:

[00:00:03.620]Hello, everyone, welcome to our session, Girls with ASD,
[00:00:07.080]Masking Mental Health and Methods to Support.
[00:00:10.020]I have four co presenters today,
[00:00:12.720]Marci Haight is the, is the technology specialist
[00:00:15.360]and integration specialist for Plattsmouth Public Schools,
[00:00:20.870]and also has a daughter with autism.
[00:00:23.490]Nicole Heller is a school psychologist
[00:00:25.460]for Elkhorn Public Schools.
[00:00:27.020]Jen Johnson is a school psychologist
[00:00:29.100]for Wahoo Public Schools,
[00:00:30.830]and Beth Klootwyk is a school psychologist
[00:00:32.980]for Elkhorn Public Schools.
[00:00:34.780]And my name is Teri McGill
[00:00:36.320]and I am the Metro Region ASD Coordinator
[00:00:38.870]with the Nebraska ASD Network.
[00:00:42.128](air whooshing)
[00:00:44.040]So today we only have 65 minutes,
[00:00:46.470]to talk about our girls on the spectrum,
[00:00:48.530]which is just a really small amount of time.
[00:00:51.050]So, our goal today is to really provide
[00:00:53.240]you with some information and a lot of resources,
[00:00:56.640]in order to help you work with your girls on the spectrum.
[00:00:59.230]So in your handouts
[00:01:00.820]you do have a resource sheet,
[00:01:03.100]and it is full of a variety of different resources,
[00:01:07.580]everything is from books that are out there on girls
[00:01:09.870]on the spectrum to websites,
[00:01:13.450]to webinars, all of that information.
[00:01:16.670]So we'll kind of point out some of the things
[00:01:18.370]that are on that list
[00:01:19.203]as we go through the presentation today.
[00:01:21.733](air whooshing)
[00:01:23.490]So our objectives for this presentation,
[00:01:26.730]are similar to what you would, what you saw
[00:01:30.770]in your conference, sort of manuals
[00:01:35.350]and with all the different sessions.
[00:01:37.210]So we want to, for sure, like I just said,
[00:01:40.110]access and provide you access to resources to identify,
[00:01:44.260]our girls on the spectrum,
[00:01:45.760]and, of course, a variety of other resources also.
[00:01:48.950]Gather knowledge about how our girls
[00:01:51.040]and young women with ASD camouflage and mask,
[00:01:54.540]and also how mental health,
[00:01:56.770]what are the mental health repercussions
[00:01:58.440]that come from our girls camouflaging and masking?
[00:02:01.800]And then identify strategies for supporting our girls
[00:02:04.810]and young women with ASD within our schools.
[00:02:08.980]This description or presentation summary is the one
[00:02:12.480]that you have, with all your conference information,
[00:02:15.710]so we're not gonna spend time going over that.
[00:02:19.538](air whooshing)
[00:02:23.170]Hi, everyone, so I'm gonna just speak to you briefly
[00:02:26.830]about the prevalence rates,
[00:02:28.850]of autism spectrum disorder currently.
[00:02:31.870]So the CDC has given us some current estimated information
[00:02:37.000]with regard to the prevalence of autism spectrum disorder
[00:02:40.960]and this would be across the United States.
[00:02:43.520]So one in 59 births across again, the US,
[00:02:47.500]and one in 37 of those individuals would be boys
[00:02:51.510]based on that CDC data.
[00:02:54.122]So what we're seeing right now with regard
[00:02:57.100]to the information that is most currently available,
[00:03:00.560]is that autism spectrum disorder is actually four times
[00:03:04.160]more common in boys versus girls.
[00:03:08.190]Now this number is down somewhat, from four point, down 4.5.
[00:03:15.240]However, we would still submit
[00:03:17.150]that we're likely missing some of our girls,
[00:03:19.010]which is why we're all here today.
[00:03:20.470]So, that puts us at one in 37 among girls,
[00:03:25.530]or excuse me, with boys and one in 51 with girls.
[00:03:28.150]So with regard to our Nebraska numbers,
[00:03:31.930]we're actually fairly consistent,
[00:03:34.610]in reflecting what those national numbers indicate as well.
[00:03:39.060]So based on data that was collected over last school year,
[00:03:43.170]so 2018, 2019,
[00:03:45.680]or excuse me, the school year
[00:03:47.090]before, females the incidents of females in our schools
[00:03:51.470]with autism verification is 710,
[00:03:55.490]versus males who are at 3,903,
[00:03:59.170]and then of course you can see that total
[00:04:00.720]there 4,613 students age birth to 21,
[00:04:06.520]currently with a primary verification of autism.
[00:04:16.717](air whooshing)
[00:04:18.730]All right!
[00:04:19.563]So now we're gonna get into the gender bias of autism.
[00:04:24.341](air whooshing)
[00:04:29.760]So it starts with some referral bias,
[00:04:33.260]because girls on the spectrum do show different
[00:04:37.860]and less severe communication and social challenges,
[00:04:41.800]we often then attribute those girls as challenged
[00:04:45.800]to shyness or anxiety or something else.
[00:04:49.760]And then that can lead to fewer referrals at school,
[00:04:54.610]or misdiagnosis in that medical field.
[00:05:00.400]And what we've learned about autism in the past
[00:05:02.720]has typically come from what we know
[00:05:04.480]about males with autism.
[00:05:06.610]Research in the area of autism has typically focused
[00:05:09.760]on the characteristics that present in males.
[00:05:12.470]So what we know about autism is actually what we know
[00:05:15.340]about male autism.
[00:05:18.401](air whooshing)
[00:05:21.790]And that criteria for diagnosing ASD,
[00:05:26.780]really just like Jen had said, is the data is based entirely
[00:05:32.240]from studies on boys,
[00:05:34.290]and so evaluators who are then observing females
[00:05:38.020]struggling socially tend not to think of autism.
[00:05:42.450]They tend to focus on those secondary characteristics,
[00:05:45.130]such as anxiety or other mental health issues,
[00:05:48.720]or eating disorders.
[00:05:50.350]And then when we have a female
[00:05:53.320]in front of us, we are predisposed to look
[00:05:58.230]for those male symptoms.
[00:06:10.830]Okay, we're gonna talk about real quick
[00:06:12.740]some characteristics of females on the spectrum,
[00:06:16.420]and this is an area where we have, we have some resources
[00:06:23.210]for you and we're going to do a quick chat box activity.
[00:06:27.270]So if you can look over, if we can look,
[00:06:33.180]yeah, there we go!
[00:06:34.170]If you can look over your handout in your activity folder,
[00:06:37.620]that is titled female autism spectrum indicators checklist.
[00:06:42.860]So this has some ideas for indications
[00:06:48.820]that, and characteristics of females on the spectrum,
[00:06:53.540]and part of the chat box activity
[00:06:55.240]that we wanna do just for a minute or two,
[00:06:58.750]is look over the informal checklist of characteristics,
[00:07:03.570]and then in your chat box,
[00:07:06.370]maybe list one or two characteristics
[00:07:08.950]that you were not aware of, where you're looking
[00:07:11.720]through it and you're like, oh, I didn't realize
[00:07:13.770]that could be a characteristic of a girl
[00:07:17.140]on the autism spectrum.
[00:07:18.910]So we're gonna give you about a minute, a minute and a half,
[00:07:21.790]if you could go ahead and just put in the chat,
[00:07:24.130]put a couple of ideas in the chat box,
[00:07:27.320]for other people to see that maybe is kind of an eye-opener
[00:07:30.470]for you in this area.
[00:07:33.414](air whooshing)
[00:08:28.830]We're gonna go ahead and move on but feel free to keep
[00:08:31.000]putting some of those ideas in the chat box.
[00:08:35.370](air whooshing)
[00:08:36.203]And as we move on we are gonna talk
[00:08:37.630]about so camouflage and girls with ASD.
[00:08:40.380]So what is camouflaging?
[00:08:42.490]It's something kind of unique in a way to girls
[00:08:45.560]on the spectrum.
[00:08:46.810]Is the use of conscious or unconscious strategies,
[00:08:50.230]which may be explicitly learned or explicitly developed,
[00:08:53.830]to minimize the appearance autistic characteristics,
[00:08:57.150]during a social setting.
[00:08:58.620]So these are things that girls have either truly learned,
[00:09:02.330]because they've taken the time
[00:09:03.760]to figure them out,
[00:09:04.690]or they just do without even really thinking about it.
[00:09:08.050]Most people will, the research will say that they're experts
[00:09:10.900]in pretending to not have autism.
[00:09:13.820]That's the phenomenon we call camouflaging.
[00:09:16.160]They wear what some people call as a mask,
[00:09:18.890]or adapt a persona that is just constructed in a way
[00:09:22.470]so they can copy the behaviors of somebody else they feel
[00:09:25.310]is typical or quote unquote normal,
[00:09:28.350]and hide their symptoms of autism
[00:09:30.370]in order to be more like those individuals.
[00:09:38.283]So, there are a couple different types of camouflaging.
[00:09:44.520]There's the introvert and the intrusive extrovert.
[00:09:48.370]The introvert really actively minimizes
[00:09:52.140]or avoid social engagement.
[00:09:55.256]They recognize how complex
[00:09:59.630]and overwhelming those social situations can be.
[00:10:04.550]And so they often just choose to be alone,
[00:10:08.840]and, you know, do spend time by themselves.
[00:10:12.330]And then you have the intrusive extrovert,
[00:10:15.200]who really seek out social experiences.
[00:10:19.280]However, they're not reading
[00:10:21.010]those social signals accurately,
[00:10:25.590]or are regulating and recognizing the intensity
[00:10:32.070]of their social engagement.
[00:10:35.050]They are often unable to accurately read
[00:10:38.670]those social situations and then act inappropriately.
[00:10:42.870]And what happens,
[00:10:45.930]is that they may feel, they may develop these friendships,
[00:10:50.360]but they are quickly resolved
[00:10:52.820]and they don't understand why,
[00:10:55.210]because sometimes they get a one friend
[00:10:59.120]and then kind of just attach
[00:11:02.180]themselves and it becomes overwhelming to that other friend.
[00:11:06.102](air whooshing)
[00:11:10.280]The other camouflaging expert or extrovert,
[00:11:15.110]is actually the most common with girls.
[00:11:18.790]They recognize their differences,
[00:11:21.260]and they are, you know, they recognize that they need
[00:11:24.450]to read those nonverbal cues,
[00:11:26.550]and they understand social situations and making friends,
[00:11:30.760]so they keenly observe others.
[00:11:33.520]And they look and they observe what they should be doing,
[00:11:38.670]and then camouflage their social differences
[00:11:42.710]and wear a mask, so that they can act out that role
[00:11:46.840]of a typical girl.
[00:11:52.570]And I just this quote that we found,
[00:11:56.290]I think it really explains that a little bit.
[00:12:00.320]It says, "I learned to pass socially by observing
[00:12:03.100]others, watching shows, movies,
[00:12:06.310]devouring young adult contemporary fiction,
[00:12:09.490]and collecting women's magazines.
[00:12:12.070]They were all intense interests,
[00:12:14.520]but definitely not a healthy way to acquire
[00:12:17.260]realistic social goals."
[00:12:19.030]And so there are searching out ways to get
[00:12:22.950]social information, to feel like they can fit in better.
[00:12:29.920]And the thing with camouflaging
[00:12:31.390]is nearly all of us, everyone makes small adjustments
[00:12:34.610]to fit in better and to conform to those social norms.
[00:12:38.070]We all do it whether you're at a conference
[00:12:40.380]and you try to sit by people, you know,
[00:12:42.250]and have conversations or, you know, your persona at home
[00:12:45.750]versus at work versus, you know,
[00:12:47.550]maybe another social situations,
[00:12:50.290]but what's different is our girls on the spectrum,
[00:12:53.610]are doing this constantly and deliberately.
[00:12:56.770]Most of us are able to do it unconsciously,
[00:12:58.970]and these girls are making a deliberate,
[00:13:01.500]constant effort in order to fit in with that persona
[00:13:05.580]that they need, they feel is what they need
[00:13:07.500]to be in those situations.
[00:13:10.474](air whooshing)
[00:13:14.030]So there have been some studies that are coming
[00:13:18.880]out, they're doing some research,
[00:13:21.670]on this camouflaging autistic traits questionnaire,
[00:13:26.430]and they've designed it to measure camouflaging behaviors
[00:13:29.630]in adults right now.
[00:13:31.350]And they're looking at how camouflaging is impacting
[00:13:38.250]our results on the ADOS test,
[00:13:41.770]because individuals, especially girls
[00:13:46.130]and some boys are able to do some camouflaging.
[00:13:55.380]And within this CAT-Q,
[00:13:58.040]they have discussed the camouflaging model.
[00:14:03.000]There are three areas for that compensation, masking
[00:14:07.280]and assimilation, and I'm gonna talk about some examples
[00:14:11.540]of each of those areas.
[00:14:16.670]So compensation may look like copying others,
[00:14:19.960]facial expressions and body language,
[00:14:23.150]repeating others' phrasing and tone.
[00:14:26.060]Think of canned speech and really listen for that.
[00:14:30.470]And canned speech is, you know, phrases
[00:14:33.980]or words that are misplaced,
[00:14:38.320]and may not fit the situation.
[00:14:41.560]May also use some social scripts,
[00:14:44.220]in those situations as well.
[00:14:48.500]And then masking is monitoring
[00:14:51.750]and adjusting our face and body to appear relaxed,
[00:14:55.190]and then that helps us appear interested in others,
[00:15:00.350]forcing eye contact,
[00:15:02.960]or at least to look like you're making eye contact,
[00:15:06.420]and then it's actively try not to talk
[00:15:10.610]about your special interests.
[00:15:15.730]And then the last area is assimilation,
[00:15:18.420]and that's feeling the need to put on an act.
[00:15:22.470]You know, not being yourself in a social situation,
[00:15:26.390]forcing yourself to interact, even though it's difficult,
[00:15:31.310]and tends, conversation tends then to not be natural,
[00:15:36.400]and so they may avoid interacting.
[00:15:40.060]They may be quiet so that they're not drawing
[00:15:42.760]attention to oneself.
[00:15:46.380]A few other examples are, or similar to the ones
[00:15:50.220]we've already talked to are those mimicking
[00:15:51.980]a facial expressions,
[00:15:53.240]not looking somebody directly in the eye,
[00:15:55.210]but maybe looking at the bridge of their nose
[00:15:57.370]or the top of their forehead,
[00:16:00.040]pretending to make eye contact.
[00:16:02.330]Using those strategies to develop a list
[00:16:04.980]of appropriate social topics,
[00:16:07.010]and then staying close to other girls
[00:16:09.040]and kind of being around them but not really being a part
[00:16:12.350]of the friend group.
[00:16:13.820]And these, and while we're not talking about assessment
[00:16:16.240]per se, these are all very subtle,
[00:16:17.960]and are hard to pick up just by observing.
[00:16:20.880]You're probably more likely to find
[00:16:22.550]these out when you actually talk to girls on the spectrum
[00:16:24.940]and hear what they have to say
[00:16:26.150]about what they do on the day-to-day basis,
[00:16:28.500]to camouflage and look like their peers.
[00:16:32.930]And Jen, I just wanted to add there that last bullet
[00:16:36.970]of staying close to other girls
[00:16:38.430]and weaving in and out of their activities.
[00:16:40.530]From a distance that often looks
[00:16:43.250]to those of us who are observing as that child
[00:16:45.530]has a friend group,
[00:16:46.930]and that they are interacting with peers.
[00:16:49.920]And oftentimes what we see there is that the peers
[00:16:52.830]are sort of tolerating that girl
[00:16:54.550]being around and they're actually not interacting.
[00:16:57.310]And in one situation, I got permission to be able to talk
[00:17:00.950]to the peers, and that actually gave me some really good
[00:17:04.350]information about, you know,
[00:17:05.950]kind of what was really happening in that situation,
[00:17:08.960]because looking at it, things looked pretty good,
[00:17:12.120]but they, things actually weren't, you know,
[00:17:15.490]that child was really not a part of that friend group.
[00:17:19.049](air whooshing)
[00:17:27.360]Okay, so because they are working so hard to camouflage,
[00:17:35.310]there are some pretty significant consequences.
[00:17:39.490]A lot of times at school, we don't see problems necessarily.
[00:17:44.610]They're able to hold it together all day,
[00:17:47.200]but then at home they're melting down,
[00:17:50.990]and so that's why it's so important to get information
[00:17:55.390]at home as to what's happening,
[00:17:57.940]and really consider that information
[00:18:00.590]when you are assessing the need,
[00:18:03.840]especially for a 504 or a special education services,
[00:18:07.970]at in the school environment.
[00:18:11.010]Because we usually need to have then some things
[00:18:14.850]put in place during the day,
[00:18:16.800]so that the amount of holding it together all day is eased.
[00:18:23.020]Okay, so we're not melting down at home.
[00:18:26.130]It causes physical and emotional exhaustion,
[00:18:29.350]sometimes they need alone time or time to sleep, to recover,
[00:18:34.410]and it really leads to social exhaustion.
[00:18:37.570]So they're pretending to fit in and they use
[00:18:40.470]their intellect, their knowledge of everything they've read
[00:18:43.590]about on social situations,
[00:18:47.740]and what they should be doing as a, as a female.
[00:18:51.360]And it's a lot of effort,
[00:18:54.170]and they're using that instead of just that instinct,
[00:18:58.420]and inclination that we have as females.
[00:19:02.840]This then causes adrenaline overload,
[00:19:05.620]and sometimes other girls can get
[00:19:09.774]some symptoms such as stomach aches,
[00:19:12.830]and maybe selective mutism headaches.
[00:19:16.210]And at school, they may come quiet or withdrawn.
[00:19:20.950]They may have difficulty completing work,
[00:19:23.180]or even have school refusal,
[00:19:25.390]and not wanting to come to school.
[00:19:29.660]And I just wanna add something right here with camouflage,
[00:19:33.300]that as coming from a parent, that a lot of times
[00:19:36.890]they're able to fit in so well, and that's why I think
[00:19:40.770]it's so important for any staff that's working
[00:19:45.270]on diagnostics to really, you know,
[00:19:49.230]try to have a conversation with the parents,
[00:19:51.600]because in my case, you know, my daughter was able
[00:19:56.110]to do everything that was expected of her at school,
[00:19:59.610]but then she would come home and just completely lose
[00:20:02.620]it because she had worked so hard,
[00:20:05.260]to keep everything together all day.
[00:20:08.020]That, and then, so just because you're not seeing
[00:20:11.110]those behaviors at school,
[00:20:13.130]doesn't mean that those behaviors aren't happening at home.
[00:20:16.130]So really just an, a reminder to make sure you're keeping
[00:20:19.690]the parents and guardians,
[00:20:22.663]in that whole process of fact finding and information.
[00:20:29.100]Thank you, Marci, for that insight into being a parent
[00:20:32.150]of a child on the autism spectrum, who happens to be a girl.
[00:20:36.350]You probably have already had a little bit of a chance
[00:20:38.510]to look over this quote,
[00:20:39.900]but when you look at girls on the spectrum, you know,
[00:20:42.070]when you think of autism, you typically think
[00:20:43.870]about those social differences
[00:20:45.450]and how most often we look for kids who kind of don't fit
[00:20:48.770]in socially or aren't really socially aware.
[00:20:51.620]What's unique about lots of times girls
[00:20:53.900]is that they do realize they're different,
[00:20:56.210]and they want to fit in, but they wanna fit in a way
[00:20:59.110]that doesn't have negative consequences to them.
[00:21:01.280]So they have that social awareness,
[00:21:03.650]and they've strongly, so strongly that they adopt
[00:21:07.720]the persona, they put on a mask, they hide it all day,
[00:21:11.190]to be accepted.
[00:21:12.970]So that's why it's so important to be talking
[00:21:15.260]to our families and to be talking to our girls,
[00:21:17.540]to see how hard they're working, what they're doing,
[00:21:20.520]what's important to them, and those factors
[00:21:23.470]when we're looking at girls that might be on the spectrum.
[00:21:30.920]All right, we're gonna do a quick chat box activity.
[00:21:34.390]I want you to think about a girl,
[00:21:36.660]or girls that you have taught or currently teaching,
[00:21:40.530]what may have been some examples of camouflaging
[00:21:43.770]that you've attributed to something else?
[00:21:46.940]And as you're thinking
[00:21:48.460]of that, we're just gonna take just a second
[00:21:51.470]or two and then we're gonna move
[00:21:53.070]on, and we'll just watch your chat.
[00:22:07.514](air whooshing)
[00:22:13.630]Like Beth said, go ahead and keep adding
[00:22:16.240]all those comments to the chat box,
[00:22:18.200]and we'll be responding to your comments.
[00:22:20.430]We're anxious to hear if, as you think back,
[00:22:25.020]if you are wondering,
[00:22:28.010]if a girl that you've worked
[00:22:29.700]with was actually camouflaging or masking.
[00:22:32.290]So go ahead and keep adding those comments to the chat box,
[00:22:35.910]and we'll continue to move on.
[00:22:38.794](air whooshing)
[00:22:40.460]Okay, now we're gonna move on to some other areas
[00:22:43.180]that we would like you to give consideration
[00:22:45.730]to, when we're looking at skills with girls
[00:22:49.350]on the autism spectrum.
[00:22:51.210]So the area that we're gonna kind of move towards now
[00:22:54.090]is called executive functioning,
[00:22:56.230]and executive functioning really encompasses a number
[00:22:59.750]of different areas with regard to thinking
[00:23:02.750]about your behavior,
[00:23:04.760]and essentially your emotional regulation
[00:23:07.220]or your ability to kind of have your emotions fit
[00:23:11.250]the context, meaning they fit the situation,
[00:23:13.940]and have them be consistent with what would be expected
[00:23:19.520]by others in your environment.
[00:23:21.990]Oftentimes, when I talk about executive functioning
[00:23:24.570]with folks, I will conceptualize
[00:23:26.710]it as, think about going on a trip, right?
[00:23:29.860]And so if I am planning on going on a trip,
[00:23:32.630]that entails a lot of things.
[00:23:35.530]First of all I have to plan my trip
[00:23:37.270]and I have to think about what route am I gonna take?
[00:23:39.610]Now, fortunately, we can plug things into our phones,
[00:23:42.810]these days but sometimes that's not an option,
[00:23:44.820]or we might have to get a map
[00:23:46.070]out, and really be mindful of what is the best way to go.
[00:23:51.340]We also have to organize our things.
[00:23:53.380]So in terms of what am I taking from my trip?
[00:23:56.880]I need to plan out what will the weather be at my location
[00:24:00.540]versus what is the weather like at home?
[00:24:03.120]And based on that I have to have an idea
[00:24:06.970]that might not be consistent with my current environment.
[00:24:10.700]I also need to be mindful of how am I gonna manage my time
[00:24:13.920]to get there?
[00:24:15.050]Am I traveling by car?
[00:24:16.440]Am I traveling by plane?
[00:24:18.230]If I'm going to the airport,
[00:24:19.570]how early do I need to get there?
[00:24:22.210]Lots of things are involved in that process,
[00:24:24.930]including working memory and being able to rely
[00:24:27.750]on information that we, and draw on information
[00:24:30.430]that we have from previous trips,
[00:24:33.170]or in terms of what has happened in the past
[00:24:37.430]that might dictate my current behavior.
[00:24:40.710]We also have to realize that sometimes things
[00:24:43.210]don't go our way, right?
[00:24:44.230]Sometimes planes are delayed.
[00:24:46.170]Maybe I didn't have gas in my tank
[00:24:48.990]and I needed to, and rather than having a big reaction
[00:24:53.030]or response to that, be able to kind of inhibit
[00:24:56.380]those major reactions,
[00:24:57.860]so that it doesn't impede our functioning.
[00:25:00.230]The other piece that is really part
[00:25:02.230]of that would be regulating that aspect,
[00:25:05.420]so that others around us, aren't like, she's totally
[00:25:08.190]freaking out and melting down.
[00:25:09.640]And what do I attribute this to?
[00:25:10.980]She just needs to switch up her plane ticket.
[00:25:14.520]The other piece of this is task initiation.
[00:25:16.900]So, ensuring that you get started in a timely manner,
[00:25:20.800]and get that task moving,
[00:25:23.570]and then being flexible as well.
[00:25:25.530]So if I'm driving someplace in my car
[00:25:28.420]and all of a sudden there's road construction,
[00:25:30.570]I may need to be able to change my plans,
[00:25:33.340]right in that moment,
[00:25:34.400]and switch to going a different direction
[00:25:36.620]or taking a different route.
[00:25:39.130]And then being persistent in those schools, right?
[00:25:42.010]So if my ultimate goal is to get to my destination,
[00:25:45.170]then I need to do all things that will get
[00:25:47.770]me to that end point.
[00:25:50.280]Lots of skills are involved in executive functioning
[00:25:53.420]and it's kind of a difficult thing really to conceptualize
[00:25:56.950]sometimes when we think about all of the things
[00:25:59.540]that executive function entails.
[00:26:02.610]So for that reason, you'll often hear folks
[00:26:04.920]refer to executive functioning skills,
[00:26:07.810]as being consistent with inconsistencies.
[00:26:11.990]So essentially when we look at executive functioning,
[00:26:14.960]we're not necessarily looking at a skill deficit per se,
[00:26:19.700]more of what we would refer to as a performance deficit.
[00:26:22.550]Meaning I have these skills and capabilities,
[00:26:26.580]but the ability to access and demonstrate those skills
[00:26:29.810]is sometimes impeded in the heat of the moment.
[00:26:32.640]And there are a number of variables
[00:26:34.810]or factors that might contribute to that interference
[00:26:37.700]or to that inability to demonstrate those skills.
[00:26:41.190]Some of those things might be stress, right?
[00:26:43.270]So I might be worried about what is going
[00:26:46.540]on around me, about time issues.
[00:26:49.940]A number of areas can contribute to stress, anxiety as well.
[00:26:55.730]So being worried or anxious, depression,
[00:27:00.830]being able to, obviously depression would involve
[00:27:04.270]being sad about something.
[00:27:06.630]And then even just that self-deprivation piece as well.
[00:27:09.980]So you can see this great quote
[00:27:11.360]here from Cook and Garnett,
[00:27:13.187]"deep down I knew I was bright,
[00:27:15.610]but I feel so damn stupid watching everyone else get
[00:27:19.340]it while I floundered or froze.
[00:27:21.660]I'd keep trying to process to the point of collapse."
[00:27:25.320]And so you can see where a girl on the spectrum might feel
[00:27:28.320]that elevated level of anxiety,
[00:27:30.400]particularly in those social situations,
[00:27:33.180]and it becomes quite debilitating,
[00:27:35.040]it's debilitating for all of us.
[00:27:37.060]And certainly that heightened anxiety,
[00:27:40.340]and stress associated with not always being able
[00:27:43.690]to interpret things effectively,
[00:27:46.220]likely contributes to difficulties
[00:27:48.420]with the executive functioning.
[00:27:51.884](air whooshing)
[00:27:56.310]Okay, another area to consider with our girls
[00:27:59.160]on the spectrum is sensory processing,
[00:28:01.680]or that self-regulation piece,
[00:28:04.190]which can be really difficult for some of our girls.
[00:28:07.850]So again, sensory and we're in a minute
[00:28:10.630]gonna talk about interoception,
[00:28:12.760]both of those are, can be full day trainings
[00:28:14.750]in their own, right?
[00:28:16.120]So, really what we just want you to know
[00:28:19.000]is that you really do need to respect the sensory
[00:28:21.970]and respect those deficits our kids
[00:28:23.750]have, and provide the supports that they need
[00:28:26.340]throughout the day.
[00:28:27.620]And so here's a quote from Jennifer O'Toole
[00:28:30.260]who is a female on the spectrum.
[00:28:32.407]"Believe us when we say it's too loud, it smells too bad,
[00:28:35.870]or it doesn't taste right.
[00:28:37.540]It may seem okay to you, but be hell for us.
[00:28:41.440]If our senses are overloaded,
[00:28:43.240]other things will suffer including our learning."
[00:28:45.970]So again, that gives us just a really good insight
[00:28:48.170]to maybe what some of our females on the spectrum
[00:28:51.540]might be feeling throughout the day in a variety
[00:28:54.590]of different contexts, whether they're at school, at home,
[00:28:58.700]at the grocery store, all of those kinds of things.
[00:29:01.570]If you want to see a really cool video,
[00:29:05.170]you can go, there's a link on your resource sheet
[00:29:07.570]to this, to what's called Aspie blog,
[00:29:10.030]and the video is on YouTube,
[00:29:11.677]"Sensory Overload Through My Eyes."
[00:29:13.460]This is a young lady with autism,
[00:29:15.520]who made a video to show people in her world,
[00:29:19.600]what it was like for her dealing
[00:29:22.510]with all of the sensory pieces in a day.
[00:29:25.190]I always give a little warning
[00:29:26.940]that you can, if you get motion sick,
[00:29:30.500]that you might, you might have some of that in this video,
[00:29:33.840]but she really shows how's lights and sounds and movement,
[00:29:38.730]and some of those things are really difficult
[00:29:41.040]for her during the day.
[00:29:42.100]So that's just a resource you can look up on your own.
[00:29:46.200]And then interoception,
[00:29:48.020]so interoception, is really, we talk
[00:29:51.900]about it as being our eighth sense.
[00:29:53.810]And so it's a sense that allows us to notice
[00:29:56.360]our internal body signals,
[00:29:58.150]like a growling stomach, racing heart, tense muscles,
[00:30:01.340]or when we maybe need to use the restroom.
[00:30:03.610]So when we notice these signals,
[00:30:05.760]our brain uses them as clues to our emotions.
[00:30:09.160]So interoception helps us to feel many important emotions,
[00:30:13.540]and there's a whole bunch of them listed there.
[00:30:16.710]Kelly Mahler who is really our expert
[00:30:19.760]and our guru in this area,
[00:30:21.970]has many resources in this area,
[00:30:23.900]including a curriculum and assessment.
[00:30:25.720]And so on your resource sheet,
[00:30:27.430]that information is there, and we'll talk
[00:30:29.250]about it a little more
[00:30:30.700]about this, further down in the presentation.
[00:30:34.690]Oh, nope, it's right here, so sorry!
[00:30:37.000]So on your resource page, there are links available,
[00:30:40.210]for webinars on interoception
[00:30:43.560]and those webinars are done by Kelly Mahler.
[00:30:46.770]And also in your regional libraries,
[00:30:49.100]you can check with your regional coordinators
[00:30:51.260]through the Nebraska ASD Network,
[00:30:53.190]and many of our regions, regional ASD libraries,
[00:30:57.580]have Kelly Mahler's curriculum and assessment.
[00:31:01.170]And so if you're interested
[00:31:02.320]in that, reach out to your regional coordinator.
[00:31:08.121](air whooshing)
[00:31:08.954]Okay, we're gonna talk
[00:31:09.787]about some common coexisting mental health disorders.
[00:31:14.990]And in the next slide, you can see a list
[00:31:19.260]of what have been shown
[00:31:22.820]are the most common co-existing disorders,
[00:31:26.450]and they include anxiety, eating disorders,
[00:31:31.160]OCD, obsessive compulsive disorder,
[00:31:34.510]catastrophic thinking, ADHD and depression.
[00:31:39.570]So when anxiety and mood disorders,
[00:31:43.320]eating disorders, et cetera, are present,
[00:31:45.850]consider the possible, we need to consider
[00:31:48.290]the possible underlying characteristics of the autism,
[00:31:52.760]or the cause of those coexisting conditions.
[00:31:58.390]And many who go unidentified in school,
[00:32:02.560]or are undiagnosed,
[00:32:06.560]experience secondary mental health issues
[00:32:09.820]such as the ones on the slide.
[00:32:13.520]And what we are finding
[00:32:15.550]is that the secondary mental health issues
[00:32:18.300]can actually present much more vividly,
[00:32:21.790]than what we would consider to be kind of the main streamed
[00:32:27.140]autism spectrum disorder characteristics,
[00:32:29.480]meaning that the autism is manifesting
[00:32:34.870]itself through what we as educators,
[00:32:39.530]or parents see as anxiety, ADHD, depression.
[00:32:46.250]Those might be the outwardly noticeable conditions
[00:32:52.120]that we find that we are taking our children
[00:32:55.460]to the doctor to address,
[00:32:57.270]or that we are as teachers and school professionals,
[00:33:03.160]that we are wanting to test the girls in reference
[00:33:08.090]to these, but they are actually underlying or coexisting
[00:33:14.370]issues with autism spectrum disorder.
[00:33:23.608](air whooshing)
[00:33:28.260]So now we are going to move
[00:33:30.090]ahead and talk about resources and strategies.
[00:33:33.980]And again, we know we don't have a lot of time to get
[00:33:38.660]into a lot of strategies,
[00:33:40.010]we wanna give you some things to take
[00:33:41.870]with you that you might be able to use.
[00:33:44.320]And in those strategies, we're gonna show you some ideas
[00:33:47.350]for some of those co-existing mental health conditions,
[00:33:51.460]that Marci just talked about.
[00:33:56.030]The first thing I'm gonna talk about is social exhaustion.
[00:33:59.670]So this often comes from our girls having to work so hard
[00:34:03.550]to mask their autism,
[00:34:05.650]or to do that camouflaging.
[00:34:07.470]And so we wanna, a lot of times what we hear,
[00:34:11.860]from school staff,
[00:34:12.830]is that they're not seeing the behaviors at school,
[00:34:15.530]and then parents are reporting again.
[00:34:17.670]And like several of the ladies here I've talked
[00:34:19.790]about, that when the young lady goes home,
[00:34:23.340]then they have just these really big meltdowns
[00:34:27.570]with their young lady on the spectrum.
[00:34:29.620]So we, lots of people will say,
[00:34:31.427]"well, what do we do about that, because we don't see
[00:34:34.900]those behaviors at school?"
[00:34:36.520]And we certainly understand that dilemma,
[00:34:38.530]but what we know is there are some things that we can put
[00:34:40.860]in place in order to help relieve,
[00:34:43.190]some of that stress that our girls are feeling
[00:34:46.000]throughout the day,
[00:34:47.480]because they're feeling that need to mask or camouflage.
[00:34:54.810]So one of those strategies is homebase,
[00:34:57.540]and this is a really important strategy to put in place
[00:35:01.010]for our girls, even if you're not seeing,
[00:35:04.680]those meltdowns at school,
[00:35:07.540]because what this does is allows a safe place,
[00:35:11.590]for the, for the student to go in order to sort of let
[00:35:15.610]their hair down, so to speak.
[00:35:17.290]Okay, so to be able
[00:35:18.550]to sort of just kind of be themselves and relax
[00:35:23.900]for a few minutes, so there's not a lot of people
[00:35:26.120]around in a homebase area,
[00:35:28.760]it generally will be an area that's kind of blocked
[00:35:31.610]off, so there might be partitions.
[00:35:33.750]And again, so that they can feel like they can take
[00:35:36.440]some deep breaths,
[00:35:37.860]and they can relax and sort of DSD, sort of escalate
[00:35:42.500]from maybe be running at a very high level,
[00:35:45.750]feeling like they're always sort of on having to mask
[00:35:49.100]or having to camouflage.
[00:35:50.620]So adding the, some homebase time to their schedule,
[00:35:53.790]gives them a way to be able to sort of decompress,
[00:35:57.580]and that really can help when they go home,
[00:36:00.380]that they, that they don't sort of take all that stress
[00:36:03.070]with them home.
[00:36:04.890]And then another one is having a safe person to talk to.
[00:36:08.720]And I think this one is really, really important,
[00:36:11.820]and generally you wanna have a couple of safe people,
[00:36:14.750]in case somebody is not available at a time
[00:36:17.040]one of our girls might need them.
[00:36:19.180]But those folks need to take some time to pair
[00:36:21.580]and build a relationship with the young lady
[00:36:24.270]that they're working with.
[00:36:25.580]And make sure they know that it's safe
[00:36:27.940]for them to come and talk.
[00:36:29.380]And it's safe for them to come say
[00:36:31.110]that they're feeling anxious or they're feeling stressed,
[00:36:33.700]or they're feeling exhausted today,
[00:36:36.780]from again, having to put that mask
[00:36:39.210]on or having to camouflage throughout the day.
[00:36:41.750]And then providing an individual break,
[00:36:44.970]and maybe that break is just in their classroom
[00:36:48.000]or at their desk, maybe they can put their earbuds
[00:36:50.110]in for a few minutes and listen to music,
[00:36:52.790]or maybe they do go to that safe person's spot
[00:36:57.430]or their home-based spot,
[00:36:58.590]but building those in, not making our girls work,
[00:37:02.510]to earn a break, but again, building these things
[00:37:05.150]in so they're available and part of the schedule,
[00:37:08.130]for your girls on the spectrum.
[00:37:12.500]And then some, one of the other things
[00:37:14.700]that a lot of our girls on the spectrum
[00:37:17.820]and in our research we found is that lots of times our girls
[00:37:22.040]struggle with anxiety and depression
[00:37:24.197]and some of those coexisting mental health conditions.
[00:37:27.370]And it's important that we make sure that we're teaching
[00:37:31.540]our girls and our boys,
[00:37:34.480]that they can change those thoughts.
[00:37:37.020]They can change the thought patterns that are going
[00:37:39.360]on in their head.
[00:37:40.450]And so we talked to them a lot about what we call
[00:37:43.210]an inner coach,
[00:37:44.400]and that's someone who's sort of using,
[00:37:46.930]your using your positive self-talk,
[00:37:48.730]to remind yourself to think positive,
[00:37:51.970]about yourself and others.
[00:37:53.410]It also can remind you for some kids,
[00:37:55.490]we use that image, which you see here over a remote control,
[00:37:58.720]to change the thought channel.
[00:38:00.980]So if you are being, if you have a student,
[00:38:04.320]a young lady who has come to school and is very negative,
[00:38:07.960]and is doing negative self-talk,
[00:38:09.710]and, or has a lot of thoughts that they're worrying
[00:38:12.930]about, it's important that we work with them to understand
[00:38:15.730]you can change that thought channel.
[00:38:18.480]And then for some of our younger kids,
[00:38:20.780]where some are younger girls,
[00:38:21.870]we talk about things like cloudy thoughts.
[00:38:23.720]So those are the more negative thinking,
[00:38:25.910]or sunny thoughts,
[00:38:27.460]which is thinking about something positive,
[00:38:31.020]or a positive outcome,
[00:38:33.150]or what could you do to change this.
[00:38:35.370]And so those are those sunny thoughts that we can talk,
[00:38:38.240]we can help our girls remember.
[00:38:43.310]Recess lunch, some of those times
[00:38:46.060]can be really, really hard for some of our girls
[00:38:48.330]on the spectrum.
[00:38:49.440]And so really kind of thinking about those things
[00:38:52.050]ahead of time, working with the girls that you're working
[00:38:55.860]with on the spectrum.
[00:38:57.630]Pair them up with students during lunch and during recess.
[00:39:03.340]One of the things that's really key to making this work,
[00:39:06.230]is that we have spent some time talking
[00:39:08.470]to our sort of peer models, about autism,
[00:39:13.570]and about strategies for them to help
[00:39:15.650]their friend with autism.
[00:39:17.380]And so, again, parent permission
[00:39:19.510]for that, of course, 'cause we're sharing information,
[00:39:22.260]but that will really help.
[00:39:23.520]We need to give our peers some strategies
[00:39:26.160]and some tools, so that they know ways to interact
[00:39:29.370]with our girls on the spectrum.
[00:39:31.560]For younger kids, you can structure that up by using
[00:39:34.060]a visual mini schedule at recess,
[00:39:36.560]and so they, each child you might have two peer buddies,
[00:39:40.310]and a young girl with autism.
[00:39:42.320]They each pick something to do on the playtime,
[00:39:44.510]or on recess, pick an activity,
[00:39:47.120]and then use a timer out there, and they move from one
[00:39:49.870]to the other together with each other.
[00:39:53.300]For lunch, considering a quiet area for a small group,
[00:39:57.860]to meet and so that lowers anxiety levels,
[00:40:00.910]also priming and pre-teaching again our peer buddies
[00:40:03.980]and our child with autism,
[00:40:06.770]how to start some conversations,
[00:40:09.100]or what might be some topics of interest to your friends
[00:40:12.260]that are in your lunch group, those kinds of things.
[00:40:14.950]Great time to work on generalization of social skills,
[00:40:18.430]and remember that visual supports, cues
[00:40:21.510]are, and the need to sort of help facilitate
[00:40:24.900]some of those skills,
[00:40:25.790]when our kids are in sort of a recess group,
[00:40:31.160]or a lunch group,
[00:40:32.420]we gotta be sure that we're there to help facilitate
[00:40:35.070]and coach those things.
[00:40:38.470]And then don't forget about your social narratives
[00:40:40.630]and social scripts.
[00:40:41.830]These are often things that can be very helpful
[00:40:43.880]and help reduce anxiety and stress for our girls
[00:40:46.320]on the spectrum.
[00:40:47.470]And most of you guys have all,
[00:40:50.280]if you've worked with our special ed kids,
[00:40:51.870]or if you've worked with our kids with autism,
[00:40:53.550]you've probably used these pieces,
[00:40:55.530]but sometimes we forget that we can use them as far
[00:40:58.340]as helping them engage socially,
[00:41:01.110]or helping them understand how to handle situations
[00:41:04.880]where the kid they're frustrated or anxious.
[00:41:07.470]And so keep in mind that those evidence-based practices,
[00:41:11.100]work very well with our girls on the spectrum.
[00:41:16.070]And then know that there's some programs
[00:41:18.190]out there to also help our girls,
[00:41:20.770]with some of their social communication skills.
[00:41:23.650]The peers curriculum
[00:41:24.870]is an evidence-based social skills program,
[00:41:27.630]that really helps individuals on the spectrum,
[00:41:31.820]and this doesn't necessarily need be girls.
[00:41:34.290]Girls and boys on the spectrum
[00:41:36.390]oftentimes are grouped together.
[00:41:38.180]But they're learning 16 weeks of lessons,
[00:41:43.140]and it is, they're wonderful, they're lessons,
[00:41:46.110]of course, talking about communication and conversation,
[00:41:50.050]and how to learn about other people's interests.
[00:41:52.350]And then even things as far as how to repair
[00:41:55.330]your reputation, and how to handle bullying and teasing.
[00:41:58.830]So there, if you haven't seen this, again there are webinars
[00:42:02.890]available in for this, for the peers,
[00:42:05.620]and also trainings throughout all the different regions,
[00:42:08.820]we do some training on the peers curriculum.
[00:42:11.080]And then "Talk With Me,"
[00:42:13.120]by Kerry Mataya, is another great program
[00:42:17.290]that actually works specifically on conversations,
[00:42:19.020]as a conversation framework.
[00:42:21.070]And one of the things we like about this program
[00:42:22.660]is they do put, they do have in there reminders,
[00:42:26.560]that conversations with girls and boys
[00:42:28.810]are oftentimes very different.
[00:42:30.450]The topics they're talking about, sort of the underlying,
[00:42:34.220]so for a lot of our girls our conversations
[00:42:36.370]are sort of, the sort of underlying pieces emotion,
[00:42:39.310]in those conversations.
[00:42:40.750]And oftentimes we forget that and we sort of teach
[00:42:44.540]them, sort of the way the boys, we teach our boys,
[00:42:48.780]which maybe isn't as much emotion but more fact-based
[00:42:51.430]for a lot of their conversations.
[00:42:54.350]Again, there are webinars for our peers.
[00:42:58.300]So if you want more information on the peers,
[00:43:00.770]on your resource list or a list of four webinars
[00:43:03.460]that you can go to, including one for getting started
[00:43:06.460]with adolescence and one for getting started with peers
[00:43:09.210]for young adults.
[00:43:10.410]So those are available and you can also check with regional,
[00:43:13.890]your regional coordinator about it in person training
[00:43:16.210]down the road.
[00:43:20.012](air whooshing)
[00:43:21.110]Okay, so jumping back to executive functioning skills,
[00:43:23.740]we're just gonna go over one of the options
[00:43:27.400]that is available to you with regard to teaching
[00:43:32.090]and developing executive functioning skills.
[00:43:34.320]And essentially I'm working on that building flexibility,
[00:43:38.900]with both our girls and our boys on the spectrum.
[00:43:42.000]So, this is a specific curriculum unstuck
[00:43:46.060]and on target with an emphasis on teaching
[00:43:49.710]those skills that are involved,
[00:43:52.130]are inherent in executive functioning.
[00:43:56.390]And it is a direct teaching method,
[00:43:58.410]which essentially will help individuals set goals,
[00:44:03.060]to build that flexibility
[00:44:04.390]as well as that capacity for planning.
[00:44:07.890]Also, if you want some additional information
[00:44:09.910]there you can certainly refer to those webinars,
[00:44:13.920]through the autism network.
[00:44:16.210]Awesome, we highly encourage you to take advantage of that.
[00:44:21.900]So what are some additional
[00:44:23.090]executive functioning strategies?
[00:44:25.680]You also have a link for this on your resource sheet,
[00:44:29.140]and we would encourage you to check
[00:44:30.780]this out if this is something that you feel
[00:44:32.410]like your students,
[00:44:34.170]or your children or the individuals
[00:44:36.310]that you know with autism spectrum disorder
[00:44:38.130]might benefit from.
[00:44:40.230]But essentially this is a program to prepare young adults,
[00:44:45.590]for that transition into adulthood,
[00:44:48.290]and it goes through specific units
[00:44:51.110]or skillsets that those individuals,
[00:44:54.220]will need or would benefit
[00:44:55.930]from in order to help foster their success,
[00:44:58.520]when they move out into the world,
[00:45:00.970]out into a university or a job,
[00:45:04.030]or things of that nature as well.
[00:45:05.670]And so it essentially helps them to develop
[00:45:08.310]those executive functioning skills,
[00:45:10.160]and outlines for them what skills are involved
[00:45:15.020]with those different areas of executive functioning.
[00:45:17.920]And you can see here an example,
[00:45:20.260]with the organizational component
[00:45:22.090]and some various tasks associated with that we would look
[00:45:26.040]to build with our students.
[00:45:31.197]I just wanna jump, (indistinct chatter)
[00:45:32.160]in before we go on to anxiety,
[00:45:34.460]because we also have a couple additional webinars
[00:45:37.180]on our web, on the ASD network state website,
[00:45:40.810]and those webinars are done by Sarah Ward.
[00:45:43.370]And Sarah Ward is from the East Coast,
[00:45:45.790]and she is just a really amazing guru in the area
[00:45:49.690]of executive functioning.
[00:45:51.210]And so those will be listed,
[00:45:52.530]those are listed on your resource sheet.
[00:45:54.630]And then Jill Kuzmas, most many of you have probably heard
[00:45:57.500]of her, she also has lots of resources in areas
[00:46:02.330]of social and executive functioning and friendship
[00:46:05.840]and all of those different kinds of areas.
[00:46:08.860]And her name and her website are also on the resource list.
[00:46:15.320]Thanks Teri!
[00:46:16.340]Yeah, some great resources available
[00:46:18.470]to you on that resource list.
[00:46:20.590]One of the other areas that we wanna discuss is anxiety,
[00:46:24.380]and what are some strategies?
[00:46:25.657]Because we know there is such a high rate of comorbidity
[00:46:29.060]or co-occurrence of anxiety for our girls on the spectrum.
[00:46:32.730]We wanna touch on just a few of the options
[00:46:35.120]that you might have in addressing anxiety with our girls.
[00:46:38.740]One of those options,
[00:46:40.390]which is derived from the CBT toolbox
[00:46:43.280]for children and adolescents,
[00:46:45.650]which is a phenomenal resource,
[00:46:47.290]and there are a number of different interventions
[00:46:49.360]within that particular resource
[00:46:51.260]that you might be able to utilize.
[00:46:53.570]One of the ways, when we think of intervening with anxiety,
[00:46:58.270]is we develop a hierarchy.
[00:47:00.040]And so we wanna conceptualize anxiety in terms
[00:47:02.850]of kind of you can see this tiered triangle, if you will,
[00:47:08.060]and develop a list with your girl,
[00:47:12.500]in terms of what are those things in your environment,
[00:47:17.440]or what variables are resulting in a lot of stress for you.
[00:47:21.470]And then based on that hierarchy, so starting with things
[00:47:24.830]that maybe don't cause very much stress,
[00:47:26.980]things that really are just day-to-day,
[00:47:29.700]and things that really don't bother you in the list,
[00:47:32.580]and then building up to the top of that pyramid,
[00:47:35.100]with things that would cause you a great deal of anxiety.
[00:47:38.640]And based on that hierarchy then there are tools
[00:47:43.030]or intervention tools associated with those levels,
[00:47:47.590]to address that anxiety for girls.
[00:47:49.840]So a great resource to check out.
[00:47:52.510]And I would add to that, Nicole,
[00:47:54.440]that we use a lot of rating scales
[00:47:57.470]in our, with our individuals with autism, five point scale,
[00:48:01.660]and zones of regulation.
[00:48:04.040]Sometimes, especially as our girls get older,
[00:48:06.650]we need something that looks different,
[00:48:09.350]because they've had some of those that maybe they've used
[00:48:12.670]when they were younger, elementary school,
[00:48:14.940]and we sort of sometimes get a little pushback,
[00:48:17.350]because I did that in elementary school or that's babyish.
[00:48:20.750]So I kinda like this one,
[00:48:22.430]especially for some of our older kids,
[00:48:24.040]this is something that could be on a small card,
[00:48:27.110]it could be in a binder, they could have it in their bag,
[00:48:30.230]but it does look different.
[00:48:32.100]And for some of our girls possibly looks
[00:48:35.080]a little more grown up.
[00:48:36.400]And so it might be something
[00:48:38.240]that they maybe will sort of accept
[00:48:42.040]and use a little bit easier.
[00:48:44.840]Yeah, great points Teri! (indistinct chatter)
[00:48:46.880]I just wanna add something else too real fast!
[00:48:49.640]Sorry, we have also, since so many of our schools
[00:48:55.340]are one-to-one with Chromebooks,
[00:48:58.540]or iPads or whatever, we have put like a Google Form
[00:49:06.040]on there, that we're having our middle school
[00:49:09.330]and high school students,
[00:49:10.810]just rate themselves throughout the day,
[00:49:13.710]and have strategies available
[00:49:15.320]to them through that Google Form,
[00:49:17.960]because it's just readily available,
[00:49:21.310]to them through their Chromebook.
[00:49:23.580]I love that, Beth, thank you for bringing
[00:49:25.360]that up 'cause self-monitoring is so important,
[00:49:28.310]and to teach our individuals on spectrum,
[00:49:32.560]especially our girls that we're talking about today,
[00:49:34.620]to sort of self-monitor,
[00:49:36.370]along the way throughout the day.
[00:49:39.530]And again, then knowing where they can access,
[00:49:42.410]some of those supports because when you get
[00:49:45.010]in those higher levels,
[00:49:46.400]you kind of lose those executive functioning skills,
[00:49:48.610]and then trying to figure out what I need to do to help
[00:49:52.450]myself at this point can be difficult.
[00:49:54.640]So that's a great idea,
[00:49:56.160]thanks for sharing that.
[00:49:58.769]And that ties in nicely with our next slide
[00:50:00.930]which goes over anxiety and sensory needs.
[00:50:03.790]Jennifer O'Toole has a great book
[00:50:05.420]here you have it, linked in your resources
[00:50:07.340]as well, that girls on the spectrum
[00:50:10.280]or just people in general,
[00:50:11.790]have a lot of times difficulties recognizing
[00:50:14.560]when they're feeling anxious
[00:50:15.920]and what's happening in their body,
[00:50:17.400]so then we don't always know what to do.
[00:50:19.670]So some of the steps are you need to recognize
[00:50:22.010]that your body is feeling anxious.
[00:50:23.710]We'll talk about grounding activities
[00:50:25.470]and those kinds of things later.
[00:50:27.210]Using that inner coach to talk to herself.
[00:50:30.110]Asking a girl what she needs, but she has to understand
[00:50:33.390]within herself what her body's doing, and what she needs.
[00:50:37.430]Identifying, choosing a solution,
[00:50:39.320]just like they were talking about with accessing technology
[00:50:42.290]or accessing a coach,
[00:50:43.870]or accessing a homebase,
[00:50:45.360]and then being able to use that solution on their own.
[00:50:48.060]So sometimes these strategies,
[00:50:49.870]we need to sit down with a girl and come up with.
[00:50:52.070]Sometimes we have to teach them.
[00:50:53.970]This is where that interoception stuff
[00:50:55.860]will come in for some of our individuals on the spectrum,
[00:50:58.920]recognizing that their muscles are tight,
[00:51:01.100]or that they're scrunching their face,
[00:51:02.680]doesn't always come naturally.
[00:51:04.160]So sometimes we have to teach those skills
[00:51:06.130]as this is what my body's doing, which is then telling
[00:51:09.100]me, I'm feeling an emotion
[00:51:10.980]and making those connections together.
[00:51:13.730]Another strategy is talking about the personal bubble.
[00:51:17.590]This comes out of that CBT workbook
[00:51:19.540]as well, if you look on the next slide.
[00:51:22.720]Understanding that your social network
[00:51:25.560]and your social bubble,
[00:51:27.000]changes with who knows what, and who's safe
[00:51:29.600]and who's not safe.
[00:51:30.900]Now this one talks about how close
[00:51:33.560]somebody can be in, like now that the time that we're living
[00:51:36.500]in, makes that a little bit trickier,
[00:51:39.580]as well as once we get to our older individuals
[00:51:41.870]who are using social media to understand,
[00:51:44.350]what's a personal friend on social media
[00:51:46.430]versus just somebody I interact with.
[00:51:49.300]But definitely taking that time to look at who can know
[00:51:52.350]what information, who's safe
[00:51:53.900]for me to go with with my feelings,
[00:51:55.810]and who's maybe somebody that I'm not safe to share
[00:51:59.310]all that with.
[00:52:00.920]And Jen, thanks for mentioning social networking
[00:52:03.650]and social media,
[00:52:05.110]because this social bubble would look different,
[00:52:07.370]if you have kids who are doing Instagram, Facebook, TikTok,
[00:52:13.060]all of those kinds of platforms.
[00:52:16.000]We really would need to add
[00:52:18.120]to this so that they really understand,
[00:52:21.270]where individuals that are friends with you on social media,
[00:52:25.240]where do they lie when it comes to this?
[00:52:27.530]And so I think that's a really, really great point,
[00:52:30.560]and when the, in today's world, is absolutely a necessity.
[00:52:35.520]And just that understanding
[00:52:37.000]of just because they're my friend on Facebook
[00:52:40.010]or they liked my post,
[00:52:41.690]that doesn't necessarily mean
[00:52:44.390]that's somebody, who's my intimate friend,
[00:52:47.450]who I can share details with or can trust.
[00:52:51.310]Which is hard for any kid in high school and adults.
[00:52:55.750]So you might have your personal bubble for people
[00:52:58.010]in your life,
[00:52:58.843]and then you might have to create a whole another set
[00:53:01.140]of personal bubbles for social media.
[00:53:06.290]Such important distinctions, thank you!
[00:53:10.240]With regard to some of those interventions
[00:53:12.560]that Jen referred to, one of the things that we might think
[00:53:15.450]of in helping our girls on the spectrum to help curb
[00:53:19.880]that anxiety or at least help contend
[00:53:22.270]with it, would be grounding.
[00:53:24.110]And you can see here in terms of the strategies listed,
[00:53:29.190]finding five things you can see.
[00:53:30.650]So connecting yourself to your environment,
[00:53:32.850]and again facilitating that connection,
[00:53:35.400]that interoception component for them.
[00:53:39.260]Five things you can touch, three things you can hear,
[00:53:41.740]two things you can smell, and one thing you can taste.
[00:53:44.840]So connecting that sensory component of their bodies
[00:53:48.940]to their environment,
[00:53:50.490]and essentially what that helps facilitate
[00:53:52.650]is just being centered,
[00:53:54.960]as well as being present in the moment.
[00:53:57.930]The 10 point check-in is also another great strategy
[00:54:00.660]that might be used.
[00:54:01.580]So using that countdown with taking 10 deep breaths,
[00:54:06.930]excuse me, and then you can see working your way
[00:54:10.470]all the way down to number one,
[00:54:12.220]in which you would hope that the individual feels better.
[00:54:15.850]I've also had some kiddos that by the time they get
[00:54:18.470]to the one don't feel like they necessarily
[00:54:20.410]have all of that resolved,
[00:54:22.130]and we might work through that 10 point check-in,
[00:54:25.790]more than once to get them to a state
[00:54:27.980]where they're more relaxed and comfortable again.
[00:54:32.360]In terms of some other ways to kind of think about things.
[00:54:35.840]So another way is to conceptualize that thought pattern,
[00:54:40.830]and you'll recall when Teri was going
[00:54:43.620]through some of her slides,
[00:54:46.220]the remote control and changing the channel, right?
[00:54:49.260]So essentially, that is what this is as well.
[00:54:53.180]But perhaps again, for kiddos that are older,
[00:54:56.190]so middle school and high school age,
[00:54:58.080]being able to change their channel
[00:54:59.760]as well, but it's essentially taking a negative thought
[00:55:03.230]or something that is perceived to be a negative situation
[00:55:06.940]and then reframing that in a way that makes it positive,
[00:55:11.030]and then associating that positive thought
[00:55:13.290]then with a positive outcome,
[00:55:16.200]versus something that is negative.
[00:55:19.690]Another way to conceptualize things would be to look
[00:55:23.750]at anxiety, and then again, to stop,
[00:55:27.900]to rewind those thoughts,
[00:55:29.620]and reframe those thoughts.
[00:55:31.050]And again, we would encourage conceptualizing things
[00:55:33.820]in a more positive light,
[00:55:35.580]and then bringing forth that other idea
[00:55:40.160]or rethinking that idea.
[00:55:45.080]And then some other ones we've already talked
[00:55:46.830]about the incredible five point scale,
[00:55:48.920]this is just a quick reminder
[00:55:50.350]that there's lots of different ways you can make this look.
[00:55:53.160]You can add visual supports,
[00:55:54.820]you can add just text, any of those kinds of things
[00:55:57.710]to help differentiate what your student needs.
[00:56:00.730]And then we also have a handout
[00:56:02.890]for you or it's in your resource kit,
[00:56:06.030]for anxiety strategies for school,
[00:56:08.800]which is on the next slide there.
[00:56:10.110]I'm not gonna go over it 'cause there's tons
[00:56:12.170]of, there's 20 tips, these are just some very basic ones.
[00:56:15.310]Please, please, please take some time to look it over.
[00:56:18.150]So you can have some ideas about different strategies
[00:56:20.440]that work for all students
[00:56:26.950]And another program
[00:56:28.700]that's out there, that some of our school counselors
[00:56:31.730]are actually already using is called Coping Cat,
[00:56:34.760]and this is a really, really great program.
[00:56:37.700]It addresses a variety of anxiety pieces.
[00:56:43.040]It targets kids seven to 13,
[00:56:45.640]doesn't need to just be girls, but our girls
[00:56:47.410]definitely oftentimes do struggle with anxiety.
[00:56:51.730]It is 16 sessions, or you can do brief copycat
[00:56:56.270]which is eight sessions,
[00:56:57.890]and it's a really user-friendly manual.
[00:57:00.100]So you don't have to have any special training to do it.
[00:57:03.520]But I would highly suggest that you team, when you do this.
[00:57:07.150]So lots of times counselors will be working
[00:57:10.010]through the lessons and Coping Cat,
[00:57:12.230]but we want, and then do such a nice job of making sure
[00:57:15.180]that they're bringing in the special education teachers,
[00:57:18.570]the school psychologist, the gen ed teacher, the parents,
[00:57:22.070]and making sure everyone knows sort of what the lessons
[00:57:25.640]are that they're working
[00:57:26.500]on, and of course what the vocabulary
[00:57:28.400]is, and how they're cueing the child,
[00:57:30.670]all of those things.
[00:57:31.580]So I highly recommend with this strategy
[00:57:33.800]and all the others we've talked about to be sure
[00:57:36.970]that there is a, you're using that your whole team
[00:57:40.360]in order to implement the strategy.
[00:57:44.410]And then this is another strategy
[00:57:47.250]that's out or another program,
[00:57:48.770]excuse me, that's out there.
[00:57:50.320]And aim is really looking at using
[00:57:52.860]cognitive behavior therapy along with behavioral principles,
[00:57:59.150]in order to work with our kids.
[00:58:01.390]So it's actually best (indistinct)
[00:58:03.600]it can, it's sort of raises the bar
[00:58:06.270]because it's, again, very evidence-based,
[00:58:09.300]and can help children who are struggling
[00:58:12.170]from social discomfort, challenging behaviors,
[00:58:15.030]daily struggles with life,
[00:58:17.730]not navigating the social world, all of those pieces.
[00:58:21.470]There is a workbook and then there's a manual,
[00:58:23.630]and there is a website
[00:58:24.890]here because this is through Dr. Dixon's group,
[00:58:29.630]and you do need to get some training in this.
[00:58:32.380]And so again, the network has done
[00:58:35.650]a little bit with Dr. Dixon and we did offer a training,
[00:58:38.660]and we had lots of folks across the state, take it.
[00:58:41.290]And there may be more training coming down the road,
[00:58:43.640]but you can also get on the website
[00:58:45.210]and see if you can find more information on this program,
[00:58:48.540]or check with your regional coordinator.
[00:58:52.868](air whooshing)
[00:58:53.701]Okay, we're gonna talk a little bit about resources,
[00:58:56.320]for depression in our girls with autism spectrum disorder.
[00:59:02.410]And I will just say that depression seems to be a big one
[00:59:07.290]as far as a coexisting condition,
[00:59:09.740]for reasons that we've talked about previously,
[00:59:12.600]earlier in this presentation, such as trouble fitting
[00:59:17.350]in at school,
[00:59:19.420]not being able to find friends who similar interests,
[00:59:23.480]and just feeling a sense of exclusion in general.
[00:59:28.400]So there are lots of resources out there but a couple
[00:59:31.420]that we wanted to highlight,
[00:59:34.910]talk, we're talking about obstacles,
[00:59:37.650]such as acting before thinking
[00:59:39.450]or allowing our feelings to take over,
[00:59:43.770]kind of a hopeless feeling or not seeing, not able to see,
[00:59:48.040]what solutions are available to us and to the girls,
[00:59:54.810]they can make them, they can cause
[00:59:56.820]them to have poor decisions,
[00:59:58.810]and just feel like they can't, they are unable
[01:00:02.620]to solve the problem.
[01:00:04.280]So this stoplight activity can help our girls think
[01:00:08.120]about how to solve a difficult problem.
[01:00:11.190]If you think about a problem
[01:00:12.810]you might have and apply the following steps
[01:00:15.490]to it, they are stop and think about the problem,
[01:00:19.380]and take a few deep breaths.
[01:00:21.670]Think about what the situation
[01:00:22.920]is, think about what the positives and negatives are.
[01:00:26.280]The yellow signifies slow down and make a plan.
[01:00:28.840]What are things that you could do or say?
[01:00:32.270]And then the green is go with your plan.
[01:00:35.190]Think about what will happen if you use your plan,
[01:00:37.860]and what will you do if that does not happen?
[01:00:42.900]It can be easy for our girls to feel really hopeless,
[01:00:45.480]and also it's very difficult for some of our girls
[01:00:48.700]on the spectrum,
[01:00:50.010]to be able to execute a plan,
[01:00:51.930]even when you are helping them brainstorm
[01:00:54.550]what they can do, that's all well and good,
[01:00:57.000]but when it comes to actually executing that plan,
[01:01:00.370]they may really need a lot of support from us.
[01:01:06.520]And then also when we're talking about self-care,
[01:01:10.800]what are some strategies that can help
[01:01:13.450]our girls feel better?
[01:01:15.200]They can ask themselves these questions,
[01:01:17.330]or as our parents
[01:01:18.720]or school professionals we can guide
[01:01:24.580]them through some of these steps.
[01:01:26.650]What are positive things I can use?
[01:01:28.830]What things should I avoid?
[01:01:31.390]And I'll also say in this case that a support system,
[01:01:36.960]we've talked about this, a support system is vital.
[01:01:40.560]So think about who to include in that, such as teachers
[01:01:44.290]or counselors, family members, a therapist,
[01:01:48.160]support group members, if they belong to a support group
[01:01:51.820]or close friends.
[01:01:53.370]Those are all important to lay out with your girl.
[01:01:59.410]And then also keep in mind that list
[01:02:01.700]is going to be very fluid,
[01:02:03.130]or maybe very fluid from week to week
[01:02:05.450]or from month to month, you will want to revisit
[01:02:07.450]that with them and see who is on their list
[01:02:10.500]and who they can count on as a support system.
[01:02:18.320]So here's just another visual resource,
[01:02:22.010]as far as identifying a problem,
[01:02:25.170]who can help, who can help me with that problem?
[01:02:28.490]What are the steps that I need to formulate this plan?
[01:02:34.400]What will I, what can I say to myself?
[01:02:36.410]What kind of self-talk can I use to help me with this?
[01:02:39.350]And then revisiting it after the plan has been executed
[01:02:44.090]to kind of see how did that choice that I made to address
[01:02:50.115]the problem, how did that help?
[01:02:55.690]All right, I'm gonna give you a few
[01:02:58.470]self-harm intervention strategies.
[01:03:02.350]The biggest thing is we wanna just distract,
[01:03:05.440]and then use a substitution behavior.
[01:03:08.290]So many people that do engage in self-harm,
[01:03:13.160]indicate that just a lane, an urge to self-injure
[01:03:16.470]by just a few minutes,
[01:03:18.350]can be enough to make that urge fade away.
[01:03:25.410]A few strategies,
[01:03:26.650]and you also have this in your handouts,
[01:03:31.900]and here's also the link for it.
[01:03:33.940]And there is several strategies on there for different
[01:03:37.840]things, but examples are feeling angry,
[01:03:41.270]rip up a paper, hit a pillow,
[01:03:45.450]you feel like empty or unreal,
[01:03:48.960]squeeze ice, stomp your feet.
[01:03:51.630]And just some other distraction or substitution techniques,
[01:03:55.360]do some yoga, clean, things like that.
[01:03:59.490]So I encourage you, if you do have students
[01:04:05.720]or your children are doing some self-harm,
[01:04:09.500]obviously reach out to your counselor,
[01:04:15.070]but also try to utilize some of these self harm strategies.
[01:04:22.802](air whooshing)
[01:04:24.280]Okay, real quick,
[01:04:25.250]going to go over some unique needs and topics,
[01:04:31.030]that our girls might need extra help with.
[01:04:32.970]So we're talking about nonverbal language and signals.
[01:04:36.110]We're talking about what they can do to handle
[01:04:38.900]mean girls or bullying?
[01:04:40.750]What to do with relationships, crushes and dating?
[01:04:45.960]A big one for some of our girls,
[01:04:48.370]is grooming and hygiene.
[01:04:52.210]And a lot of this stuff is what we consider
[01:04:54.200]to be like that hidden curriculum of things
[01:04:56.760]that we just assume that we learn along the way,
[01:05:00.620]but it's, it can be so difficult for our girls
[01:05:03.330]on the spectrum.
[01:05:04.640]So there are lots of resources out there that talk
[01:05:08.520]about, specific to our girls,
[01:05:13.210]our prepubescent girls,
[01:05:15.050]all the way up through young adulthood
[01:05:17.530]as far as dealing with bullies,
[01:05:20.030]dealing with social issues,
[01:05:22.790]or social media issues,
[01:05:24.940]and then also talking about sexual relationships
[01:05:30.820]and sexual health, as well as puberty and hygiene.
[01:05:36.750]And so I encourage you as a teacher
[01:05:40.120]or as a parent to seek out some of these resources.
[01:05:45.618](air whooshing)
[01:05:49.200]And all those books that we showed you are on your list,
[01:05:52.420]and many of them are available
[01:05:54.200]in some of the regional libraries.
[01:05:55.940]So if you're interested in checking those books
[01:05:58.590]out or taking a look
[01:05:59.610]at them, let your regional coordinator know.
[01:06:02.440]Now in your handouts, you do have strategies for teaching,
[01:06:06.560]a lot of those unique needs that Marci
[01:06:08.440]was just talking about.
[01:06:09.850]So we just wanna give you, have you grab that handout,
[01:06:14.550]and take a look at that handout.
[01:06:16.830]Here's what it looks like.
[01:06:18.480]Okay, and just briefly take a look
[01:06:20.350]at that and then let us know,
[01:06:22.880]is there something that you think you could try right away
[01:06:26.090]with one of your girls on the spectrum?
[01:06:28.800]Okay, or maybe a girl that you were maybe suspecting
[01:06:31.130]is on the ASD spectrum.
[01:06:33.100]So take a look at that list
[01:06:35.640]and go ahead and put in the chat box,
[01:06:37.840]something that maybe you want to try
[01:06:40.010]or that you've already tried,
[01:06:42.140]and there's only a few of them listed here, but if you pull
[01:06:45.900]out that handout out of the folder,
[01:06:48.060]you'll see that there's a whole bunch
[01:06:49.700]of different strategies you can take a look at.
[01:06:52.000]We're gonna give you just a few seconds
[01:06:53.460]to take a look at that, and then go ahead and type
[01:06:56.303]in the chat box.
[01:06:58.159](air whooshing)
[01:07:29.870]Okay, we want you to go ahead and keep putting
[01:07:32.100]those comments or ideas for things you wanna try
[01:07:34.830]with some of the, your girls on the spectrum
[01:07:38.180]that you're working with.
[01:07:39.340]So go ahead and continue that and we'll continue to respond
[01:07:42.760]to you in the chat box.
[01:07:44.030]We also wanna open it up to questions at this point.
[01:07:46.700]So if you have questions about any of the content
[01:07:49.960]or questions about a girl on the spectrum,
[01:07:53.510]feel free to go ahead and start typing
[01:07:55.230]those in the chat box.
[01:07:56.870]And all of us will grab a hold of those questions
[01:08:00.510]and give you a response.
[01:08:08.550]Continue to add those questions and from all five
[01:08:11.610]of us, we just wanna thank you for spending this time
[01:08:13.710]with us during the conference.
[01:08:15.360]And our emails are available to you on the front page,
[01:08:20.130]so please feel free to email any of us if you have questions
[01:08:24.040]further down the road.
[01:08:25.190]So thanks again and enjoy the rest of the conference.
[01:08:29.562](air whooshing)

The screen size you are trying to search captions on is too small!

You can always jump over to MediaHub and check it out there.

Comments

0 Comments

Girls with ASD_ Masking Mental Health

Description

Searchable Transcript

Comments icon comment

Related Channels

Comments