*Do read this , even though it is very long. For the last couple of months
i am finding the "think and act method" (i have already shared the tucker
turtle slides) very useful in all spheres of life , for my child.
Decision making ability is the foundation of independence.*
*sangeetha*
Part of the brain wiring differences for those on the spectrum is they
often have weak neurological connections (neurological pathways) between
the different brain centers. These weaker connections make it more
difficult for the different brain centers to communicate with one another.
This has major influence on the way we process, interpret, and respond to
information. This also has major impact on why many people on the spectrum
have emotional regulation difficulties; thus poor emotional control
problems.
In a very simplistic view, the brain has an “emotion” center (Limbic
system) and the “thinking” center (Frontal Cortex). The emotion center is
part of the primitive center deeper in the brain, which experiences “raw”
emotion. It is the part of the brain that provides immediate raw emotion
and the fight or flight reaction. The thinking center (pre-frontal lobes)
provides us the ability to immediately inhibit our raw emotion long enough
to appraise and evaluate the actual degree of threat, and taper down our
emotional reaction. It allows us to control our impulses, by overriding our
primitive raw emotions. This inhibiting, appraising, and overriding ability
of the cortex can only occur if the neurological pathways from the
“thinking” center to the “emotion “ center are strong enough to keep the
emotional impulses in check.
Now, if these communication pathways are underdeveloped and weak, then the
thinking center cannot rapidly inhibit the emotional response long enough
to appraise and override the reaction. Hence the person emotionally goes
from 0-100 quickly, over-reacts, and also takes much longer to calm down.
The overwhelming emotional tidal wave quickly sets off the “fight or
flight” response, which in turn overpowers the “thinking center’s” ability
to inhibit it. The person reacts more from the primitive survival (emotion)
center than from the “thinking” (appraising, evaluating) part of the brain.
In order for the brain to be able to cognitively appraise, assess, and
evaluate what is needed, it has to be able to inhibit the immediate
response from the emotion center (Limbic System).
In normal development the Limbic System (emotion center) exists at birth.
The “thinking” center (pre-frontal cortex) is the slowest to develop;
gradually developing through childhood and early adulthood. That is why
infants and young children have poor impulse control and weak ability to
regulate their emotions. As the nervous system matures over the years, the
thinking center develops and exerts more control over the emotion center.
The person becomes better able to inhibit his impulses, appraise the
situation, plan a course of action, think about the consequences of his
actions, monitor and evaluate the effects of his behavior. However, in
autism, if the neurological connections are underdeveloped (or diffusely
overdeveloped) and the communication is weak between these two centers, the
thinking center will not be as able to immediately inhibit the strong
reactions from the emotion center. They are more likely to act on impulse,
even though they can tell you later that they shouldn’t have. They are more
likely to be overwhelmed and emotionally reactive. Also, when they cannot
be confident that their “thinking” center will inhibit these reactive
emotional responses, they are more anxious about being emotionally
reactive. This increased anxiety further hinders their “thinking brain’s
“ability to inhibit and control the reactive emotion center. The person
becomes anxious and apprehensive when experiencing emotion and panics
easily from fear that their emotions will overwhelm them. They cannot trust
that their thinking center will be able to control their emotional
responses. This insecurity leaves them feeling vulnerable in any situations
that may overwhelm them.
Given the nature of this weakness, how can we help? Research on brain
plasticity has shown we can strengthen neurological pathways by exercising
them. If that is true, then we should (in theory) be able to strengthen the
neurological pathways that connect the “thinking” center to the “emotion”
center; to become better able to inhibit and control our emotional
reactions. We can do this in children by activating the “thinking” center
early enough to inhibit the “emotion center”. *By practicing “think before
we act” strategies, we can strengthen the neurological pathways that allow
the thinking center to inhibit and override the emotion center. *We can
help the child strengthen this ability by:
1. Continually* model for the children *how to “think things through”. How
to stop and think, before acting. How to accurately appraise how
threatening a situation is, assess what is needed, plan a response, and
execute and monitor our actions. Parents can do this by “thinking out loud”
as they go through the day. Slowing things down and “thinking out loud” how
they appraise and evaluate what to do and how to do it. They can “think out
loud” as they face simple challenges in their daily routine.
2. In addition, parents can help the children learn to “think” their way
through things; to stop and think, as the children do things throughout the
day. Do the activities with the child, slowing them down, and “thinking it
out” together (*talk it through*). We need to develop “self talk”
strategies to gradually develop internal thinking. Appraising what is
needed, how to do it, and monitor how well they are doing. Mentoring how to
appraise, monitor, and evaluate. This process activates the “thinking”
center of the brain, making it stronger and more automatic in response. We
need to activate the “thinking” center to inhibit the emotion center. We
need to practice this strategy throughout the day to engrain activating the
thinking center, as “habit”, in all daily activity. This will strengthen
the “thinking” functions to become better at inhibiting the reactions from
the emotion center.
3. Parents can also help the child practice and* role play* using these
“thinking” (problem solving) strategies for situations that commonly cause
strong emotional reactions for the child. We do this by making a list of
common, frustrating situations for the child. We write out each one on an
index card. On each card we describe what the problem situation is. Next we
make a problem solving worksheet with four questions on it: (1) what is the
problem, (2) why is it a problem, (3) what are possible options, and (4)
what are the possible effects of each option? Essentially a “think it
through”, problem solving worksheet. Then each day we pick a couple of
problem cards and use the worksheet to “think them through.” In addition,
as new situations crop up, we write them on index cards and add them to the
stack of cards to practice. This way we are using real life situations that
are common for the child. This is a very laborious approach at first, but
teaches the child to think out solutions to common problems in their lives,
plus teaches them to “stop and think” before hitting boiling point. It
becomes easier and quicker as times goes on. Start by practicing a self
talk script, like “stop, think, act” that will initially inhibit (check)
the emotional impulse long enough to activate the “thinking” brain. Then
use a brief 3-5 question outline to “think it out”. Three different types
are presented below. However, you can create any 3-5 question outline that
is specific to helping your child. These outlines give scripted routines
that can be learned and engrained as cognitive appraisals.
Appraising Event
1. What can I expect?
2. What is expected of me?
3. What do I need to do?
4. What problems may occur?
5. How will I respond if problems arise?
Problem Solving
1. What is the problem?
2. Why is it a problem?
3. What are my options?
4. What are consequences of each option?
5. What option to try?
Appraising Threat of Problem
1. What could go wrong?
2. How likely is that to happen?
3. How bad would it be if it did happen?
4. How do I respond if it did happen?
Write out these outlines on small laminated cards that can be put in the
child’s pocket. Start by practicing them at home by role playing situations
and thinking them through. Once the child feels comfortable with the
strategies then begin to use them in actual situations.
4. Next, the parents and children need to identify the early signs of
apprehension and agitation, so that they can intervene early, *help the
child “stop and think”, *and activate the “thinking” brain center early
enough to inhibit their emotional reactions. We often ignore the early
signs and jump in with advice once the child is full blown! Then it is too
late. Know your child’s early signs. It is very important that this process
is activated early in the emotional chain so that it is easier for the
child to inhibit the emotional reaction before it becomes overwhelming.
5. You cannot teach a new response in the heat of the moment. That is why
it is important to role play and teach the coping skill when the child is
calm and organized. Once the child can instill this problem solving
competently during practice sessions, then we start programming little
snags into the children’s day that will present the “just right” challenge
(a little anxiety) so the children can practice using their “thinking
strategies”. We make a list of common situations that causes anxiety for
them, and start with minor snags first. They first learn to use these
skills under manageable situations, before trying to tackle more
problematic events. With the parents help in scaffolding these events for
success, the children become stronger in using their “thinking” brain to
inhibit and control their “emotional” brain.
As the child learns to activate their “thinking” center quicker and more
efficiently, they strengthen the neurological connections between the brain
centers, and become more confident in controlling their emotional impulses.
Don’t expect this to occur overnight. It needs frequent and long term
practice to develop these neurological connections.
