Episodios
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Join Dr. Regan for the fifth episode of the Lifespan of a Household series. Today's episode focuses on topics important to autistic individuals who are parenting young children.
Autism in the Adult website
Resources for professionals
Video Visits
Video Courses
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Join Dr. Regan for the 4th episode in the Lifespan of a Household series. Today's episode focuses on topics important to the autistic individual who is preparing for parenting.
Autism in the Adult website
Resources for professionals
Video Visits
Video Courses
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Join Dr. Regan for this third episode in the "Lifespan of a Household" series. This episode highlights topics important to living in shared space, including the sensory environment, alone time, and control over objects. Also, check out links to resources on her website and a transcript of the episode below.
Autism in the Adult website
Resources for professionals
Video Visits
Video Courses
Hi, everyone. Thanks for joining me for this third episode in our series on autism and the lifespan of a household. My name is Dr. Theresa Regan, and I'm your host. I'm a neuropsychologist, a certified autism specialist, and mom to a young adult on the spectrum. This series is the result of listener requests about living as a couple or as a family within a shared household. And as we've touched on, one of the challenges of tackling the topic is that households can take so many different forms. And I know that I can't do them all justice in just one series, but I wanted to touch on some important life seasons within a household.
So our first episode was about dating, and the second covered the topic of physical intimacy and relationships. And today we're going to talk about sharing physical space with other people. So joining households, living in the same space. I'll also let you know that a lot of my website renovations have been completed. There are still some things I'm tweaking and trying to make work better, but lots of the pages are active and working. And I also now have the new service of video visits for people to consult me about the topic of autism or how that impacts you in your household. There are some geographic limitations and there are some specifics about payment and if you are interested in that type of service head on over to my website at adultandgeriatricautism.com and look under video visits.
So there are many different instances where physical space might be shared in a type of household. So we may be talking about a traditional couple or a family household or even other situations like having roommates or renting a portion of someone else's home. And sharing living space can be complex for lots of reasons, but for the autistic, there may be a few specific challenges that we could cover in the episode today that would help people navigate those things. So in particular, we're going to cover the sensory environment, alone time, and having control over objects.
So let's tackle the sensory environment first. First, because the autistic individual may have sensory sensitivities, living in the household with other people may be overwhelming because people bump into each other or reach over each other or they brush against each other to navigate the physical space. Noise can be another sensory input that's elevated in a household, and the noise could include voices, babies crying, arguments, even just surround noise like television or music. How things smell can be important to someone on the spectrum. The scent of food cooking or aftershave, candles, cigarettes, cleaning products, taste and texture can come into play if we're talking about shared groceries or family meals, does everyone have to eat the same thing?
Let's not forget about visual inputs. So not only does this include lighting, but a very common issue that I hear about is concern for the visual space or having visual chaos. So for some on the spectrum, the sight of a visual messiness or overcrowdedness or chaos can be overwhelming. And this could include things like decorations, messy work areas, things on the floor, clothes, garbage, food, strewn about various surfaces. And this visual chaos can feel overwhelming. Now, before you start laughing because you've seen someone's space and you know that they're not concerned about visual chaos, that's true. Not everyone on the spectrum will have the same sensory processing feature. And neither will everyone who is neurotypical. So people in the household will have different preferences. Many people on the spectrum may have very little care for the visual cleanliness or organization of their space except for a few specific things. So maybe they have very significant care about where their favorite objects are placed or how things are lined up, but other things are strewn over the floor and there's not much care at all. The more people there are in the household, the more mix there will be of habits and preferences and clash with the habits and preferences of others. Another complicating factor is that as people age across life seasons, their sensory processing and preferences can also change. So you have not only complexity, but you have this multifaceted, always changing sensory sensory environment, and sensory preferences across multiple people within the same shared living space. So that is a moving, dynamic, complex kind of issue.
Now, one of the best ways to start addressing this is what we've talked about in multiple other episodes, And that is self-awareness. So that's that ability to say, hey, I know what makes me tick. I know what my nervous system likes and doesn't like. I know what I need today. And I also observe and have talked to and am aware of other household members. I have awareness that what they need may not be the same thing I need. And this place is shared by people with different needs. So having awareness of what the needs are is a huge place to start. The next step is to add the right now element. So the self-awareness that we talked about, that's the always element. Like, I know what's generally, typically always true about our household from day to day. Now, look at the right now element. So in this specific moment, what do people need? What do people need this morning, today, this week, this holiday season? One way to accomplish this in a household is to have huddles. So a huddle is a very quick rundown. It's a triaging process. For those of you who maybe use that in a workplace or know what that means, triaging is the ability to quickly scan what's happening, what's most important, what needs to be done the quickest, and to prioritize how these things will be handled. So in a triaging process where people are able, they're already self-aware, they're are able to highlight how their system is doing and what the day will be or has been like given their schedule. A huddle could take place between two parents of three young kids, maybe in the morning and after work. This type of brief communication helps everyone get on the same page. So instead of this confrontation and argument where one person says, I told you to do this or why are you doing that? We start with, hey, this is really chaotic. what do you need right now? This is what I need. This is the schedule for the day. This type of communication also represents and reestablishes that the household is committed to partnership. I want you to do well. I want to know what's important to you and what you need. And here is what is a priority for me today. So rather than being impulsive and reactive to what's happening throughout the day, oh my gosh, something just happened to me. I react to it because I want it to stop. We can start off with awareness and a general game plan rather than kind of flipping around crisis mode, and often that means pushing against other people.
The household itself will also need some adaptations to the sensory needs of the individual. So not only do we start with self-awareness and then have up-to-date huddles, like this is what's going on this morning, this is what's going on after work, we also have to look at the sensory needs in the whole household and how that can be adapted. So there will likely be some foods that are completely off the table, like there's just such a high smell, taste, or texture aversion that cannot be avoided or coped with that it's not worth the amount of drain on people in the household. So one person may love fish or collard greens or something with a strong smell or scent that's really overwhelming to someone else and there's just no way around it. It just gets into the house. So those foods are off the table. If you're going to have that food, go out to someone's house as a guest and eat it there or eat it at a restaurant. Some adaptations may not be all or nothing. They may have to do with getting equipment like sound-canceling headphones or earbuds for people, sometimes having a designated quiet time if the kids are old enough to understand stand and regulate this. Like 12 to 1 is quiet time. A weighted blanket may be a good sensory tool for calming, as might something like a rocking chair or a swing set.
Another thing I want to point out that may be confusing to people about the sensory environment in household with neurodiversity is that the person who is sound sensitive may also make a lot of noise. And that seems to be because the noise they make is predictable and controlled by them, whereas the noise that comes at them can feel repeatedly startling and overwhelming and they don't have the control that they need. And another thing is that sometimes, you know, it's this hard to understand presentation because the person may be loud because they're overwhelmed and need quiet. So it can be, you can't always kind of look and say, well, you're being loud, you must not need quiet. Or you're running around and crashing and rolling, you must not need quiet time. So a lot of times those kinds of behaviors are a signal that the person does need some regulation help, and that can be achieved by a quieter space, time alone, a weighted blanket, and those kinds of things.
In addition to having things about the environment that support sensory needs within the household, consider having separate time or alone time so that people don't have to do things together. I know sometimes as a family, we try to create this together time or a family evening or a forced family time. And sometimes that's great and there are great memories. And other times, you may become aware that the needs of the people in the household are such that separation time is so important that there's a place for that as well. So for example, one person could do homework in one household location and a second person in another. So rather than having both kids at the table doing homework so that it's convenient for for the parent to help or whatever, that just may be unrealistic for either of those individuals and their sensory needs. They may need space and quiet and time. One individual could work on a chore at a separate time or space than another individual doing their chore. So I worked with a family once that had two teen girls and one was neurotypical and one was autistic And they were very perplexed at the autistic individual who didn't have a diagnosis that all of a sudden she would melt down and push her sister and just be so, quote, unreasonable, end quote, that she'd have to wait outside until she could calm down and come back in. And what actually was happening is that because they were doing chores in the same room, which was the kitchen every night, but the chores were split. The shared space was too much. And sometimes the sister would do just silly, friendly, wonderful things that she thought would be no big deal, but were really overwhelming. At the end of the day, you know, the resilience for the one child was just really low and touch, especially unexpected touch, a hug from behind, tapping on the shoulder would just set things off. So allowing people to do their chores in separate areas.
There could also be individual variants. Sometimes our kind of go-to within a household is that everyone is the same. It's most fair if everything is the same for every child all the time. And actually that just may not be realistic and it may not end with the best outcome. So sure, there are some things that are the same for every person in the household and there probably needs to be some individual variance as well. So this is your toothpaste flavor. This is your shampoo scent. And in the end, the target will be a balance of number one, no one does this. So maybe that's smoking or Cook's Curry or Blair's Music all the time. Number two, individual variations. So we make sacrifices for each other and we give each person breaks and some alone time. And number three, some of we all do this. Like we all have huddles. We all try to figure out how everyone can get their needs met. We all try to focus on compromise and having an awareness in the moment. So having a mix of this never happens, this always happens, and let's do some individual triaging. That's going to work really nicely.
So what we covered so far was the sensory environment. And the second point we're going to talk about is alone time. So alone time is typically really important for the regulation of the nervous system for the autistic. So protecting someone's alone time likely needs to be a very high priority. You can see how this gets easily eaten up, particularly if there's kind of a traditional family unit where there are multiple people in the same household. Everyone comes together at dinnertime. They have multiple things that they need to get finished. They need to work together. There are errands to run. And there's a lot of times when other people need something from you. I want a snack, I need help with this, I need you to do X, Y, Z so I can have a break. This would be a good time for a huddle. So let's regroup. Let's get a game plan that we actually decide on rather than just reacting about. And let's not let life roll over us and us trying to keep up with the flow. You might want to designate where someone can get alone time. Maybe there's a tree house, a garage apartment, a basement area. Try to be creative and create space for this. So it may be in a corner of a room with a small tent-like structure and pillows inside. Maybe under a table with a blanket for small children. The adults need alone time too. Regrouping after After work, it can be really hard for both spouses to come home from work and then feel like they both need alone time and yet they have kids running around in the house or other demands on them. The huddle can help work together to figure out how each person can decompress. Maybe alone time is riding your bike after work, driving your kid to baseball practice, but needing to read a book in the car rather than getting out and visiting with parents or watching practice. Maybe there are things the family do all together, like eating meals or doing chores or playing games or watching movies, but there may be room for thinking about who needs alone time rather than together time, and not to have this picture that the family is doing the the best when everyone wants to be together all of the time. So really trying to protect and designate alone time and separation time for each family member based on what their nervous system needs.
The third thing I want to talk about in a neurodiverse household has to do with having control over objects. So this may or may not be something that rings a bell with you or that you relate to. But for many people on the spectrum, they just have a real keen eye for objects and they may like to accumulate them or have collections of them. They may have a hard time throwing things away or sorting through things that they don't need. And so there can can be this real feeling of importance about where the objects are and are they safe and can I see them? And so that may have to be taken into account within a household as well. The person may say, yes, a place for everything and everything in its place. Again, that these objects are important and the symmetry of them is important and where they go is important. And I want people to put everything back where it should belong. One person may really focus on keeping items rather than parting with them to free up space and reduce clutter. letter and that can be a difference in how different people in the household want to work. So it could really stress someone to have too many objects in the house and it can really stress another person to part with an object.
Take for example an autistic child who leaves their stuffed animal in the family car and wakes up in the middle of the night and realizes that that they don't have their stuffed animal and they're very worried that rabbit is not going to be okay in the car. So if I can't see where rabbit is, then I feel like they might not be okay. I really need parent to go out and get the stuffed animal from the car. Now for the autistic child, that may be a very strong, important nervous system need because they may actually really worry about this object if it's not in a known location. So understanding is one of the first steps, right? I understand why this child needs this and I respond according to how high the importance is for them. Compromise is another part of this. Like if I have self-awareness that that objects are really important to you, and you have self-awareness, that visual calm is really important to me, then can we compromise? Could a compromise be that we store things in a storage unit that are not out in the open, but you know that they're safe and protected, and you can can alternate objects whenever you want. So you could take some objects that are on display at home. You can go to the storage unit and change them out for other objects and bring those objects home. So some sort of compromise would be ideal. So understanding this actually is really important to them. And them understanding what's very important to you.
So what doesn't work is these repeated conversations about, it's fine, it's just a stuffed animal, it's just a transformer collection, it's, you know, even for people who are retiring and downsizing, we hear this, that, you know, I just can't get rid of my collections, it would be like a death in the family to downsize. It can be that upsetting. So again, I think the part I want to point out here is that that neurologic. Strain is very real for them. That's really a very difficult thing to do. And reasoning with the person about why you don't need these boxes anymore or the cleanliness of the area or the safety of the area, that's really not going to be that compelling to them. What might work a little bit better is number one, seeing if they can give some of the objects to a trusted person so that it has a good home, rather than just throwing it out or giving it away to an unknown person. Another thing that could work is compromising about a space where things can go. As we said, it could be a rented space, it could be an outbuilding, a place in the basement, and how much can be visible at one time. And it also could be compromise about spaces that are protected. So you have your space in this man cave here or whatever, and you get to put your objects in this space. But every other place in the house that's a family area, we compromise about. And then I get my space. And so I get to make decisions totally in my space about visual calm and being uncluttered. So we have some compromise space and some individualized space.
Living in a household is complex because everyone has a nervous system. Everyone's system is a little bit different than the other person's. And the best place to start is self-awareness. And knowing that there's going to be this fluidity from day to day and from life season to life season. The things that are calming or soothing or upsetting and frustrating are going to be different to a two-year-old than they are to an 18-year-old than they are to a 50-year-old, etc. So this dynamic and moving thing that is a household is going to have these elements. So self-awareness, compromise, huddling up, making some decisions about the space and how the space can support the needs of the individuals, and really knowing what is legitimately very difficult for each person.
I'm so glad you joined me today to talk about living in a household, sharing space, joining households. Households, and I hope you'll continue to listen to this series on the Lifespan of House
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Dr. Regan continues the series about the lifespan of a relationship and/or household. The first episode focused on dating relationships, and this second episode focuses on sexual intimacy in relationships with an autistic partner.
Dr. Regan's Resources:
Empowered Parenting
Zur Institute courses for clinicians
Understanding Autism in Adults and Aging Adults, 2nd ed
Audiobook
Book: Understanding Autistic Behaviors
Autism in the Adult website homepage
Website Resources for Clinicians
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Dr. Regan begins a new series about the lifespan of a relationship and/or household. This first episode focuses on dating relationships. The episode provides practical insights and strategies to help you make informed and intentional choices in your relationships, ensuring they are fulfilling and sustainable for both partners.
Dr. Regan's Resources:
Empowered Parenting
Zur Institute courses for clinicians
Understanding Autism in Adults and Aging Adults, 2nd ed
Audiobook
Book: Understanding Autistic Behaviors
Autism in the Adult website homepage
Website Resources for Clinicians
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Join Dr. Regan for the final episode of the Powerful Self-Care Series. Rather than becoming the victim of an intense world, constantly in survival mode, learn strategies for self-care. This episode focuses on how to increase resilience in active and effective ways.
Empowered Parenting
Dr. Regan's Resources:
Zur Institute courses for clinicians
Understanding Autism in Adults and Aging Adults, 2nd ed
Audiobook
Book: Understanding Autistic Behaviors
Autism in the Adult website homepage
Website Resources for Clinicians
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Join Dr. Regan for this second episode of the Powerful Self-Care Series. Rather than becoming the victim of an intense world, constantly in survival mode, learn strategies to become effective with self-care. This episode focuses on how to reduce draining inputs in order to budget your resilience.
Explore Dr. Regan's new Learning and Equipping page and the specific course page for "Empowered Parenting."
Dr. Regan's Resources:
Zur Institute courses for clinicians
Understanding Autism in Adults and Aging Adults, 2nd ed
Audiobook
Book: Understanding Autistic Behaviors
Autism in the Adult website homepage
Website Resources for Clinicians
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Join Dr. Regan for this first episode of a new self-care series. Rather than becoming the victim of an intense world, constantly in survival mode, learn strategies to become powerful at self-care. The first step is self-awareness which can begin by noticing your fight, flight, freeze, and physical reactions to events and experiences.
Explore Dr. Regan's new Learning and Equipping page and the specific course page for "Empowered Parenting."
Dr. Regan's Resources:
Zur Institute courses for clinicians
Understanding Autism in Adults and Aging Adults, 2nd ed
Audiobook
Book: Understanding Autistic Behaviors
Autism in the Adult website homepage
Website Resources for Clinicians
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Join Dr. Regan for the third and final episode of the Communication Series. This episode highlights ways to communicate while talking about challenging topics.
Explore Dr. Regan's new Learning and Equipping page and the specific course page for "Empowered Parenting."
Dr. Regan's Resources:
Zur Institute courses for clinicians
Understanding Autism in Adults and Aging Adults, 2nd ed
Audiobook
Book: Understanding Autistic Behaviors
Autism in the Adult website homepage
Website Resources for Clinicians
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Join Dr. Regan for the second episode in the Communication Series. This episode highlights ways to use communication to protect and grow relationships.
Dr. Regan's Resources:
Zur Institute courses for clinicians
Understanding Autism in Adults and Aging Adults, 2nd ed
Audiobook
Book: Understanding Autistic Behaviors
Autism in the Adult website homepage
Website Resources for Clinicians
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Join Dr. Regan for the first episode of the new Communication Series. This first episode highlights moments of connection, such as talking in the car, going out on date night, and catching up with a friend. Tune in to hear what to avoid and what to focus on to enhance connection.
Dr. Regan's Resources:
Zur Institute courses for clinicians
Understanding Autism in Adults and Aging Adults, 2nd ed
Audiobook
Book: Understanding Autistic Behaviors
Autism in the Adult website homepage
Website Resources for Clinicians
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In this third episode of the executive function series, Dr. Regan discusses sticking, releasing, and switching gears in everyday life.
Related resources:
Podcast Episode: Autism and "Just Right"
Podcast Episode: Gaining Momentum for Activities
Amazon: Time Timer (I don't receive any income from your purchase)
Dr. Regan's Resources:
Zur Institute courses for clinicians
Understanding Autism in Adults and Aging Adults, 2nd ed
Audiobook
Book: Understanding Autistic Behaviors
Autism in the Adult website homepage
Website Resources for Clinicians
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The Holidays and Autism: Holding Fast and Letting Go
Planning a Merry Holiday on the Autism Spectrum
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In this second episode of the executive function series, Dr. Regan breaks down how speed, working memory, and sequencing impact daily life.
I Love Lucy chocolate factory TV clip
Executive Function Book Series by Dawson and Guare:
Smart But Scattered (children's version)
Smart But Scattered (Teen version)
Smart But Scattered (adult version)
Dr. Regan's Master Class for Clinicians (Sept, Oct, Nov, Dec 2023)
Zur Institute: Master Class
Dr. Regan's Resources
Book: Understanding Autism in Adults and Aging Adults, 2nd ed
Audiobook
Book: Understanding Autistic Behaviors
Autism in the Adult website homepage
Website Resources for Clinicians
Read the transcript:
100:00:05,570 --> 00:00:06,059Hello,
200:00:06,070 --> 00:00:06,820everyone.
300:00:06,829 --> 00:00:08,659This is Doctor Regan.
400:00:08,670 --> 00:00:13,670I'm joining you for an episode of Autism in the adult podcast.
500:00:14,020 --> 00:00:14,880For those of you.
600:00:14,890 --> 00:00:16,260New to the podcast.
700:00:16,270 --> 00:00:18,020I'm a neuropsychologist,
800:00:18,030 --> 00:00:20,190a certified autism specialist,
900:00:20,420 --> 00:00:25,180and the founder and director of an autism diagnostic clinic for adolescents,
1000:00:25,190 --> 00:00:28,940adults and aging adults in Central Illinois.
1100:00:29,549 --> 00:00:35,240And today you are listening to the second episode in a series on executive function.
1200:00:35,750 --> 00:00:47,139And this is a topic we're covering because many of the strengths and challenges that go along with the autistic neurology fall within the realm of executive function.
1300:00:48,849 --> 00:00:51,619Before we dive into that topic for today,
1400:00:51,759 --> 00:00:58,540I'd like to thank Amanda who pointed out that my diagnostic terms in the first episode were imprecise.
1500:00:58,830 --> 00:01:03,279I use terms that are common in my day to day interactions with patients,
1600:01:03,290 --> 00:01:04,819families and physicians,
1700:01:05,080 --> 00:01:07,900which are the terms ADD and ADHD.
1800:01:08,089 --> 00:01:09,099However,
1900:01:09,110 --> 00:01:16,800the most precise and current terminology is ADHD predominantly inattentive presentation.
2000:01:17,379 --> 00:01:21,389ADHD predominantly hyperactive -
2100:01:21,470 --> 00:01:26,199impulsive presentation, or ADHD combined presentation.
2200:01:27,379 --> 00:01:29,589And I guess in reviewing that in my mind,
2300:01:29,599 --> 00:01:32,720I think it's similar with the term dementia,
2400:01:32,730 --> 00:01:37,550which is often still used in day to day language in clinical settings,
2500:01:37,559 --> 00:01:42,690even though the most recent and precise term is major neurocognitive disorder.
2600:01:43,360 --> 00:01:43,650So,
2700:01:43,660 --> 00:01:44,410thanks Amanda,
2800:01:44,419 --> 00:01:51,279I'll stick to being precise and specific in podcasts about the topic of ADHD
2900:01:51,839 --> 00:01:55,230And instead of using each of the subtypes,
3000:01:55,239 --> 00:02:07,379I will just use the term ADHD unless I'm speaking about specific features of one subtype. As we discussed in the first episode,
3100:02:07,389 --> 00:02:16,580executive function is really a broad term and it's includes multiple subfunctions or subcategories.
3200:02:17,179 --> 00:02:33,800And this is a series that I really encourage you to listen to the first episode before listening to subsequent episodes because it really went through a lot of layers of explaining executive function, ADHD, and autism ...
3300:02:34,350 --> 00:02:37,160how those relate or don't relate to each other.
3400:02:38,539 --> 00:02:43,720So the subcategories of executive function include things like attention,
3500:02:43,990 --> 00:02:45,919goal directed persistence,
3600:02:45,929 --> 00:02:47,949organization, response
3700:02:47,960 --> 00:02:50,020inhibition and several more.
3800:02:50,440 --> 00:02:50,990In fact,
3900:02:51,000 --> 00:02:53,229depending on what source you're using,
4000:02:53,240 --> 00:02:57,669there can be about 12 or so sub functions identified,
4100:02:57,679 --> 00:03:06,410even though there's really no complete agreement on how to list out the sub functions within executive function.
4200:03:08,110 --> 00:03:17,000There are two main developmental diagnoses with large executive function components and these include ADHD and autism,
4300:03:18,710 --> 00:03:23,160the ADHD criteria, as we talked about in the previous episode,
4400:03:23,339 --> 00:03:28,899only describe symptoms falling within about four of the subcategories.
4500:03:29,720 --> 00:03:35,460I would label these subcategories in the ADHD as organization,
4600:03:35,500 --> 00:03:41,690attention, response inhibition, and goal directed persistence. For example,
4700:03:41,699 --> 00:03:50,500"fails to give close attention to details or makes careless mistakes" is one of the criteria that can be met in ADHD.
4800:03:50,919 --> 00:04:08,720And I would say that, as a symptom, that falls within the subcategory of attention. "Blurts out answers before questions have been completed" is an ADHD symptom that falls within the executive function
4900:04:08,729 --> 00:04:13,100subcategory of response inhibition.
5000:04:13,809 --> 00:04:20,420So is somebody able to inhibit or stop a response until they think it through?
5100:04:21,890 --> 00:04:31,679So autism will present with core executive function features in some combination as well across the totality of the 12 categories.
5200:04:31,959 --> 00:04:40,040And these features are some of the strengths and gifts within the autism presentation.
5300:04:40,049 --> 00:04:45,309and also some of the challenges. In this episode,
5400:04:45,320 --> 00:04:48,559we're going to focus on the executive function
5500:04:48,570 --> 00:04:53,600sub features of working memory, speed, and sequencing.
5600:04:54,100 --> 00:05:01,769And I've chosen these abilities to highlight together because we often use them together to accomplish daily tasks.
5700:05:02,059 --> 00:05:06,010And I'm hoping that in explaining them and presenting them together,
5800:05:06,049 --> 00:05:14,709you'll be able to watch yourself or watch other people in your life to see how these executive function abilities work for them.
5900:05:16,929 --> 00:05:18,720Similar to the last episode,
6000:05:18,730 --> 00:05:22,329I'm going to walk you through various levels of information.
6100:05:22,339 --> 00:05:24,940So stick with me.
6200:05:24,950 --> 00:05:34,839First, I want to make a comparison between the center of the brain, which is called the subcortical areas, and a conveyor belt.
6300:05:35,600 --> 00:05:36,329You'll,
6400:05:36,339 --> 00:05:41,320you've probably heard that the brain has both gray matter and white matter.
6500:05:42,929 --> 00:05:44,720The outside of the brain and
6600:05:45,089 --> 00:05:54,059certain areas in the center are gray and these gray matter sections are connected by white matter tracts.
6700:05:55,109 --> 00:06:04,440The color white comes from the fact that there's a fatty substance called myelin covering these neuron tracks.
6800:06:04,450 --> 00:06:13,290And the presence of the fatty covering allows the nerve signals to travel faster than without that covering.
6900:06:13,399 --> 00:06:19,579So the center of the brain impacts speed of thinking and processing.
7000:06:20,540 --> 00:06:23,829So in conditions like multiple sclerosis,
7100:06:23,839 --> 00:06:24,989for example,
7200:06:25,000 --> 00:06:27,869where you have demyelinating,
7300:06:28,410 --> 00:06:31,989that is the white matter starts to degrade,
7400:06:32,000 --> 00:06:37,029one of the features can be a slowing of processing.
7500:06:39,200 --> 00:06:51,100So the first point is that speed is a function of the subcortical pathways that impact executive function and several autistic characteristics.
7600:06:51,109 --> 00:06:55,640So we do want to focus on this subcategory of speed.
7700:06:57,649 --> 00:07:01,179Another subcategory is working memory.
7800:07:02,950 --> 00:07:05,600What is this part of executive function?
7900:07:05,869 --> 00:07:06,160Well,
8000:07:06,170 --> 00:07:08,880even though we call it working memory,
8100:07:09,239 --> 00:07:16,350a neuropsychologist or a cognitive scientist might say it's actually really more attention than memory
8200:07:16,829 --> 00:07:30,880in that it has to do with the amount of information a person can hold within their attention without storing it by really memorizing it for later.
8300:07:31,700 --> 00:07:35,589So it usually doesn't end up in permanent memory.
8400:07:35,929 --> 00:07:40,670But we're able to hold information our in our attention.
8500:07:41,549 --> 00:07:54,390And some people have a really strong working memory and others really struggle with this. And you'll see different estimates probably about how large working memory generally is.
8600:07:54,779 --> 00:08:02,779But most times a person can hold about five plus or minus two bits of information in their attention.
8700:08:03,679 --> 00:08:07,209This makes sense because if you were
8900:08:07,769 --> 00:08:12,690using phones in the old days where we didn't have cell phones and
9000:08:12,700 --> 00:08:14,670phone numbers in our phone ...
9100:08:14,970 --> 00:08:20,799a lot of times someone would tell us their phone number or we'd look at it in a phone book and we'd have to
9300:08:21,149 --> 00:08:26,350kind of rehearse it in our working memory while we dialed.
9400:08:26,359 --> 00:08:31,489So we held seven digits ... in those days...
9500:08:32,190 --> 00:08:38,090in our mind while we pushed in the information to the phone.
9600:08:40,789 --> 00:08:43,140So let me give another illustration.
9700:08:43,299 --> 00:08:45,469Working memory is what we use,
9800:08:45,479 --> 00:08:46,309for example,
9900:08:46,320 --> 00:08:48,609if we hear an instruction with ...
10000:08:48,619 --> 00:08:52,099let's say three parts to it and we go to carry it out.
10100:08:52,559 --> 00:08:57,010Our boss may ask us to print the schedule for the day,
10200:08:57,250 --> 00:09:01,809put a copy on her desk, and check the phone messages from overnight.
10300:09:02,929 --> 00:09:07,559So we have to keep these tasks in mind while doing them.
10400:09:07,570 --> 00:09:11,359We have to hold them in our mind.
10500:09:11,500 --> 00:09:15,849And although we may recall the sequence of requests later in the day,
10600:09:15,859 --> 00:09:22,320we're unlikely to remember them in a month or a year because we haven't memorized them.
10700:09:23,299 --> 00:09:25,190But while we're carrying them out.
10800:09:25,200 --> 00:09:31,179We may be able to keep them in mind because they're in our working memory.
10900:09:31,450 --> 00:09:37,469So the term working means that we keep things in mind while we're using them.
11000:09:37,479 --> 00:09:44,950I'm using this information of what the three tasks are while I'm accomplishing the tasks.
11100:09:46,280 --> 00:09:50,619Working memory is what we use when we walk into a room for something.
11200:09:50,900 --> 00:09:55,950And then sometimes if the information has left our working memory,
11300:09:55,960 --> 00:09:58,270we feel frustrated that oh,
11400:09:58,280 --> 00:10:01,869I walked into a room to get something and now it's gone.
11500:10:02,109 --> 00:10:05,489That's something that has slipped through our working memory.
11600:10:07,250 --> 00:10:08,229Similarly,
11700:10:08,239 --> 00:10:09,299we may say,
11800:10:09,309 --> 00:10:09,340oh,
11900:10:09,349 --> 00:10:10,219shoot,
12000:10:10,229 --> 00:10:12,599I was going to say something or ask something,
12100:10:12,609 --> 00:10:14,000but I forgot what it was.
12200:10:14,859 --> 00:10:21,489We were keeping it in our mind while the other person finished their sentence.
12300:10:21,500 --> 00:10:24,179But then by the time they were finished,
12400:10:24,229 --> 00:10:27,229our thought had slipped through our working memory.
12500:10:27,239 --> 00:10:30,789It wasn't held the way that we wanted it to be.
12600:10:30,799 --> 00:10:36,770And so we were unable to bring it back when the person,
12800:10:37,960 --> 00:10:39,789signaled that it was our turn.
12900:10:42,080 --> 00:10:51,950So to summarize our abilities within executive function stem anatomically from the center and the front part of the brain pathways,
13000:10:51,960 --> 00:10:55,780the subcortical pathways that connect with the frontal lobes.
13100:10:55,789 --> 00:11:01,719And these pathways include white matter which impacts how quickly someone can think,
13200:11:01,729 --> 00:11:03,340process and respond.
13300:11:03,900 --> 00:11:08,130And this part of the brain also impacts working memory,
13400:11:08,140 --> 00:11:14,349which is our ability to hold information in mind while we work with and use it.
13500:11:15,409 --> 00:11:26,900So let's tie these concepts speed and working memory with the conveyor belt image that I mentioned earlier in the talk about the third piece for today,
13600:11:26,909 --> 00:11:36,059which is sequencing. A sequence of something is the order in which the things occur or they're arranged.
13700:11:36,270 --> 00:11:41,020And when we listened to our boss ask us to do three things,
13800:11:41,030 --> 00:11:44,210she presented them in a certain sequence.
13900:11:44,219 --> 00:11:46,349And when we listen to someone,
14000:11:46,789 --> 00:11:50,820the words and their meanings and concepts,
14100:11:50,830 --> 00:12:00,309these come toward our ears and into our brains as sequences of data. Picture that conveyor belt.
14200:12:00,320 --> 00:12:01,109Now,
14300:12:01,440 --> 00:12:07,289a conveyor belt is a surface that moves and it brings items to you.
14400:12:07,809 --> 00:12:15,039A person in a factory may work with items coming toward them on a moving surface.
14500:12:15,380 --> 00:12:18,630Perhaps they're employed to sort the items.
14600:12:18,710 --> 00:12:19,869For example,
14700:12:19,880 --> 00:12:23,859here come green and red candies.
14800:12:23,869 --> 00:12:40,484And I'm employed to take the green candies coming toward me and put them in the green box and to take the red candies and put them in the red box. Or maybe someone's employed to assemble something. As the item comes toward you,
14900:12:40,494 --> 00:12:42,385you add this piece,
15000:12:42,395 --> 00:12:50,575then you place it back on the moving belt and the next person will add the next piece and so forth.
15100:12:50,585 --> 00:12:54,804So items come to you in a sequence,
15200:12:54,815 --> 00:12:57,205one item after another,
15300:12:57,215 --> 00:12:58,445after another,
15400:13:00,450 --> 00:13:09,960the items also come with a particular speed on this moving surface and it can be increased .. like wow,
15500:13:09,969 --> 00:13:14,260the items are really coming quickly now... or slowed down.
15600:13:15,520 --> 00:13:21,830You can see that if the speed is set for a pace that most people can keep up with,
15700:13:21,840 --> 00:13:24,900there will be success in completing the task.
15800:13:25,250 --> 00:13:31,169But maybe there would even be a pace that would be too slow for the workers.
15900:13:31,390 --> 00:13:32,489For example,
16000:13:32,500 --> 00:13:34,349a worker might get bored.
16100:13:34,539 --> 00:13:37,330If the items aren't coming fast enough.
16200:13:38,270 --> 00:13:42,039a bored worker might have distraction and restlessness.
16300:13:42,049 --> 00:13:42,059Oh,
16400:13:42,070 --> 00:13:42,969my gosh.
16500:13:42,979 --> 00:13:44,510This is so slow.
16600:13:45,080 --> 00:13:47,090If the pace were too fast,
16700:13:47,099 --> 00:13:50,770the worker wouldn't be able to use all the items coming toward them.
16800:13:50,780 --> 00:13:52,400Things would get past them,
16900:13:52,440 --> 00:13:59,609things would get missed and only a portion of the items could be manipulated and used for that task.
17000:14:00,659 --> 00:14:07,349So the speed and the number of items coming at us needs to be at a just right spot.
17100:14:08,780 --> 00:14:12,729My favorite image for this is a classic,
17200:14:12,739 --> 00:14:26,489I love Lucy clip from the Chocolate Factory television episode. This episode aired in 1952 and it's considered one of the funniest of the whole comedy series.
17300:14:26,760 --> 00:14:38,130I've linked a clip of the Chocolate Factory scene with the conveyor belt in the show notes for those of you who would like to view it or who haven't seen it.
17400:14:38,140 --> 00:14:51,250It's a great demonstration of what can go wrong if the speed of the moving belt is too slow or too fast or if too many items are being sequenced on the conveyor belt at once.
17500:14:54,169 --> 00:14:57,700Now let's get back to the conveyor belt in our minds.
17600:14:57,710 --> 00:15:03,270So if my boss is giving me instructions with multiple details or steps,
17700:15:03,739 --> 00:15:17,219it is as if the words or chunks of information are coming toward me from her voice into my mind ... just like the little pieces of chocolate on the conveyor belt
17800:15:17,229 --> 00:15:18,849in the comedy clip.
17900:15:19,080 --> 00:15:24,369The speed of the conveyor belt is how quickly she's speaking.
18000:15:24,780 --> 00:15:31,669And my perception of the speed is impacted by how quickly my brain can process and keep up.
18100:15:31,700 --> 00:15:35,340If my brain's conveyor belt is slower.
18200:15:35,349 --> 00:15:37,200If I have slower information
18300:15:37,210 --> 00:15:44,609processing, the speed that she's giving me information for the conveyor belt may be overwhelming to me.
18400:15:45,400 --> 00:15:48,559Or if I have really fast processing,
18500:15:48,750 --> 00:15:56,630I may get really bored and distracted while she's talking because there's just not enough that's new coming toward me.
18600:15:58,960 --> 00:16:01,130Let's take another example,
18700:16:01,229 --> 00:16:04,549this one involving a student in a class.
18800:16:04,630 --> 00:16:08,919So a teacher is presenting information to the class.
18900:16:08,950 --> 00:16:18,429The student is required to receive the bits of information at the speed they're presenting as if in the conveyor belt analogy.
19000:16:18,440 --> 00:16:20,369And here comes new information.
19100:16:20,380 --> 00:16:34,260Then the student must hold the information in mind while deciding what parts to write in their notebook or to type in their laptop.
19200:16:34,429 --> 00:16:38,099All of this must be done while the teacher is still speaking.
19300:16:38,489 --> 00:16:40,849And this is all executive function.
19400:16:40,859 --> 00:16:43,630So we'll touch on this in a different episode,
19500:16:43,640 --> 00:16:49,349but the student must use another piece of executive function in this task as well ...
19600:16:49,409 --> 00:16:50,909prioritization.
19700:16:51,440 --> 00:16:57,010So I'm receiving a lot of information on this conveyor belt from the teacher.
19800:16:57,020 --> 00:17:08,349But what information is important for my notes and what is not important. To what do I give priority when there's a lot on the conveyor belt.
19900:17:08,729 --> 00:17:09,668For example,
20000:17:09,678 --> 00:17:13,348it's not necessary to write down every word
20100:17:13,359 --> 00:17:16,668the teacher is saying. What the efficient,
20200:17:16,678 --> 00:17:22,529just-right thing to do would be to pick out these most important things,
20300:17:22,538 --> 00:17:23,409these themes,
20400:17:23,418 --> 00:17:25,529these categories, definitions,
20500:17:25,538 --> 00:17:26,188dates,
20600:17:26,239 --> 00:17:30,308these are the things we need to jot down in our notes.
20700:17:30,359 --> 00:17:35,668And our executive function is what helps us with this whole process.
20800:17:36,069 --> 00:17:36,520Now,
20900:17:36,530 --> 00:17:38,319if it's working well,
21000:17:38,449 --> 00:17:40,900the student just does this automatically.
21100:17:42,060 --> 00:17:45,949If things are hard in that area of executive function,
21200:17:46,329 --> 00:17:48,099the person may feel like,
21300:17:48,109 --> 00:17:48,540gosh,
21400:17:48,550 --> 00:17:48,560I,
21500:17:48,569 --> 00:17:49,760I cannot,
21600:17:50,729 --> 00:17:51,140you know...
21700:17:51,150 --> 00:17:53,500note taking is very difficult for me.
21800:17:53,510 --> 00:17:55,229I just can't keep up.
21900:17:55,239 --> 00:18:07,400I can't keep the things in my mind while I'm writing because I either lose them because the teacher is still speaking or I lose what the teacher is now saying.
22000:18:07,680 --> 00:18:15,839So it either is something that happens smoothly and automatically or it really becomes a very difficult thing.
22100:18:17,900 --> 00:18:20,290Let me give you a social example.
22200:18:20,579 --> 00:18:27,829Imagine a person at a social event where a group of people are speaking about a funny experience.
22300:18:28,300 --> 00:18:35,770An individual in the group will need to be taking in what multiple people are saying...
22400:18:35,890 --> 00:18:44,390So there are multiple conveyor belts and speeds all while holding parts of the conversation in mind.
22500:18:45,390 --> 00:18:59,500And this person also then has to think about what they might say or contribute to the conversation and how to time what they're going to contribute and still keep up with the speed of the exchange.
22600:19:01,930 --> 00:19:11,260This example also involves those executive function abilities of working memory and speed and sequencing.
22700:19:13,219 --> 00:19:15,989Let me give you a life activity example,
22800:19:16,770 --> 00:19:25,459driving is a good example of a life activity that requires a person to take in multiple streams of information.
22900:19:25,469 --> 00:19:26,040In this case
23000:19:26,050 --> 00:19:29,300visual ... at varying speeds.
23100:19:29,579 --> 00:19:36,520Oh, this visual information is coming at me as I'm driving through the visual space.
23200:19:36,920 --> 00:19:59,699So the individual must first notice incoming visual details, adapt to unpredictable changes in the visual field (like, oh now I have less space in this lane than I did because the car is coming over toward me), and make quick safe decisions about how to respond.
23300:20:00,310 --> 00:20:06,989So one individual may feel like this all comes very automatically and at a speed that really works for them,
23400:20:07,750 --> 00:20:15,699another individual may feel overwhelmed by the amount of visual information coming at them in such a quick time...
23500:20:15,839 --> 00:20:21,800particularly because it's unpredictable and it involves safety issues.
23600:20:21,810 --> 00:20:26,040So if I can't keep on top of this visual information,
23700:20:26,689 --> 00:20:31,400I really might get in a situation that's really pretty dangerous.
23800:20:32,479 --> 00:20:37,500Other people while they're driving may feel concerned because they get bored.
23900:20:37,729 --> 00:20:51,510There's just not enough new information in the visual field to keep their mind on the road and they may find their mind wandering in a way that kind of makes them nervous and and leads them feeling like...
24000:20:51,810 --> 00:20:54,469they just can't focus very well while they're driving.
24100:20:56,550 --> 00:21:00,859What is often the case is that for many on the autism spectrum,
24200:21:01,079 --> 00:21:18,439they'll take longer to adjust to driving than their non autistic peers ... most often because they feel like things are really happening quickly and they can feel overwhelmed by the amount the speed and the unpredictability of information on that conveyor belt.
24300:21:20,229 --> 00:21:22,069So going back to our episode,
24400:21:22,079 --> 00:21:25,569topics of speed, working memory, and sequencing,
24500:21:25,810 --> 00:21:31,199we've reviewed that an individual must adapt to the speed of incoming information,
24600:21:32,060 --> 00:21:35,949then sequence through the items coming toward them.
24700:21:36,479 --> 00:21:46,319Hold enough of the information in mind that is important while then doing something with or responding to the information.
24800:21:47,660 --> 00:21:57,680And this is all part of the subcortical frontal pathways of the brain and the ability that globally we call executive function.
24900:21:59,540 --> 00:22:00,479So far,
25000:22:00,489 --> 00:22:05,479we've emphasized information coming toward us on the conveyor belt.
25100:22:05,489 --> 00:22:15,589But we can also think of executive function abilities for the information that we send out on conveyor belts to other people or to the environment.
25200:22:16,900 --> 00:22:18,229For example,
25300:22:18,239 --> 00:22:25,199how quickly do we produce a product or a response to questions from others?
25400:22:26,219 --> 00:22:29,920One person may be quick and efficient with tasks,
25500:22:30,150 --> 00:22:37,920but maybe they make a few errors on the way. Another person may finish the task more slowly,
25600:22:37,930 --> 00:22:39,099but to them,
25700:22:39,109 --> 00:22:43,699accuracy is really important and they notice a lot of detail.
25800:22:45,390 --> 00:22:51,369Neither of these executive function styles is inherently better than the other
25900:22:51,380 --> 00:22:52,390all the time.
26000:22:52,630 --> 00:23:01,430But the person whose executive function is more methodical and detail oriented in producing output may struggle in a job where the boss says,
26100:23:01,439 --> 00:23:02,089hey,
26200:23:02,150 --> 00:23:05,020the priority on this project is speed.
26300:23:05,030 --> 00:23:08,130I need this quickly. And vice versa.
26400:23:08,140 --> 00:23:17,930The individual who works quickly and decisively may really struggle at jobs where the smallest detail can make or break a project.
26500:23:19,800 --> 00:23:27,930Individuals who make decisions more slowly may show resistance when pressed for an answer or an action.
26600:23:29,319 --> 00:23:37,910Other people may almost feel this psychological opposition when they try to encourage the person to decide or to move on.
26700:23:39,000 --> 00:23:40,500Let's take an action.
26800:23:40,510 --> 00:23:42,359Let's stop thinking about it.
26900:23:43,430 --> 00:23:52,579One example could be adult children trying to press their dad to get his roof fixed. If he has executive function
27000:23:52,589 --> 00:23:56,030that's significant for being very slow,
27100:23:56,040 --> 00:23:57,530methodical...
27200:23:57,680 --> 00:24:04,130He may forever be saying things like "I'll think about that" or "I'll know when the time is right,"
27300:24:04,400 --> 00:24:07,439but there's never any real movement toward action.
27400:24:07,449 --> 00:24:09,099There's this stickiness,
27500:24:09,109 --> 00:24:15,680the conveyor belt toward decisiveness kind of gets stuck. Again,
27600:24:15,689 --> 00:24:19,260this approach to action is not right or wrong,
27700:24:19,270 --> 00:24:25,800but it's about whether it works for him in certain instances and against him and others.
27800:24:26,030 --> 00:24:28,219And when the roof is falling in,
27900:24:28,229 --> 00:24:31,219it's really likely working against him.
28000:24:32,000 --> 00:24:43,489Another factor that impacts whether something helps a situation or not is how extreme or inflexible the executive function reaction is in that situation.
28100:24:44,079 --> 00:24:45,949So for example,
28200:24:46,239 --> 00:24:51,810 if we have this situation with the dad and his roof...
28400:24:51,839 --> 00:25:00,250a really extreme slow and resistant response to the need for action in that circumstance...
28500:25:00,260 --> 00:25:00,540well,
28600:25:00,550 --> 00:25:01,880that's creating safety,
28700:25:01,890 --> 00:25:02,530health,
28800:25:02,540 --> 00:25:05,930financial issues ... that it really could hurt the person.
28900:25:07,520 --> 00:25:08,349Ideally,
29000:25:08,359 --> 00:25:13,770our brain is supposed to help us have the just right amount of speed,
29100:25:14,359 --> 00:25:14,650(you know,
29200:25:14,660 --> 00:25:16,300not too quickly,
29300:25:16,310 --> 00:25:19,439not too slowly) and sequencing.
29400:25:19,790 --> 00:25:27,349I see details that are important but I can let other things go so that I can get to the best outcome.
29500:25:27,770 --> 00:25:30,199And when it's important to, you
29600:25:30,209 --> 00:25:33,510can adjust to the situation itself.
29700:25:33,520 --> 00:25:33,900Wow,
29800:25:33,910 --> 00:25:37,540I didn't expect this situation but I can adjust to that.
29900:25:39,459 --> 00:25:48,989But sometimes the struggle that a person is having is really that it's hard to get to that just right spot for ... for anything,
30000:25:49,000 --> 00:25:51,880whether it's speed or executive function or,
30100:25:51,890 --> 00:26:00,180or anything else in life ... rather than sometimes swinging to that too much extreme.
30200:26:02,329 --> 00:26:13,569One more example of the sequencing of output could be seen when multiple smaller actions are needed to complete a larger task.
30300:26:14,099 --> 00:26:20,699So a classic example of this would be the parental request that their child clean his room.
30400:26:21,680 --> 00:26:32,449So the child has to think through all of the pieces of action that will need to be engaged with in order to get this finished product.
30500:26:32,849 --> 00:26:37,989It's almost like saying what are all the pieces I need to put on this conveyor belt,
30600:26:38,020 --> 00:26:46,030all the pieces that I need to to bring together for the whole action of having a clean room or the whole outcome.
30700:26:47,310 --> 00:26:48,500There's a first step,
30800:26:48,510 --> 00:26:49,400a second step,
30900:26:49,410 --> 00:27:01,109a third step ... all on the conveyor belt until a finished product is reached. Some ways in which this executive function task can get stuck would include...
31000:27:01,400 --> 00:27:01,930"Wow,
31100:27:01,939 --> 00:27:06,599there are so many actions or pieces to the task.
31200:27:07,040 --> 00:27:10,829 I just don't know where to start.
31300:27:11,949 --> 00:27:12,930I'm stuck.
31400:27:12,939 --> 00:27:16,599I'm overwhelmed by the amount of possibility.
31500:27:16,880 --> 00:27:23,709I can't get my direction to navigate the task even though I could do all of these little pieces,
31600:27:23,760 --> 00:27:25,310where should I start?"
31700:27:25,930 --> 00:27:28,400And this is often the situation.
31800:27:29,089 --> 00:27:31,959And the parent may say,
31900:27:31,969 --> 00:27:32,170"Hey,
32000:27:32,180 --> 00:27:33,369start wherever you want,
32100:27:33,380 --> 00:27:34,449it doesn't matter."
32200:27:35,349 --> 00:27:41,739But that's not likely to help the child who actually needs someone to sequence the task with them.
32300:27:42,089 --> 00:27:43,810Tell me where to start.
32400:27:43,829 --> 00:27:46,319How can I get going with this task?
32500:27:46,709 --> 00:27:49,630And then after I do the task,
32600:27:50,239 --> 00:27:51,619... the first task,
32800:27:51,849 --> 00:27:53,739what's the second task I should do?
32900:27:53,750 --> 00:27:59,199How should I string things along without getting overwhelmed or stuck or lost?
33000:28:00,739 --> 00:28:11,000The child knows how to do each little part of the task but doesn't have the sequencing ability to navigate this larger task without assistance.
33100:28:11,010 --> 00:28:22,510And so the parent who realizes this might take a picture representing each smaller task ... like a photo of clothes in the laundry basket,
33200:28:23,010 --> 00:28:25,750a photo of books on the bookshelf,
33300:28:25,760 --> 00:28:34,650a photo of the bed made ... whatever the five or seven steps to having a clean room might be.
33400:28:34,920 --> 00:28:39,849You can put these photos up in a place where the child can see them.
33500:28:41,369 --> 00:28:45,739The child then can look at the photos independently and see...
33600:28:45,750 --> 00:28:50,199Oh the first photo is clothes in the the clothes hamper.
33700:28:50,209 --> 00:28:56,800So I'm gonna do that first... and sometimes the child likes to take the photo down when the task is done.
33800:28:57,099 --> 00:28:58,959And so "I know that's done."
33900:29:01,010 --> 00:29:10,609That's just one way to help teach an executive function skill for someone who is overwhelmed and trying to do that independently.
34000:29:13,040 --> 00:29:21,750Knowing that the full anatomical maturity of executive function isn't complete until the age of 20 or 21 or so.
34100:29:21,959 --> 00:29:29,050The parent realizes that part of their role is to help the child learn strategies for approaching tasks
34200:29:29,060 --> 00:29:37,170requiring executive function ... and to assist in areas where the child is still really developing that ability.
34300:29:38,719 --> 00:29:39,479Additionally,
34400:29:39,489 --> 00:29:42,089as we noted in the previous episode,
34500:29:42,170 --> 00:29:47,069everyone will have individual strengths and struggles in executive function.
34600:29:47,880 --> 00:29:52,810If this is a child who grows up and continues to have a weakness
34700:29:52,819 --> 00:29:56,369organizing a sequence to complete a task,
34800:29:56,410 --> 00:30:02,300they can really benefit from a strategy approach to give their brain some assistance.
34900:30:02,780 --> 00:30:04,729So their strategy might be...
35000:30:04,739 --> 00:30:09,880What if I think about this task as seven smaller tasks?
35100:30:09,890 --> 00:30:10,979What would those be?
35200:30:12,170 --> 00:30:24,239I would invite you to notice tasks in your everyday life that are easy or difficult for you and consider if they have executive function components like speed,
35300:30:24,349 --> 00:30:26,500working memory, or sequencing.
35400:30:27,219 --> 00:30:29,000Notice what's easy for you,
35500:30:29,010 --> 00:30:31,890what's difficult for you in these situations.
35600:30:32,449 --> 00:30:40,930This increased self-awareness can be a first step toward getting the best outcome in a variety of situations.
35700:30:41,349 --> 00:30:48,170You may realize "my nervous system default is to process information slowly.
35800:30:48,719 --> 00:30:54,170But this new job that I have requires speed in these areas.
35900:30:54,380 --> 00:30:56,650And how can I get a better outcome?"
36000:30:57,750 --> 00:30:58,130Well,
36100:30:58,140 --> 00:31:03,170the basic neurology of speed that your nervous system is set toward,
36200:31:03,410 --> 00:31:03,890you know,
36300:31:03,900 --> 00:31:06,890you may not be able to adjust that piece.
36400:31:06,959 --> 00:31:16,819But perhaps you could focus on strategies to reduce anything that would take away from the speed you're capable of neurologically.
36500:31:17,160 --> 00:31:20,589So perhaps you want to reduce distractions,
36600:31:20,920 --> 00:31:32,089maybe ask someone for input about what the most important thing to focus on is and really make sure that you're accountable to someone who can see the big picture a little better.
36700:31:33,599 --> 00:31:36,140As I noted in the previous episode,
36800:31:36,189 --> 00:31:43,150I like the book series Smart but Scattered when it comes to strategies for executive function,
36900:31:43,160 --> 00:31:47,949but you can choose whatever resources best fit your needs.
37000:31:48,119 --> 00:31:52,010And if you want to dive into more about executive function,
37100:31:52,170 --> 00:31:58,609learn about more strategies for success in areas that are causing you difficulty... by all means,
37200:31:58,619 --> 00:32:01,969reach out and find things that work well for you.
37300:32:04,079 --> 00:32:08,390I wanna thank you for joining me to learn about the executive function
37400:32:08,400 --> 00:32:12,560sub features of speed, sequencing, and working memory.
37500:32:12,849 --> 00:32:21,650And I hope it increases your understanding of what makes you tick. We'll be continuing our series on executive function next time.
37600:32:21,660 --> 00:32:24,810So I invite you to join me for that third episode.
-
Do you understand what Executive Function (EF) refers to and why it is important? If you have EF difficulties, have you been diagnosed with ADHD? Do you wonder if you have a diagnosis of autism or if you should have a dual diagnosis of autism and ADHD? Dr. Regan breaks down the concepts and shares about the relationship between EF, ADHD, and autism.
Executive Function Book Series by Dawson and Guare:
Smart But Scattered (children's version)
Smart But Scattered (Teen version)
Smart But Scattered (adult version)
Dr. Regan's Master Class for Clinicians:
Zur Institute: Master Class
Dr. Regan's Resources
Book: Understanding Autism in Adults and Aging Adults, 2nd ed
Audiobook
Book: Understanding Autistic Behaviors
Autism in the Adult website homepage
Website Resources for Clinicians
Read the transcript:
100:00:07,670 --> 00:00:08,560Hi there.
200:00:08,569 --> 00:00:13,960This is Doctor Regan joining you for an episode of Autism in the Adult podcast.
300:00:14,850 --> 00:00:16,670I'm a neuropsychologist,
400:00:16,680 --> 00:00:24,350the founder and director of an autism diagnostic clinic in Central Illinois and the parent of a teen on the spectrum.
500:00:25,180 --> 00:00:25,899Today,
600:00:25,909 --> 00:00:31,610you are joining me for the first episode in a new series about executive function.
700:00:31,989 --> 00:00:36,509And I'm really excited for the series since announcing the topic.
800:00:36,520 --> 00:00:38,509At the end of our last episode,
900:00:38,520 --> 00:00:45,709I've received lots of emails from interested listeners before we dive into today's episode.
1000:00:45,720 --> 00:00:45,990Though,
1100:00:46,000 --> 00:00:50,490I wanna give a shout out to the clinicians and professionals who may be listening.
1200:00:50,799 --> 00:01:00,610I'm currently developing a master class with the continuing education platform called Zur Institute.
1300:01:01,020 --> 00:01:04,010This offering is unique for several reasons.
1400:01:04,019 --> 00:01:05,449One is the format,
1500:01:06,050 --> 00:01:09,550there will be four 2-hour webinars,
1600:01:09,559 --> 00:01:11,949one in each of September,
1700:01:12,209 --> 00:01:13,099October,
1800:01:13,110 --> 00:01:16,180November and December of 2023.
1900:01:16,809 --> 00:01:23,629And the first hour will be education while the second full hour will be reserved for discussion,
2000:01:23,639 --> 00:01:32,519question and answer and interaction with you about clinical questions and practice issues related to the topic for that day.
2100:01:32,889 --> 00:01:44,419Another unique feature of this offering will be the focus on advanced topics. So click on the link in the show notes to read more about the topics and how to sign up.
2200:01:45,330 --> 00:01:49,569If you are a clinician wanting beginner or intermediate courses,
2300:01:49,599 --> 00:01:54,440check out my other offerings on Zur or at my website,
2400:01:54,449 --> 00:01:57,819which is also linked through the show notes.
2500:01:58,440 --> 00:01:59,040All right,
2600:01:59,050 --> 00:02:01,580let's talk about executive function.
2700:02:02,449 --> 00:02:07,800I'll warn you that today's episode will require some executive function to get through.
2800:02:08,350 --> 00:02:14,740And I've spent a lot of time trying to make sure that I'm linking all of the themes together.
2900:02:15,179 --> 00:02:16,649So with that in mind,
3000:02:16,800 --> 00:02:22,440I want to start off with just a general definition of executive function.
3100:02:24,440 --> 00:02:26,500Later in our talks,
3200:02:26,509 --> 00:02:34,229we will cover a more precise and descriptive definition including sub elements and what we might call those.
3300:02:35,020 --> 00:02:45,990So executive function refers to a set of brain based abilities related to the functioning of the pathways connecting the center and the front of the brain.
3400:02:46,679 --> 00:02:48,710And the reason for the name,
3500:02:48,720 --> 00:02:59,850executive functioning is that executive is defined as having the power to put plans and actions into effect.
3600:03:00,860 --> 00:03:04,710So a CEO for example,
3700:03:05,240 --> 00:03:14,669is the chief executive officer of a business company and is in charge of directing the tiers of the company,
3800:03:14,679 --> 00:03:16,250the regional officers,
3900:03:16,259 --> 00:03:17,059managers,
4000:03:17,070 --> 00:03:18,270direct workers,
4100:03:18,490 --> 00:03:24,440directing all the pieces to work together toward the same goal.
4200:03:24,970 --> 00:03:33,339So these pathways of the brain help the parts of the brain work together to achieve a goal.
4300:03:34,259 --> 00:03:38,360Another image that I like is the symphony conductor,
4400:03:38,899 --> 00:03:42,190directing all the instruments in the orchestra,
4500:03:42,199 --> 00:03:46,130even if all the instruments are performing perfectly,
4600:03:46,240 --> 00:03:48,300if there's no conductor,
4700:03:48,679 --> 00:03:56,179there's no unified sound with melody and movement and this synchrony of sound.
4800:03:56,399 --> 00:04:04,309So the sounds don't come together to create a moving and meaningful piece of music without the conductor.
4900:04:05,039 --> 00:04:09,100So executive function is like the symphony conductor,
5000:04:09,490 --> 00:04:14,199it should bring all of the working parts of the brain together to perform.
5100:04:14,210 --> 00:04:17,049So that something meaningful happens.
5200:04:18,998 --> 00:04:19,688As I said,
5300:04:19,699 --> 00:04:22,848executive function is a set of brain skills,
5400:04:22,859 --> 00:04:24,408it's not one skill.
5500:04:25,160 --> 00:04:29,929And as we understand what the center of the brain,
5600:04:30,109 --> 00:04:37,130the subcortical areas of the brain and the connections through the center with the front of the brain,
5700:04:37,140 --> 00:04:38,350the frontal lobes.
5800:04:38,809 --> 00:04:42,209When we understand what these areas are in charge of,
5900:04:42,220 --> 00:04:46,820we refer to those set of abilities as executive function.
6000:04:46,829 --> 00:04:53,149So these executive function abilities hang together anatomically in the brain.
6100:04:53,540 --> 00:04:56,640So through that subcortical frontal system,
6200:04:57,339 --> 00:05:04,059so the number one point is that executive function refers to a series of skills,
6300:05:04,070 --> 00:05:05,519not one skill.
6400:05:05,850 --> 00:05:10,190And these skills are linked with anatomy,
6500:05:10,200 --> 00:05:13,290with the subcortical frontal systems of the brain.
6600:05:13,609 --> 00:05:21,279And the skills help the brain produce a meaningful synchronous um behavior or,
6700:05:21,290 --> 00:05:22,489or product.
6800:05:24,070 --> 00:05:24,470Now,
6900:05:24,480 --> 00:05:32,950let's talk about the diagnosis of AD D and A DH D and just for simplicity's sake,
7000:05:32,959 --> 00:05:33,920from now on,
7100:05:33,929 --> 00:05:39,920I'll really just refer to these as AD D but I'm referring to both diagnoses.
7200:05:41,269 --> 00:05:45,839This diagnosis was introduced in the diagnostic manual,
7300:05:45,850 --> 00:05:57,970the DSM - III in 1980 it was important because it described a developmental neurologic condition of executive function.
7400:05:58,950 --> 00:06:02,820So executive function was not a new concept,
7500:06:02,989 --> 00:06:10,739but the diagnosis of ADD was the one that captured this developmental piece.
7600:06:11,190 --> 00:06:22,299So here we have a diagnosis then that we can use to describe a difficulty that an individual has based on their developmental wiring.
7700:06:22,309 --> 00:06:26,200The way that the brain system has developed,
7800:06:26,239 --> 00:06:38,600the way they're wired in the executive function areas of the brain don't finish their anatomic development until about the age of 20 or 21.
7900:06:38,980 --> 00:06:39,440So,
8000:06:39,450 --> 00:06:40,799anatomically,
8100:06:40,989 --> 00:06:45,730executive function is still developing until about that age.
8200:06:47,119 --> 00:07:02,500So the number two point is that ADD was a notable addition to the diagnostic manual in 1980 because it represents a diagnosis for executive function difficulties that are developmental in nature.
8300:07:04,059 --> 00:07:05,190Now,
8400:07:05,399 --> 00:07:19,910I want to talk about the relationship between executive function and AD D executive function is not specific to ADD or ADHD.
8500:07:20,690 --> 00:07:23,239So the difficulties in that domain,
8600:07:23,540 --> 00:07:26,559they're not specific to this diagnosis.
8700:07:26,570 --> 00:07:36,290We're discussing executive function is one of the most sensitive brain functions to any kind of stress,
8800:07:36,299 --> 00:07:39,619whether that is physical or psychological.
8900:07:40,049 --> 00:07:45,429One of the first things to show difficulty is going to be executive function.
9000:07:47,630 --> 00:07:56,119It's often the first thing to become difficult and the last thing to resolve or heal after some type of challenge.
9100:07:57,390 --> 00:07:58,829For example,
9200:07:59,089 --> 00:08:02,600if an 80 year old has a bladder infection.
9300:08:02,609 --> 00:08:11,040What's probably the most sensitive cognitive function that's going to be disrupted first ... executive function.
9400:08:11,739 --> 00:08:25,959And if someone is recovering from a traumatic brain injury and they've gone through rehab and it's two or three months after ... what's probably the residual problem that's still kind of healing up.
9500:08:25,970 --> 00:08:26,299Well,
9600:08:26,309 --> 00:08:28,679that would be executive function as well.
9700:08:31,179 --> 00:08:39,059So there may be developmental differences in executive function and that's what we discuss
9800:08:39,070 --> 00:08:41,969when we talk about the diagnosis of ADD,
9900:08:43,000 --> 00:08:47,960there can also be acquired differences in executive function.
10000:08:48,409 --> 00:08:51,690This would include differences after,
10100:08:51,700 --> 00:08:52,450as we said,
10200:08:52,460 --> 00:08:53,869a traumatic brain injury,
10300:08:53,880 --> 00:08:58,830a stroke, within the context of a dementia... acquired
10400:08:58,840 --> 00:09:02,070meaning that this is not developmental.
10500:09:02,080 --> 00:09:06,469It's something that has occurred in the course of the life span.
10600:09:08,809 --> 00:09:10,039Executive function,
10700:09:10,049 --> 00:09:15,609difficulties can occur with acute or chronic medical problems.
10800:09:15,619 --> 00:09:19,820So an acute medical issue would be like an infection.
10900:09:19,830 --> 00:09:20,599For example,
11000:09:20,609 --> 00:09:23,340this is something that comes and then it goes,
11100:09:23,609 --> 00:09:24,500it's acute,
11200:09:24,510 --> 00:09:25,460it's new,
11300:09:25,619 --> 00:09:35,299it kind of can hit kind of hard and then heal up and go. Or executive function can be disrupted due to chronic medical problems.
11400:09:35,330 --> 00:09:37,510So someone with kidney failure,
11500:09:37,520 --> 00:09:38,469for example,
11600:09:38,479 --> 00:09:40,090who's on dialysis,
11700:09:40,289 --> 00:09:45,484what's the most likely thing they're going to have some difficulties with in the cognitive domain.
11800:09:45,585 --> 00:09:45,955Well,
11900:09:45,965 --> 00:09:47,765that would be executive function,
12000:09:47,914 --> 00:09:52,255someone with sugar fluctuations in the context of diabetes,
12100:09:52,284 --> 00:09:56,525someone with metabolic differences like their sodium is too low.
12200:09:56,554 --> 00:10:02,385These can also cause a disruption in someone's executive function system,
12300:10:04,080 --> 00:10:10,169even differences in the load that the person is carrying with regard to stress,
12400:10:10,179 --> 00:10:11,530emotional pain,
12500:10:11,539 --> 00:10:12,330trauma,
12600:10:12,340 --> 00:10:13,679lack of sleep,
12700:10:13,710 --> 00:10:17,429and even just having too much on our schedule.
12800:10:17,780 --> 00:10:25,729These examples of things don't change the anatomy of the brain and how the parts of the brain are working.
12900:10:25,739 --> 00:10:32,450But it really does interfere with our access to using our full capacity,
13000:10:32,460 --> 00:10:37,109our full anatomic, biologic capacity for executive function.
13100:10:37,530 --> 00:10:37,880So,
13200:10:37,890 --> 00:10:39,359if we've had trauma,
13300:10:39,479 --> 00:10:39,830you know,
13400:10:39,840 --> 00:10:43,409our brain may just go offline if we dissociate.
13500:10:43,659 --> 00:10:50,400And even though our anatomy is working well to produce this executive function,
13600:10:50,750 --> 00:10:55,419we may experience a psychological process that takes us offline.
13700:10:56,520 --> 00:10:57,299In addition,
13800:10:57,309 --> 00:10:59,390even with normal aging,
13900:10:59,469 --> 00:11:02,750what's the first thing to start to show difficulty?
14000:11:02,830 --> 00:11:03,270Yes,
14100:11:03,280 --> 00:11:04,830it's executive function.
14200:11:05,200 --> 00:11:08,419And if you are aging really well,
14300:11:08,440 --> 00:11:08,900you're,
14400:11:08,909 --> 00:11:10,820you're really aging nicely.
14500:11:10,900 --> 00:11:13,380You don't have any additional medical issues,
14600:11:13,390 --> 00:11:14,719you haven't had an injury.
14700:11:15,059 --> 00:11:20,659The first thing you're gonna start to notice is some problem in the area of executive function.
14800:11:20,849 --> 00:11:26,770That's just the aging process and how it impacts that subcortical frontal system.
14900:11:27,210 --> 00:11:37,190So you may walk into a room and you can't remember why, or you have this tip of the tongue phenomenon where you know what you wanna say
15000:11:37,200 --> 00:11:38,549but you can't get it out.
15100:11:38,570 --> 00:11:40,049That's executive function.
15200:11:40,619 --> 00:11:45,500You may have to think more slowly or take in less information at a time.
15300:11:47,140 --> 00:11:53,719So all individuals are likely to experience executive function difficulty in these contexts.
15400:11:54,270 --> 00:11:56,609So consider this comparison,
15500:11:57,869 --> 00:12:01,799executive function is similar to fatigue,
15600:12:01,809 --> 00:12:02,739for example,
15700:12:02,750 --> 00:12:10,200in that it's a nonspecific feature of many different kinds of conditions.
15800:12:10,849 --> 00:12:12,820So if someone has fatigue,
15900:12:13,409 --> 00:12:18,700there would be hundreds... thousands of conditions that could produce fatigue,
16000:12:19,020 --> 00:12:22,039anything from lack of sleep to infection,
16100:12:22,109 --> 00:12:23,799autoimmune conditions.
16200:12:23,809 --> 00:12:25,440And so many more things.
16300:12:26,419 --> 00:12:27,340Similarly,
16400:12:27,349 --> 00:12:34,140executive function difficulty can be caused by so so many conditions and situations,
16500:12:34,150 --> 00:12:34,880trauma,
16600:12:34,890 --> 00:12:35,520aging,
16700:12:35,530 --> 00:12:36,320ADD,
16800:12:36,330 --> 00:12:37,780autoimmune conditions,
16900:12:37,789 --> 00:12:39,669delirium, autism, and many,
17000:12:39,679 --> 00:12:40,429many more.
17100:12:40,799 --> 00:12:49,750So the third point we've really focused on here so far is that executive function is not specific to ADD.
17200:12:50,080 --> 00:12:55,119So many many things can trigger this executive function problem.
17300:12:57,539 --> 00:12:58,150Therefore,
17400:12:58,159 --> 00:13:01,859if someone presents with executive function difficulty --
17500:13:02,200 --> 00:13:05,030so I'm having a hard time paying attention,
17600:13:05,039 --> 00:13:07,700I just can't take in information very well.
17700:13:07,729 --> 00:13:10,349I can't organize myself well --
17800:13:10,359 --> 00:13:20,570the clinician should consider differentials in the diagnostic process because so many things can present with those features.
17900:13:20,840 --> 00:13:24,369There should be this process of taking into account.
18000:13:24,630 --> 00:13:26,590What is this person's age?
18100:13:26,599 --> 00:13:28,750What is their recent life experience?
18200:13:28,760 --> 00:13:30,679What are their medical issues?
18300:13:30,690 --> 00:13:33,390When did the executive function issue start?
18400:13:34,210 --> 00:13:39,469But executive function difficulty does not automatically mean ADD.
18500:13:39,479 --> 00:13:41,549It does not equal ADD,
18600:13:41,559 --> 00:13:43,739it's not equivalent to ADD.
18700:13:45,469 --> 00:14:00,440So we would consider a handful of things that could cause executive function problems in this person, and then would perform an evaluation to see what the most likely contributors are in this case.
18800:14:01,289 --> 00:14:04,830So let's go over our first three points.
18900:14:05,109 --> 00:14:09,489Executive function refers to a series of skills,
19000:14:09,500 --> 00:14:16,190not one skill and these skills are linked anatomically within the same pathways --
19100:14:16,200 --> 00:14:27,729these subcortical frontal system pathways -- and they also work together to provide some meaningful and organized output from the brain.
19200:14:29,229 --> 00:14:47,950The second point is that ADD was added to the diagnostic manual in 1980 to describe developmental executive function differences, and that was really helpful to have a diagnosis for developmental differences in executive function.
19300:14:49,669 --> 00:15:00,539The third point is that executive function is not specific to ADD -- many many things can trigger executive function difficulty.
19400:15:01,239 --> 00:15:10,909And so we would never want to hear executive function difficulty and then translate that automatically into ADD.
19500:15:15,289 --> 00:15:20,659So we talked about how executive function refers to a series of skills.
19600:15:21,270 --> 00:15:28,479There's not a unanimous consensus about what constitutes all these subparts,
19700:15:28,489 --> 00:15:30,979how to number them and what to call them.
19800:15:31,090 --> 00:15:37,080But many conceptualizations may refer to about 12 to 15 components.
19900:15:37,090 --> 00:15:38,039Give or take.
20000:15:39,330 --> 00:15:44,460These often include things like organization, sequencing,
20100:15:44,469 --> 00:15:46,020processing speed,
20200:15:46,030 --> 00:15:48,260prioritizing, planning,
20300:15:48,270 --> 00:15:49,960task initiation,
20400:15:50,070 --> 00:15:52,130sustained attention, goal
20500:15:52,140 --> 00:15:53,510directed persistence,
20600:15:53,520 --> 00:15:54,859impulse control,
20700:15:54,869 --> 00:15:56,099time management,
20800:15:56,109 --> 00:15:57,640generation of ideas,
20900:15:57,650 --> 00:15:58,739working memory,
21000:15:58,750 --> 00:16:01,880flexibility and emotional regulation.
21100:16:03,119 --> 00:16:06,030So it's not important for you to know what those mean.
21200:16:06,250 --> 00:16:14,309But I want you to get the sense that there are these multiple components and we'll look at each of these later in our series.
21300:16:14,320 --> 00:16:15,559But for now,
21400:16:15,570 --> 00:16:16,150wow,
21500:16:16,159 --> 00:16:19,669executive function is a broad category.
21600:16:22,250 --> 00:16:28,020ADD, which as we said describes a condition of developmental
21700:16:28,030 --> 00:16:36,700executive function difficulty, includes four areas as I would describe them.
21800:16:36,710 --> 00:16:38,880So someone may say,
21900:16:38,890 --> 00:16:38,909oh,
22000:16:38,919 --> 00:16:40,869I think it's more like five.
22100:16:40,940 --> 00:16:42,520so it doesn't matter,
22200:16:42,530 --> 00:16:44,270but it's a small subset.
22300:16:44,280 --> 00:16:45,679We've got attention,
22400:16:45,909 --> 00:16:47,119organization,
22500:16:47,130 --> 00:16:47,940goal directed
22600:16:47,950 --> 00:16:50,109persistence, and impulse control.
22700:16:51,869 --> 00:17:09,130The diagnostic criteria for ADD only describe four areas of executive function even though our current understanding is that there are probably more like 12 to 15 components.
22800:17:10,900 --> 00:17:28,949So you can see that someone could have significant difficulty with executive function developmentally and not meet the criteria for ADD because these four specific areas included may not be the ones that are causing this problem.
22900:17:29,290 --> 00:17:31,949This person's individual difficulty...
23000:17:33,109 --> 00:17:36,160I also want you to know that every single person,
23100:17:37,189 --> 00:17:40,119regardless of developmental neurology,
23200:17:40,130 --> 00:17:41,920health background,
23300:17:42,130 --> 00:17:46,449all humans will have a pattern of executive function,
23400:17:46,630 --> 00:17:48,839strengths and weaknesses.
23500:17:49,040 --> 00:17:51,599That's the normal way of our neurology.
23600:17:52,329 --> 00:17:56,780So out of those 12 to 15 subsets of skills,
23700:17:56,959 --> 00:18:11,640you can kind of imagine this graph across the all of these different points and sometimes we'll have ups and downs there that can help inform us what we struggle with and what we're really finding easy.
23800:18:12,449 --> 00:18:18,640So a person who's really good in the areas of generating ideas and flexibility,
23900:18:18,650 --> 00:18:21,339this person might be called creative.
24000:18:21,349 --> 00:18:22,920All these ideas,
24100:18:22,930 --> 00:18:24,140they're very flexible,
24200:18:24,150 --> 00:18:25,579they go from here to there,
24300:18:25,839 --> 00:18:29,609but they may struggle with other areas of executive function,
24400:18:30,040 --> 00:18:31,959they may be impulsive,
24500:18:32,000 --> 00:18:35,979have difficulty with time management, organization...
24600:18:36,180 --> 00:18:41,780So everybody has their own pattern with an executive function.
24700:18:43,069 --> 00:18:45,640So let's go back here.
24800:18:45,650 --> 00:18:52,219We are setting up a discussion of the relationship between executive function and ADD.
24900:18:52,819 --> 00:19:01,339And one of the difficulties we currently have is that our understanding of executive function has evolved since 1980.
25000:19:01,780 --> 00:19:12,500But we have a diagnosis that covers only a small subset of how we currently conceptualize executive function.
25100:19:13,349 --> 00:19:25,880This creates difficulty in that someone may clearly have developmental executive function problems but not fit into the box of the ADD diagnostic criteria.
25200:19:28,280 --> 00:19:29,010Now,
25300:19:29,849 --> 00:19:33,420let's compare ADD and autism.
25400:19:35,489 --> 00:19:43,300Everyone on the autism spectrum will have executive function difficulty in some form or pattern.
25500:19:45,040 --> 00:19:48,290That's because of the neurology of autism.
25600:19:50,880 --> 00:19:57,329The term executive function is not specifically used in the autism criteria,
25700:19:57,359 --> 00:20:09,849but many of the criteria describe behavioral patterns that tap into that neurology and that reflect difficulty in executive function and that subcortical frontal system.
25800:20:11,849 --> 00:20:21,040So autism has this executive function component plus many nonexecutive function elements as well.
25900:20:22,930 --> 00:20:28,709So ADD is a diagnosis of four or so elements of executive function.
26000:20:29,219 --> 00:20:37,819Autism is a diagnosis that includes elements of executive function and elements outside of executive function.
26100:20:39,469 --> 00:20:52,160The diagnostic manual indicates that the diagnosis of ADD cannot be made if another diagnosis better accounts for the client's whole presentation.
26200:20:54,359 --> 00:21:15,699The diagnostic manual says about autism that ADD can also be in diagnosed along with autism when attentional difficulties or hyperactivity exceeds that typically seen in autism.
26300:21:19,569 --> 00:21:21,280So let's regroup.
26400:21:21,969 --> 00:21:23,310Executive function,
26500:21:23,319 --> 00:21:28,189difficulties occur secondary to so many developmental,
26600:21:28,199 --> 00:21:30,339physical and psychological states.
26700:21:30,859 --> 00:21:39,660And ADD and autism are two developmental diagnoses that include executive function difficulty.
26800:21:40,829 --> 00:21:49,989ADD includes about four elements of the 12 to 15 sub elements of executive function that we generally think of.
26900:21:50,359 --> 00:22:02,369And autism includes some pattern of executive function difficulty across elements and also has nonexecutive function
27000:22:02,680 --> 00:22:04,239parts to the criteria.
27100:22:06,560 --> 00:22:18,890what should happen is that an individual presenting with developmental executive function difficulty would see a clinician who develops an appropriate differential,
27200:22:19,770 --> 00:22:24,810that is the person has developmental executive function difficulty,
27300:22:24,839 --> 00:22:27,569but that's not specific to ADD.
27400:22:27,579 --> 00:22:33,810So let's consider other developmental conditions like autism.
27500:22:33,819 --> 00:22:40,819And also let's consider other relevant information like the trauma history,
27600:22:40,829 --> 00:22:42,640medical conditions,
27700:22:42,670 --> 00:22:44,229intellectual abilities,
27800:22:44,239 --> 00:22:45,839learning disabilities,
27900:22:45,849 --> 00:22:47,810language processing ability.
28000:22:48,040 --> 00:22:53,819And let's figure out what the basis of this executive function problem is.
28100:22:56,089 --> 00:23:02,239But what actually happens is that a teacher, doctor, or clinician says,
28200:23:02,359 --> 00:23:02,979oh,
28300:23:02,989 --> 00:23:06,750this person has developmental executive function difficulty.
28400:23:07,010 --> 00:23:07,900Therefore,
28500:23:07,910 --> 00:23:10,280we're going to diagnose them with ADD.
28600:23:11,709 --> 00:23:13,319Then years later,
28700:23:13,569 --> 00:23:17,390they come to see a professional who does an evaluation and says,
28800:23:17,400 --> 00:23:18,050well,
28900:23:18,469 --> 00:23:21,589this person does have executive function problems,
29000:23:21,599 --> 00:23:32,270but the root of their attention problem is that they have an intellectual disability and nobody's ever checked or they can't process language well.
29100:23:32,280 --> 00:23:33,239And so of course,
29200:23:33,250 --> 00:23:42,689they can't attend in the classroom... or they have a learning disability so they can't attend if they can't understand what they're learning.
29300:23:44,040 --> 00:23:52,050Some of these individuals have executive function difficulty because they've been on the autism spectrum all along.
29400:23:52,060 --> 00:23:56,359But autism was never included in the differential process.
29500:23:56,890 --> 00:24:00,250So they've never been assessed for autism.
29600:24:01,310 --> 00:24:11,819It's kind of like hearing that someone has difficulty with fatigue and then assigning a diagnosis of chronic fatigue syndrome without thinking through any differential.
29700:24:12,660 --> 00:24:12,880Now,
29800:24:12,890 --> 00:24:18,630not everyone with fatigue is best served by a diagnosis of chronic fatigue syndrome.
29900:24:18,829 --> 00:24:40,849And not everyone with executive function difficulty is best described by a diagnosis of ADD. ADD should be given if another diagnosis or condition does not more fully explain the full constellation of characteristics.
30000:24:42,290 --> 00:24:51,180So even if the individual meets all the criteria for difficulty in those four subs skills,
30100:24:52,859 --> 00:25:04,869the diagnosis is not made if this executive function difficulty is better explained by autism or intellectual disability or learning disability,
30200:25:04,880 --> 00:25:05,550et cetera.
30300:25:05,630 --> 00:25:11,089So the question in the case of ADD diagnosis shouldn't just be,
30400:25:11,099 --> 00:25:15,319are the criteria met ... but are the criteria met
30500:25:15,329 --> 00:25:29,270and is this the diagnosis that best explains the whole presentation for this student or client or patient? In autism,
30600:25:29,280 --> 00:25:41,550executive function difficulties for one individual may include maybe two of those four subs skills that are in our definition of ADD and maybe three other executive function skills.
30700:25:42,910 --> 00:25:44,500They still have autism,
30800:25:44,619 --> 00:25:48,989they still have executive function difficulty as we would expect.
30900:25:49,260 --> 00:25:54,510But perhaps they're less likely to have a pairing of an ADD diagnosis.
31000:25:56,579 --> 00:26:06,150Another person on the autism spectrum may have all four of those difficulties in the ADD category and maybe a couple that aren't.
31100:26:06,500 --> 00:26:12,170And so they get these two diagnoses autism and ADD.
31200:26:14,069 --> 00:26:14,900However,
31300:26:14,910 --> 00:26:22,260if the executive function difficulty is not excessive for what we expect to see in autism,
31400:26:22,640 --> 00:26:24,650they shouldn't have that diagnosis.
31500:26:24,660 --> 00:26:25,869That second one,
31600:26:26,209 --> 00:26:27,239it's redundant.
31700:26:27,250 --> 00:26:28,500It's repetitive.
31800:26:29,599 --> 00:26:37,270So then do we take away the ADD diagnosis once someone has a diagnosis of autism?
31900:26:37,640 --> 00:26:39,449And it's not excessive?
32000:26:39,760 --> 00:26:40,099Well,
32100:26:40,109 --> 00:26:40,989we could,
32200:26:41,130 --> 00:26:42,829if we wanted to be precise,
32300:26:42,839 --> 00:26:47,369This is really what the manual talks about as making the most sense.
32400:26:48,699 --> 00:26:49,250However,
32500:26:49,260 --> 00:26:50,390practically speaking,
32600:26:50,400 --> 00:26:51,790this gets difficult.
32700:26:51,800 --> 00:27:02,290So one reason is that people don't understand the context of this ADD diagnosis and what it means and what it doesn't mean.
32800:27:03,219 --> 00:27:04,930And many times after I see a
32900:27:04,939 --> 00:27:07,349a client for an autism evaluation,
33000:27:07,359 --> 00:27:11,079I'll tell them their diagnosis is autism spectrum disorder.
33100:27:11,239 --> 00:27:12,719And then they will ask,
33200:27:12,729 --> 00:27:15,910did you also check for ADD I think I have that too.
33300:27:16,800 --> 00:27:21,949And so it's a difficult thing to just answer with a couple sentences as you can see.
33400:27:22,489 --> 00:27:25,150Do they have executive function difficulty?
33500:27:25,160 --> 00:27:26,359Absolutely.
33600:27:26,719 --> 00:27:36,709Do they have executive function difficulty that fits into that four subset category that we have as our diagnosis for ADD? Possibly
33700:27:36,719 --> 00:27:37,790yes or possibly no.
33800:27:37,800 --> 00:27:48,400Depending on the case. And does the executive function difficulty exceed what is generally seen in autism? Really infrequently.
33900:27:48,410 --> 00:27:49,260Honestly,
34000:27:49,670 --> 00:27:52,079I have made both diagnoses,
34100:27:52,089 --> 00:28:00,579but I don't frequently see the executive function as really standing out higher than you know...
34200:28:00,589 --> 00:28:02,369the group of people that I see.
34300:28:03,780 --> 00:28:04,890So conceptually,
34400:28:04,900 --> 00:28:05,640to me,
34500:28:05,959 --> 00:28:11,540it makes no actual sense to talk about autism with and without ADD.
34600:28:11,979 --> 00:28:12,589In fact,
34700:28:12,599 --> 00:28:13,339at this stage,
34800:28:13,349 --> 00:28:15,630in our understanding of the nervous system,
34900:28:15,949 --> 00:28:27,680it doesn't make sense to talk about a diagnosis that is ADD that only includes four or so subsets of the executive function skills.
35000:28:29,040 --> 00:28:36,209I would propose that it would make more sense to just have a diagnosis that says executive function disorder.
35100:28:37,050 --> 00:28:45,969And then you could say comma developmental or comma acquired or perhaps you could list the pattern ... like for this person,
35200:28:45,979 --> 00:28:48,920these are the strengths and these are the difficulties.
35300:28:49,760 --> 00:29:00,569It would be nice to increase the understanding that saying the diagnosis of autism automatically communicates that there are executive function difficulties present.
35400:29:02,079 --> 00:29:04,569That's not really our reality right now though.
35500:29:05,920 --> 00:29:11,339So even though that makes the most sense to me as a neuropsychologist,
35600:29:12,650 --> 00:29:22,829one of the practical difficulties (aside from people not understanding the terms) is that if we take away the ADD diagnosis for an autistic client,
35700:29:23,229 --> 00:29:26,390the individual can't get their attention medication,
35800:29:26,719 --> 00:29:32,670even if it has helped their executive function difficulty within the autism spectrum.
35900:29:33,890 --> 00:29:34,699Now,
36000:29:34,709 --> 00:29:41,439the medication is often not as effective on the spectrum as off the spectrum.
36100:29:41,619 --> 00:29:44,380But if someone has been helped by it,
36200:29:44,500 --> 00:29:47,099there's no reason to take it away because,
36300:29:47,390 --> 00:29:47,619you know,
36400:29:47,630 --> 00:29:50,670just because that ADD doesn't entirely fit.
36500:29:51,239 --> 00:29:54,130So practically speaking,
36600:29:54,569 --> 00:30:01,030they're gonna end up keeping that diagnosis because they understand what it means
36700:30:01,310 --> 00:30:04,770snd they don't understand what not having it means.
36800:30:04,979 --> 00:30:11,170And also they need medication or benefit from medication that requires that diagnosis.
36900:30:12,540 --> 00:30:17,469The other thing that's really a caution that I'd like you to think about...
37000:30:20,109 --> 00:30:33,630I really advise a lot of caution when reading things and listening to people speak about ADD and ADHD because we'll start to hear things...
37100:30:33,640 --> 00:30:34,609You know,
37200:30:34,619 --> 00:30:35,489people will say,
37300:30:35,500 --> 00:30:35,930well,
37400:30:35,939 --> 00:30:38,969you know what's really common for people with ADD,
37500:30:39,140 --> 00:30:49,670it's common that they become hyper focussed or it's common that they have difficulty with social interactions or it's common that they have sensory processing difficulties.
37600:30:51,680 --> 00:30:52,030The
37700:30:52,040 --> 00:31:07,280the problem with these statements is that the individuals who have received diagnoses of ADD often receive this just because they've had executive function difficulty,
37800:31:07,900 --> 00:31:11,900but they haven't had much if any differential assessment.
37900:31:13,010 --> 00:31:25,439So we don't know if it's really true that individuals with a pure ADD often have these coexisting features.
38000:31:26,739 --> 00:31:33,219Because what makes a lot of sense is that within the ADD population,
38100:31:33,229 --> 00:31:42,439there's some subset of it autistic individuals who say I have ADD and I notice that I also have trouble reading social cues.
38200:31:43,380 --> 00:31:44,109Well,
38300:31:44,219 --> 00:31:47,780the difficulty reading social cues then becomes a
38400:31:47,790 --> 00:31:51,130"common feature" associated with ADD.
38500:31:51,140 --> 00:31:53,239But we don't know,
38600:31:53,780 --> 00:31:55,880does this person have autism?
38700:31:55,890 --> 00:31:57,150Have they been assessed?
38800:31:57,160 --> 00:31:57,520And,
38900:31:57,869 --> 00:31:58,770and if so,
39000:31:58,780 --> 00:32:08,359if we get this group of just really pure ADD diagnoses and nothing else explains those features better,
39100:32:08,650 --> 00:32:12,369I would love to know what ... kind of... is associated with that.
39200:32:13,420 --> 00:32:14,670But at this point,
39300:32:14,939 --> 00:32:21,119we really don't know. The research using people diagnosed with ADD...
39400:32:21,520 --> 00:32:24,770They don't go through any differential process.
39500:32:24,780 --> 00:32:25,969They just look and say,
39600:32:25,979 --> 00:32:27,739oh you have a diagnosis,
39700:32:27,750 --> 00:32:30,670let's put you in the ADD group and study you.
39800:32:31,280 --> 00:32:33,890So you see why this is a huge problem.
39900:32:34,050 --> 00:32:36,270It's a very messy group,
40000:32:36,280 --> 00:32:43,810a mixed group of people who have executive function problems from childhood.
40100:32:45,310 --> 00:33:08,609But it hasn't really been distinguished as to whether other contributors to executive function difficulty may have actually been there rather than just a pure developmental difficulty within these four categories or subtypes/subsets within that executive function definition.
40200:33:10,469 --> 00:33:15,219So that was a long meandering explanation,
40300:33:15,229 --> 00:33:16,660but really important.
40400:33:16,670 --> 00:33:19,959And I'm glad you followed me through those twists and turns.
40500:33:20,719 --> 00:33:22,780What do I want you to walk away with?
40600:33:22,790 --> 00:33:23,760Let me recap.
40700:33:23,770 --> 00:33:24,270Again.
40800:33:24,750 --> 00:33:28,199Executive function refers to a series of skills,
40900:33:28,209 --> 00:33:32,189not one skill that are linked anatomically,
41000:33:32,199 --> 00:33:41,599they hang together in the subcortical frontal systems of the brain and they work together to help us make a cohesive and meaningful product.
41100:33:42,540 --> 00:33:51,050ADD was added to the diagnostic manual in 1980 to describe developmental executive function differences.
41200:33:51,060 --> 00:33:54,630And that was really a good advancement at the time.
41300:33:56,219 --> 00:34:01,199Executive function is not specific to ADD and many,
41400:34:01,209 --> 00:34:05,250many things can trigger executive function difficulty.
41500:34:05,959 --> 00:34:09,209So we would never want to hear...
41600:34:09,219 --> 00:34:15,669executive function difficulty ...and translate that automatically into ADD.
41700:34:17,688 --> 00:34:25,579This is where the differential diagnostic process should come in someone presenting with executive function difficulty.
41800:34:26,089 --> 00:34:27,579Then we would say,
41900:34:27,589 --> 00:34:27,878well,
42000:34:27,888 --> 00:34:35,039what conditions that could produce this kind of difficulty may present in the specific student,
42100:34:35,049 --> 00:34:36,269client, or patient?
42200:34:36,519 --> 00:34:40,648And what would be most likely do they have a medical condition?
42300:34:40,849 --> 00:34:43,638Has someone looked for an intellectual disability,
42400:34:43,648 --> 00:34:45,358auditory processing problems,
42500:34:45,368 --> 00:34:46,519learning disability,
42600:34:47,399 --> 00:34:47,739you know,
42700:34:47,750 --> 00:34:57,810perhaps an older individual presents with concerns that they have ADD and yet they have some medical issues,
42800:34:57,820 --> 00:34:58,850normal aging,
42900:34:58,860 --> 00:34:59,860some trauma.
43000:35:00,270 --> 00:35:02,590So what has the differential been,
43100:35:02,820 --> 00:35:04,909has there been a differential?
43200:35:06,429 --> 00:35:10,280What often happens instead is that especially during childhood,
43300:35:10,290 --> 00:35:12,189adolescence and young adulthood,
43400:35:12,340 --> 00:35:26,300someone presents with executive function difficulty and they're given a diagnosis of ADD without ruling out autism or other possible contributors to the inattention and other features.
43500:35:27,939 --> 00:35:56,770This leads to personal stories and articles and research studies about common features in ADD that are actually describing features in this huge mix of individuals with a variety of factors impacting their executive function rather than a research study with a group of people who have features specific to our definition of ADD and do not have other diagnostic conditions like autism.
43600:35:58,129 --> 00:35:58,739To me,
43700:35:58,750 --> 00:36:03,409it rarely makes sense to describe both ADD and autism.
43800:36:03,649 --> 00:36:13,639Usually the ADD diagnosis is describing these four subs skills of executive function when actually there are more like 12 to 15.
43900:36:14,030 --> 00:36:22,580And they're describing it in autism where executive function difficulty is always present in some form.
44000:36:24,379 --> 00:36:40,040And the diagnostic manual says that ADD should only be diagnosed when it's the diagnosis that explains the features the best you don't diagnose it just because the criteria are met,
44100:36:40,300 --> 00:36:46,689you diagnose it if the criteria are met and other things are not better explanations.
44200:36:47,669 --> 00:36:56,580I rarely see executive function difficulties in clients that extend beyond what I would expect for the autism profile.
44300:36:56,800 --> 00:36:59,919I have seen it certainly and I have diagnosed it.
44400:37:00,179 --> 00:37:01,739But by definition,
44500:37:01,750 --> 00:37:04,139if it's more than you'd expect,
44600:37:04,149 --> 00:37:04,459it's,
44700:37:04,469 --> 00:37:07,500it's not going to be common. To me,
44800:37:07,510 --> 00:37:08,979it makes sense to talk about
44900:37:08,989 --> 00:37:18,189executive function as including a series of sub abilities of which we can look at patterns of strengths and weaknesses in everyone,
45000:37:18,459 --> 00:37:20,260including those on the spectrum.
45100:37:20,879 --> 00:37:22,129But for now,
45200:37:22,250 --> 00:37:37,090we have this tiny subset of executive function characteristics in the DSM five called ADD that I would suggest should be expanded to reflect all of the executive function characteristics with,
45300:37:37,100 --> 00:37:39,770with specifiers like developmental.
45400:37:40,610 --> 00:37:42,959Thank you for listening to the recap.
45500:37:42,969 --> 00:37:48,899Thank you for going on this pathway of information with me today about executive function,
45600:37:48,909 --> 00:37:50,540ADD, and autism.
45700:37:50,800 --> 00:37:51,919In future episodes,
45800:37:51,929 --> 00:37:57,370we will break down some of the subsets of executive function and talk more about those.
45900:37:58,219 --> 00:38:07,370My favorite book series on Executive Function is The Smart But Scattered series which I will link in the show notes.
46000:38:07,979 --> 00:38:09,439Now there are many,
46100:38:09,449 --> 00:38:16,669many good books and resources on executive function and I certainly have not read or reviewed them all.
46200:38:16,909 --> 00:38:20,729You are encouraged to use the resources that best meet your needs.
46300:38:20,979 --> 00:38:23,530So look for the link for the smart but scattered.
46400:38:23,540 --> 00:38:26,449If you don't already have a series that meets your need,
46500:38:26,889 --> 00:38:34,830I do want to say that I don't get any financial compensation for recommending any of the resources that I list for you in my podcast episodes.
46600:38:34,939 --> 00:38:39,370These are just recommendations from things that have helped me in the past.
46700:38:39,379 --> 00:38:47,659I hope you have a great few weeks, and I look forward to you joining me for our next episode on Executive Function.
-
Have you ever struggled over whether to accept an invitation or opportunity? Should I say yes, or no? Join Dr. Regan as she discusses the importance of identifying goals and asking "what might that look like" before making a final decision.
Previous podcast episodes mentioned:
Attention Deficit Disorder and Autism: Similarities and Differences
Dr. Regan's Master Class for Clinicians:
Zur Institute: Master Class
Dr. Regan's Resources
Book: Understanding Autism in Adults and Aging Adults, 2nd ed
Audiobook
Book: Understanding Autistic Behaviors
Autism in the Adult website homepage
Website Resources for Clinicians
Read the transcript:
100:00:07,670 --> 00:00:08,520Hi there.
200:00:08,529 --> 00:00:13,520This is Doctor Regan joining you for an episode of Autism in the Adult podcast.
300:00:13,760 --> 00:00:15,029I'm your host.
400:00:15,039 --> 00:00:18,739I'm also a neuropsychologist, author and speaker,
500:00:19,000 --> 00:00:24,719a certified autism specialist and the parent of a teen on the autism spectrum.
600:00:25,850 --> 00:00:29,040You are joining me today for an episode entitled,
700:00:29,049 --> 00:00:30,620"what might that look like?"
800:00:30,909 --> 00:00:35,240One of the things that clients and families often ask me is,
900:00:35,250 --> 00:00:39,909"should we plan on this" or "should I say yes to this?"
1000:00:40,189 --> 00:00:40,669Now,
1100:00:40,680 --> 00:00:48,659this could mean being the best man at a family wedding or taking a family vacation to a cabin in the woods.
1200:00:49,419 --> 00:00:53,509It could mean accepting a full time job in an office setting.
1300:00:54,299 --> 00:00:55,029Now,
1400:00:55,529 --> 00:00:58,509my response is rarely yes or no,
1500:00:58,520 --> 00:01:01,270but rather "what might that look like?"
1600:01:02,590 --> 00:01:05,519So before we jump into the topic for today,
1700:01:05,529 --> 00:01:09,559we are coming up to the third anniversary of this podcast,
1800:01:09,879 --> 00:01:19,639the first episode launched on August 7th 2020 it highlighted similarities and differences between autism and ADD or ADHD.
1900:01:20,050 --> 00:01:20,379Now,
2000:01:20,389 --> 00:01:33,279this premiere episode is one of the most popular of the podcast and I plan to expand this topic into a series after today's episode which will further define executive function,
2100:01:33,550 --> 00:01:41,050its presentation in autism and ADD, and resources for harnessing the power of executive function.
2200:01:42,199 --> 00:01:43,089Secondly,
2300:01:43,099 --> 00:01:46,930I want to inform clinicians about an upcoming master class.
2400:01:46,940 --> 00:01:52,069I'm offering through Zur Institute about autism across the lifespan.
2500:01:53,190 --> 00:02:04,459I received so many emails and messages through my website about people seeking autism informed clinicians to provide them with diagnostic input information,
2600:02:04,470 --> 00:02:08,919education and solutions for roadblocks they may have encountered.
2700:02:09,649 --> 00:02:17,270So the bottom line is that more clinicians are needed to serve individuals who are searching for this specialization.
2800:02:17,600 --> 00:02:28,779And my response has been to offer multiple courses through Zur Institute. It's a continuing education site for clinicians.
2900:02:29,330 --> 00:02:36,809My goal is to equip clinicians across various regions to assist individuals in their communities.
3000:02:36,860 --> 00:02:39,320When this type of service is needed,
3100:02:39,979 --> 00:02:51,729the master class offering will focus on advanced topics and it starts in September space is limited and I'll have the link in the show notes.
3200:02:52,360 --> 00:02:55,449So let's jump into our topic for today.
3300:02:56,380 --> 00:03:10,369The autistic individual may have opportunities to accept or decline invitations and the invitation may be to enter an advanced academic program rather than the basic program.
3400:03:10,789 --> 00:03:13,770Perhaps the invitation is to travel.
3500:03:14,429 --> 00:03:24,199The invitation may be to lead a group such as being the best man at a family wedding or presenting research to professionals.
3600:03:25,720 --> 00:03:33,619My experience is that there's value in viewing the invitation not so much as a yes or no question.
3700:03:33,889 --> 00:03:35,369Do I accept this?
3800:03:35,380 --> 00:03:36,580Do I say no.
3900:03:36,759 --> 00:03:38,880But by asking ourselves,
4000:03:38,889 --> 00:03:40,410what might that look like?
4100:03:41,149 --> 00:03:41,710A yes,
4200:03:41,720 --> 00:03:47,160no view would be to see the invitation as a formed and complete package.
4300:03:47,289 --> 00:03:51,080So if I say yes to being the best man,
4400:03:51,089 --> 00:03:53,080I will plan the bachelor party,
4500:03:53,089 --> 00:03:54,240make a speech,
4600:03:54,380 --> 00:03:55,020toast,
4700:03:55,029 --> 00:03:56,509the couple at the reception,
4800:03:56,520 --> 00:04:00,869et cetera saying no to the invitation means I'll,
4900:04:00,880 --> 00:04:03,440I won't participate in these activities.
5000:04:03,990 --> 00:04:05,360But instead of a yes,
5100:04:05,369 --> 00:04:06,589no mindset,
5200:04:07,100 --> 00:04:11,199we can often talk through alternatives by asking,
5300:04:11,210 --> 00:04:12,919what might that look like?
5400:04:13,300 --> 00:04:14,990What might it look like to say?
5500:04:15,000 --> 00:04:15,729Yes,
5600:04:16,170 --> 00:04:19,630in a way that works for me and for the people around me.
5700:04:22,149 --> 00:04:26,200The first point to think about is what is the ultimate goal?
5800:04:26,209 --> 00:04:28,320What is the desired outcome?
5900:04:29,779 --> 00:04:36,600The goal for a vacation with family members may be to have relaxing experiences,
6000:04:36,660 --> 00:04:43,480to see natural landscapes that you've never seen and to connect with other family in a meaningful way.
6100:04:44,829 --> 00:04:50,709The goal for presenting your research to professionals may be to advance your career,
6200:04:50,720 --> 00:04:57,040make professional connections with others and highlight your role in the work that's been done.
6300:04:58,730 --> 00:05:09,549Identifying what a good outcome would look like is empowering because it helps us identify a handful of core foundational objectives.
6400:05:10,029 --> 00:05:12,640And when we work toward those objectives,
6500:05:12,649 --> 00:05:17,220we can release some of the trappings that may be part of the activity,
6600:05:17,230 --> 00:05:23,959but they're really not core to what we're going after for the individual,
6700:05:23,970 --> 00:05:26,440considering a full-time office job,
6800:05:26,470 --> 00:05:31,089he may decide that the foundational goals would be to have work stability.
6900:05:31,510 --> 00:05:34,140If he's currently doing consulting work,
7000:05:34,149 --> 00:05:35,200for example,
7100:05:35,290 --> 00:05:35,769he would,
7200:05:35,779 --> 00:05:45,109he may want more of a predictable salary and to have his name associated with a company that has a respected reputation in his field.
7300:05:46,239 --> 00:05:53,489So the first step you can focus on is determining what would be a good outcome.
7400:05:54,480 --> 00:06:02,549What would it look like in this situation to really dive in and also to feel like things went well.
7500:06:04,519 --> 00:06:10,970The first step you should focus on is determining what a good outcome would look like in this situation.
7600:06:11,589 --> 00:06:15,779What would a good outcome for participating in the wedding look like?
7700:06:16,140 --> 00:06:21,519What about going on a family vacation or accepting an office job?
7800:06:22,910 --> 00:06:32,970The second part after we've identified what the core features we're going after are those core foundational goals?
7900:06:33,179 --> 00:06:35,000We can ask ourselves,
8000:06:35,010 --> 00:06:36,459what might it look like?
8100:06:36,470 --> 00:06:41,559What might the situation look like that would allow for those outcomes?
8200:06:42,480 --> 00:06:44,950So let's go back to the examples.
8300:06:45,410 --> 00:06:49,690The gentleman invited to be best man at an out of town family wedding.
8400:06:49,700 --> 00:06:51,200Let's call him Joe.
8500:06:51,790 --> 00:06:54,510He may realize his instinct is to say,
8600:06:54,519 --> 00:06:55,160no,
8700:06:55,679 --> 00:06:58,809he knows that he gets overwhelmed in crowds.
8800:06:58,820 --> 00:07:09,809He dislikes being the center of attention and he relies on routine and specific favorite activities to remain grounded in daily life.
8900:07:10,170 --> 00:07:24,489He feels pulled in different directions because he wants to support his family member and he knows that it's really an honor to be asked to connect with the couple in this way at the ceremony.
9000:07:25,890 --> 00:07:28,390So Joe and his family may want to discuss,
9100:07:28,399 --> 00:07:31,570what would it look like for you to be best man?
9200:07:31,809 --> 00:07:36,630What might it look like for Joe to be best man in a relational,
9300:07:36,640 --> 00:07:38,899satisfying and meaningful way?
9400:07:38,940 --> 00:07:44,929But in a way that also offers him the freedom and the space to take care of his needs.
9500:07:45,790 --> 00:07:46,920So at this point,
9600:07:46,929 --> 00:07:57,320there is a commitment to the core goals and there is flexibility with the trappings that might otherwise go along with a wedding ceremony.
9700:07:59,109 --> 00:08:00,369In the case of the wedding,
9800:08:00,380 --> 00:08:02,769Joe may have a separate hotel room,
9900:08:02,779 --> 00:08:07,369so he has a quiet alone space to regroup as needed.
10000:08:08,350 --> 00:08:20,239Joe may know that he is grounded and centered when he gets pressure inputs in his muscles and joints and he gets these inputs at home with a weighted blanket,
10100:08:20,260 --> 00:08:22,339rock climbing and bike riding.
10200:08:23,239 --> 00:08:36,650He's decided to choose a hotel that has a swimming pool and an elliptical machine so that he can get these pressure inputs in ways that will still feel grounding to him.
10300:08:38,489 --> 00:08:48,789Joe also plans to use small noise canceling earbuds as needed just to shield himself from some of the noise in crowded areas.
10400:08:48,968 --> 00:08:50,289They're barely visible,
10500:08:50,299 --> 00:08:55,698they help him a lot and it'll be a step toward really increasing his comfort.
10600:08:56,940 --> 00:09:00,880Joe and his family agree that he won't attend the bachelor party,
10700:09:01,150 --> 00:09:09,630but still he'll have a time that evening where he and the groom have a private drink together to celebrate the union.
10800:09:11,020 --> 00:09:18,960Joe also decides to record a video of him toasting the couple rather than making a live toast.
10900:09:19,409 --> 00:09:26,979These things in combination with others really help him or regulate himself to have a relation,
11000:09:27,010 --> 00:09:33,950meaningful contribution at the ceremony and to also protect what his nervous system needs.
11100:09:34,820 --> 00:09:38,260The main points are that Joe and his family are thinking,
11200:09:38,450 --> 00:09:39,950what might this look like?
11300:09:39,960 --> 00:09:47,789What do we want to work toward and how can we best get there with a mindset toward getting everyone's needs met.
11400:09:49,020 --> 00:09:50,140Similarly,
11500:09:50,150 --> 00:09:53,250the researcher invited to present her work.
11600:09:53,260 --> 00:09:54,030Let's call her,
11700:09:54,039 --> 00:10:03,669Susan may avoid the invitation because handling unexpected situations during a presentation is very stressful to her.
11800:10:04,080 --> 00:10:10,799She also really shies away from being the center of attention and speaking in front of others.
11900:10:11,409 --> 00:10:19,219If she does present her goals would be to take credit for her work and to connect with like minded professionals.
12000:10:20,369 --> 00:10:26,169Perhaps her focus on what might this look like leads to the following plan,
12100:10:27,190 --> 00:10:35,840Susan and her mentor decide to present the information together with specific slides identified for each of them.
12200:10:36,559 --> 00:11:02,320So this plan allows Susan to have an experienced partner to guide her through unexpected glitches and it also ensures that Susan can count on presenting specific material but also have expected breaks while her mentor is speaking during the question and answer section at the end of the presentation,
12300:11:02,539 --> 00:11:13,679Susan will take the lead on questions she feels comfortable with and her mentor may cue and structure her thoughts by adding prompts like saying Susan,
12400:11:13,690 --> 00:11:19,400this may be a good time to discuss your findings in the area of XY or Z.
12500:11:21,340 --> 00:11:37,650So what might that look like process allowed Susan to work toward her desired goals without taking an all or nothing approach to all of the trappings that may typically accompany a professional presentation.
12600:11:38,219 --> 00:11:47,140So the first thing we talked about was figuring out what's foundational in the goals and then figuring out how to get there,
12700:11:47,150 --> 00:11:52,770what might it look like to accommodate these goals and to let some other things go.
12800:11:54,070 --> 00:11:57,070The third thing to think about is when to say no.
12900:11:57,840 --> 00:11:59,729So having said all this,
13000:11:59,739 --> 00:12:12,960there will be times when what might this look like when that process leads to the conclusion that really this is probably unlikely to help achieve our best,
13100:12:12,969 --> 00:12:14,179our best outcome,
13200:12:14,190 --> 00:12:15,369our best goals.
13300:12:16,030 --> 00:12:17,479Um So saying,
13400:12:17,489 --> 00:12:20,460no may be the best decision in that case,
13500:12:21,900 --> 00:12:27,979although there would be benefits to finding a compromise that meets the needs of multiple people.
13600:12:27,989 --> 00:12:45,590The process may be unrealistic in a particular situation and that may be because the individual's needs at that time are so high in this season of struggle or it may be because features of the situation just can't be adjusted.
13700:12:47,289 --> 00:12:53,179Let's take the consultants situation who's considering a full-time office job.
13800:12:53,390 --> 00:13:15,960Let's call him a the best answer for him may be no if he is in an unusual season of struggle and maybe he's having difficulty consistently getting his consulting work done and to then switch to a setting that would be more challenging for him may really not be good timing,
13900:13:16,719 --> 00:13:22,520his needs as an individual may be so far from what the job can offer him.
14000:13:22,770 --> 00:13:25,729That the best answer in this season is no.
14100:13:27,179 --> 00:13:28,309Alternatively,
14200:13:28,320 --> 00:13:32,619the answer may be no if he's doing well in his consulting work.
14300:13:32,830 --> 00:13:42,119But there are core features of the job that would prevent him from having the flexibility that he would really need to thrive.
14400:13:42,809 --> 00:13:47,280He may realize that he would need a hybrid work model,
14500:13:47,289 --> 00:13:50,280combining office work and remote work.
14600:13:51,070 --> 00:13:57,289He may have the self awareness that working on new business proposals keeps his interest level up,
14700:13:57,650 --> 00:14:06,549but he needs help maintaining interest in projects that feel like old hat that the work can get boring very quickly.
14800:14:06,640 --> 00:14:21,630And the consulting job allows him to pick and choose the types of projects that he does and for things not to get stale if the office job offers him stability in one sense,
14900:14:21,729 --> 00:14:26,719but a lack of flexibility to kind of meet in the middle.
15000:14:27,530 --> 00:14:30,950He may need to say no to that invitation.
15100:14:31,330 --> 00:14:33,929Uh Based on what he knows about himself,
15200:14:38,130 --> 00:14:42,099an individual invited to come along for a family vacation.
15300:14:42,239 --> 00:14:44,090Let's call her MEREDITH.
15400:14:44,460 --> 00:14:49,940She may realize that no is the answer that makes the most sense in her season.
15500:14:50,799 --> 00:14:53,890After thinking through what might this look like,
15600:14:53,900 --> 00:15:02,969she can't envision any way that realistically meets her needs and achieves the goal of connecting with family on this trip.
15700:15:04,080 --> 00:15:05,250For example,
15800:15:05,260 --> 00:15:14,809she may have a really severe fear of flying and taking multiple planes is the only way to participate in the vacation as planned.
15900:15:16,049 --> 00:15:23,179MEREDITH may realize that her core goal is to connect with two family members in particular.
16000:15:23,880 --> 00:15:26,580So her next thought process might be,
16100:15:27,229 --> 00:15:30,859I'm going to have to say no to the invitation of the trip.
16200:15:30,929 --> 00:15:34,429But how else could I connect with those family members?
16300:15:34,500 --> 00:15:37,849Even I'm if I'm going to turn down this invitation,
16400:15:39,489 --> 00:15:55,979this process of evaluating invitations and opportunities by asking what might that look like can help us identify what our core goals and needs are while adjusting or releasing things that really aren't foundational.
16500:15:57,039 --> 00:15:59,809The decisions often don't need to be all or nothing.
16600:15:59,820 --> 00:16:03,750Although after thinking through what might this look like?
16700:16:03,940 --> 00:16:08,150We might see that some opportunities just aren't a good fit.
16800:16:10,030 --> 00:16:22,359I hope you have invitations that help you grow toward your goals and that your decision making process can also reflect your values and your needs at all seasons of your life.
16900:16:22,460 --> 00:16:24,500Thank you for joining me today.
17000:16:24,750 --> 00:16:36,599The next episode will launch our new series on Executive Function and clinicians ... check out the link to the master class opportunity with Zur Institute coming up in the fall.
17100:16:36,690 --> 00:16:41,710I hope you can join me next time for our episode on Executive Function.
-
Do you want to live with more intention to achieve your goals? In this 6th episode in a series on Intentional Living, Dr. Regan discusses ways to grow in areas of interest by expanding skills and using free or low cost methods of networking and introducing products or services to others.
Previous podcast episodes mentioned:
Shifting Autistic Characteristics Across the Lifespan
Autism in Women
Coursera (online courses)
Dr. Regan's Resources
Book: Understanding Autism in Adults and Aging Adults, 2nd ed
Audiobook
Book: Understanding Autistic Behaviors
Autism in the Adult website homepage
Website Resources for Clinicians
Read the transcript:
100:00:06,019 --> 00:00:06,829Hello,
200:00:06,840 --> 00:00:16,920this is Doctor Regan joining you for the sixth episode of Our Living With Intention series on the Autism in the Adult podcast.
300:00:17,290 --> 00:00:20,159I am the mom of a teen on the spectrum.
400:00:20,459 --> 00:00:26,180I have a doctorate in the field of brain behavior relationships called neuropsychology.
500:00:26,440 --> 00:00:28,549I'm also an author and speaker,
600:00:28,559 --> 00:00:36,279a certified autism specialist and the founder and director of an autism diagnostic clinic in Central Illinois,
700:00:36,290 --> 00:00:38,000serving adolescents,
800:00:38,009 --> 00:00:40,060adults and aging adults.
900:00:42,180 --> 00:00:45,069Before we jump into our topic for today,
1000:00:45,090 --> 00:00:48,250let's take a throwback to past episodes.
1100:00:48,619 --> 00:00:51,790Looking back to two years ago at this time,
1200:00:51,869 --> 00:00:54,779I published an episode about autism in women.
1300:00:55,299 --> 00:00:59,330It's been one of the most listened to episodes of the podcast.
1400:00:59,779 --> 00:01:02,270And one year ago at this time,
1500:01:02,279 --> 00:01:13,699we were in the midst of a series about how autism characteristics may shift somewhat across the lifespan during puberty across life,
1600:01:13,709 --> 00:01:17,879seasons in women and throughout the aging years,
1700:01:19,120 --> 00:01:23,569I'll go ahead and link these episodes in the show notes in case you miss them.
1800:01:24,989 --> 00:01:25,199Now,
1900:01:25,209 --> 00:01:30,139let's talk about our current episode in The Living With Intention series.
2000:01:32,319 --> 00:01:37,309I've named the series Living With Intention because sometimes as humans,
2100:01:37,319 --> 00:01:53,690we just kind of get swept up in the demands of daily life or we get stuck in some areas and it can help to pause and consider where we would like to be in various areas of our lives.
2200:01:54,370 --> 00:02:02,739And then to think about how to take small achievable steps on a path toward our intention.
2300:02:03,839 --> 00:02:04,629And so far,
2400:02:04,639 --> 00:02:13,050we've spoken about three areas of life that someone may have goals for such as improving regulation,
2500:02:13,539 --> 00:02:15,539that means feeling centered,
2600:02:15,550 --> 00:02:18,619calm and psychologically present.
2700:02:19,720 --> 00:02:27,210We talked about communicating and connecting and also about addressing issues of household culture.
2800:02:28,750 --> 00:02:29,449Today,
2900:02:29,460 --> 00:02:32,679we will look at the area of interests.
3000:02:32,690 --> 00:02:44,070Many people that I work with share that they're so captivated by a certain topic or activity that they would love to expand this in their life.
3100:02:44,100 --> 00:02:45,500For example,
3200:02:45,509 --> 00:02:47,470if someone is an artist,
3300:02:47,710 --> 00:02:52,380they may share that they think they would like to sell designs on Etsy,
3400:02:54,000 --> 00:03:01,710another person may share that they are immersed in sewing and this is so interesting and calming to them.
3500:03:02,210 --> 00:03:09,970They've developed quite a skill in this area and they're wondering if they could expand by doing some things in their community.
3600:03:11,270 --> 00:03:21,240Another may have an amazing brain for sports statistics and wish that they could get into sports casting as a niche in life.
3700:03:23,399 --> 00:03:23,929Again,
3800:03:23,940 --> 00:03:29,149it's important to emphasize that these are goals that the individual presents with.
3900:03:29,360 --> 00:03:33,800This is not an episode about what someone's goals should be,
4000:03:33,949 --> 00:03:37,210but rather to address the thought of gosh,
4100:03:37,220 --> 00:03:48,089I love this stuff and I would love to do more or use it in a way that reaches a wider area or a wider audience.
4200:03:49,759 --> 00:03:58,970So how does one start a path toward getting more involved in the area of an intense interest?
4300:04:00,710 --> 00:04:07,130So how to get started as we talked about in the second episode on this series,
4400:04:07,399 --> 00:04:14,979it is recommended that we take small defined achievable steps in the direction we would like to go.
4500:04:15,850 --> 00:04:22,579So one such step may be to gain some additional skills in the area of interest.
4600:04:22,869 --> 00:04:23,880For example,
4700:04:23,890 --> 00:04:29,679if someone produces a product and they would like to offer the product on the internet,
4800:04:29,920 --> 00:04:39,200they may wish to get training in things like basic marketing strategies using social media for sales and creating a website.
4900:04:40,209 --> 00:04:44,359Someone who creates a myriad of characters and stories,
5000:04:44,549 --> 00:04:59,209this individual may want to write fiction books in order to bridge the gap from having great ideas and wonderful creativity to bringing together some stories into a book.
5100:04:59,239 --> 00:05:03,730The individual may wish to take a formal course in creative writing.
5200:05:06,600 --> 00:05:07,010Now,
5300:05:07,019 --> 00:05:12,209I know taking a course can feel daunting but a wonderful place to learn.
5400:05:12,220 --> 00:05:20,209Some of these skills is on the internet and there are Myriads of free online courses in various areas.
5500:05:21,209 --> 00:05:21,739In fact,
5600:05:21,750 --> 00:05:28,390there are so many options that I just can't even list the top opportunities in the show note links.
5700:05:28,399 --> 00:05:29,690There are so many,
5800:05:30,160 --> 00:05:34,279but I'll share a few things about learning from the internet.
5900:05:35,190 --> 00:05:37,279Have you ever heard of a MOOC?
6000:05:38,040 --> 00:05:41,059That's M - O - O - C.
6100:05:41,480 --> 00:05:46,750It's a massive open online course - MOOC.
6200:05:47,040 --> 00:05:54,359And this is a free web-based distance learning program that's designed for huge numbers of people.
6300:05:54,369 --> 00:05:59,869Thus the word massive ... of geographically dispersed students.
6400:06:00,049 --> 00:06:08,380So open means that these are accessible to multiple levels of people very often,
6500:06:08,390 --> 00:06:11,929these are free and they're online.
6600:06:11,940 --> 00:06:13,820So this is all web based.
6700:06:15,440 --> 00:06:21,950I myself have been a student in several MOC courses to learn things that I can't learn locally.
6800:06:22,079 --> 00:06:23,089For example,
6900:06:23,100 --> 00:06:28,390I got to take a Behavioral Genetics course through the University of Minnesota.
7000:06:28,609 --> 00:06:33,429I took a neuroanatomy course through the University of Illinois Chicago.
7100:06:34,790 --> 00:06:39,619And what happens is that you earn a participation certificate from the course,
7200:06:39,630 --> 00:06:41,079which is free,
7300:06:41,910 --> 00:06:50,410but the benefits are both the information you learn and also having this on your resume as an area of self study.
7400:06:50,839 --> 00:07:00,309So the MOOC platforms also have developed paid versions of courses where you earn some type of verified credit or certificate.
7500:07:00,739 --> 00:07:16,459And they also have programs that are kind of compilation certificates... like, take seven writing courses and get this advanced writing certificate or a grouping of computer courses for an IT specialization certificate.
7600:07:18,709 --> 00:07:25,670The particular site for MOOC courses that I used was Coursera.org and I'll put that in the show notes.
7700:07:25,899 --> 00:07:29,600But there are so many sites to choose from.
7800:07:30,920 --> 00:07:38,549I encourage you to use an internet search engine for free online courses in the area of your interest.
7900:07:41,500 --> 00:07:57,809Another opportunity for learning more skills in your area of interest would be youtube tutorials and also programs like Adobe that offer video instruction to become more expert in their program offerings.
8000:07:58,720 --> 00:07:59,809In this context,
8100:07:59,820 --> 00:08:03,690you could learn things like video and audio editing,
8200:08:03,700 --> 00:08:04,609photography
8300:08:04,619 --> 00:08:05,399editing,
8400:08:05,459 --> 00:08:08,390how to use website design software...
8500:08:08,799 --> 00:08:19,959Podcast platforms like Podbean and others also provide podcasts about how to become and succeed as a podcaster in your area of interest.
8600:08:20,200 --> 00:08:27,609And they also offer blog posts and articles about all the things their sites offer to support your goals.
8700:08:27,619 --> 00:08:52,500So there's a lot of free learning opportunities in the form of videos, in the form of programs that offer their own education about their products and also podcasts that just talk about how to develop your niche in addition to increasing skills in your area.
8800:08:52,780 --> 00:09:09,849Another way to take a step toward your goal of expanding your interest would be to start doing some things on a volunteer basis or to provide giveaways or free products as promotions to highlight your work or skills.
8900:09:10,549 --> 00:09:11,380So again,
9000:09:11,390 --> 00:09:14,409this doesn't need to be the end goal,
9100:09:14,489 --> 00:09:14,799you know,
9200:09:14,809 --> 00:09:18,950to be volunteering as the ultimate end,
9300:09:19,299 --> 00:09:28,400but it can be one step to help you become more comfortable in this area to gain experience and also to get your offerings out there.
9400:09:30,989 --> 00:09:40,159Someone who bakes may wish to donate cookies to the local elementary school open house with a nicely crafted sign about their business,
9500:09:40,169 --> 00:09:42,229including their contact information.
9600:09:42,630 --> 00:09:51,179They could even put a QR code on the sign so parents can scan the sign and save their contact information in their website location.
9700:09:52,320 --> 00:10:03,489The individual who loves sports statistics and wants to become a sportscaster may wish to volunteer time to local sports teams as the sports announcer during the games.
9800:10:04,450 --> 00:10:07,229This helps the person create contacts,
9900:10:07,510 --> 00:10:13,479get used to the tasks involved in doing the work and lets other people see their skills.
10000:10:15,929 --> 00:10:24,049There are other ways to use free venues to increase your credentials and get your work out there.
10100:10:27,109 --> 00:10:30,419Looking for free opportunities to get involved,
10200:10:30,440 --> 00:10:32,510advance your skills and get your work out.
10300:10:32,520 --> 00:10:38,219There is a really good way to step toward that intention of expansion.
10400:10:38,539 --> 00:10:39,739So for example,
10500:10:39,750 --> 00:10:45,809someone who's trying to develop creative writing skills may wish to enter their stories into contests.
10600:10:46,270 --> 00:10:48,960And once you have a body of work developed,
10700:10:49,119 --> 00:11:02,169you might find it fairly straightforward to enter appropriate work in various contests for review and as your work earns mentions or comments or awards,
10800:11:02,280 --> 00:11:06,270these can be highlighted in your credentials on your website.
10900:11:09,760 --> 00:11:21,210Someone who loves making characters and writing may also want to write fan fiction on the internet as a way of using a resource to get their work out there.
11000:11:23,190 --> 00:11:25,659For an individual who loves,
11100:11:25,669 --> 00:11:26,229loves,
11200:11:26,239 --> 00:11:35,909loves running and decides they may wish to do some personal training for other long distance runners locally or in their community,
11300:11:36,080 --> 00:11:42,500this person may wish to enter races and keep track of these credentials to market their services.
11400:11:43,030 --> 00:11:47,200Some races or events may be free and others may have a fee.
11500:11:47,250 --> 00:11:48,000But in the end,
11600:11:48,010 --> 00:11:52,440this could be a way of meeting people with similar interests,
11700:11:52,460 --> 00:12:02,169getting your name out there as someone who's actively pursuing running and training and getting some race placements to add to your credentials.
11800:12:05,869 --> 00:12:12,099The important things about these approaches are that they're small steps,
11900:12:12,640 --> 00:12:14,979they're toward your desired outcome.
12000:12:14,989 --> 00:12:22,760Whatever you've decided your intention is this is where I'd like to be in this area of my life.
12100:12:23,669 --> 00:12:30,200And these small steps help you get a feel for what your goal may feel like in the end.
12200:12:31,190 --> 00:12:32,320For example,
12300:12:32,330 --> 00:12:46,000someone who thinks that they might want to become a teacher will gain a lot of information about teaching by volunteering to teach a course at the community center every Saturday for four weeks.
12400:12:46,400 --> 00:12:53,440So they get a taste of what it feels like to instruct a small group of adults or Children.
12500:12:54,250 --> 00:13:03,460They get a taste for some of the paperwork or the communication demands in between the actual classes and instruction.
12600:13:04,229 --> 00:13:10,000Some people who love a particular topic and they think they might want to teach,
12700:13:10,030 --> 00:13:19,200end up realizing after some of these volunteer opportunities that the actual process of teaching is not something they love.
12800:13:22,530 --> 00:13:28,270Another important thing about this approach is that for some of the options.
12900:13:28,609 --> 00:13:35,520There's really not a high demand for in-person contact or being in crowded classrooms.
13000:13:36,059 --> 00:13:52,239Some individuals may feel that expanding their interests into well formed skills or offerings is most daunting because they really can't imagine themselves opening a whole storefront or running a restaurant full of people.
13100:13:52,640 --> 00:13:58,770But this approach can harness all of the online opportunities for learning,
13200:13:58,780 --> 00:13:59,909for creating,
13300:13:59,919 --> 00:14:05,880for selling through the internet while engaging in certain community events that you choose.
13400:14:06,159 --> 00:14:16,099You get to decide how much uh event based activity do I want to do in the community or how much do I want to travel?
13500:14:16,229 --> 00:14:23,330How much customer interaction do I want versus time to regroup in my own space?
13600:14:26,590 --> 00:14:31,000I'm a firm believer that your community needs your gifts,
13700:14:31,010 --> 00:14:32,159your knowledge,
13800:14:32,169 --> 00:14:40,070your passion and whatever area you find that in and finding ways to take steps to your passion,
13900:14:40,080 --> 00:14:42,229not only blesses you,
14000:14:42,440 --> 00:14:49,280but those around you and having ways of expressing that also is something that fills you up.
14100:14:49,619 --> 00:14:50,969I love creating.
14200:14:50,979 --> 00:14:51,929I love writing,
14300:14:51,940 --> 00:14:52,909I love running.
14400:14:52,919 --> 00:14:54,690I love sports statistics.
14500:14:54,960 --> 00:15:06,270We like to have some balanced way of allowing you to learn and grow in this area to feed that passion and to serve your community.
14600:15:09,030 --> 00:15:16,119Thank you so much for joining me for the sixth episode of the Living With Intention series.
14700:15:16,349 --> 00:15:27,099And I invite you to check out the show notes for links to opportunities mentioned in this episode and for links to other offerings on my website.
14800:15:27,349 --> 00:15:31,880And I hope that you join me for the next podcast episode.
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Do you want to live with more intention to achieve your goals? In this 5th episode in a series on Intentional Living, Dr. Regan identifies ways to improve household interactions by attending to the needs of the group and establishing traditions and structured activities.
Dr. Regan's Resources
Book: Understanding Autism in Adults and Aging Adults, 2nd ed
Audiobook
Book: Understanding Autistic Behaviors
Autism in the Adult website homepage
Website Resources for Clinicians
Read the transcript here:
100:00:06,139 --> 00:00:06,480Hi,
200:00:06,489 --> 00:00:07,110everyone.
300:00:07,119 --> 00:00:12,170This is Doctor Regan joining you for an episode of Autism in the Adult podcast.
400:00:12,489 --> 00:00:14,970I'm the mom of a teen on the spectrum.
500:00:14,979 --> 00:00:17,500I have a doctorate in neuropsychology.
600:00:17,700 --> 00:00:20,790It's the field of brain behavior relationships.
700:00:20,909 --> 00:00:25,649And I'm the director of an autism diagnostic clinic for adolescents,
800:00:25,659 --> 00:00:29,149adults and aging adults in Central Illinois.
900:00:30,010 --> 00:00:30,459Today,
1000:00:30,469 --> 00:00:38,180you're joining me for the fifth episode in a series about living with intention making goals,
1100:00:38,189 --> 00:00:43,500shifting in areas of life to get you closer to where you would like to be.
1200:00:44,240 --> 00:00:55,540So there were two episodes about how to choose an area of life to target and how to approach change with some specific goals and strategies.
1300:00:56,009 --> 00:01:02,369We had episodes about improving regulation and about communicating and connecting.
1400:01:02,979 --> 00:01:09,629So today we have an episode focused on household living and the culture of the household.
1500:01:10,400 --> 00:01:10,690Now,
1600:01:10,699 --> 00:01:13,250before we dive into the topic for today,
1700:01:13,260 --> 00:01:20,519I want to invite you to check out the resources on my website at adult in geriatric autism dot com.
1800:01:20,959 --> 00:01:28,410There are posts and videos for many different types of listeners and learners including clinicians.
1900:01:29,019 --> 00:01:29,529Also,
2000:01:29,540 --> 00:01:31,610you may find one of my books helpful,
2100:01:31,620 --> 00:01:32,580many of you know,
2200:01:32,589 --> 00:01:39,069that my first book called Understanding Autism in Adults and Aging Adults is in the second edition.
2300:01:39,500 --> 00:01:40,589And if you don't know,
2400:01:40,599 --> 00:01:44,550I have a second book called Understanding Autistic Behaviors,
2500:01:44,559 --> 00:01:47,250which is more of a workbook format.
2600:01:47,540 --> 00:01:55,809So it explains the neurology ... kind of the neurologic-why of some of the behavioral patterns.
2700:01:55,819 --> 00:02:02,110And it outlines ways to work toward increased well-being if someone's in a season of struggle.
2800:02:04,419 --> 00:02:07,430So let's focus on household living.
2900:02:07,470 --> 00:02:16,449So I want to highlight this topic because many people talk to me about the complexities of living in a household with other people.
3000:02:16,949 --> 00:02:22,330Most often this has to do with spouses or partners or with couples who have Children.
3100:02:22,690 --> 00:02:27,350Not only is the individual trying to increase their own self awareness.
3200:02:27,360 --> 00:02:27,559You know,
3300:02:27,570 --> 00:02:29,050this is how I'm wired,
3400:02:29,059 --> 00:02:30,529this is what makes me tick,
3500:02:30,539 --> 00:02:31,770this is what I need.
3600:02:32,059 --> 00:02:33,830But in a household,
3700:02:33,860 --> 00:02:41,160this is really next level awareness because there's now this demand to be aware of yourself,
3800:02:41,169 --> 00:02:46,289multiple other people and the interplay between all of the people.
3900:02:46,500 --> 00:02:47,630And on top of that,
4000:02:47,639 --> 00:02:52,100the needs and interplay change from day to day and from life,
4100:02:52,110 --> 00:02:53,770season to life season.
4200:02:54,789 --> 00:03:00,240It's so so easy to default to this kind of household interaction.
4300:03:00,449 --> 00:03:02,039Stop doing that.
4400:03:02,050 --> 00:03:03,440Why are you doing that?
4500:03:03,449 --> 00:03:08,440I've told you 100 times to X Y Z.
4600:03:08,860 --> 00:03:09,800Oh my gosh,
4700:03:09,809 --> 00:03:12,440you are so loud,
4800:03:12,449 --> 00:03:21,630messy clingy and guess what this focus on telling people to be different every day is just not that effective.
4900:03:21,960 --> 00:03:27,679And that's why we find ourselves saying the same things every day over and over.
5000:03:27,690 --> 00:03:28,770And not only that,
5100:03:28,910 --> 00:03:35,339but these repetitive interactions cause a strain on the relationships in the household.
5200:03:35,369 --> 00:03:40,940And they create this kind of adversarial connection rather than a partnering connection.
5300:03:41,330 --> 00:03:50,050So the big message is I want you to be different now rather than I want to partner with you to make things better,
5400:03:50,110 --> 00:03:51,339better for you,
5500:03:51,350 --> 00:03:53,839better for me and better for the household.
5600:03:54,520 --> 00:04:01,009So let's talk about some specific areas of focus and strategy that might help.
5700:04:01,820 --> 00:04:05,509The first thing we're gonna talk about is focus on the other.
5800:04:05,889 --> 00:04:06,199Now,
5900:04:06,210 --> 00:04:07,690during the previous episode,
6000:04:07,699 --> 00:04:14,910we talked about the importance of expanding our awareness from only what do I need right now,
6100:04:14,919 --> 00:04:22,100which actually can be difficult to figure out to what does the other person need right now.
6200:04:22,399 --> 00:04:24,170And when we add that element,
6300:04:24,420 --> 00:04:28,109we can get away from this push and pull of,
6400:04:28,119 --> 00:04:31,769stop doing that to oh,
6500:04:31,779 --> 00:04:35,309things might be able to go smoother in this area.
6600:04:35,660 --> 00:04:42,910I wonder what the need is that's connected with that behavior and how could I support change?
6700:04:43,250 --> 00:04:46,109So as we're talking about households,
6800:04:46,119 --> 00:05:00,899this concept of focus on the other then becomes expanded and that makes things a little more complex but also much more important and potentially really helpful,
6900:05:00,950 --> 00:05:04,730especially if this becomes the culture of the household,
7000:05:04,760 --> 00:05:09,079meaning that this is how we do things it becomes more automatic.
7100:05:09,089 --> 00:05:13,880It becomes something that everyone's focusing on as best they can.
7200:05:14,980 --> 00:05:28,660Let's imagine that a gentleman who's on the autism spectrum is also a dad and a husband and he's coming home from work after what's been a really draining and complex day,
7300:05:29,059 --> 00:05:36,130he's had work demands but also lots of other layers of unexpected changes in his schedule,
7400:05:36,140 --> 00:05:38,230detours on the route home.
7500:05:38,600 --> 00:05:43,970There were lots of sensory overload moments and a disagreement with a work colleague.
7600:05:44,750 --> 00:05:51,579So he comes home and mom who is home with three kids is not on the spectrum,
7700:05:51,589 --> 00:05:55,070but she does have sensory processing sensitivities,
7800:05:55,200 --> 00:05:56,220stickiness,
7900:05:56,230 --> 00:05:58,529and kids hanging on her and noise.
8000:05:58,540 --> 00:06:02,600And she's getting to the point that that has been really overwhelming today.
8100:06:03,359 --> 00:06:05,149She is home with three kids.
8200:06:05,160 --> 00:06:21,200A daughter who is eight has been home from school with the stomach flu but is feeling better and is now running around the house in her tutu singing and spinning and waving her magic wand around an autistic son who is 11,
8300:06:22,160 --> 00:06:25,049is melting down while doing his math homework.
8400:06:25,070 --> 00:06:32,630And another son is 15 and is playing loud music in his room with the door shut.
8500:06:34,019 --> 00:06:35,790So the first approach,
8600:06:35,799 --> 00:06:41,040the one that is our most typical go to may look like this.
8700:06:41,549 --> 00:06:42,899Dad walks in.
8800:06:43,059 --> 00:06:46,480Mom is yelling at her two youngest kids to be quiet.
8900:06:46,660 --> 00:06:51,549She's juggling hot food in the kitchen while trying to get food ready for dinner.
9000:06:52,700 --> 00:06:58,130The youngest daughter runs up to dad and wants to show off her tutu and her magic wand.
9100:06:58,540 --> 00:07:03,549And dad hears the loud music coming from upstairs and mom is thinking,
9200:07:03,559 --> 00:07:06,059thank goodness he is home.
9300:07:06,220 --> 00:07:07,549I need some help.
9400:07:07,559 --> 00:07:14,130I need some relief and dad is thinking I can't wait to get out of here and go for my bike ride.
9500:07:16,299 --> 00:07:23,519So mom and dad get in a fight about how he comes home and goes off by himself and she's been there all day,
9600:07:23,529 --> 00:07:24,309et cetera.
9700:07:25,209 --> 00:07:28,279So dad feels the pressure to make things right.
9800:07:28,510 --> 00:07:30,950He yells at his oldest son saying,
9900:07:30,959 --> 00:07:34,070why don't you turn off your music and come down and help your mother.
10000:07:34,390 --> 00:07:40,850And he yells at the middle son and says that math really isn't that hard and he should stop crying.
10100:07:42,920 --> 00:07:55,970We all get that right like we are at the end of our rope and we just want to make the chaos stop and calm down and we want other people to do their part.
10200:07:58,119 --> 00:08:00,250Let's think about a second approach.
10300:08:01,019 --> 00:08:17,299This is increased awareness that all of these people have really legitimate needs and a realization that there needs to be a way to figure out what they are and then to try to work together to do something.
10400:08:19,170 --> 00:08:22,100Mom is overwhelmed with sensory inputs.
10500:08:22,109 --> 00:08:26,929She's drained from the whole day of being the only adult at home,
10600:08:27,079 --> 00:08:33,700which means that she has been the go to person for everyone's needs in the household.
10700:08:34,559 --> 00:08:37,588So she needs quiet alone time.
10800:08:37,838 --> 00:08:39,598She needs compliments,
10900:08:39,609 --> 00:08:41,059she needs support.
11000:08:41,900 --> 00:08:44,830The youngest daughter suddenly feeling better.
11100:08:45,239 --> 00:08:54,210She needs to run off some of her nonsick energy and be recognized as someone who's beautiful and magical with her wand.
11200:08:55,409 --> 00:08:59,330The middle son has also been very drained from the day.
11300:08:59,669 --> 00:09:06,080He gets overwhelmed with the social and sensory environment at school and he has a math learning disability.
11400:09:06,719 --> 00:09:17,369So he has gone from a draining environment to a draining environment and he's doing a task that he just knows he can't have success with.
11500:09:18,260 --> 00:09:21,840He's unable to get his bearings to calm,
11600:09:22,059 --> 00:09:23,469to reenter,
11700:09:23,479 --> 00:09:25,869he needs some regulation help.
11800:09:27,960 --> 00:09:39,880The oldest son is feeling the angst of being a teen and this comes with easy irritation thinking his parents don't know anything and the loud music releases some of his irritability.
11900:09:40,000 --> 00:09:43,450It establishes his identity as his own person.
12000:09:43,619 --> 00:09:46,969So that is a lot.
12100:09:49,590 --> 00:09:51,229In this case,
12200:09:51,900 --> 00:10:07,090it often helps to have some type of planned huddle uh between the couple or with the family about what is the status right now and what do you need?
12300:10:09,809 --> 00:10:18,659The huddle is just a coming together to talk briefly about what are we gonna do next?
12400:10:18,900 --> 00:10:20,820What's going on and what are we gonna do?
12500:10:21,979 --> 00:10:26,710The status is really high chaos for everyone in this family right now.
12600:10:27,979 --> 00:10:35,590And sometimes families make up kind of humorous labels for levels of chaos or crisis.
12700:10:35,880 --> 00:10:50,049One family might use a color code where a code red is the most chaos or sometimes a movie related code where the most chaos is the Lord of the Rings scene where the orcs come.
12800:10:51,070 --> 00:10:54,030The status could also be a factual description.
12900:10:54,190 --> 00:10:55,340Bad day at work,
13000:10:55,349 --> 00:10:57,619really drained or bad day at home,
13100:10:57,630 --> 00:10:58,539really drained.
13200:10:58,710 --> 00:11:02,919And I'm at my breaking point at the highest level of chaos.
13300:11:02,929 --> 00:11:05,309Both mom and dad really need alone time.
13400:11:05,669 --> 00:11:06,280Now,
13500:11:06,289 --> 00:11:07,820what do the kids need?
13600:11:08,450 --> 00:11:08,929Well,
13700:11:08,940 --> 00:11:11,000you may have a quick family huddle,
13800:11:11,320 --> 00:11:12,780what do you need?
13900:11:13,210 --> 00:11:21,960Or the parents may have a sense already of what the kids would probably need to regulate and regroup.
14000:11:22,349 --> 00:11:27,219One helpful thing in this scenario might look like the following.
14100:11:27,840 --> 00:11:36,130Dad could go on his bike ride but also take the 11 year old son who's on the autism spectrum on the ride as well.
14200:11:37,150 --> 00:11:42,070They both really feel better after they get some pressure input,
14300:11:42,080 --> 00:11:45,929that's proprioceptive input and movement input,
14400:11:45,940 --> 00:11:47,330vestibular input.
14500:11:47,669 --> 00:11:53,450You can see our episode about sensory inputs for regulation.
14600:11:54,070 --> 00:11:57,539And this is why the bike ride is so important.
14700:11:57,760 --> 00:12:03,200If we tell dad not to go on the bike ride because the house is in chaos,
14800:12:03,599 --> 00:12:07,409he's not going to be able to regulate himself.
14900:12:07,590 --> 00:12:09,849So we want a dad who comes back,
15000:12:09,859 --> 00:12:12,979regulated centered calm.
15100:12:13,239 --> 00:12:14,640Um not at,
15200:12:14,650 --> 00:12:15,890at the breaking point.
15300:12:16,539 --> 00:12:30,619This bike ride also gives time for their mind to settle and it's a kind of together activity where they actually don't have to talk So it's the thing they like to do and we're together,
15400:12:30,630 --> 00:12:36,780but we don't have to say anything and that's very calming and regulating for them.
15500:12:38,750 --> 00:12:40,349Perhaps in this scenario,
15600:12:40,359 --> 00:12:51,559mom chooses a bubble bath with headphones and music and gives the 15 year old a task to keep him busy and to acknowledge his independence.
15700:12:52,200 --> 00:13:01,650So there's a small corner store about three blocks away and she gives him $15 to walk to the corner store and to take the eight year old,
15800:13:03,049 --> 00:13:11,119the eight year old can spin and sing and walk with her wand and he gets to choose whatever he wants for,
15900:13:11,130 --> 00:13:13,539quote dessert for the family.
16000:13:14,460 --> 00:13:18,489He chooses lots of movie candy like now and laters,
16100:13:18,500 --> 00:13:21,059Mike and Ike and Swedish fish.
16200:13:21,070 --> 00:13:25,109And he lets his sister pick out a Princess Pez dispenser.
16300:13:25,700 --> 00:13:27,390Then they walk home,
16400:13:27,400 --> 00:13:29,330mom's done with their bath.
16500:13:29,340 --> 00:13:38,270Dad and son are home and this is a regrouping time that acknowledges as many people's needs as possible.
16600:13:38,609 --> 00:13:44,409And then there can be a huddle at that point about how the rest of the night might go.
16700:13:46,419 --> 00:13:54,750But we at least want to problem solve when as many people as possible are more centered and less close to the breaking point.
16800:13:57,289 --> 00:14:06,520So this focus and strategy is uh really pinpointing what other people need people in the household.
16900:14:06,869 --> 00:14:12,479And it uses the huddle concept to come together and make a plan.
17000:14:12,849 --> 00:14:14,979So it's a quick coming together.
17100:14:14,989 --> 00:14:16,690It's not like a family meeting,
17200:14:16,700 --> 00:14:18,739where we talk through things,
17300:14:18,859 --> 00:14:21,580it's what's going on and what do we need to do.
17400:14:23,190 --> 00:14:23,679Now,
17500:14:23,690 --> 00:14:26,760we all know that this doesn't make everything easy,
17600:14:26,780 --> 00:14:35,969but it often makes things better and it creates partnerships within the household rather than really strained relationships.
17700:14:40,070 --> 00:14:44,280Let's look at another approach to household culture.
17800:14:44,419 --> 00:14:51,020So the second one is focusing on tradition and structure in order to interact,
17900:14:52,859 --> 00:14:55,090individuals with autistic neurology,
18000:14:55,099 --> 00:15:04,099often prefer structured topic based activities rather than hanging out or sharing about their day or sharing about feelings.
18100:15:04,510 --> 00:15:10,869These are typically more enjoyable to them than just unstructured together time.
18200:15:12,219 --> 00:15:16,950It might involve harnessing their knowledge about something that they love.
18300:15:19,450 --> 00:15:25,099And once you know who in the family really likes this kind of interaction.
18400:15:25,109 --> 00:15:26,320And you can say,
18500:15:26,479 --> 00:15:29,049I know this is what we enjoy best.
18600:15:29,380 --> 00:15:35,059This awareness can help increase the number of nice family memories or interactions.
18700:15:35,380 --> 00:15:37,239So for example,
18800:15:37,250 --> 00:15:46,159let's take a family um who likes to socially connect at the dinner table by sharing about their day,
18900:15:46,380 --> 00:15:47,929how the practice went,
19000:15:47,940 --> 00:15:49,409how their soccer game?
19100:15:49,419 --> 00:15:53,669Did uh did your friend feel good about their science project?
19200:15:53,679 --> 00:15:56,809How is your boss's husband doing since his surgery,
19300:15:56,820 --> 00:15:57,510et cetera?
19400:15:58,900 --> 00:16:02,880In contrast to another family with neurodiversity,
19500:16:02,890 --> 00:16:03,359now,
19600:16:03,369 --> 00:16:10,299they may prefer something more structured and less about how people felt or responded,
19700:16:10,780 --> 00:16:14,119less open ended or broad questions about the day.
19800:16:14,340 --> 00:16:15,919So what might that look like?
19900:16:17,909 --> 00:16:25,080This family might start a tradition at the dinner table where they each share an interesting fact that they learned that day.
20000:16:25,159 --> 00:16:30,159So perhaps the eight year old learned that most fish don't have eyelids.
20100:16:30,580 --> 00:16:33,000The 15 year old learned that on average,
20200:16:33,010 --> 00:16:36,739every person on earth owns 86 Lego Bricks.
20300:16:40,210 --> 00:16:42,320Let's look at another example.
20400:16:42,330 --> 00:16:44,059Let's take a spouse.
20500:16:44,400 --> 00:16:56,059We're looking at a woman who feels dissatisfied because her husband doesn't engage in conversations during times like car rides or while at a restaurant and waiting on their meal.
20600:16:56,739 --> 00:17:03,609She's realized though that they can have a really good social interaction if it's structured about a topic.
20700:17:04,250 --> 00:17:12,939She's also noticed that they have a good time interacting if they take online quizzes or play trivia together during these times.
20800:17:13,660 --> 00:17:22,630So the passenger in the car can ask the driver trivia questions and then they can switch and she notices that they really end up laughing,
20900:17:22,640 --> 00:17:24,089they learn new things.
21000:17:24,099 --> 00:17:25,530It works out well.
21100:17:25,540 --> 00:17:28,380It's actually a really connecting time,
21200:17:28,689 --> 00:17:34,829uh much better than the silence of sitting together without interacting.
21300:17:37,680 --> 00:17:39,530Let's take a third family.
21400:17:39,619 --> 00:17:53,829This family has teens and it's been struggling because the kids are a bit more moody than they were as youngsters and they're too old for some of the things that they used to do as a family when they were younger.
21500:17:54,099 --> 00:17:54,380You know,
21600:17:54,390 --> 00:17:57,170they don't like going to the zoo anymore.
21700:17:58,119 --> 00:18:05,349This family realized that structuring some traditions for activities has worked better than small talk.
21800:18:05,359 --> 00:18:13,849Like how with school they might have a Friday night tradition of board games and pizza or they might rotate,
21900:18:13,859 --> 00:18:16,530who gets to pick the Friday night activity.
22000:18:16,979 --> 00:18:21,810One teen may pick a movie and chooses the snacks next week,
22100:18:21,819 --> 00:18:26,089another chooses a board game and challenges kids against parents.
22200:18:26,579 --> 00:18:31,229And the next week mom chooses a Lock Drew mystery for the family to solve together.
22300:18:32,780 --> 00:18:43,729So this approach harnesses the fact that individuals with autistic neurology may really enjoy each other within the context of some structure,
22400:18:43,739 --> 00:18:53,310topic and activity rather than these loose connecting moments or open ended questions like how is your day and what's going on in your life.
22500:18:56,209 --> 00:19:00,420There's so much that goes into the culture of a household.
22600:19:00,790 --> 00:19:18,670But these two tips of helping people get their needs met and coming together with structure and topic focused activities can be part of what helps shift things in a good direction for many families and it really protects those partnering kinds of relationships.
22700:19:19,989 --> 00:19:24,660Thank you for joining me today to talk about households and families,
22800:19:24,819 --> 00:19:27,060protecting the wellness of our family.
22900:19:27,069 --> 00:19:32,709Connections can help us feel more supported and resilient overall.
23000:19:33,530 --> 00:19:42,430And next time we will round out this series by focusing on adding meaning and growth to areas of special interest.
23100:19:42,619 --> 00:19:44,219I hope you can join me then.
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Do you want to live with more intention to achieve your goals? In this 4th episode in a series on Intentional Living, Dr. Regan identifies ways to use communication to create connection and help you achieve the life goals you aim for.
Resources mentioned in the podcast:
Talking About Autism podcast series
The Science of Making Friends: book
Better Small Talk: book
Crucial Conversations: book
Dr. Regan's Resources
Book: Understanding Autism in Adults and Aging Adults, 2nd ed
Audiobook
Book: Understanding Autistic Behaviors
Autism in the Adult website homepage
Website Resources for Clinicians
Read the transcript here:
100:00:03,809 --> 00:00:04,659Hi there.
200:00:04,670 --> 00:00:06,679This is Doctor Theresa Regan.
300:00:06,969 --> 00:00:11,510I'm joining you for an episode of autism in the Adult podcast.
400:00:11,800 --> 00:00:13,619I'm a neuropsychologist,
500:00:13,859 --> 00:00:19,120the founder and director of an autism diagnostic clinic in Central Illinois.
600:00:19,290 --> 00:00:21,959And I'm the parent of a teen on the spectrum.
700:00:22,680 --> 00:00:27,440Did you know that I did a podcast series on talking about autism?
800:00:27,659 --> 00:00:30,420This was in February of 2022.
900:00:30,559 --> 00:00:43,909It had three episodes where I covered things like how to talk to other people about your journey to seek a diagnostic evaluation or how to tell people that you've received a new diagnosis of autism.
1000:00:44,340 --> 00:00:53,270We cover topics about how to process and navigate the emotions of other people during conversations about autism.
1100:00:53,909 --> 00:01:01,279And we also reviewed how to talk to someone that you are familiar with --someone in your family,
1200:01:01,290 --> 00:01:05,739someone that you know -- about the possibility that they are on the spectrum.
1300:01:06,089 --> 00:01:08,930Maybe they haven't thought about it that way,
1400:01:08,940 --> 00:01:12,319but you recognize some characteristics in them.
1500:01:13,010 --> 00:01:18,069I'm going to put a link to this series talking about autism in the show notes.
1600:01:18,599 --> 00:01:26,940But today you are joining me for episode number four in a series about intentional living on the autism spectrum,
1700:01:28,309 --> 00:01:33,629we all get into rhythms and routines that have a life of their own.
1800:01:33,900 --> 00:01:36,000Sometimes our schedules,
1900:01:36,010 --> 00:01:37,540what we typically do,
2000:01:37,550 --> 00:01:41,440what we don't do... things that crop up in our lives.
2100:01:41,449 --> 00:01:56,860They catch us up in their momentum and sometimes it's just nice to pause and to step back and really see if the life that we're living lines up with where we'd like to be in the future.
2200:01:57,389 --> 00:02:01,150Are we choosing this life?
2300:02:01,160 --> 00:02:07,860Are we being swept away without really pausing to make some choices and decisions?
2400:02:08,440 --> 00:02:14,639And certainly we can't have the final say in everything that our life entails.
2500:02:14,649 --> 00:02:22,020But we really will be able to capture more of our dreams and visions for the future
2600:02:22,029 --> 00:02:27,259if we pause and make choices that line up with those...
2700:02:27,690 --> 00:02:29,339those goals that we have.
2800:02:31,770 --> 00:02:38,740This need to pause and reevaluate our intentions and choices is a universal human need.
2900:02:39,470 --> 00:02:49,300But we're spending some time talking about this in the context of autism because sometimes the individual on the spectrum will struggle more with this,
3000:02:49,750 --> 00:03:03,759possibly because they have difficulty switching gears from the typical routine or maybe this individual has problems finding the energy or the momentum to get going with something new.
3100:03:04,820 --> 00:03:12,910This person may feel like it's challenging to get out of the hyper focus of the moment and to try to think long term.
3200:03:13,919 --> 00:03:16,889So in the first episode for this series,
3300:03:16,899 --> 00:03:25,009we talked about how to get to the point where you can actually choose a goal that is difficult in itself.
3400:03:26,360 --> 00:03:35,020We outlined several life categories that you could analyze to see if you would like to think of a goal in these categories.
3500:03:35,940 --> 00:03:36,190Now,
3600:03:36,199 --> 00:03:41,110the second episode was about how to make specific goals within a category.
3700:03:41,990 --> 00:03:50,080So we want the goal to help us shift from our current place and leave the boundaries of our comfort zone.
3800:03:50,440 --> 00:03:58,820But we don't want it to be overwhelming or self defeating because we picked a goal that's just too difficult,
3900:03:58,830 --> 00:03:59,720too big...
4100:03:59,960 --> 00:04:02,059feels insurmountable.
4200:04:03,929 --> 00:04:16,660The third episode in this series about living with intention had to do with strategies to reach goals within the area of health and wellness specifically with regulation.
4300:04:17,278 --> 00:04:25,069And this is often a good place to start in our lives when we're trying to grow and challenge ourselves.
4400:04:25,079 --> 00:04:29,028Because if we're setting goals,
4500:04:29,199 --> 00:04:34,989this is really us setting a goal to do difficult things.
4600:04:35,290 --> 00:04:39,399And if we're not regulated when we start these goals,
4700:04:39,410 --> 00:04:41,750if we're not feeling grounded,
4800:04:41,760 --> 00:04:42,859centered,
4900:04:42,869 --> 00:04:45,609calm and psychologically present,
5000:04:45,750 --> 00:04:47,880attentive and rested,
5200:04:48,480 --> 00:04:56,290it's really difficult to leave our comfort zone in any other area to really have intentional living.
5300:04:56,619 --> 00:05:04,480So it is often nice to make sure that we're really well regulated before we jump into any other goals.
5400:05:05,790 --> 00:05:16,679So now today you are listening to the fourth episode and we're going to focus on intentional living within communication and relationships.
5500:05:17,359 --> 00:05:21,399And you may be asking why do I need to have social goals?
5600:05:21,570 --> 00:05:22,010Well,
5700:05:22,019 --> 00:05:22,950you don't,
5800:05:23,149 --> 00:05:30,350your communication and your social network don't have to match any particular template that others use.
5900:05:30,420 --> 00:05:32,489But at the same time,
6000:05:32,500 --> 00:05:35,619if you have a vision for your future,
6100:05:36,269 --> 00:05:44,089you may need to grow in certain areas of communication or connection so that you can meet the goals that you do have.
6200:05:45,309 --> 00:05:46,640For example,
6300:05:46,649 --> 00:05:52,359one person may want to become a history teacher because they love history.
6400:05:52,959 --> 00:05:54,299That is a great goal.
6500:05:54,309 --> 00:05:59,600It's a way of sharing your love of a topic with other people.
6600:06:00,269 --> 00:06:04,579But you'll also need to have some skills for communication,
6700:06:04,589 --> 00:06:08,549updates with your work team and with your students and families.
6800:06:08,579 --> 00:06:11,079Maybe about projects or grades,
6900:06:11,350 --> 00:06:18,500you'll have to have communication skills to interact with people who are really upset with you or disagree with you.
7000:06:19,329 --> 00:06:26,329Maybe you'll be put in charge of a major project for the school and you'll have to present on the topic.
7100:06:27,269 --> 00:06:29,600If you already have these skills,
7200:06:29,609 --> 00:06:30,709that's super,
7300:06:30,720 --> 00:06:32,869you don't need to grow in this area.
7400:06:33,239 --> 00:06:43,220But if you don't focusing on this area of growth may help you in the future as you take your path toward your ultimate goals.
7500:06:44,989 --> 00:06:55,670Another example would be someone who's just retired and maybe they're finding it difficult to connect or get along with their partner now that they're both at home a lot.
7600:06:56,190 --> 00:07:01,600So perhaps this person has a goal to connect in a more effective way.
7700:07:01,709 --> 00:07:09,320She may have a goal for communication and connecting in the home with this new life season of retirement.
7800:07:11,369 --> 00:07:12,309In contrast,
7900:07:12,320 --> 00:07:15,920you may be someone who's all set in this area.
8000:07:16,170 --> 00:07:17,190But in the future,
8100:07:17,200 --> 00:07:26,429you may want to have some things tucked away for different tasks or goals that crop up along the way this episode may be for you.
8200:07:27,339 --> 00:07:39,309So let's focus on three things to keep in mind that may help you reach a goal for more effective communication and connection in a particular area of your life.
8300:07:40,220 --> 00:07:41,350And let's face it,
8400:07:41,359 --> 00:07:46,690you are probably already super good at communicating about topics,
8500:07:46,700 --> 00:07:47,929facts,
8600:07:47,940 --> 00:07:49,149details,
8700:07:49,380 --> 00:07:58,790things like teaching about history or telling your partner that we're out of milk and somebody's got to get this supply at the store.
8800:07:59,600 --> 00:07:59,910Well,
8900:07:59,920 --> 00:08:07,660the trickier area of communication more often shows up when we're in an interaction and we start thinking,
9000:08:07,670 --> 00:08:08,250wow,
9100:08:08,260 --> 00:08:10,339what just happened here?
9200:08:10,920 --> 00:08:16,299What did this person react to in this conversation?
9300:08:16,309 --> 00:08:18,799I'm not even sure where they're coming from.
9400:08:18,970 --> 00:08:21,399I don't know what this person wants from me.
9500:08:22,059 --> 00:08:23,109After all,
9600:08:23,119 --> 00:08:25,549I was right about what I said.
9700:08:26,040 --> 00:08:29,429So why all this emotion or all this up and down?
9800:08:30,100 --> 00:08:36,469Let's look at a few areas of focus that can balance out that connection piece.
9900:08:36,989 --> 00:08:38,070First of all,
10000:08:38,080 --> 00:08:42,669I want to introduce and bring more into your awareness,
10100:08:42,679 --> 00:08:45,349this focus on the other.
10200:08:46,200 --> 00:08:49,210So when you are communicating with someone,
10300:08:49,219 --> 00:08:51,409whether that is a history teacher,
10400:08:51,419 --> 00:08:55,380talking to a parent or a woman who's just retired,
10500:08:55,390 --> 00:08:56,710talking to her partner.
10600:08:57,080 --> 00:09:05,799There is a difference between communication that's factually correct and communication that is effective.
10700:09:07,400 --> 00:09:09,309It helps to be correct.
10800:09:10,020 --> 00:09:13,549But we also want communication that's more than correct.
10900:09:13,559 --> 00:09:15,630We want it to be productive,
11000:09:15,739 --> 00:09:16,489helpful,
11100:09:16,500 --> 00:09:18,710valuable and fruitful.
11200:09:19,380 --> 00:09:21,880So remember what your goals are,
11300:09:22,369 --> 00:09:36,729is your goal to strengthen your relationship with your partner? is your goal to be a history teacher? ...and all these other goals you might have where communication and connection are important to meet that goal.
11400:09:37,030 --> 00:09:52,440One way to improve the effectiveness of our communication is to be able to pause during an interaction and focus on the other person rather than on the topic.
11500:09:53,280 --> 00:09:55,710And sometimes to be honest,
11600:09:56,559 --> 00:10:03,530this whole interaction happens and we never pause and we're a bit surprised and taken aback.
11700:10:03,710 --> 00:10:08,690And we process things after that's OK too.
11800:10:09,489 --> 00:10:16,400The goal eventually will be able to pause and process a bit during the interaction to adjust.
11900:10:16,760 --> 00:10:22,270But we may start by analyzing and thinking through things after the fact,
12000:10:23,789 --> 00:10:26,580focus on the other person.
12100:10:26,590 --> 00:10:32,859So ask yourself things like what does this person need from me right now?
12200:10:33,369 --> 00:10:37,549Other than being correct about the facts,
12300:10:37,559 --> 00:10:38,150I'm saying,
12400:10:38,159 --> 00:10:44,359what do they need from me in the social conversation?
12500:10:46,299 --> 00:11:04,739Maybe they need to feel heard or they need you to understand how difficult their day has been or they need you to know and really recognize their contribution to the team even though you've decided to take the work project in another direction.
12600:11:05,359 --> 00:11:05,830Now,
12700:11:05,840 --> 00:11:11,169these kinds of wonderings and kind of exploring these questions,
12800:11:11,179 --> 00:11:17,400this could be something that we do in a counseling or therapy session really in depth,
12900:11:17,409 --> 00:11:17,979right?
13000:11:18,250 --> 00:11:24,849So if you are trying to um process your relationship with your partner,
13100:11:24,979 --> 00:11:29,270maybe you process interactions with a therapist.
13200:11:29,719 --> 00:11:38,489But there are also probably a few things to say during these interactions that might help um you focus on the other,
13300:11:38,669 --> 00:11:40,450the other person's needs.
13400:11:41,150 --> 00:11:43,260So you could say things like,
13500:11:43,510 --> 00:11:51,989tell me more about how you're doing and what I can do to help? if somebody has come up to you and they're upset,
13600:11:52,010 --> 00:11:53,450they're emotional,
13700:11:53,700 --> 00:11:56,630they're in really a confrontational moment.
13800:11:57,479 --> 00:12:05,929-- Letting them know that you'd like to know how they're doing and what you can do to help ... can be a connecting moment.
13900:12:07,650 --> 00:12:14,340What do you want me to know that you feel like I don't understand about what your experience is.
14000:12:15,489 --> 00:12:18,020What are your needs in this situation?
14100:12:18,030 --> 00:12:25,270Tell me what you need... or I really value you and I do want to be part of the solution,
14200:12:25,280 --> 00:12:26,530not the problem.
14300:12:28,989 --> 00:12:32,109Do you need to say these specific words?
14400:12:32,169 --> 00:12:32,840No,
14500:12:33,109 --> 00:12:40,169it's important to make them your own and to match them to the person that you're talking to in the context.
14600:12:40,179 --> 00:12:54,169But the sentiment is there that you want good things to come out of this conversation that you want to know where they're coming from and what you can do um to advance things,
14700:12:54,179 --> 00:12:54,849support them,
14800:12:54,859 --> 00:12:56,070make things better.
14900:12:58,150 --> 00:13:05,010The basic idea is to pause and to ask for input about what they need in this situation.
15000:13:05,380 --> 00:13:09,359And it doesn't mean you have to change your opinion or your decisions.
15100:13:09,369 --> 00:13:16,159But in the midst of factual things like projects and chores making plans,
15200:13:16,169 --> 00:13:23,619there's still value that is found in recognizing the needs of the other during these interactions.
15300:13:24,030 --> 00:13:31,809And that can help bridge the gap from conversation that is factual to conversation,
15400:13:31,820 --> 00:13:33,460that is effective.
15500:13:33,909 --> 00:13:36,419The second thing I'd like you to keep in mind.
15600:13:36,429 --> 00:13:45,219And this is also a way of focusing on connecting with the other is the use of compliments and gratitude.
15700:13:46,400 --> 00:13:55,640This is another way that we can attend to the person and set the stage for the communication and the relationship.
15800:13:56,309 --> 00:14:00,119So some would say this person's only doing their job,
15900:14:00,130 --> 00:14:03,520why do I have to compliment them or thank them?
16000:14:03,830 --> 00:14:05,400I don't need that.
16100:14:05,460 --> 00:14:06,460I don't want that.
16200:14:06,469 --> 00:14:07,859I don't even like that.
16300:14:09,039 --> 00:14:17,140But this is a relatively easy thing that helps attend to what the other person needs even if you don't need it.
16400:14:17,489 --> 00:14:22,489So it sets the stage for people to understand how you view them.
16500:14:23,099 --> 00:14:26,729And when difficult things do happen in the relationship,
16600:14:26,750 --> 00:14:33,030the way that we interpret those may have to do with how this stage has been set in the past.
16700:14:33,179 --> 00:14:34,150For example,
16800:14:34,159 --> 00:14:40,770if is this a person who really knows for multiple examples in the past that you value them.
16900:14:41,070 --> 00:14:45,000And therefore this glitch in communication or this disagreement,
17000:14:45,289 --> 00:14:46,669it's tough,
17100:14:47,150 --> 00:14:50,669maybe it's unpleasant but it's not monumental.
17200:14:51,500 --> 00:14:56,039Or is this someone who really doesn't know that you value them?
17300:14:56,049 --> 00:15:00,760And therefore every communication glitch is really a big deal.
17400:15:01,109 --> 00:15:04,580So compliments and gratitude set the stage.
17500:15:04,590 --> 00:15:07,260This is how I think about you.
17600:15:07,270 --> 00:15:09,419This is how I think about our team.
17700:15:09,479 --> 00:15:10,080Again,
17800:15:10,090 --> 00:15:11,140I see you,
17900:15:11,200 --> 00:15:16,099I value you and it doesn't have to be mushy and emotional.
18000:15:16,109 --> 00:15:18,840It should fit the context and the person.
18100:15:19,070 --> 00:15:19,789But again,
18200:15:19,799 --> 00:15:28,119just a very uh brief uh effective way of adding to that connection during communication.
18300:15:29,119 --> 00:15:32,179Let's talk about two levels of compliment.
18400:15:32,419 --> 00:15:40,890One is a compliment about a skill or achievement and one is a compliment about a personal attribute.
18500:15:41,530 --> 00:15:44,820So the second one is really a higher level.
18600:15:45,080 --> 00:15:52,830Um and it gives a stronger message that I see you and I value you,
18700:15:52,900 --> 00:15:56,789not only do I see your product and I appreciate the product,
18800:15:56,799 --> 00:16:00,590but I see the person that produced that and,
18900:16:00,599 --> 00:16:03,210and I value your contribution.
19000:16:04,179 --> 00:16:04,440Now,
19100:16:04,450 --> 00:16:11,880they're both powerful and you can choose the type that you use based on how well you know the person,
19200:16:11,890 --> 00:16:17,549what your goal is in that social interaction and what else is happening in the context.
19300:16:18,559 --> 00:16:19,530For example,
19400:16:19,539 --> 00:16:26,830a partner who's trying to improve his relationship with his spouse could either say this is a delicious dinner.
19500:16:26,840 --> 00:16:33,270It's great to come home after all these pressured meetings to a really pleasant meal.
19600:16:33,280 --> 00:16:35,549And I thank you so much for fixing it.
19700:16:36,700 --> 00:16:47,549That would be a really nice way to set the relationship stage that you see the work that went into this and you've enjoyed the meal and you're grateful.
19800:16:48,489 --> 00:16:48,900Now,
19900:16:48,909 --> 00:16:53,099if it's a partner use this next level of compliment,
20000:16:53,559 --> 00:17:04,060he may have said you are such a great cook and you seem to know just what would help me unwind from a long and pressured day at work.
20100:17:04,069 --> 00:17:06,140I so appreciate that about you.
20200:17:07,819 --> 00:17:14,420Compliments and thank yous this gratitude and acknowledgement of the other,
20300:17:14,739 --> 00:17:17,199what they've brought the skill sets,
20400:17:17,209 --> 00:17:19,609they have individual attributes.
20500:17:19,930 --> 00:17:27,670This can all help set the stage for a relationship that the other person feels safe and happy with.
20600:17:32,109 --> 00:17:36,300The third way of adding to this communication,
20700:17:36,310 --> 00:17:49,010that's not only factual but also effective is to think about to identify and discuss topics and life events that are important to the other person,
20800:17:49,290 --> 00:17:51,800even when they are not important to you,
20900:17:51,810 --> 00:17:54,119you really honestly don't care about them.
21000:17:55,420 --> 00:17:56,170But again,
21100:17:56,180 --> 00:17:59,310we're looking for communication that's effective.
21200:17:59,349 --> 00:18:11,849And you're choosing those moments when you are really working toward your longer term goals that I do want to have a better work team relationship.
21300:18:11,859 --> 00:18:16,250I do want to be able to be an effective teacher.
21400:18:16,569 --> 00:18:29,770So listen for things that are important to the other person and this might be things about their family it's good to know with people that you see or work with on a regular basis.
21500:18:29,780 --> 00:18:31,449What's their partner's name?
21600:18:31,459 --> 00:18:32,829What are their kids' names?
21700:18:32,839 --> 00:18:35,770What family are they interacting with?
21800:18:35,780 --> 00:18:37,280Who do they live with?
21900:18:37,420 --> 00:18:41,880Maybe they're talking about taking their son to his soccer tournament this weekend.
22000:18:43,329 --> 00:18:47,650This may be topics that they're passionate about but you are not.
22100:18:48,040 --> 00:18:55,550Maybe they love sci-fi movies or quilting might even be milestones in their life.
22200:18:55,560 --> 00:18:59,459It could be that they've had a birthday recently or a marriage anniversary.
22300:18:59,910 --> 00:19:04,699Maybe they've moved into a new apartment or purchased their first home.
22400:19:05,670 --> 00:19:08,849Even though these things are not important to you,
22500:19:09,140 --> 00:19:18,819they are important to the other and connecting in a more effective way with this person is part of your intentional life choice.
22600:19:19,500 --> 00:19:27,630You may consider making an effort to interact with this person once a week or once a month just to ask about things that are important to them.
22700:19:28,849 --> 00:19:34,180You don't have to know about the topic in order to bring it up in conversation.
22800:19:34,329 --> 00:19:35,579So people will say,
22900:19:35,589 --> 00:19:36,119well,
23000:19:36,150 --> 00:19:39,599not only do I not know about sci-fi movies,
23100:19:39,609 --> 00:19:44,859but I'm really not at all interested and I don't know what I would say.
23200:19:45,969 --> 00:19:47,300Um That's ok,
23300:19:47,829 --> 00:19:49,219this is about them.
23400:19:49,229 --> 00:19:54,540The goal is not to add content and correct factual information.
23500:19:54,550 --> 00:20:03,560The goal is to connect effectively and to set the stage of connection and you can do that without any factual knowledge.
23600:20:04,680 --> 00:20:08,869So you could say I don't know much about that topic.
23700:20:09,329 --> 00:20:09,349Uh,
23800:20:09,359 --> 00:20:11,550what do you like most about it?
23900:20:11,729 --> 00:20:13,750What first got you interested in,
24000:20:14,270 --> 00:20:15,489in that area?
24100:20:16,180 --> 00:20:18,310What's coming up related to that topic?
24200:20:18,319 --> 00:20:18,410So,
24300:20:18,420 --> 00:20:22,829let's say this is the sci-fi lover and you might say,
24400:20:22,839 --> 00:20:23,369hey,
24500:20:23,510 --> 00:20:26,630any big movies coming up that you're gonna go see.
24600:20:27,290 --> 00:20:28,660I'm not,
24700:20:28,670 --> 00:20:28,920um,
24800:20:28,930 --> 00:20:30,920up on what's at the movie theater.
24900:20:31,260 --> 00:20:31,579Um,
25000:20:31,589 --> 00:20:42,010so then this invites them to talk about their favorite topic And then later you could ask them how the movie was or someone who has,
25100:20:42,020 --> 00:20:42,319um,
25200:20:42,329 --> 00:20:52,209a real love for fish tanks and fish and little um villages in the fish tank that they build.
25300:20:52,219 --> 00:20:53,170Um You could say,
25400:20:53,180 --> 00:20:53,420hey,
25500:20:53,430 --> 00:20:55,920any new fish in your fish tank lately,
25600:20:55,930 --> 00:20:57,229what if you got that's new?
25700:20:57,239 --> 00:20:58,510Do you have a picture?
25800:20:59,290 --> 00:21:04,520So the purpose is not to contribute to a topic.
25900:21:04,530 --> 00:21:06,969The purpose is not to be correct.
26000:21:07,000 --> 00:21:09,329The purpose is to say,
26100:21:09,339 --> 00:21:09,739hey,
26200:21:09,750 --> 00:21:10,500I see you.
26300:21:10,510 --> 00:21:11,500I hear you.
26400:21:11,839 --> 00:21:16,969Um And I'm really acknowledging what's important to you.
26500:21:17,359 --> 00:21:18,319You could say,
26600:21:18,329 --> 00:21:18,540hey,
26700:21:18,550 --> 00:21:21,260how did the move to your new apartment go this weekend?
26800:21:21,270 --> 00:21:22,959Did you get hit with the rain?
26900:21:24,160 --> 00:21:28,770You can acknowledge what a big job it is to move and say,
27000:21:28,780 --> 00:21:29,140hey,
27100:21:29,150 --> 00:21:31,209I hope you feel settled in soon.
27200:21:31,859 --> 00:21:33,250You could say,
27300:21:33,260 --> 00:21:35,650how did your son's soccer tournament go?
27400:21:35,969 --> 00:21:37,550Did he feel good about it?
27500:21:38,199 --> 00:21:41,689Did you get to visit any interesting places or?
27600:21:41,699 --> 00:21:44,109I'm so glad you guys have that opportunity.
27700:21:44,219 --> 00:21:45,790What a big commitment that is,
27800:21:45,800 --> 00:21:56,670but I'm sure you'll have lots of great memories and perhaps you set a goal where you're going to ask someone on your work team,
27900:21:56,680 --> 00:22:04,550a follow up question once a week or three times a week and you're gonna rotate people.
28000:22:05,400 --> 00:22:16,810This is a way to make the goal real and to keep that intentionality in mind while working toward the goals that you do have.
28100:22:17,229 --> 00:22:17,579Now,
28200:22:17,589 --> 00:22:22,260there is so much we could cover about communicating and connecting.
28300:22:22,599 --> 00:22:29,119But hopefully this episode gives you some concrete things to use today in your relationships.
28400:22:29,380 --> 00:22:36,319We've reviewed the importance of pausing during an interaction to think about or ask the person what they need.
28500:22:36,790 --> 00:22:45,790We reviewed types of compliments and ways of expressing gratitude and how these can set the stage for helping with future interactions.
28600:22:46,280 --> 00:22:57,229And we reviewed that acknowledging what topics and life events are important to the other person can also really increase the value and fruitfulness of an interaction.
28700:22:58,829 --> 00:23:03,979If you want to dive deeper into communication and connection topics,
28800:23:04,199 --> 00:23:06,560there are great resources out there.
28900:23:07,050 --> 00:23:07,420Now,
29000:23:07,430 --> 00:23:11,130I don't have any financial interest in any of these products.
29100:23:11,170 --> 00:23:16,859I'm just offering some ideas of things that have helped or helped my clients in the past.
29200:23:17,619 --> 00:23:25,219I've linked some of my favorites in the show notes and one is a great book called The Science of Making Friends,
29300:23:25,250 --> 00:23:30,760which highlights strategies from the peers program that's out of U C L A.
29400:23:31,160 --> 00:23:34,910And there are chapters on finding and choosing good friends,
29500:23:35,339 --> 00:23:37,579elements of good conversations,
29600:23:37,949 --> 00:23:39,680dealing with arguments,
29700:23:39,689 --> 00:23:41,290handling and addressing,
29800:23:41,300 --> 00:23:43,569teasing and cyberbullying,
29900:23:43,890 --> 00:23:48,239minimizing rumors and gossip and changing a bad reputation.
30000:23:48,589 --> 00:23:48,959Now,
30100:23:48,969 --> 00:23:53,699this is a book that's focused on an audience of teens and young adults.
30200:23:54,239 --> 00:24:00,270I like to take those kind of books and apply the basic concepts to whatever age group I'm working with.
30300:24:00,489 --> 00:24:03,550But if you really don't relate to books in that way,
30400:24:03,560 --> 00:24:09,130and it's going to be distracting if people in the examples are from a different generation,
30500:24:09,199 --> 00:24:10,989that book may not be for you.
30600:24:11,479 --> 00:24:16,920There are also well known books such as Better Small Talk by Patrick King,
30700:24:17,319 --> 00:24:25,550How To Win Friends and Influence people by Dale Carnegie and Crucial Conversations by multiple people,
30800:24:25,560 --> 00:24:27,959Joseph Granny Carri Patterson,
30900:24:28,000 --> 00:24:30,569Ron mcmillan and Switzer.
31000:24:31,390 --> 00:24:40,640This book is a great tool to expand your skills at persuasion without being abrasive and to engage in conversations.
31100:24:40,650 --> 00:24:44,439Even when emotions are really running high,
31200:24:44,770 --> 00:24:46,979we're gonna need to know how to do that.
31300:24:46,989 --> 00:24:51,859If we're gonna be in connecting relationships that are really fruitful.
31400:24:52,339 --> 00:24:58,449There are many other great sources out there as well and I encourage you to find some that speak to you.
31500:24:58,530 --> 00:24:58,839Well,
31600:24:58,849 --> 00:25:04,819thanks again for joining me for this fourth episode of The Living With Intention Series.
31700:25:04,849 --> 00:25:10,410If you have goals that require you to expand your repertoire for communicating and connecting,
31800:25:10,589 --> 00:25:15,030I hope these tips and resources are a great place to start.
31900:25:15,819 --> 00:25:22,310Join me next time as we continue this series about intentional living on the autism spectrum.
-
Want to live with more intention in order to achieve your goals? You may wish to start with steps to improve your core resilience so you can challenge yourself in other life areas. In this third episode in a series on intentional living, Dr. Regan identifies ways to improve resilience by using physical inputs to calm and center the nervous system.
As referenced in the current episode:
Dr. Regan's Zur Institute courses for clinicians
Autism in the Adult regulation series- episode one
The Alert Program
The Alert Program: Your Best Self Online Course
Dr. Regan's Resources
Book: Understanding Autism in Adults and Aging Adults, 2nd ed
Audiobook
Book: Understanding Autistic Behaviors
Autism in the Adult website homepage
Website Resources for Clinicians
Read the transcript here:
100:00:05,710 --> 00:00:06,119Hi,
200:00:06,130 --> 00:00:06,800everyone.
300:00:06,809 --> 00:00:11,319This is Dr Regan, host of the podcast Autism in the Adult.
400:00:11,539 --> 00:00:13,239I'm a neuropsychologist,
500:00:13,250 --> 00:00:17,729a certified autism specialist and mom to a teen on the spectrum.
600:00:18,149 --> 00:00:25,360It's my great pleasure to direct an autism diagnostic clinic in Central Illinois for adolescents,
700:00:25,370 --> 00:00:27,360adults and aging adults.
800:00:27,790 --> 00:00:32,139If you are a clinician wanting to increase your knowledge of autism,
900:00:32,150 --> 00:00:34,259in order to better serve your clients,
1000:00:34,490 --> 00:00:38,250you may want to check out my courses at Zur Institute,
1100:00:38,349 --> 00:00:40,409Z U R Institute.
1200:00:40,759 --> 00:00:44,880The links will be in the show notes for this podcast episode.
1300:00:45,520 --> 00:00:48,130If you're a regular follower of the podcast,
1400:00:48,139 --> 00:00:54,569you will know that we are in the third episode in a series about living with intention on the spectrum.
1500:00:55,400 --> 00:01:00,009I would encourage you to listen to the first two episodes to get the most information.
1600:01:00,139 --> 00:01:03,849Although this episode can be stand alone as well.
1700:01:04,300 --> 00:01:04,750Today,
1800:01:04,760 --> 00:01:10,569we'll be talking about a goal within the area of health and wellness and specifically,
1900:01:10,580 --> 00:01:16,230we're going to focus on improving regulation using sensory inputs.
2000:01:16,389 --> 00:01:16,699Now,
2100:01:16,709 --> 00:01:21,449I have several other episodes about regulation and I'll link them in the show notes,
2200:01:21,900 --> 00:01:33,330but in short regulation refers to the ability to stay centered balanced to get that just right state to be both calm and attentive.
2300:01:33,339 --> 00:01:34,349At the same time,
2400:01:35,419 --> 00:01:38,050this regulation can look like a meltdown,
2500:01:38,059 --> 00:01:39,209a panic attack,
2600:01:39,220 --> 00:01:44,309an outburst or it could look like withdrawal from a place or activity.
2700:01:44,319 --> 00:01:45,230For example,
2800:01:45,239 --> 00:01:50,510I need to quit this conversation or I need to go to my room off by myself.
2900:01:50,519 --> 00:01:52,180I can't attend work today.
3000:01:52,190 --> 00:01:53,519I can't go to school.
3100:01:54,300 --> 00:01:56,809It can also look like freeze,
3200:01:57,209 --> 00:02:01,470like shutting down feeling offline or dissociating.
3300:02:02,309 --> 00:02:03,080And finally,
3400:02:03,089 --> 00:02:13,020disregulation can look like the experience of physical symptoms that are not rooted or at least not completely caused by a physical condition,
3500:02:13,250 --> 00:02:15,520injury or disease process.
3600:02:16,020 --> 00:02:21,479Individuals on the spectrum are more likely to struggle with dysregulation in some form.
3700:02:21,789 --> 00:02:30,639Although what the dysregulation looks like can be different from one person to the next and can also change over the lifespan of the individual.
3800:02:30,649 --> 00:02:52,699So we can see how important the wellness topic of regulation is and why we're talking about regulation as a goal first because for some people on the spectrum regulation needs to improve before they can experience enough resiliency to get out of their comfort zone in other areas of life,
3900:02:52,710 --> 00:02:58,130like relationships or working or other areas that we've discussed in the series.
4000:02:58,139 --> 00:02:58,860So far,
4100:02:59,470 --> 00:03:08,910the tricky thing is that there are often more limitations to the success of regulation strategies on the spectrum than for the neurotypical.
4200:03:09,089 --> 00:03:17,360And the go to strategies are often some combination of counseling or talking through the difficulty,
4300:03:17,369 --> 00:03:20,089maybe reasoning through problems,
4400:03:20,339 --> 00:03:27,479we might add medication for the support of regulation or use punishment and reward programs.
4500:03:28,350 --> 00:03:38,270It's not that there's anything wrong with these approaches and they can be helpful as part of a layer in an overall program to help with regulation.
4600:03:38,279 --> 00:03:39,470However,
4700:03:39,750 --> 00:03:42,919if these are the only approaches we're relying on,
4800:03:42,970 --> 00:03:46,100there are likely to be some pretty big limitations.
4900:03:47,050 --> 00:03:49,550So let's think about how the nervous system works.
5000:03:49,559 --> 00:03:52,699If an infant is screaming,
5100:03:52,710 --> 00:03:54,500relentlessly crying,
5200:03:54,509 --> 00:03:55,500very upset,
5300:03:55,509 --> 00:03:57,029can't calm down.
5400:03:57,320 --> 00:03:58,039In other words,
5500:03:58,050 --> 00:03:59,660they can't regulate.
5600:04:00,460 --> 00:04:05,610We don't try to reason with them about how they're completely safe.
5700:04:05,619 --> 00:04:07,509They've just been fed,
5800:04:07,520 --> 00:04:12,589they're not in any danger or that their crying is really too loud.
5900:04:12,600 --> 00:04:13,869It's bedtime.
6000:04:14,690 --> 00:04:17,260We don't go reasoning through all that.
6100:04:17,998 --> 00:04:23,368We don't give them medication for depression or for anxiety.
6200:04:23,959 --> 00:04:28,348We don't use rewards or punishments in the traditional sense.
6300:04:28,799 --> 00:04:29,239Again,
6400:04:29,248 --> 00:04:31,928it's not that I don't recommend these approaches.
6500:04:31,938 --> 00:04:34,588I think they can be very helpful at times.
6600:04:34,598 --> 00:04:40,098But I'm pointing out that there is another way for humans to regulate their nervous system.
6700:04:40,378 --> 00:04:43,428And if you picture what we do for the infant,
6800:04:44,070 --> 00:04:46,149we hold them.
6900:04:46,359 --> 00:05:02,649Sometimes we swaddle the infant in a blanket and the holding or swaddling gives them pressure inputs that gives them this snug hug and then what do we do?
7000:05:02,660 --> 00:05:02,920Well,
7100:05:02,929 --> 00:05:09,059typically we rack them and this gives their brain some movement to input.
7200:05:10,410 --> 00:05:13,260This isn't always a magic way of calming an infant.
7300:05:13,269 --> 00:05:18,619But it often helps quite a bit as an approach to help the infant regulate,
7400:05:18,630 --> 00:05:19,820to center,
7500:05:19,920 --> 00:05:21,470to feel calm.
7600:05:21,630 --> 00:05:26,179Because the infant relies on the adult for regulation.
7700:05:26,730 --> 00:05:29,140This approach of using pressure,
7800:05:29,420 --> 00:05:34,540which we call proprioceptive inputs and movement.
7900:05:34,579 --> 00:05:35,579In this case,
8000:05:35,589 --> 00:05:38,799I'm talking about vestibular inputs.
8100:05:39,170 --> 00:05:48,589This approach of getting these inputs into the nervous system helps people of all ages and with all variations of nervous connections,
8200:05:48,600 --> 00:05:49,859nervous systems,
8300:05:50,410 --> 00:05:53,359uh whether you are neurotypical,
8400:05:53,369 --> 00:05:55,850whether you are neuro diverse,
8500:05:55,859 --> 00:05:57,380it doesn't matter we do.
8600:05:57,390 --> 00:05:59,890This is how our nervous system works.
8700:06:00,049 --> 00:06:08,470That's why therapists working with little kids on regulation may have them do heavy work like carrying or pushing something heavy.
8800:06:08,690 --> 00:06:10,679That's for the pressure input.
8900:06:11,630 --> 00:06:15,489It's why some individuals like weighted blankets for calming,
9000:06:15,750 --> 00:06:17,679that's pressure as well.
9100:06:18,480 --> 00:06:22,820Other individuals like to ride their bike after work or go jogging.
9200:06:22,970 --> 00:06:23,279Well,
9300:06:23,290 --> 00:06:25,179that's movement input.
9400:06:25,290 --> 00:06:34,579So we all tap into some of these inputs without really realizing why we like them or what role they have in helping us feel centered.
9500:06:34,790 --> 00:06:35,309Today,
9600:06:35,320 --> 00:06:47,570we'll focus on increasing your awareness of what your nervous system may need as far as physical inputs to help with regulation as well as how and when to use them.
9700:06:48,450 --> 00:06:58,929One place to start can be to think about what you have historically been drawn to perhaps as a child or in school or most recently,
9800:06:59,600 --> 00:07:03,250you can get pressure in the muscles or the joints,
9900:07:03,260 --> 00:07:11,390proprioceptive inputs into the brain pressure in the muscles could be from a massage or laying in a hammock.
10000:07:11,399 --> 00:07:13,579You get that squeeze input,
10100:07:14,049 --> 00:07:16,429laying under a weighted blanket,
10200:07:16,779 --> 00:07:20,070draping over an exercise ball,
10300:07:20,679 --> 00:07:22,609curling up in a chair.
10400:07:22,619 --> 00:07:25,950When we say I just want to curl up and read a good book.
10500:07:26,320 --> 00:07:28,140That's when we're giving ourselves,
10600:07:28,149 --> 00:07:43,269that kind of squeeze input being in the fetal position helps us have that squeeze hugs or bear hugs can give us that input laying on the ground or flapping on the ground.
10700:07:43,869 --> 00:07:48,160Pressure into the joints could be from things like pushing,
10800:07:48,190 --> 00:07:49,000pulling,
10900:07:49,010 --> 00:07:49,950hanging,
11000:07:50,329 --> 00:07:54,200anything that offers resistance through the joints,
11100:07:54,829 --> 00:07:56,970hanging from a pull up bar,
11200:07:56,980 --> 00:07:58,559shoveling snow,
11300:07:58,709 --> 00:07:59,750swimming,
11400:08:00,019 --> 00:08:03,670stretching a Farrah band or resistance band,
11500:08:04,079 --> 00:08:08,959riding a bike pressure through the jaw by chewing,
11600:08:08,970 --> 00:08:14,140resistive foods can also be pressure input for the nervous system.
11700:08:14,459 --> 00:08:29,549Maybe somebody loves to attack some beef jerky or crunchy food or chew gum pressure through the hands or feet by using a stress ball or rolling your foot over a tennis ball.
11800:08:30,959 --> 00:08:34,729You'll get the most input for the nervous system.
11900:08:34,770 --> 00:08:37,530When you're doing whole body activities,
12000:08:37,539 --> 00:08:40,890then when you're using the jaw or hands and feet,
12100:08:41,119 --> 00:08:44,390but we can't always do whole body activities.
12200:08:44,789 --> 00:08:56,200Maybe we're in a classroom and all we can do is have some gum that we're gonna chew on and maybe squeeze a stress ball under the desk movement.
12300:08:56,210 --> 00:09:02,099Input like the rocking baby gives vestibular input into the brain,
12400:09:02,789 --> 00:09:08,140the brain does not get vestibular input when we move our arms and legs,
12500:09:08,150 --> 00:09:10,619but we stand or sit still.
12600:09:11,049 --> 00:09:13,049There's no vestibular input.
12700:09:13,059 --> 00:09:14,479When we're on a treadmill,
12800:09:14,489 --> 00:09:15,590for example,
12900:09:15,880 --> 00:09:18,700or we're using a stationary bike,
13000:09:19,299 --> 00:09:22,369the fluid in our ears has to be moving.
13100:09:22,559 --> 00:09:24,739So when we're moving through space,
13200:09:24,750 --> 00:09:26,719like running through the neighborhood,
13300:09:26,729 --> 00:09:29,450swinging or riding a bike outside,
13400:09:29,530 --> 00:09:32,059then we're getting vestibular input.
13500:09:32,849 --> 00:09:34,700So those who say,
13600:09:34,710 --> 00:09:34,900oh,
13700:09:34,909 --> 00:09:36,539I love riding my bike,
13800:09:36,549 --> 00:09:39,349but I will not ride a stationary bike.
13900:09:39,520 --> 00:09:44,690What they may be saying is that their nervous system really needs that movement,
14000:09:44,700 --> 00:09:47,890that vestibular input through space.
14100:09:48,950 --> 00:09:53,469There are three types of vestibular input linear.
14200:09:54,030 --> 00:09:57,369So going in a relatively straight line,
14300:09:57,380 --> 00:10:00,690like if you're jumping up and down on a trampoline,
14400:10:00,840 --> 00:10:06,750swinging front and back or rocking left and right or front to back,
14500:10:07,650 --> 00:10:10,919rotary is spinning or twirling.
14600:10:10,929 --> 00:10:14,020That's the second kind of vestibular input.
14700:10:14,710 --> 00:10:19,919And the third kind are inversions which involves being upside down,
14800:10:19,929 --> 00:10:21,840like hanging upside down,
14900:10:21,849 --> 00:10:26,429doing a forward bend or doing a down dog position.
15000:10:26,440 --> 00:10:27,080In yoga.
15100:10:27,900 --> 00:10:31,719The movement inputs can be alerting or calming,
15200:10:31,859 --> 00:10:35,929intense or gentle as an individual.
15300:10:35,940 --> 00:10:40,390You can see what helps your nervous system at any given time.
15400:10:40,799 --> 00:10:45,210Someone who wants to feel calm or may want to rock in a rocking chair,
15500:10:45,940 --> 00:10:57,330sometimes people like to ride in the car and that just helps them feel centered and calm babies or little kids might fall asleep in the car.
15600:10:57,340 --> 00:11:01,530Even when they were so upset when they were actually getting in the car,
15700:11:01,809 --> 00:11:07,580another person may really feel calmer when they've been swinging again.
15800:11:07,590 --> 00:11:15,320We have the swings for infants that they can rock in and get that gentle front and back motion.
15900:11:17,619 --> 00:11:24,390Someone who wants to feel more alert and activated like I need energy,
16000:11:24,400 --> 00:11:26,809I need momentum to get going.
16100:11:27,169 --> 00:11:31,609They may want to ride their bike down a hill or jump on a trampoline.
16200:11:31,940 --> 00:11:35,349That vigorous movement input is often more alerting.
16300:11:35,909 --> 00:11:37,250So someone might say,
16400:11:37,260 --> 00:11:37,630oh,
16500:11:37,640 --> 00:11:38,820now,
16600:11:38,900 --> 00:11:40,669now I'm really awake.
16700:11:41,099 --> 00:11:46,719Every nervous system though responds a bit uniquely to these different kinds of inputs.
16800:11:46,809 --> 00:11:57,619So it's really important to know your own system to try different things safely and to gradually develop your own insight about what you need.
16900:11:57,630 --> 00:12:03,809And when there are some activities that provide both pressure and movement input,
17000:12:04,169 --> 00:12:09,510riding a bike gives pressure through the joints as well as movement through space.
17100:12:10,119 --> 00:12:10,890Climbing,
17200:12:10,900 --> 00:12:18,349a rock wall provides really intense pressure in the joints as well as gentle movement up the wall,
17300:12:19,200 --> 00:12:22,619swimming provides resistance through the joints.
17400:12:22,640 --> 00:12:32,409Some mild pressure on the muscles from the water pressure and some movement which could be mild or more intense depending on the speed of movement.
17500:12:32,419 --> 00:12:35,530Whether the person is going upside down.
17600:12:35,570 --> 00:12:39,450Are they diving off of a height or going down a water slide?
17700:12:39,700 --> 00:12:43,289If you think back to what you have really loved to do,
17800:12:43,869 --> 00:12:47,750you may get clues about what your nervous system prefers.
17900:12:48,280 --> 00:12:54,820One person may have a history of a love for diving and they've been on the swim team during school,
18000:12:55,140 --> 00:12:59,880but maybe they don't have any source of inputs since they graduated.
18100:13:00,510 --> 00:13:05,349They haven't even realized how important these inputs were to their regulation.
18200:13:06,130 --> 00:13:09,520Another person may have a love of roller coasters,
18300:13:09,530 --> 00:13:10,880fast motorcycles,
18400:13:10,890 --> 00:13:11,989skydiving,
18500:13:12,150 --> 00:13:15,780their system loves intense vestibular inputs.
18600:13:16,440 --> 00:13:18,479Another may love weightlifting,
18700:13:18,489 --> 00:13:20,289cracking their knuckles.
18800:13:20,489 --> 00:13:25,159This is another source of joint pressure and heavy work,
18900:13:25,169 --> 00:13:26,219like yard work,
19000:13:26,229 --> 00:13:26,799gardening,
19100:13:26,809 --> 00:13:30,750household projects involving a lot of lifting of supplies.
19200:13:31,570 --> 00:13:34,270If you can pinpoint what your system has liked,
19300:13:34,280 --> 00:13:35,260historically,
19400:13:35,359 --> 00:13:40,359you may have a place to start in experimenting with what your system needs.
19500:13:40,369 --> 00:13:44,599Now also take into account your current health,
19600:13:44,609 --> 00:13:49,640your physical abilities or restrictions and your doctor's advice.
19700:13:49,690 --> 00:13:53,020If you can't pinpoint what you've liked in the past,
19800:13:53,030 --> 00:13:57,380start making a list of things to try a little bit at a time.
19900:13:58,010 --> 00:14:00,520Perhaps some waits on one day,
20000:14:00,530 --> 00:14:03,979a walk through nature the next or swinging at the park.
20100:14:04,760 --> 00:14:09,630Once you identify an area of inputs that your system benefits from.
20200:14:09,859 --> 00:14:10,429And again,
20300:14:10,440 --> 00:14:12,690the benefit is feeling more centered,
20400:14:12,700 --> 00:14:16,710calm and fully present than before the activity,
20500:14:16,849 --> 00:14:18,380then start thinking,
20600:14:18,390 --> 00:14:21,510how else could I get inputs like this?
20700:14:22,090 --> 00:14:23,549If you love bike riding,
20800:14:23,559 --> 00:14:27,130perhaps try swinging for movement and pressure.
20900:14:27,489 --> 00:14:32,530If you love a way to blanket over you while rocking in a rocking chair,
21000:14:32,630 --> 00:14:44,960you may want to investigate a whole body swing that can be hung from the ceiling and just envelops you like a cocoon in the fabric while you move gently or vigorously.
21100:14:45,330 --> 00:14:47,799It can even spin in rotation.
21200:14:48,840 --> 00:14:50,289If you like weights,
21300:14:50,299 --> 00:14:53,820you might wanna try rock climbing for intense joint pressure.
21400:14:54,159 --> 00:15:03,729Some people who like vestibular input like to join aerial fitness gyms that allow them to hang upside down in a safe and controlled environment.
21500:15:04,440 --> 00:15:11,190Be creative and develop some awareness of what your system responds positively toward and again,
21600:15:11,200 --> 00:15:12,010make sure you know,
21700:15:12,020 --> 00:15:13,140your own body,
21800:15:13,150 --> 00:15:17,669your limitations and any recommendations from your own physician.
21900:15:18,309 --> 00:15:19,960So let's regroup.
22000:15:19,969 --> 00:15:20,719So far,
22100:15:20,729 --> 00:15:23,570you've learned about pressure and movement inputs,
22200:15:24,140 --> 00:15:30,710the variations of intensity and exercise versus restorative based inputs.
22300:15:30,979 --> 00:15:34,809So exercise could be something like riding a bike,
22400:15:35,000 --> 00:15:35,919restorative,
22500:15:35,929 --> 00:15:40,580could be something like laying in a hammock swing or a hammock.
22600:15:42,780 --> 00:15:46,979You've considered what you have liked or not liked historically.
22700:15:46,989 --> 00:15:52,630And perhaps you have a list of things to try in order to build up a repertoire of options.
22800:15:53,479 --> 00:16:03,950The next key to growing in the area of regulation is this don't wait to do the activities until you feel like you need it.
22900:16:04,440 --> 00:16:05,950This is crucial.
23000:16:06,200 --> 00:16:06,770Now,
23100:16:06,780 --> 00:16:14,489this doesn't mean that you shouldn't listen to your body if you're ill or injured and not able to do a specific activity that day.
23200:16:14,909 --> 00:16:18,929But what often happens for the autistic is that they feel great,
23300:16:18,940 --> 00:16:19,500great,
23400:16:19,510 --> 00:16:20,330great.
23500:16:20,609 --> 00:16:23,299And then they feel really off center.
23600:16:23,309 --> 00:16:26,880And a lot of times they'll say I just did not see that coming.
23700:16:27,359 --> 00:16:32,650So by the time they use their as needed inputs,
23800:16:32,919 --> 00:16:35,169they're already deregulated.
23900:16:35,489 --> 00:16:37,250So that's not the goal,
24000:16:37,260 --> 00:16:53,179the goal is to do the activities and give regular nervous system inputs that are regulating so that the episodes of disregulation decrease in number and they're easier to recover from.
24100:16:53,919 --> 00:17:01,450So think about ways to give yourself centering inputs multiple times a day and that will be individual to you.
24200:17:02,090 --> 00:17:04,979Some people might do this three times a day,
24300:17:04,989 --> 00:17:06,239maybe at the beginning,
24400:17:06,250 --> 00:17:07,300middle and end,
24500:17:07,660 --> 00:17:16,099they may need some pressure and movement in the morning to wake up to become energized and to also feel calm and attentive,
24600:17:16,780 --> 00:17:20,349they may need inputs over the lunch hour or midday.
24700:17:20,359 --> 00:17:21,689And then again at night,
24800:17:22,069 --> 00:17:26,869perhaps restorative inputs like a rocking chair or a weighted blanket,
24900:17:27,050 --> 00:17:28,910maybe some nighttime yoga.
25000:17:30,459 --> 00:17:34,349Then when you do become deregulated on any given day,
25100:17:34,359 --> 00:17:39,810think ahead of time about what your as needed inputs might be.
25200:17:40,310 --> 00:17:43,000So when you're in the moment of disregulation,
25300:17:43,010 --> 00:17:46,089it's really difficult to figure out what you need.
25400:17:46,760 --> 00:17:50,150So you may be able to think to yourself ahead of time.
25500:17:50,489 --> 00:17:50,829You know,
25600:17:50,839 --> 00:17:52,619when I get dis regulated,
25700:17:52,630 --> 00:17:55,239this is what that looks and feels like.
25800:17:55,459 --> 00:17:59,160And when I start to see myself in that place,
25900:17:59,170 --> 00:18:08,060I can try these handful of things to see if it helps in that moment of crisis or kind of surprise.
26000:18:08,119 --> 00:18:08,260Uh,
26100:18:08,270 --> 00:18:09,579off centering,
26200:18:10,239 --> 00:18:11,290you may say,
26300:18:11,300 --> 00:18:11,729ok,
26400:18:11,739 --> 00:18:14,099I've had a particularly intense day.
26500:18:14,109 --> 00:18:16,609I'm feeling more off center than usual.
26600:18:16,699 --> 00:18:26,630I'm going to walk around my work building three times or I'm going to do forward bends and shake my head back and forth or listen to music with my headphones.
26700:18:26,910 --> 00:18:30,449This can be what as needed inputs look like.
26800:18:30,880 --> 00:18:34,569So you can see that like with the music and headphones,
26900:18:34,579 --> 00:18:41,739sometimes the regulating inputs could be also um a sensory input from another domain.
27000:18:41,770 --> 00:18:43,790What do you like to listen to?
27100:18:43,800 --> 00:18:46,810What scent do you like to smell like?
27200:18:46,819 --> 00:18:48,550Lavender or vanilla?
27300:18:48,920 --> 00:18:54,790But usually the big regulating inputs will involve movement and pressure.
27400:18:56,229 --> 00:18:57,680So today,
27500:18:57,689 --> 00:19:02,069we have chosen a growth area within health and wellness.
27600:19:02,099 --> 00:19:16,849This may be a good place for you to start as you live life with intention because feeling more grounded can help you feel more resilient as you try to stretch your comfort zone in other areas.
27700:19:17,270 --> 00:19:18,060Remember,
27800:19:18,069 --> 00:19:23,439the general approach we discussed in episode two when developing this program.
27900:19:23,900 --> 00:19:28,569So try to set up small reachable steps forward,
28000:19:28,859 --> 00:19:31,849use strategy to find your momentum.
28100:19:32,339 --> 00:19:37,130And once you've integrated the physical inputs into your daily routine,
28200:19:37,469 --> 00:19:41,599that momentum will kick in and it'll help you.
28300:19:41,609 --> 00:19:45,550Um not feel that this whole thing is effortful.
28400:19:45,560 --> 00:19:49,010It'll be just what you do on a regular basis.
28500:19:49,599 --> 00:19:54,290You'll also reap the benefits of having a more regulated nervous system.
28600:19:55,109 --> 00:19:57,050Be sure to check out the show notes,
28700:19:57,060 --> 00:20:01,969I have various links that we've mentioned here in the episode.
28800:20:02,020 --> 00:20:06,089One is a link to the Z Institute courses,
28900:20:06,099 --> 00:20:11,619Z U R for clinicians to learn more about autism in adolescents,
29000:20:11,630 --> 00:20:13,489adults and aging adults.
29100:20:14,020 --> 00:20:21,680I also have links to my podcast episodes about regulation if you'd like to do a deeper dive.
29200:20:22,030 --> 00:20:39,989And I'm also including links to the alert program put together by occupational therapists who have expertise in teaching people about using sensory inputs like movement or pressure to help regulate the nervous system,
29300:20:40,000 --> 00:20:42,310to feel calmer and more attentive.
29400:20:43,599 --> 00:20:51,569There's also a link specifically for their for All Program alert program four.
29500:20:51,579 --> 00:20:52,880That's the number four,
29600:20:52,890 --> 00:20:57,469not the word all dot com alert program for all dot com.
29700:20:57,800 --> 00:20:59,890That is a self guided study.
29800:20:59,900 --> 00:21:05,400You can purchase for a deeper dive into your own nervous system,
29900:21:05,410 --> 00:21:08,469figuring out what kind of inputs help you regulate.
30000:21:08,890 --> 00:21:13,630And I will have all four of those links in the show notes.
30100:21:15,270 --> 00:21:17,359Thank you for joining me today.
30200:21:17,489 --> 00:21:34,439I hope you will be able to enjoy the benefits of a more regulated nervous system and be sure to listen to our next episode as we continue this series on living with intention making goals and leaving our comfort zone.
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