autism and cognitive behavioural therapy

[gladysmay]

I am curious as to how talking therapies work for someone on the autisitic spectrum, it worries me there seems to be so many schools of thought on this. We had a bad experience with a therapist who thought AS was a response to high technology, and suggested my son not interact with tv, his computer or listen to a radio for at least three weeks - well, i dont think he could last three minutes (exageration but you get the point)! needless to say we waved goodbye. does anyone have any good experience or knowledge of cbt, how it works with ASD's or is it best avoided, does it come under 'seeking a cure' or can it genuinely guide and give structure to thougt processes?

[Canopus]

That was the attitude of the headmaster at my residential school. He blamed my condition on spending too much time attached to a computer and not enough time participating in team activities with other kids. The headmaster also refused to allow the school to buy a TV with teletext because he thought some kids would spend hours flicking through the pages.

[Kathryn]

Hi Gladysmay,

 

There do seem to be many views on this. Some people on the spectrum appear to have benefited from CBT to help with anxiety, for example, others have found it useless. Obviously the therapist has to have an understanding of ASD or they will make the wrong assumptions about the reasons for particular behaviour.

 

My daughter could not cope with talking therapy at all. She was struggling with expressing herself generally and found it particularly hard to talk about feelings. She could only relax when talking about her particular favourite subjects, but instead of using this as a way in, the therapist saw this as evasive and prevented her from doing it.

 

She couldn't really understand the purpose of the sessions, what the therapist wanted from her or what was going to happen, and this added another layer of anxiety - she needs structure and certainty which is why she's happier when seeing the GP or physiotherapist - she knows what they are for.

 

So we had a bad experience too - but this says more about the lack of experience of the therapist than therapy in general!

 

K x

[Martian Martian]

Tom is going through a spell at a pre-school assessment development unit, and when we first mentioned that he was really bright particularly when using the PC, the woman replied 'well, we don't use computers or television here.

 

Although she didn't offer any explanation, implicit was the belief that these things are of no use in encouraging communication.

 

Utter mince!! When Tom is on the computer, it gives us many more opportunities to communicate; plus he is beginning to rote-learn some of the letters - he can google 'boohbah' (very occasionally uttering the sounds that go with them).

 

I've heard of people that communicate through the use of a keyboard - perhaps my wee man will be the same?

[Flora]

I think it depends on the therapist as much as it depends on the approach. William had a course of CBT with the OT earlier this year. She was great and rather than making him talk they made great use of diagrams, pictures and number values. She also didn't concentrate on the behaviour or reaction, she concentrated on the cause. I don't think it helped relieve his anxiety directly, but she taught William ways of communicating the cause of his anxiety, which has been a massive help in identifying the help he actually needs. She taught him to find evidence to prove or disprove his negative thoughts, and while he is unable to do this by himself it's been an excellent tool for me to help him look at things realistically.

 

Lauren

[gladysmay]

Tom is going through a spell at a pre-school assessment development unit, and when we first mentioned that he was really bright particularly when using the PC, the woman replied 'well, we don't use computers or television here.

 

Although she didn't offer any explanation, implicit was the belief that these things are of no use in encouraging communication.

 

Utter mince!! When Tom is on the computer, it gives us many more opportunities to communicate; plus he is beginning to rote-learn some of the letters - he can google 'boohbah' (very occasionally uttering the sounds that go with them).

 

I've heard of people that communicate through the use of a keyboard - perhaps my wee man will be the same?

 

 

there is a book just published by jessica kingsley publishers called Getting IT Using Information Technology to empower people with Communication Difficulties by Dinah Murray and Ann Aspinall, havnt read it but it might be of interest

[gladysmay]

Hi Gladysmay,

 

There do seem to be many views on this. Some people on the spectrum appear to have benefited from CBT to help with anxiety, for example, others have found it useless. Obviously the therapist has to have an understanding of ASD or they will make the wrong assumptions about the reasons for particular behaviour.

 

My daughter could not cope with talking therapy at all. She was struggling with expressing herself generally and found it particularly hard to talk about feelings. She could only relax when talking about her particular favourite subjects, but instead of using this as a way in, the therapist saw this as evasive and prevented her from doing it.

 

She couldn't really understand the purpose of the sessions, what the therapist wanted from her or what was going to happen, and this added another layer of anxiety - she needs structure and certainty which is why she's happier when seeing the GP or physiotherapist - she knows what they are for.

 

So we had a bad experience too - but this says more about the lack of experience of the therapist than therapy in general!

 

K x

[gladysmay]

clicked in the wrong place (always excuses!) anyway, seems to be very difficult to actually find a therapist that has experience of working with ASD's and usually have to go private. We found that informing ourselves more about AS and others experiences via the web and books helped to build back the confidence lost but it was a case of having to look eleswhere. I absolutely agree with the wrong assumptions being made about why a person is behaving a certain way, point you make so clearly.

 

 

Has anyone been first diagnosed as bipolar or as having a personality disorder prior to later discovering it was an ASD?

Edited June 3, 2006 by gladysmay

[Zemanski]

Com has had CBT from the LEA specialist in ASCs for the last year.

 

She uses a combination of Tony Attwoods anxiety based programme and another AS specific programme (sorry can't remember which one) and she adapts it to his specific profile and issues as they arise. Also she uses me to inform her of where to go next with him so it is very closely based on his needs and reactions and is carried over to both school and home environments which I think makes it easier for Com to generalise the skills he is using. (part of the programme she has developed includes training the LSAs by involving them in the CBT).

 

Com loves these sessions, both the 1-1 and the group social skills she runs, and it has really helped him build his awareness of his own feelings and those of others. She concentrates on his strengths and is fantastic at building his self-esteem. She recognises when things are getting too personal to handle and always backs off, pehaps taking a different approach another time.

 

CBT done properly and from an AS perspective can be brilliant, as it has been for Com, but there are too many people who try to use it without really understanding the person they are working with. Com has been very lucky to meet someone who wants to learn from him as much as she wants to help him

 

Always make sure the programme being used is ASC specific and that there is good communication between you and the therapist

 

Zemanski

[curra]

M has been in therapy for several months and I believe it's CBT. At first he didn't engage at all and he ended frustrated after each session because he felt that he was not being understood. The counsellor tried to make him face the consequences of his actions and make him see that he is able to do many things that he doesn't usually do. The demands caused him more stress, later he became very depressed and angry, so he was given medication while the therapy continued. He's much better now, thanks to the medication and to a more flexible approach in the therapy. There are no big demands on him anymore to change what he cannot change, and there's more praise for his achievements as well as guidance and structure. He still doesn't like going to go to the sessions and once he's there he doesn't talk much, so I can' t really say how successful it has been so far. The counsellor gives me good ideas and support, so I think that yes, it's been positive on the whole.

 

 

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Curra

[lil_me]

If it was't for the television I don't think my son would have talked at all.

[gladysmay]

tv and computer games, I think the autism research centre at cambridge are looking at this area, also lego therapy, more understanding of how our kids interact is grreat.

 

thanks for all contributions so far, really interesting and helpful :)