Tuesday, December 11, 2007

Asperger's Syndrome: Understanding the Communication Barrier

A Guide for Adults with Asperger’s Syndrome:
Communication Ethics and Implications
By Michelle Fattig-Smith, Ed.S.
Doctoral Candidate NCU

In Ethics in Human Communication, the author states that his primary intentions for the book are: “to provide information and insights concerning a variety of potential perspectives for making ethical judgments about human communication; to sensitize participants in communication to the inherency of potential ethical issues in the human communication process; to highlight the complexities and difficulties involved in making evaluations of communication ethics; to encourage individuals to develop thoughtfully their own workable approach to assessing communication ethics; and to aid individuals in becoming more discerning evaluators of communication through enhancing their ability to make specifically focused and carefully considered judgments,” (Johannesen, 2002, p. xi). Persons with Asperger’s Syndrome, a neurobiologically based disorder with characteristics that directly affect the ability to relate meaningfully to others (American Association for Marriage and Family Therapy, 2007, p. 1), deserve the same core expectations of intrinsic dignity and worth of person, with equal opportunity towards the fulfillment of individual potential and toleration of diversity, as are considered values core to the democratic process (Johannesen, 2002, p. 23). However, people with Asperger’s Syndrome tend to have difficulty understanding emotions in others and can be viewed as egotistical, selfish, or uncaring (Forder, 1997, p. 6). Typical symptoms can also include an inability to think in abstract ways, difficulty empathizing with others, difficulties understanding another person’s point of view, difficulty with conversational skills, difficulty controlling emotions and difficulty or inability to manage appropriate social interaction (Better Health Channel, 2007). Given the diagnostic definition, symptoms of Asperger’s include: “impaired ability to utilize social cues such as body language, irony, or other “subtext” of communication; restricted eye contact and socialization; limited range of encyclopedic interests; perseverative, odd behaviors; didactic, verbose, monotone, droning voice; “concrete” thinking; over-sensitivity to certain stimuli; and unusual movements,” (Kutscher, 2006, p. 1); therefore, the communication patterns of a person with Asperger’s Syndrome seem to violate the ethically correct pattern of human communication (Johannesen, 2002, p. 59). As such, if the framework for evaluating the ethics of communication condemn the person with Asperger’s Syndrome’s fundamental communication patterns, as unethical techniques, which “tend to poison instead of refreshen the life blood” of a system, (Johannesen, 2002, p. 29) the adult with Asperger’s must be able to “accept responsibility for all undesired and undesirable consequences of our communication so far as they can be known,” (Johannesen, 2002, p. 47) or decide if “there (is) a realistic choice (at least temporarily) of refraining from communication-or not communicating at all,” (Johannesen, 2002, p. 17). Reports seem to indicate that some people with Asperger’s tend to improve into adulthood, but there is a tendency for the idiosyncratic difficulties to persist into adult life and outcomes, especially if not recognized or treated, can be poor (Ysai, 2007, p. 2).
This condition was originally described by Hans Asperger in Vienna in 1944. Although Asperger was not aware of Leo Kanner's work on autism, he did use the word autism ("autistic psychopathy") to describe the social deficits he observed in a group of boys. His original description, in German, received little attention in the English-language literature until recent years. In people with Asperger's Syndrome, deficits in social interaction and unusual responses to the environment, similar to those in autism, are observed. (Yale Developmental Disability Clinic, 2007)
Trust and Ethics
Establishing trust, grounded in ethical standards, is paramount to promoting and maintaining a democratic society (Tichy & Mcgill, 2003, p. 24) and organizational success. Team building is important with meaningful interaction between team members to enhance outcomes. Effective team building includes collaborative efforts that are purpose driven, with common goals, and emphasizing the team’s capacity for success (Harvey & Drolet, 2006). A question posed, “are leaders more effective when they are nice to people, or are leaders more effective when they use certain techniques for structuring and ordering tasks (Ciulla, 2004, p. 14)?” Many neurotypical leaders do not focus on fostering collaboration through reflective thinking to empower teachers (Glickman, Gordon, & Ross-Gordon, 2004, p. 68), but rely on traditional power structures; therefore, leaders with Asperger’s Syndrome must be overly focused on promoting such effort towards collaboration, as it is inherently difficult for most adults with the disorder to be flexible in routine or schedules or to be neurologically able to understand other’s emotional needs, (Better Health Channel, 2007) in order to promote trust through empowerment and collaborative spirit.
Leadership Attributes
The “industrial paradigm, which views leadership as good management,” includes a strong emphasis on the personal attributes of a leader (Ciulla, 2004, p. 7). Adults with Asperger’s Syndrome may show a wide range of ability in social skills and behaviors, and since common difficulties include forming and maintaining friendships, taking things said to them very literally, and understanding social rules and body language (Better Health Channel, 2007), extra effort must be made to overcome neurobiological inabilities, in order to foster strong working relationships. Social skills training or job coaching to talk about the challenges and practice modeling appropriate prosocial behaviors can be helpful (Better Health Channel, 2007).
Ethical Judgment and Standards
Making ethical judgments is a balance of allowing for “degrees of rightness and wrongness,” when a behavior demonstrated “can be judged by standards of right and wrong,” (Johannesen, 2002, p. 1). The brain of a person with Asperger’s tends to be very intolerant of imperfection or people being inconsistent, and as such, adults with Asperger’s Syndrome may be prone to immature conflict resolution skills, jumping to conclusions, or briefly intense anger when perceiving or misperceiving an ethical or personal injustice. In order to maintain a professional persona, calming or relaxing techniques may be considered, as well as learning self-talk methods, stop think act techniques, or a time-out to consider the consequences or discuss with a targeted and trustworthy person to help put a situation into perspective (Attwood, 2007). “Leaders will keep alive values that are not so easy to embed in laws-about our caring for others, about honor and integrity, about tolerance and mutual respect, and about human fulfillment within a framework of values,” (Ciulla, 2004, p. 8).
Asperger’s Syndrome was first identified in the 1940’s in Germany, but has only been widely known or diagnosed since approximately 1994, when it was included in the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV). The unwritten social rules, such as speech intonation, facial expressions, slang terms and communicative reciprocity that most neurotypical people are able to decode without difficulty in daily interactions, remain “a mystery to people with Asperger’s Syndrome. So while many may have high IQs and be technically and logically extremely proficient, they lack the ability to relate to other people,” (Attwood, 2007).
An ethical judgment could be considered matters of “individual personal opinion,” so there is no definitive answer and therefore; it could be considered unethical to “judge the ethics of others,” (Johannesen, 2002, p. 2), as some may judge or consider persons with Asperger’s to be “geeks, nerds, self-centered or obsessive. Geniuses such as Wittgenstein and Einstein are believed to have had Asperger’s Syndrome.” Adults with Asperger’s can be extremely vulnerable and socially excluded (Attwood, 2007), and in order to be a successful leader, the natural inclinations and social interaction patterns of the leader with Asperger’s will have to be overcome or compensated. According to James MacGregor Burn’s theory of transforming leadership, “A leader’s role is to exploit tension and conflict within people’s value systems and play the role of raising people’s consciousness,” (Ciulla, 2004, p. 15); therefore, self-advocacy and education for those in the work setting may be beneficial in promoting awareness and understanding. Since Asperger’s Syndrome is frequently misdiagnosed as Attention Deficit Disorders, learning disabilities, bi-polar, anxiety, or depression, many leaders with Asperger’s Syndrome may not fully be aware of their deficits in social interaction or relationship building needs (Hoover, 2006, p. 1).
Communication Barriers
A communicator should “consider the ethical criteria held by his or her audience,” if he or she wishes to be successful in a “human communication transaction,” (Johannesen, 2002, p. 3). Authenticity in communication allows for straightforward, honest sharing of information or feelings, which are “relevant and legitimate,” without saying anything or everything that comes to mind (Johannesen, 2002, p. 59). However, persons with Asperger’s Syndrome typically lack or have difficulty with this social filter. Good leaders should provide “personal and professional support, communicating clearly as well as listening, taking needed action, and delegating,” (Ciulla, 2004, p. 55). Many people with Asperger’s Syndrome have a difficult time with casual conversational skills and the tendency towards perfectionism can be “so focused on the details that they don’t make mistakes and they find it hard to accept human error in others,” (Asperger’s Syndrome Foundation, 2007). People with Asperger’s tend towards pedantic speech, perseverative or one-sided conversation, lack of eye contact, monotone, thought tics, and an authoritarian nature (Attwood, 2007), none of which are considered the good communication skills of a leader. This is considered “monological communication: defensive communication, manipulative communication, inauthentic communication, directive communication,” (Johannesen, 2002, p. 55), characterized by “self-centeredness, deception, pretense, display, appearance, artifice, using, profit, unapproachableness, seduction, domination, exploitation, and manipulation,” (Johannesen, 2002, p. 60). Becoming involved in a support group or social skills project, as well as self-advocating and educating coworkers may be of benefit to develop more socially acceptable communication patterns.
Ethics and Asperger’s Syndrome
“Without ethical principles it would be impossible for human beings to live in harmony and without fear, despair, hopelessness, anxiety, apprehension, and uncertainty,” (Johannesen, 2002, p. 5). Persons with Asperger’s Syndrome tend to be very rule-bound, detail oriented to the level of missing the big picture, prefer technical information over abstract, solution focused, with a failure to develop peer relationships (Aspergers Society of Ontario, 2007). As ethics appear to provide for neurotypicals the ability live in “harmony and without fear, despair, hopelessness, anxiety, apprehension, and uncertainty,” (Johannesen, 2002, p. 5), so could be considered ‘the rules’ for the person with Asperger’s. For the leader with Asperger’s Syndrome, communication may be a way for giving and receiving information, not as a social interaction. People with Asperger’s may be avoidant of social contacts or social events, and may experience anxiety, fear, despair, hopelessness, helplessness, depression, apprehension, and uncertainty when forced into social interaction with unwritten social rules (Aspergers Society of Ontario, 2007). Choosing a profession with little need for social interaction and highly focused technical aspects or a vocation that focuses on a person’s strengths would generally be recommended (Grandin, 1999); however, for person’s with Asperger’s who choose a profession like educational leadership, a support network or job coach may be helpful. It has been said that the freedom of the will and personal responsibility is, too, the “proverbial knife that cuts both ways,” (Johannesen, 2002, p. 6).
Criticism in leadership research is the lack of a clear definition (Ciulla, 2004, p. 9). “Deontological ethics that bases right and wrong on duty to obey universal and absolute principles,” (Johannesen, 2002, p. 8) may be the closest theory for ethics and the Asperger’s brain. A person with Asperger’s tends to respond poorly to change, sensory stimulation, lack of understanding of rules or expectations, and demonstrates a rigid, rule bound response pattern. When the rules are changed, or expectations are unclear, it can lead to exaggerated emotional responses (Asperger’s Society of Ontario, 2007). A person with Asperger’s Syndrome, generally at the core of the behaviors, prefers universal and absolute principles and doing right for right’s sake. Whereas, it may be more of a neurotypical pattern to demonstrate teleological ethics, or ethics of act based on the consequences of the action (Johannesen, 2002, p. 8). Therefore, a leader with Asperger’s may need to make conscious reminders that others working with and for him or her, may need tangible rewards or recognition for effort and not be satisfied for good work for good work’s sake.
Transformational leadership involves the concern with “end-values, such as liberty, justice, and equality,” (Ciulla, 2004, p. 15) and “moral character involves persistence, backbone, courage, toughness, energy, focus, and strength of conviction necessary for actually performing the behaviors necessary to accomplish the act,” (Johannesen, 2002, p. 10) leaving an “effect on followers by shaping their perceptions and responses,” (Ciulla, 2004, p. 55). The leader with Asperger’s may tend to be more concerned with “what he leaves behind with this world, than the accolades he receives,” (Fattig, 2007), as well as the “end value on people he touched,” (Ciulla, 2004, p. 16).
Character is an “organized set of actional tendencies” and “if these tendencies contradict one another, change significantly, or alter in ‘strange’ ways, the result is questioning of character….Without this kind of predictability, there is no trust, no community, no rational human order,” (Johannesen, 2002, p. 13). “The leader most needs followers. When those are lacking, the best ideas, the strongest will, the most wonderful smile have no effect.” Followers should be considered “fellow travelers with similar aspirations and rights to be reckoned with,” and having “the same moral, intellectual, and emotional commitment,” (Ciulla, 2004, pp. 33-37).
Common Traits
Making unintentional mistakes raises no moral alarm for persons considered neurotypical, however, intentionally and deliberately deceiving others might be morally culpable, as “communicators have an ethical obligation to double-check the soundness of their evidence and reasoning before they present it to others; sloppy preparation is not an adequate excuse to lessen the harshness of our ethical judgment,” (Johannesen, 2002, p. 9). A strong leader gives credit to others, and has no need for recognition or limelight (Ciulla, 2004, p. 49). For persons with Asperger’s, unintentional mistakes may raise a moral alarm as problems with social cues, using social rules, and literal interpretation or communication from others can cause ‘intent’ to be attached to even unintentional mistakes or slights (Aspergers Society of Ontario, 2007). So too, can deliberate or uneducated ignorance cause harm, i.e. statements such as, “He can not have Asperger’s Syndrome, he doesn’t lick strangers in the face,” (Lawrence, 2007) or “We don’t believe in that Asperger’s stuff,” (Buhlke, 2007), or “He can’t be autistic, he’s too smart,” (Smith, 2007). When “professionals” assert these mistruths under the guise of ‘expert authority,’ they utilize communication techniques of an insincere person, “sincerity is more difficult to check and easier to fake than logicality or consistency,” (Johannesen, 2002, p. 10), and “it’s difficult to have heroes in a world where every wart and wrinkle of a person’s life are public,” (Ciulla, 2004, p. 3). When a professional makes such statements, it can seriously impact upon a person trying to find support and answers to a debilitating disorder.
“A single lie does not necessarily make us a liar; but a series of lies may,” (Johannesen, 2002, p. 12), to the neurotypical brain; however, to the more rule-bound, right or wrong, socially naïve (Aspergers Society of Ontario), Asperger’s brain, a single lie a liar makes. “Integrity flaw outweighs any other,” (Johannesen, 2002, p. 13) and “dogmatic inflexibility is ethically suspect,” (Johannesen, 2002, p. 14). Dogmatic inflexibility, by the very nature of the disorder according to the Diagnostic Criteria for Asperger’s Disorder 299.80 (DSM-IV-TR), is a neurobiological pattern of rigidity without option or choice. Over time, a person with Asperger’s may begin to distrust people, because of past negative experience with people (Autism Awareness Centre, 2007). “Unless there are reasons to be skeptical, we expect people to mean what they say,” because “trust in some degree of truthfulness is a foundation of relations among human beings.” Each communication has unspoken expectations or ‘unwritten rules,’ which helps to define the relationship between the communicators (Johannesen, 2002, p. 14). A leader with Asperger’s tends toward very literal interpretation and may have difficulty understanding dishonesty, so he or she may adhere to a black and white opinion, i.e., if a person lies, the person is a liar (Kutscher, 2006, p. 11), and as such, anxiety and withdrawal can occur due to difficulty adapting to complex social situations and the unwritten rules (Stein, Klim, & Miller, 2004).
Minimally, “good behavior” intends no harm and respects the rights of all affected, and “bad behavior” is willfully or negligently trampling on the rights and interests of others,” (Ciulla, 2004, p. 29). Because leaders with Asperger’s Syndrome have the disadvantage of essentially violating the code of conduct for ethical leadership and social interaction by neurobiological default, to who is the ethical responsibility of good behavior owed (Johannesen, 2002, p. 16), the leader with the disability or the coworkers who are nondisabled? And if “human nature flowers at its fullest not in isolation but in relationship and interaction with the environment and other humans,” (Johannesen, 2002, p. 49), why so does the adult with Asperger’s tend towards social isolation by choice? “We attempt to understand factually and emotionally the other’s experience,” (Johannesen, 2002, p. 59), moreover, if true ethical leaders “must give full concentration to bringing their total and authentic beings” to a conservation, avoiding distractions, and “reveal ourselves to others in ways appropriate to the relationship,” (Johannesen, 2002, p. 59), can a person with Asperger’s ever be considered an ethical leader? Or do those with a neurotypical brain, or in truth, does society “strive to impose their truth or program on others” with “superior attitude” who “must coerce people to yield to what they believe others ought to know” with a “defensive attitude of self-justification,” insisting that leaders with Asperger’s communication patterns “become evil when they predominate our life and increasingly shut out dialogue” (Johannesen, 2002, p. 61), or disrupt traditional thought and practice with a version of what a leader is and can be, as “pure dialogue seldom occurs,” (Johannesen, 2002, p. 63).
Many health care providers and the public do not widely understand or recognize Asperger’s Disorder or what it means to have Asperger’s Syndrome (Watkins, 2007, p. 1) or the daily struggles entailed. However, in addition to coaching interventions, social skills training, support groups, cognitive therapy, behavioral modification training, and other traditional support therapies, pharmacological interventions may be useful for persons with Asperger’s Syndrome. Medications can be especially useful in treating symptoms such as attention deficits, hyperactivity, anxiety, obsessive compulsive behaviors, tics, delusions or hallucinations, depression, mood swings, or sleep disorders (Tsai, 2007, p. 5). Many physicians and people with the disorder may be worried about the safety of the stimulant medications due to unfavorable media reports; however, the FDA Pediatric Advisory Committee in March of 2006 found that there is no increased risk of cardiovascular incident in healthy individuals. When comparing rates of sudden death, in individuals taking ADHD medication and the general population there was found to be no significant difference. Self-advocacy will again be key, in that “many clinicians trained to treat adults have little experience in diagnosing and treating those with these impairments on the autistic spectrum,” and few treatment resources may be available (Brown, 2006, p. 2). Medications may present with unintended social side effects, and follow up visits with a physician should include discussion of social benefit or becoming less socially active and potentially minimizing any negative effects (Aull, 2004, p. abs).

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Sunday, July 29, 2007

Adults with Asperger's Sydrome and Attention Deficits

AS as an adult presents its own challenges...
Considering my early experiences in education, which were not so grand, it is a surprise to find myself in 23rd grade and actively seeking yet another degree. I have a son, who is gifted with learning disabilities, Asperger's, and ADD. I, too, have learning disabilities, AS, and ADHD. My goal in creating the Annie Books, is to make a meaningful and lasting difference in the lives of children and their parents. During my Kindergarten through Second grade years, I was placed in a box at school. I don't mean a figurative "box," I mean a real "stove" box. A hole was cut out in the front to allow me to see the teacher, but it was meant as a preventative measure for my incessant need to chat with my neighbors.
Being young and happy, I had a lot to say. I just assumed that everyone else enjoyed my company as much as I did! As I moved into upper elementary, I became more, anxious, shy and self-conscious. My social ineptness became more glaringly apparent, and my seeming inability to make or keep friends, caused me great sadness. We moved a lot, and I experienced five school systems prior to middle school. My extreme shyness and discomfort gave way in high school to a "cheerleader smile," which I used to keep anyone from asking what was wrong. AS girls are excellent at "masking" our difficulties.
I excelled at sports, academics, and leadership activities, but I could never figure out why I felt different. The meltdowns I experienced in response to random over-stimulation (could be a great basketball game or a fight with a boyfriend) became more and more extreme. My hyperactivity and impulsivity gave way to anxiety and depression. During my sophomore year, I began to believe that I was stupid, and started threatening to quit school. Six weeks after graduation, I left for the Air Force. It was during my service in the military, in night school, that I began to realize that I could be a learner. I found enjoyment in the pursuit of education.
I became a single parent at a very young age. Working fulltime during the day as a microbiologist and medical technologist, I completed my undergraduate degree and my graduate degree in School Psychology. When my son started school, he was a happy, smiling, outgoing little boy. The day he stepped into his classroom, the light in his eyes dimmed. His teachers bemoaned his inattentiveness, and seeming inability to focus.
My son was in second grade when he began labeling himself as stupid. We had many afternoon and evenings of the, as I call them, "Why can't you just(s)?" Why can't you just focus? Why can't you just get started? Why can't you just put something on paper? It took me years to understand, if he could … he would. I started reflecting on my own, "Why can't I just(s)?" Why can't I pay attention? Why can't I just be normal? Why can't I just be happy? Working as a School Psychologist, I found enjoyment and my professional niche with inner city emotionally disturbed children. I could work with all of my students and diffuse the most volatile circumstances with understanding, support, and acceptance. Unfortunately, even as a 'successful' adult, my inability to 'get' the unwritten rules of social niceties, continues to plague my interactions with same age peers. I do, however, find extreme pleasure in working with children, parents, and senior citizens. The rules are clear, and the expectations are obvious. -Michelle

Tantrums and Emotional Meltdowns with AS. Are we there yet? Are we there yet? Are we there yet?

Although, she usually says it with a bit of a twist downward at the end, so she sounds like, “I’m bo-ored.” Generally, we can expect it as soon is she is up for the weekend or any school break. We, with AS or ADD, LIKE our routines, to put it mildly, and my daughter is no different. The itchy, uncomfortable, flushed feeling is a very big problem when our routine is changed or different. The ick chemicals that flood our system in response to over or under stimulation, is difficult to shake and waking up with the dread of it hitting is, at times, unbearable.
My grandmother used to say she had ‘sit-it-is.’ When we have a large, unstructured task ahead of us (i.e., house to clean, chores to do, paper to write, etc.), we tend to get overwhelmed with the ‘getting started’ part of the equation, often waiting until the last second and trying to cram it all in OR being unable to ever get started. A typical day for me, prior to Adderall, on a weekend: ‘I need to clean the house, get groceries, and then we will have time to play.’ However, I couldn’t seem to figure out where to start, so I would have a cup of coffee and just watch ‘a few minutes’ of (whatever mindless drivel might be on). A few minutes might lead to several, leading to an hour or more, at which time I would be frustrated with myself. The initial ‘sit-it- is’ is hard to overcome, but the ensuing SIT-IT-IS is almost impossible to overcome. Therefore, anxiety, depression, self-loathing, or apathy can swoop in.
It is no wonder that many adults diagnosed with Attention Deficits or Asperger’s Syndrome are first diagnosed with depression, anxiety, or other mood disorders. I graduated high school in May, turned 18 in June (many, many years ago), and left for the Air Force in July. Growing up, my routine included school, chores, sports, church activities, etc. I managed my parents’ kennel, and had a very busy schedule and routine (comfortable fit). Then, I graduated and my sister needed to learn how to manage the kennel. Therefore, I had no chores, no school, no general activities, and my routine was GONE, ALTERED, CHANGED! Argh! I remember, I actually tried to sleep for that entire month or so, prior to leaving for basic training.
The emotional difficulty and nasty chemicals that flood our bodies in response to under or over stimulation (for you Neurotypicals (NT), who may not understand, it can be compared to that horrifying feeling you might have getting a call in the middle of the night, and realizing that your teenager didn’t make it home yet, or at other times, similar to that rush of adrenaline or fight/flight chemicals you might get if you slam the brakes on, barely missing the deer that just ran in front of you unexpectedly), are real, and we really feel them, however, they don’t dissipate as quickly as they might in NT’s.
When our daughter first announces, “I’m BO-ORED,” her little face appears somewhat pale, and her little eyes have dark circles under them. She is hypo-reactive to stimuli, so constantly has to fidget, pick, argue, tip, or otherwise seek the stimulation she needs to overcome the sit-it-is chemicals. She is, in essence, seeking a fight to feel better inside. When she says “bored” she is actually describing an aversive, frustration which is exhausting and overwhelming. Our daughter has, generally, two emotional labels when she is not feeling whippy, they are ‘bored’ or ‘mad.’ Mad feels better than empty, hurt, frustrated, embarrassed, etc., so the fight she is looking for, is a coping mechanism rather than a naughty child.
What works?
Everyone is different. Our son is hyper-reactive to stimuli, so is very easily overwhelmed by sights, lights, sounds, touch, taste (of the feel of food), and therefore, his response to the lack of routine or change is to burrow! He blocks off the windows and spends free time burrowed under blankets, in sleeping bags, or other ‘close’ spaces. His response to a change in furniture (even just moving a couch), has been, “You broke it! Put it back!” Every time I have moved with him, I have had to go into his ‘new’ room, paint, decorate, and arrange furniture exactly the way of his old, or he won’t sleep in it, EVER.
With Miss Lili, quick interactive activity, with structure and a written schedule to the day is helpful. If I can get her engaged, BEFORE the chemicals can wipe her out, she quickly regains color, happily complies with directives, and is generally our delightful little girl. As I have mentioned before, you cannot discipline away a disability. Therefore, grounding her will not wash out the ick chemicals, spanking her will not improve her attentiveness/stimuli, sending her to her room cannot override the feelings we experience biochemically. Quick interactive games to engage her may include: Slap Jack, tossing a ball or bean bag, Speed Game, Nonsensical wordplay, dictionary search, math quizzes, Sudoku, or other. If I am too late, and she just can’t get past those horrible feelings, a deep pressure hug (at first she resists, but within a few seconds her body relaxes), and defining the moment, “Lili, you are not mad at (fill in the blank) right now, you have that feeling we get. Let’s try breathing together.” She generally screams back, “I FEEL FINE,” then flees to her room and slams the door. (Embarrassment to us is also like the late night terrifying phone call-feeling (hot, sinking pit in the stomach, flushed face, top of head feels heavy pressure, etc.), so it is best to let us flee with our dignity.) She generally flits back down the stairs with a smile, within 30-45 seconds. I don’t bring it up for at least a half an hour, but will then say, “Those feelings, yep?” She looks sheepish, and nods affirmatively.
For adults, a good defense against the under-stimulated, itchy feeling is a treadmill. 30 minutes of cardio exercise increases the serotonin and improves mood dramatically. Those of us with AS and ADD tend to struggle with sleeping at night. Our brain races as our body ‘comes to rest.’ The body replenishes it’s feel-good chemicals during REM sleep, so those of us who have difficulty with sleep start the day at a disadvantage! Incorporating daily exercise boosts those feel-good chemicals, and helps smooth the emotional rough spots. Omega-3 fish oil is VERY helpful for those of us who are hyper-reactive to stimuli, as well.