Mendel Psychological Associates' blog » High-Functioning Autism

Radio: autism and social skills

Dr. Mendel — Sat, 31 Dec 2011 02:29:29 +0000

Last month I was a guest speaker at Breathing Underwater radio show at WCOM. We talked mostly about autism and social skills groups that I lead. You can hear the podcast of the show:

Dr. Mendel at WUNC Radio

WCOM is a community radio station with a studio in downtown Carrboro, North Carolina, broadcasting a 100-watt signal from an antenna at Scroggs Elementary School in Southern Village in Chapel Hill at 103.5 FM.

Support for Parents of Kids on the Spectrum

ginger — Thu, 29 Jul 2010 02:43:59 +0000

Join other parents with kids on the spectrum to explore feelings of joy and complexity, excitement and exhaustion. You’ll be choosing images and combining them in such a way to learn about yourself and your child. You’ll be sharing your experiences and insights with others and you will be receiving encouragement from the group.

Saturday, August 28, 2 PM-3:30 PM

Mendel Psychological Associates (Directions) $35

Register online now or call Ginger Poole at 919-876-1314

New Support Groups

Dr. Mendel — Mon, 26 Apr 2010 21:23:12 +0000

Family members taking care of special need child need tender loving care too. Thus, Ginger Poole is forming several support groups to address this need:

Support group for moms with kids on the Spectrum
Support group for brothers or sisters of a special needs child

We hope that you can join us.

Autism and Health Insurance

Dr. Mendel — Tue, 16 Mar 2010 19:35:51 +0000

On March 5th, 2010, Raleigh’s News and Observer published an article about insurance companies not covering mental health and “behavioral” treatment for individuals with Autism Spectrum Disorders (ASD), including Aspergers. I have been leading social skills groups for children and teenagers with Aspergers and other ASD’s for over a decade and have been confronted repeatedly with the fact that various insurance companies do not cover this service if a child’s diagnosis is an ASD. They do, however, cover the same services if a child has a different diagnosis, such as an Anxiety or Mood Disorder, or Attention Deficit Hyperactivity Disorder (ADHD). Since problems with social interactions are at the heart of Aspergers and Autism, this, to me, is a supreme – and infuriating – irony. These children and adolescents are generally extremely socially awkward and often oblivious to social cues and the nuances of social interaction the rest of us find natural and obvious. Participation in a social skills group with similar peers is the ideal way to help such youngsters. Through such groups, these children learn to interact more and more appropriately. They make friends, first in group, and eventually outside of group as well. Their behavior becomes less awkward and they become able to compromise, to take turns, and to see things from the perspective of others, generally for the first time in their lives. While I have no doubt that this type of intervention is the best way to help kids and adolescents with ASD’s, I certainly understand and share the frustration of their parents when this best practice is not covered.
Fortunately for their parents’ pocketbooks – though unfortunately for the children themselves – many of the kids with whom I work have other diagnoses in addition to Autism or Aspergers. Many have Anxiety Disorders or Obsessive Compulsive Disorder. Others have Mood Disorders, in part because as they approach adolescence and begin to realize how different they are from their peers, their social isolation and repeated experiences of rejection become increasingly frustrating to them and they become depressed, dejected, and withdrawn. When a diagnosis other than Autism is present, my social skills groups are generally covered by their insurance. But this service – so essential and beneficial to treat their core disorder: Autism – is not covered on that basis. This, to me, is utterly ridiculous. I would call on all insurance companies to recognize that Autism Spectrum Disorders are brain-based mental health problems like any other and to cover effective and appropriate treatment of ASD’s through interventions such as social skills groups.

Learning to make friends

Dr. Mendel — Thu, 11 Jun 2009 00:59:18 +0000

As many of you know, I lead several social skills groups for kids and teenagers with Aspergers and High-Functioning Autism. Six group members has always been my maximum for my groups. Recently, a boy was ready to join the high school group a little while before another boy was going to graduate from the group. I brought up the idea with the group of briefly having seven members and asked whether that would be alright with them.

They responded enthusiastically: not only was it alright with them to have seven group members for a short period of time, why not expand the group more generally? Why not have eight or even ten teenagers in the group? As one boy put it, “that way we can make even more friends!”

I found that moment moving and profound. Here was a set of kids most of whom had always been on the fringes of any social group, kids who rarely if ever had friends. These kids had chronically been the target of teasing, bullying, rejection and humiliation. But here, in this group, they had discovered that social interactions with peers could be rewarding and fun. They welcomed the opportunity to meet more kids because having that opportunity would enable them to “make even more friends.”

That view, and the sea-change it represents from the experience these kids have had previously in social settings, is what these groups are all about.

To Witness a Child Blossom

Kristin Vitko — Sun, 31 May 2009 22:41:00 +0000

I am grateful to be an Expressive Arts Therapist because to be a therapist is to be an artist.

As an artist working within relationships of growth and healing I know I am on the right path when I share remarkable moments with children, teenagers, and families. There are endless ways these moments coalesce to form deep connection, joy, understanding, and determination; in essence all the vital stuff of humanity.

The therapeutic theories and techniques that guide me have come through the careful observations and research of my colleagues and those who have come before me. Carrying out these understandings of human development, relationships, and healing through intentional creative processes is nothing less than the unfolding of meaningful experience.

Sometimes I think it is hard for parents to understand the far reaching effects of play therapy and the expressive arts. This confusion can lead to questions such as:

Is this really going to keep Johnny from hitting his sister?
Is Becky really going to get better grades by doing this?
I play with my child too, how is this going to help?

I welcome such inquiries because they come from parents who care, who want the best for their children. My response is a resounding YES, this will help.

As I engage children, adolescents and families we all have goals in mind, target behaviors to change, grades to raise, but we humans are not simple mathematical equations to solve. If we do A plus B then C will happen. Hey I admit, sometimes C does happen (thankfully) but usually not consistently over time. This is why creative collaboration and individual differences are so essential to therapy. Through creative therapies something deeper is happening. Long lasting fundamental moments of transformation are occurring. Over varying degrees of time these core changes begin to affect those most disruptive behaviors that have called out to us saying, “I need something more.” Johnny does stop hitting and Becky gets an A.

Many parents I see are already engaging with their children in creative ways each day. So I say, come in and let’s have the whole family play together. Let’s get more intentional about
play time and also weave creative methods that help into your every day routine. For developmental disorders, attachment issues, mood issues, and learning disorders the bottom line is the same, finding one’s unique path to human connection. There is no script for authentic human connection, although some explicit teaching is very helpful, when it comes down to cultivating fullness of life collaborating creatively is what leads to quality living.

I am so thankful for all the moments I have shared with my Clients. One mother heard me and her son through the wall in the waiting room and said later, “I have not heard him laugh like that for so long!”

I recently asked a seven year old girl. “What can we work on together to make the things that are hard for you easier?” She replied wistfully, “Oh, there are so many things.” I am now the keeper of a folded up drawing she titled my problem. We will pull this problem out of my drawer next session and play it out, play beyond it, play from the deeper perceptions from which this problem emerged. Expressive arts therapy calls forth the expression of these deeper perceptions because they are the stuff of art. Expressive Arts Therapy is an immensely human process and a beautiful one at that.

April is Autism Awareness Month

Dr. Mendel — Fri, 03 Apr 2009 23:28:18 +0000

In order to highlight the growing need for concern and awareness about autism, ASA has been celebrating National Autism Awareness Month since the 1970s. The United States recognizes April as a special opportunity for everyone to educate the public about autism and issues within the autism community.

We encourage you to visit the ASA website which contains a wealth of information about living with autism.

We, the therapists at Mendel Psychological Associates, write about our experiences with clients who have Aspergers and High-Functioning Autism and about our approach to working with these unique, fascinating, challenging, rewarding children and teenagers.

Social Skills Groups: The Cure for Social Avoidance

Dr. Mendel — Tue, 17 Feb 2009 04:00:00 +0000

Craig had pretty much never had a friend. Every social interaction was torture for him. He had been a target of teasing, ridicule, and bullying from the time he was a very young child. He had been hurt so many times by social rejection that it had become the norm for him. He even began to welcome it, stating that he preferred not to have any of his peers in his life: it was better to be alone than to be continually hurt. It was clear to me, and to his parents, that a social skills group would be perfect for him.

But Craig felt differently. He adamantly refused to join the group. His response, in my experience, is fairly common. And it’s really not surprising. For kids like Craig, social interactions have always been sources of pain and torment. They assume that every group experience will be negative. Why in the world would they want to join a social group?

Yet, social skills groups are ideal for kids like Craig. They see very quickly that these groups are totally different than any social situation they’ve ever experienced: this is a place in which there is absolutely no teasing, insults, or humiliation. They also see that the group is filled with kids who have struggled with the very same things they have. These kids – often for the first time in their lives – feel a sense of belonging and acceptance. They start to develop friendships with the other members of the group. As these friendships grow, so too does the child’s self-confidence. Over time, his newfound social skills become increasingly strong and stable. Eventually, he starts to apply them in the social world outside of the social skills group. His social abilities improve and he starts to make friends. Finally, social interactions need not mean pain and misery, but can instead bring closeness, joy, and affection.

Aspergers and Social Skills Group

Dr. Mendel — Fri, 09 Jan 2009 04:18:08 +0000

More often than any other question, I am asked to describe my social skills groups. I lead three groups, for upper elementary school students, middle school students, and high school students. While no particular diagnosis is required for a child to be in one of these groups, most have diagnoses of Aspergers Disorder or High-Functioning Autism. Others struggle with social anxiety or extreme shyness. What all the kids in these groups have in common is that they have trouble making friends and interacting comfortably with their peers. These are the kids who have always lived on the fringes of their peer group. They are teased, bullied, tormented, and ostracized.

And something magical happens when they join the group. Quickly, they realize that here is a place where they will not be taunted or humiliated. Here, they will not experience bullying and social rejection. They see that there are other kids like them, dealing with the same struggles, sharing the same longings for social connection and a sense of belonging. For many if not most of these kids, group is the first safe peer setting they have ever known.

These children thrive in this environment. They form friendships with one another; together, they practice social skills that seem so natural to many of us: making eye contact, listening without interrupting, giving feedback, asking questions. After a while, I’ll hear from them and their parents that they’ve begun making friends outside of group. They start to carry their new skills outside of group and practice them in “the real world” of the classroom and playground.

For me, leading these groups – getting to know these wonderful children, seeing them blossom and flourish, watching their confidence and competence grow – is one of the most rewarding things in my life.

How to Say No

Dr. Mendel — Sat, 25 Oct 2008 23:59:32 +0000

As you all know, I work with lots of kids with Aspergers Syndrome or High Functioning Autism. This advice applies particularly to these children, but I think it’s probably relevant for many if not most kids.

I have had several experiences in which the children in my groups become annoyed at me, insisting that I’ve promised to do something for them or give them something. I have felt at least equally confident that I had not said anything of the sort. For example, in my groups, I provide pizza as part of a celebration whenever a child graduates from group. I have provided pizza for the group on a few other occasions as well (which I think was a mistake, but what can I say?). Well, at various times, kids have asked me if I could get them pizza the following week. To my utter surprise, when the next week rolled around, they were dismayed and upset to learn that I wasn’t going to buy them pizza. Several of the kids stated emphatically that I had “promised to buy [them] pizza.” Looking back on the previous week, I think I had said something like “we’re not going to talk about that now; we need to listen to Jimmy’s sharing.”

A vague, non-committal response, will be heard as whatever the child hopes it to be

I’ve come to realize that a vague, non-committal response, will be heard as whatever the child hopes it to be. If I do not provide a firm “No,” my answer will quickly evolve into a promise that I am then bound to break. It struck me that I’d heard similar, flabbergasted complaints from parents over the years, that their children mishear things and insist that they said something that they had not. My advice to all such parents – advice I need to follow myself – is to make your answers very clear. Kids with Aspergers are often virtually obsessed with clarity, precision and specificity. They don’t do so well with vagueness and open-ended circumstances.

I think that there are truly only three categories of answer:

If your child asks you for something and you can provide it, by all means reply “Yes.” Be aware, however, that this is a commitment and a promise and should be kept in all but the direst of exceptional circumstances.
When the answer is no, simply say “No” (and, of course, don’t proceed to provide that item or do that favor).
Sometimes the answer is not definite. You may not be sure whether you can provide the item requested, or you simply may not want to discuss the request at that point, or you may just need to take more time to consider it. In that case, I recommend saying something like this: “The answer right now is No, but I’ll think about it more later on and we can discuss it more after you get home from school.” No guarantees, but I think that it would be hard for any child to construe this answer as a promise to do something.

A couple more quick points about this approach: if you say “No, probably,” and later change your mind and say “Yes,” your child has gotten a pleasant surprise, which is a heck of a lot better than a broken promise or the perception of a broken promise. Most importantly, if you give a firm “No,” stick to it. Saying “No” to a child’s request (or demand) and then giving in to placate him or her or reduce his or her whining or nagging sets a truly bad example and sets you up for your future “No’s” to be ignored and battled. If you choose to say “No,” stick with it, hard as this may be to do.

What a Beautiful Wish!

Dr. Mendel — Thu, 07 Aug 2008 03:15:35 +0000

A big part of my clinical practice is with kids and teenagers with Aspergers or High-Functioning Autism. I’d like to share an anecdote about one of these children that I find endearing and heart-warming. Almost two years ago, my son was born. In the weeks and months leading up to that event, I had been letting the families with whom I worked know that I would be taking about 6 or 7 weeks off to be with wife and newborn son. Just before going on parental leave, I had my final session with a boy with high functioning autism, who was then 10 years old. He said, in his characteristically sincere and intense manner, that he had something to tell me. He stood about 4 inches away from me — which was also very characteristic of him — and said, “If your wife is as nice and as smart as you are then your son is going to be the nicest genius in the whole world!” As I was beginning to glow from his comment, he continued, “And if she’s not as nice and as smart as you are, well, then he’ll have some of each of you!” We are tremendously fortunate in our son, who is happy, healthy, spirited, energetic, curious, and good-natured. And we couldn’t have asked for a better birth wish than we got from my kind, spirited, good-natured, generous client. When I thought about his words, I realized that I would have never heard such a wish had my client not had Aspergers or High Functioning Autism. This child, like many with this disorder, doesn’t screen or filter out his thoughts to nearly the extent that other children do. He is fairly oblivious to social norms and niceties. He said what was in his heart. After his comment about my son being “the nicest genius in the whole world,” he added the portion about our son’s prospects if my wife were not as nice and smart as I am because he does not think in terms of tact and etiquette. Again, he spoke directly from his heart. And I’m so glad he did.