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ASD Speaker Accommodations:Silence

• Be very quiet during presentation (e.g., chit chat is distracting)

• Please hold questions...• Q&A at the end• Unanswered Q’s to Karla’s FB page

Personal Space• Do not physically corner Karla for questions• Allow Karla to escape when she asks• Do not touch Karla when speaking to her

(c) Copyright - New Leaves Clinic

The Magic of Neurospan Profiling


Unleashing the Possibilities

Neurospan Profiling…

ASD – 1 continuum

Neurospans – 5 continuums

This difference is important because:

Neurology is far too complicated to create a single span that adequately summarizes Autism.

Multiple spans allow a care giver to understand the whole person, not just the autistic person.


ASD Neurospans

• The amount of data in permanent storage.Cognitive Capacity

• Information not based on fact.

• Eg. Social skills, Emotional understanding, ImaginationAbstraction

• Intake of data

• Eg. Sight, Sound, Touch, Taste, SmellSensory Integration

• Regulation of all information

Eg. Attention, inhibition, emotional regulation, Processing SpeedExecutive Functioning

• Anxiety: Can’t predict what happens next that creates helplessness

• Depression: Chronic helplessness creates hiding/apathy

Comorbid

Anxiety & Depression


“Personality” is a result of the interaction of an Individual’s Neurospan Profile interplaying with environmental factors

Cognitive Capacity

Abstraction

Sensory

Executive Functioning

Comorbid Anxiety &

Depression

Learned Behavior


Assessments As a Tool…

130

115

100

85


Testing /assessment (and observation) allow us to assess each of these areas to develop a Neurospan Profile for each individual based on their specific abilities

The “Perfectly” Average Neurospan Profile

70

80

90

100

110

120

130

Cognitive Capacity

Abstraction Sensory Integration

Executive Function

Standard Scores

----------------------------------------------------------------------AVERAGE

Incr

ea

sed

Sk

ill


Anxiety /depression are not typically present in a “NT” person’s profile

Karla’s Neurospan Profile (at home)

70

80

90

100

110

120

130

Cognitive Capacity


Executive Function

Standard Scores

----------------------------------------------------------------------AVERAGE

Incr

ea

sed

Sk

ill


Anxiety, Depression

Anxiety /depression (long term anxiety) are always threatening but are less a threat to overall

functioning in a “known” environment

But Wait… It Get’s Better… Neurospan Profiling can be done across some or even many

situations to really give caregivers and the ASD person reasons for otherwise strange behaviours.

Gives insight into the big question of, “Why does my (or my kids) functioning levels fluctuate so much?” “Why is everything so situational?”

It explains the commonly heard problem, “He is so smart at home but does really dumb things when we are out.”

It helps guide the decision of where to focus efforts on helping an ASD person integrate and how to best accommodate their needs.


An

xie

ty,

De

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Karla’s Neurospan Profile (unknown place or unhealthy)

70

80

90

100

110

120

130

Cognitive Capacity


Executive Function

Standard Scores

----------------------------------------------------------------------AVERAGE

Incr

ea

sed

Sk

ill


Anxiety /depression (long term anxiety) are active and

decreasing overall functioning abilities. The higher the Anxiety, the lower the

abilities…

Fix or Advocate?

70

80

90

100

Average Nuance Moderate Severe

Prime for learning and

using new skills

Will be hard but can make

some progress if

handled carefully

Risk is not worth the benefits


** Understanding individual Neurospan Profiles give guidance on where to focus efforts

Lack of using Neurospans creates: Frustrated kids & parents

ASD people feel they are broken beyond repair

ASD people become anxious, depressed – fight or flight or avoidance

ASD people learn not to trust authority

Refusal to go to public school

Optimize their skills.

Do not try to create NT skills.


Unleashing the PossibilitiesKarla’s Personal Insights on Possibilities and ASD…


‘Inside of every block of stone or marble dwells a beautiful statue”Michelangelo

“Performance = Potential – Interference”Timothy Galloway (“The Inner Game…”)

How we measure is EVERYTHING!!! Einstein… “Everybody is a genius. But if you judge a fish by its

ability to climb a tree, it will live its whole life believing that it is stupid.”

“In the measurement world, you set a goal and strive for it. In the universe of possibility, you set the context and let life unfold.”

“How often do we stand convinced of the truth of our early memories, forgetting that they are assessments made by a child? We can replace the narratives that hold us back by inventing wiser stories, free from childish fears, and, in doing so, disperse long-held psychological stumbling blocks.” ― Benjamin Zander, The Art of Possibility: Transforming Professional and Personal Life


http://www.goodreads.com/author/show/48996.Benjamin_Zander

http://www.goodreads.com/author/show/48996.Benjamin_Zander

http://www.goodreads.com/work/quotes/13067375

http://www.goodreads.com/work/quotes/13067375

Karla FisherBio

Vive La Differences…

Kids are like a box of chocolate. You never know what you are

going to get…

SCARY HOPELESS DEATH MELTDOWNS BANKRUPTCY ANTI-SOCIAL

JOBLESS INCAPABLE NON-VERBAL LOST HUMORLESS ANXIETY

DISABILITY FRIENDLESS CONFUSION ANGER LOST DREAMS EVIL ETC…

TEACHER DOCTOR MOTHER FATHER ENGINEER ATHLETE

STUDENT RESEARCHER DAUGHTER SON CHEF CASHIER

ADULT CHILD WRITER ARTIST ADVOCATE FRIEND ETC…

Label Game Part I (Define it)

High /Low Functioning….

Asperger’s is high functioning

Non-verbal is low functioning

Living Independently is high functioning

Define High and Low Functioning and apply these labels to the following profiles…


Label Game Part II


Profile Person (s) Accomplishments

Needs 24 hour nursing Care. Can do literally no self-care tasks without an aid. Is non-verbal without the use of many technical devices.

StephenHawkings

CH, CBE, FRS, FRSA (born 8 January 1942) is a British theoretical physicist and cosmologist, whose scientific books and public appearances have made him an academic celebrity. He is an Honorary Fellow of the Royal Society of Arts, a lifetime member of the Pontifical Academy of Sciences, and in 2009 was awarded the Presidential Medal of Freedom, the highest civilian award in the United States.

Completely Non Verbal (started typing on computer at 11). Defined as cognitively delayed. Self injurious much of her life. Required 1:1 intervention and services 40 hours a week for self care and cognitive training. She will likely never live independently and always require some supports.

CarlyFleishmann

Just co-authored her first book (available for purchase) at 13 years of age. Now in gifted classes in high school.

Spoke first words at the age of 4. Diagnosed by Doctors at the time as being too autistic to respond to therapies and recommended to institutionalization. Various troubles during the school years with aggression, fitting in, self care, etc.

Dr. Stephen Shore and Temple Grandin

Both with accomplishments too numerous to list

Living independently as adult. Can do basic self care most of the time. Lives modestly doing their obsession as a pastime.

Approximately 80% of AS adults

Varying degrees of accomplishments. Un-employed or under employed living on SSI or with support from others. Many are in jail or in and out of psych. hospitals for a variety of behavioral issues as a result of being misunderstood or not having proper supports or as a result of their unique Neurospanprofile.

http://en.wikipedia.org/wiki/Order_of_the_Companions_of_Honour

http://en.wikipedia.org/wiki/Order_of_the_British_Empire

http://en.wikipedia.org/wiki/Fellow_of_the_Royal_Society

http://en.wikipedia.org/wiki/Fellows_of_the_Royal_Society_of_Arts

http://en.wikipedia.org/wiki/Theoretical_physics

http://en.wikipedia.org/wiki/Physical_cosmology

http://en.wikipedia.org/wiki/Honorary_Fellow

http://en.wikipedia.org/wiki/Honorary_Fellow

http://en.wikipedia.org/wiki/Royal_Society_for_the_encouragement_of_Arts,_Manufactures_&_Commerce

http://en.wikipedia.org/wiki/Pontifical_Academy_of_Sciences

http://en.wikipedia.org/wiki/Pontifical_Academy_of_Sciences

http://en.wikipedia.org/wiki/Presidential_Medal_of_Freedom

IQ ASD versus IQ NTImportant points to consider about this chart*found in a great article about perceptions of autistic people…

Note how much lower overall autistic IQ is to NT IQ based on Wechsler’s tests (the gold standard today). This is especially large gap in children.

Note how NT children perform on both tests similarly as they do as adults (smaller spread) versus the autistic person who gains significantly more in skill as an adult . (THIS Is what I mean when I say that autistic people grow more slowly than NT people. You cannot compare where your ASD kid is today to where he is going to be as an adult by the same markers that you use for NT people. They are different. We take longer to connect some areas. Think of the tortoise and hare story here… Many of us are tortoise. Slow doesn’t mean we are not in the race and certainly doesn’t mean that we cannot win the race. )

* http://www.nature.com/nature/journal/v479/n7371/full/479033a.html


High Functioning is…


Nature Nurture

The best thing any parent can do for their child is to provide a supportive, positive, loving environment that assures that child will grow up to reach their full potential

Living perpetually to my performance potential by eliminating the interferences that cause me to falter. “Performance = Potential – Interference”

Vive La Differences……except it is very different

because even when they are all grown up, they still surprise you with all the amazing things they

are learning and being every day…

You literally NEVER know…

Fixing Autism… (Parents Vs ASD Adults)

Autistic Civil Rights facts At the beginning stages right now (similar to gay rights)

Includes autistics of various abilities (not just “high functioning” by however you are using that word)

Extremely sensitive to disrespect

“The healthy desire is for our children (or clients or friends) to live happy and fulfilling lives. The irreconcilable flaw is that autism cannot be “extracted” from a theoretical person to enable some “other” person to emerge. There is no other person. The only, and best, person is already there: an Autistic person.”

--Robb Gross (Father of an adult autistic daughter)


Unleashing the PossibilitiesKarla’s Core Philosophy on ASD Approach…




Meltdowns and Shutdowns hurt.

Hurt me emotionally as well as physically

Hurt others

Leads to GAD/Depression and other related health issues

Pushing into this “zone” feels like having flu where every muscle in the body hurts. The brain is fuzzy and energy is gone. This can last for hours or days.

Long term meltdown mode can result in Anxiety/Depression which may lead to many physical health related problems

Panic attacks

High blood pressure, etc

ASD = Whole Body DisorderPervasive Developmental Disorder

Meltdowns and Shutdowns are a “MIS-Management” issue


Pervasive – Energy Out I use energy in social situations The more chaotic the situation, the more energy used When Energy is depleted a shutdown or meltdown may occur.

These can last for hours, days, weeks or longer. Continued meltdowns can result in anxiety and other health

problems

ASD BunnyBattery = Energy

© copyright 2011 Karla FisherAll rights reserved. Use with permission only

Contact: [email protected]

mailto:[email protected]

Pervasive – Energy In I gain energy in my alone time doing my special interests I often treasure things over people for this reason With careful balance of overall energy I can spend time with people

and even go to big events This is why I have only a few “close” friends at any given time

ASD BunnyBattery = Energy




Reduced

Symptoms

Advocacy Via Awareness

Confidence via Empowerment

Health

Hierarchy of ASD Needs Social

Skills Type Training

Poor Health, low confidence and poor environments directly and dramatically affect my abilities/ symptoms so I have learned to prioritize

these areas in my life.

Social Skills (Type) training is hard on my confidence and must be given on a “risk versus benefit” basis. Best results will happen only

once other foundational areas are addressed and managed.

Reduced Symptoms MUST happen for me to absorb training and to reach my baseline for learning

Newsflash!!!Social Skills and

Flexibility Skills are situational!!!

Confidence/Self Esteem is the opposite of Anxiety


Karla’s Neurospan Profile (unknown place)

70

80

90

100

110

120

130

Cognitive Capacity


Executive Function

Standard Scores

----------------------------------------------------------------------AVERAGE

Incr

ea

sed

Sk

ill


An

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De

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Anxiety /depression (long term anxiety) are active and

decreasing overall functioning abilities. The higher the Anxiety, the lower the

abilities…

Focus on Physical Health as priority #1 Nutrition Rest Exercise

Hone Confidence Provide ASD role models Teach to the student’s strengths (Neurospan Profile)

Advocate! Hone Self Awareness Teach Basic Disability Rights Stop Problem Solving

Realistically Balance Activities All ASD people need to know their own limits

Focus on Symptom Management




Unleashing the PossibilitiesParenting Styles and Logic…




Parenting Styles… (what works) Permissive parents : are reluctant to impose rules and

standards, preferring to let their kids regulate themselves. Authoritarian parents : demand a sort of blind obedience

from their children. Authoritative parents : take a different, more moderate

approach that emphasizes setting high standards, being nurturing and responsive, and showing respect for children as independent, rational beings. The authoritative parent expects maturity and cooperation, and offers children lots of emotional support.

http://www.parentingscience.com/


http://www.parentingscience.com/permissive-parenting.html

http://www.parentingscience.com/authoritarian-parenting-style.html

http://www.parentingscience.com/authoritative-parenting-style.html

AND not OR logic (Black/White)


Unleashing the PossibilitiesADVOCATING…




Advocating


Advocacy: The “art” of finding alternative acceptable ways towards a goal using abilities instead of “problem solving”.

Problem Solving Versus Advocating…

Problem StatementIEP Viewpoint

Tone of voice

Inappropriate Language

Lack of social reciprocation

Hitting or physical aggression

Lack of friends

Lack of eye contact

Other social skills issues ad naseum

ASD Viewpoint

Meltdowns4 times a week

Anxiety*Sensory * People

Lack of EmpowermentNo clear options

The only thing that matters on this side is

the physical aggression. Implement

a ZERO tolerance policy

Measureable Goals: •Meltdowns from 4 a week average to 2 or less a week average•Stretch goal = 0 a week•Physical Aggression: 0 times or NEVER (AKA: No tolerance)

Remove the BIG Triggers to achieve goals (20/80 rule)

Besides eliminating physical aggression the

team will focus on reducing meltdowns in

general ignoring all the other “stuff”


Meltdowns and Shutdowns hurt.

Hurt me emotionally as well as physically

Hurt others

Leads to GAD/Depression and other related health issues

Pushing into this “zone” feels like having flu where every muscle in the body hurts. The brain is fuzzy and energy is gone. This can last for hours or days.

Long term meltdown mode can result in Anxiety/Depression which may lead to many physical health related problems

Panic attacks

High blood pressure, etc

ASD = Whole Body DisorderPervasive Developmental Disorder

Meltdowns and Shutdowns are a “MIS-Management” issue


Jackie and Johnny are brothers. Johnny has ASD so his nervous system is on high alert either on a low idle or high spin. The boys get up and get ready for school. Jackie executes his “getting ready” tasks without thinking about it. Johnny

has a task list and when something changes it causes anxiety to rise even more… but he holds on. The bus comes and Jackie sits with his friends to chat enjoying the nice relaxing ride to school and the socialization.

Johnny is bombarded by sensory information and bullying. He fights meltdown the whole way. Johnny holds on and makes it to class without losing control. He is proud of himself.

Let the school day begin!!!!

Jackie NT and Johnny ASD go to school


Our Breaks Aren’t Like Your BreaksNT Break

Recess Hallway chats Lunch “Getting to know you

activities…” Parties Labs Group work Field Trips Assemblies Gym

The sad irony here is that every one of these things that typical people call breaks can and most often does cause even more stress to your ASD students. Remember that they have more anxiety when they start school due to their neurology so actually need breaks (their kind) even more and should be exposed as little as possible to the NT type of breaks.

ASD Breako Alone time

o Library

o Time doing obsession (reading, computers, etc)

o Getting AWAY from people and sensory input is almost always a “safe” break…

o Alone exercise may also be a good option for some. Quiet walk, boxing, jumping, etc…


Behavior Identify the 1 or 2 things that are problems

Create a clear problem statement that include those 2 issues If you cannot articulate the problem, you cannot fix it Think hard.. Is this REALLY important?

STOP problem solving! Think Advocate instead Empower the child to advocate by providing tools and clear

steps. Create a clear BSP. Make sure student/child understands the

BSP Remember that BSP must be black/white (100% consistent)

AKA: AND logic not OR logic


Key Points to Remember… You cannot really know the future, so why limit it?

ASD is pervasive. Tokens are limited… Spend wisely.

Categorize Problems. Carefully pick the BIG ones to work on. (Spend wisely)

STOP problem solving! Think Advocate! (cater to abilities)

Use Neurospan Profiling to help make decisions about where to spend efforts/tokens.


Contacting Karla and Cynthia: Follow us on Facebook Karla’s ASD Page (Karla’s personal experience and research)

New Leaves Clinic (Info on ASD, ADHD, Dyslexia, funky brains )

Oregon RISE Conference Oregon Parent Training Institute 23rd Annual Conference

April 27-28

Sheraton - Portland Airport

OregonRiseCenter.org

888.505.2673


Backup


Unleashing the PossibilitiesKarla’s Uses Neurospan Profile to Socially Advocate…




Karla’s Problem Statement

“People are Idiots” is triggered

Me: Rude

Them: Bad, Angry

Working in high tech as a senior leader puts me in social situations

where I often fail to make good impressions. This happens because I am no longer in an environment with purely logical minded people who can discuss technical details with me to keep me in my social “comfort zone”.

The most common scenario is that I will be approached by a wife of a

colleague or boss and something they say will trigger a “People are Idiots” reaction in me. (This is not really

their fault as I have so little understanding of people overall

outside of my circles) I will react by being rude and am completely

justified in that rudeness because of my understanding of the context.

This results in me having to clean up messes later on if it is even possible.

Notice how this model… (“Fatal” flaws)

1) Does not recognize responsibility on my part of misunderstanding context…

2) Does not see emotion in my actions. (unaware)..

3) Does not have an “inhibit” button…

4) Gives the same result every time…

Me:Confused, just

ified

NT Social Skills Model for me


Inhibit?

RudeAct NT –

Social Fake

No

Yes

Bad, AngryNeutral,

Good, Weird

Typical Social Skills books teach us that our way is the wrong way. They tell us that we must develop the skills to be proficient at their game. There is no discussion of how abilities are

sometimes affected due to sensory or if there is what to do about it.

Being rude is never considered as an option. Additionally there is little

discussion on the inhibiting part or how that is the crucial part to this entire game . This is mentioned in

social skills type training so I know it is part of someone's picture

somewhere. I just had to put this together myself as I did not see it in the material I have been exposed to

like this.

Socially Advocating Skills!


Inhibit?

RudeAdvocate

and ExcuseAct NT –

Social Fake

No

Yes

Yes

Yes

Bad, AngryNeutral,

Good, WeirdNeutral,

Good, Weird

The “secret” to having good interactions is to recognize when

“anger” is starting early enough to inhibit the natural response (Path 1).

If that is possible, a choice can be made (AKA: I am empowered) how to proceed. In many cases Path 3 will be impossible due to the environment or

my abilities in the moment.

In my case implementing Path 2 or Path 3 will likely result in the same outcome. Path 2 is the option that

will be easier/more true to me so I will practice scripts for this versus try to learn NT social fakes and NT scripts.

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