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.