Robert Brooks - Raising Resilient Children with Autism Spectrum Disorders: Strategies for Maximizing Their Strengths, Coping with Adversity, and Developing a Social Mindset

RAISING Resilient CHILDREN with AUTISM SPECTRUM DISORDERS

Strategies for Helping Them Maximize Their Strengths, Cope with Adversity, and Develop a Social Mindset

ROBERT BROOKS, Ph.D., and SAM GOLDSTEIN, Ph.D.

Copyright 2012 by Robert Brooks and Sam Goldstein. All rights reserved. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher.

ISBN: 978-0-07-173986-3
MHID: 0-07-173986-6

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The information contained in this book is intended to provide helpful and informative material on the subject addressed. It is not intended to serve as a replacement for professional medical advice. Any use of the information in this book is at the readers discretion. The authors and publisher specifi cally disclaim any and all liability arising directly or indirectly from the use or application of any information contained in this book.

Since the case illustrations in this book are taken from both authors clinical and consultation practices and workshops, these examples refer to us in the plural (as we and us), not only to simplify the writing style, but also to acknowledge the contributions of material from both authors professional activities. The names of the patients are fictional to respect confi dentiality.

Poem on 115 are from My Own World, by Ayelet Kantor and June Groden, Autism and Related Developmental Disabilities, Special Interest Group (SIG) Newsletter, Volume 23, Issue 3 (Summer 2007). Reprinted with permission.

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With love to my wife, sons, daughters-in-law, and grandchildren, who continue to be a source of joy and inspiration, and in the memory of Drs. John Bauer and Mort Wiener, two of my early mentors in psychology whose influence is represented in all of my work.

R.B.

With love to my children and their partners, and to my new partner, Sherrie, for her support and inspiration.

S.G.

In the fall of 1978, coauthor Sam started his clinical internship at the Childrens Center, a facility founded in Salt Lake City by Dr. Agnes Plenk and devoted to the treatment of preschool children with emotional and behavioral problems. Ben, a four-year-old, was one of the first cases assigned to Sam. Left to his own devices, Ben wandered around the playroom rarely picking up a toy. If he did so he looked at it briefly, spun it around, and typically dropped it on the floor. Ben did not respond to his name. He was minimally toilet trained. He rarely made eye contact or demonstrated facial expressions directed at others. He flapped his hands and laughed routinely at phantoms. Ben rarely spoke. When he did speak it was in repetitive phrases using words he had heard listening to television or radio. Despite efforts at engagement, Ben seemed to resist any approach to play with Sam. He seemed preoccupied with one small car he carried around and became quite upset if the car was removed from his grasp.

Sam was assigned the job of preparing Ben to participate in the preschool group. Help him learn to socialize, Plenk advised him. Sam inquired about the source of Bens problems. He was told that Ben might have autism, a rare childhood disorder, but more likely suffered from childhood schizophrenia, a condition at that time for which there was no cure nor effective medications.

One day Plenk observed Sam using Froot Loops as a reinforcer to shape Bens behavior to sit in a chair, something Sam had learned in graduate school during clinical training. Plenk stormed into the room and grabbed the Froot Loops away from Sam, admonishing him that this is not UCLA and we are not Dr. Lovaas. We dont use food or other reinforcers to shape the behavior of children like these. She advised Sam the solution to Bens problems was in his patient approach to Ben and his ability to ultimately develop a working relationship with Ben absent primary reinforcers. Though Sam learned many importat strategies from Dr. Plenk that he has used throughout his career, ways to help children like Ben were not among them. Sam was not very successful in shaping Bens behavior that year.

When we look back on our earliest experiences with children on the autism spectrum, we are struck by our ignorance in understanding and appreciating the early needs of these children to receive a combination of behavioral shaping and appropriate socialization. It has taken nearly thirty-five years, but the medical and mental health fields devoted to researching, understanding, evaluating, and treating children on the autism spectrum are, we believe, finally getting it right. Autism is not a condition caused by refrigerator mothers or dysfunctional parenting; it is not a condition that matures and fades away if left alone; it is not a condition that simply requires behavioral shaping; nor is it a condition that simply requires that we get down on the floor, roll around, and self-stimulate along with the most impaired of these children. We have come to realize that as a developmental disorder, autism is a condition best understood as a significant impairment in the development of social interaction and social learning. It impacts children from the very moment of their birth, altering their capacity to develop normal relationships and impeding their ability to successfully interact with the world around them.