Siste episoder av Autism in the Adult podcast

1. The Power of Small Talk (EP 72)01.03.2025 (00:23:23)

   Join Dr. Regan in an episode about the power of small talk as a social welcome mat and a way of testing the waters before creating longer social connections.  Neurodiverse Love Conference 2025 Use checkout code Theresa50 for $50 off _______ Autism in the Adult website Resources for professionals Video Visits Video Courses

2. The Lifespan of a Household: Retirement and the Empty Nest (EP 71)02.02.2025 (00:29:25)

   Join Dr. Regan for this episode of the Lifespan of a Household Series. The episode focuses on the experience of the autistic adult during the seasons of retirement and the empty nest.  Calendar example:      Autism in the Adult website Resources for professionals Video Visits Video Courses

3. The Lifespan of a Household: Parenting Teens and Young Adults (EP 70)12.01.2025 (00:25:47)

   Join Dr. Regan for this episode of the Lifespan of a Household Series. The episode focuses on the experience of the autistic parent in a household with teens and young adults. Dr. Regan discusses the child's quest for identity and separation and the parent's changing role. She reviews coping strategies for the parent during this time of transition and uncertainty. Autism in the Adult website Resources for professionals Video Visits Video Courses

4. The Lifespan of a Household: Parenting Preteen Children (EP 69)17.11.2024 (00:33:52)

   Join Dr. Regan for the sixth episode of the Lifespan of a Household Series. The episode focuses on the experience of the autistic parent in a household with preteen children. Dr. Regan discusses the parent's shifting role across the child's developmental seasons, develops images to help parents relate to the shift, and provides practical input about succeeding in these changes in the parenting role.  The Holidays and Autism: Holding Fast and Letting Go Planning a Merry Holiday on the Autism Spectrum How to Talk So Kids Will Listen and Listen So Kids Will Talk   Autism in the Adult website Resources for professionals Video Visits Video Courses

5. The Lifespan of a Household: Parenting Young Children (EP 68)19.10.2024 (00:25:45)

   Join Dr. Regan for the fifth episode of the Lifespan of a Household series. Today's episode focuses on topics important to autistic individuals who are parenting young children.   Autism in the Adult website Resources for professionals Video Visits Video Courses

6. The Lifespan of a Household: Preparing for Children (EP 67)06.10.2024 (00:23:17)

   Join Dr. Regan for the 4th episode in the Lifespan of a Household series. Today's episode focuses on topics important to the autistic individual who is preparing for parenting.    Autism in the Adult website Resources for professionals Video Visits Video Courses

7. The Lifespan of a Household: Shared Living Space (EP 66)08.09.2024 (00:26:29)

   Join Dr. Regan for this third episode in the "Lifespan of a Household" series. This episode highlights topics important to living in shared space, including the sensory environment, alone time, and control over objects. Also, check out links to resources on her website and a transcript of the episode below.  Autism in the Adult website Resources for professionals Video Visits Video Courses   Hi, everyone. Thanks for joining me for this third episode in our series on autism and the lifespan of a household. My name is Dr. Theresa Regan, and I'm your host. I'm a neuropsychologist, a certified autism specialist, and mom to a young adult on the spectrum. This series is the result of listener requests about living as a couple or as a family within a shared household. And as we've touched on, one of the challenges of tackling the topic is that households can take so many different forms. And I know that I can't do them all justice in just one series, but I wanted to touch on some important life seasons within a household. So our first episode was about dating, and the second covered the topic of physical intimacy and relationships. And today we're going to talk about sharing physical space with other people. So joining households, living in the same space. I'll also let you know that a lot of my website renovations have been completed. There are still some things I'm tweaking and trying to make work better, but lots of the pages are active and working. And I also now have the new service of video visits for people to consult me about the topic of autism or how that impacts you in your household. There are some geographic limitations and there are some specifics about payment and if you are interested in that type of service head on over to my website at adultandgeriatricautism.com and look under video visits. So there are many different instances where physical space might be shared in a type of household. So we may be talking about a traditional couple or a family household or even other situations like having roommates or renting a portion of someone else's home. And sharing living space can be complex for lots of reasons, but for the autistic, there may be a few specific challenges that we could cover in the episode today that would help people navigate those things. So in particular, we're going to cover the sensory environment, alone time, and having control over objects. So let's tackle the sensory environment first. First, because the autistic individual may have sensory sensitivities, living in the household with other people may be overwhelming because people bump into each other or reach over each other or they brush against each other to navigate the physical space. Noise can be another sensory input that's elevated in a household, and the noise could include voices, babies crying, arguments, even just surround noise like television or music. How things smell can be important to someone on the spectrum. The scent of food cooking or aftershave, candles, cigarettes, cleaning products, taste and texture can come into play if we're talking about shared groceries or family meals, does everyone have to eat the same thing? Let's not forget about visual inputs. So not only does this include lighting, but a very common issue that I hear about is concern for the visual space or having visual chaos. So for some on the spectrum, the sight of a visual messiness or overcrowdedness or chaos can be overwhelming. And this could include things like decorations, messy work areas, things on the floor, clothes, garbage, food, strewn about various surfaces. And this visual chaos can feel overwhelming. Now, before you start laughing because you've seen someone's space and you know that they're not concerned about visual chaos, that's true. Not everyone on the spectrum will have the same sensory processing feature. And neither will everyone who is neurotypical. So people in the household will have different preferences. Many people on the spectrum may have very little care for the visual cleanliness or organization of their space except for a few specific things. So maybe they have very significant care about where their favorite objects are placed or how things are lined up, but other things are strewn over the floor and there's not much care at all. The more people there are in the household, the more mix there will be of habits and preferences and clash with the habits and preferences of others. Another complicating factor is that as people age across life seasons, their sensory processing and preferences can also change. So you have not only complexity, but you have this multifaceted, always changing sensory sensory environment, and sensory preferences across multiple people within the same shared living space. So that is a moving, dynamic, complex kind of issue. Now, one of the best ways to start addressing this is what we've talked about in multiple other episodes, And that is self-awareness. So that's that ability to say, hey, I know what makes me tick. I know what my nervous system likes and doesn't like. I know what I need today. And I also observe and have talked to and am aware of other household members. I have awareness that what they need may not be the same thing I need. And this place is shared by people with different needs. So having awareness of what the needs are is a huge place to start. The next step is to add the right now element. So the self-awareness that we talked about, that's the always element. Like, I know what's generally, typically always true about our household from day to day. Now, look at the right now element. So in this specific moment, what do people need? What do people need this morning, today, this week, this holiday season? One way to accomplish this in a household is to have huddles. So a huddle is a very quick rundown. It's a triaging process. For those of you who maybe use that in a workplace or know what that means, triaging is the ability to quickly scan what's happening, what's most important, what needs to be done the quickest, and to prioritize how these things will be handled. So in a triaging process where people are able, they're already self-aware, they're are able to highlight how their system is doing and what the day will be or has been like given their schedule. A huddle could take place between two parents of three young kids, maybe in the morning and after work. This type of brief communication helps everyone get on the same page. So instead of this confrontation and argument where one person says, I told you to do this or why are you doing that? We start with, hey, this is really chaotic. what do you need right now? This is what I need. This is the schedule for the day. This type of communication also represents and reestablishes that the household is committed to partnership. I want you to do well. I want to know what's important to you and what you need. And here is what is a priority for me today. So rather than being impulsive and reactive to what's happening throughout the day, oh my gosh, something just happened to me. I react to it because I want it to stop. We can start off with awareness and a general game plan rather than kind of flipping around crisis mode, and often that means pushing against other people. The household itself will also need some adaptations to the sensory needs of the individual. So not only do we start with self-awareness and then have up-to-date huddles, like this is what's going on this morning, this is what's going on after work, we also have to look at the sensory needs in the whole household and how that can be adapted. So there will likely be some foods that are completely off the table, like there's just such a high smell, taste, or texture aversion that cannot be avoided or coped with that it's not worth the amount of drain on people in the household. So one person may love fish or collard greens or something with a strong smell or scent that's really overwhelming to someone else and there's just no way around it. It just gets into the house. So those foods are off the table. If you're going to have that food, go out to someone's house as a guest and eat it there or eat it at a restaurant. Some adaptations may not be all or nothing. They may have to do with getting equipment like sound-canceling headphones or earbuds for people, sometimes having a designated quiet time if the kids are old enough to understand stand and regulate this. Like 12 to 1 is quiet time. A weighted blanket may be a good sensory tool for calming, as might something like a rocking chair or a swing set. Another thing I want to point out that may be confusing to people about the sensory environment in household with neurodiversity is that the person who is sound sensitive may also make a lot of noise. And that seems to be because the noise they make is predictable and controlled by them, whereas the noise that comes at them can feel repeatedly startling and overwhelming and they don't have the control that they need. And another thing is that sometimes, you know, it's this hard to understand presentation because the person may be loud because they're overwhelmed and need quiet. So it can be, you can't always kind of look and say, well, you're being loud, you must not need quiet. Or you're running around and crashing and rolling, you must not need quiet time. So a lot of times those kinds of behaviors are a signal that the person does need some regulation help, and that can be achieved by a quieter space, time alone, a weighted blanket, and those kinds of things. In addition to having things about the environment that support sensory needs within the household, consider having separate time or alone time so that people don't have to do things together. I know sometimes as a family, we try to create this together time or a family evening or a forced family time. And sometimes that's great and there are great memories. And other times, you may become aware that the needs of the people in the household are such that separation time is so important that there's a place for that as well. So for example, one person could do homework in one household location and a second person in another. So rather than having both kids at the table doing homework so that it's convenient for for the parent to help or whatever, that just may be unrealistic for either of those individuals and their sensory needs. They may need space and quiet and time. One individual could work on a chore at a separate time or space than another individual doing their chore. So I worked with a family once that had two teen girls and one was neurotypical and one was autistic And they were very perplexed at the autistic individual who didn't have a diagnosis that all of a sudden she would melt down and push her sister and just be so, quote, unreasonable, end quote, that she'd have to wait outside until she could calm down and come back in. And what actually was happening is that because they were doing chores in the same room, which was the kitchen every night, but the chores were split. The shared space was too much. And sometimes the sister would do just silly, friendly, wonderful things that she thought would be no big deal, but were really overwhelming. At the end of the day, you know, the resilience for the one child was just really low and touch, especially unexpected touch, a hug from behind, tapping on the shoulder would just set things off. So allowing people to do their chores in separate areas. There could also be individual variants. Sometimes our kind of go-to within a household is that everyone is the same. It's most fair if everything is the same for every child all the time. And actually that just may not be realistic and it may not end with the best outcome. So sure, there are some things that are the same for every person in the household and there probably needs to be some individual variance as well. So this is your toothpaste flavor. This is your shampoo scent. And in the end, the target will be a balance of number one, no one does this. So maybe that's smoking or Cook's Curry or Blair's Music all the time. Number two, individual variations. So we make sacrifices for each other and we give each person breaks and some alone time. And number three, some of we all do this. Like we all have huddles. We all try to figure out how everyone can get their needs met. We all try to focus on compromise and having an awareness in the moment. So having a mix of this never happens, this always happens, and let's do some individual triaging. That's going to work really nicely. So what we covered so far was the sensory environment. And the second point we're going to talk about is alone time. So alone time is typically really important for the regulation of the nervous system for the autistic. So protecting someone's alone time likely needs to be a very high priority. You can see how this gets easily eaten up, particularly if there's kind of a traditional family unit where there are multiple people in the same household. Everyone comes together at dinnertime. They have multiple things that they need to get finished. They need to work together. There are errands to run. And there's a lot of times when other people need something from you. I want a snack, I need help with this, I need you to do X, Y, Z so I can have a break. This would be a good time for a huddle. So let's regroup. Let's get a game plan that we actually decide on rather than just reacting about. And let's not let life roll over us and us trying to keep up with the flow. You might want to designate where someone can get alone time. Maybe there's a tree house, a garage apartment, a basement area. Try to be creative and create space for this. So it may be in a corner of a room with a small tent-like structure and pillows inside. Maybe under a table with a blanket for small children. The adults need alone time too. Regrouping after After work, it can be really hard for both spouses to come home from work and then feel like they both need alone time and yet they have kids running around in the house or other demands on them. The huddle can help work together to figure out how each person can decompress. Maybe alone time is riding your bike after work, driving your kid to baseball practice, but needing to read a book in the car rather than getting out and visiting with parents or watching practice. Maybe there are things the family do all together, like eating meals or doing chores or playing games or watching movies, but there may be room for thinking about who needs alone time rather than together time, and not to have this picture that the family is doing the the best when everyone wants to be together all of the time. So really trying to protect and designate alone time and separation time for each family member based on what their nervous system needs. The third thing I want to talk about in a neurodiverse household has to do with having control over objects. So this may or may not be something that rings a bell with you or that you relate to. But for many people on the spectrum, they just have a real keen eye for objects and they may like to accumulate them or have collections of them. They may have a hard time throwing things away or sorting through things that they don't need. And so there can can be this real feeling of importance about where the objects are and are they safe and can I see them? And so that may have to be taken into account within a household as well. The person may say, yes, a place for everything and everything in its place. Again, that these objects are important and the symmetry of them is important and where they go is important. And I want people to put everything back where it should belong. One person may really focus on keeping items rather than parting with them to free up space and reduce clutter. letter and that can be a difference in how different people in the household want to work. So it could really stress someone to have too many objects in the house and it can really stress another person to part with an object. Take for example an autistic child who leaves their stuffed animal in the family car and wakes up in the middle of the night and realizes that that they don't have their stuffed animal and they're very worried that rabbit is not going to be okay in the car. So if I can't see where rabbit is, then I feel like they might not be okay. I really need parent to go out and get the stuffed animal from the car. Now for the autistic child, that may be a very strong, important nervous system need because they may actually really worry about this object if it's not in a known location. So understanding is one of the first steps, right? I understand why this child needs this and I respond according to how high the importance is for them. Compromise is another part of this. Like if I have self-awareness that that objects are really important to you, and you have self-awareness, that visual calm is really important to me, then can we compromise? Could a compromise be that we store things in a storage unit that are not out in the open, but you know that they're safe and protected, and you can can alternate objects whenever you want. So you could take some objects that are on display at home. You can go to the storage unit and change them out for other objects and bring those objects home. So some sort of compromise would be ideal. So understanding this actually is really important to them. And them understanding what's very important to you. So what doesn't work is these repeated conversations about, it's fine, it's just a stuffed animal, it's just a transformer collection, it's, you know, even for people who are retiring and downsizing, we hear this, that, you know, I just can't get rid of my collections, it would be like a death in the family to downsize. It can be that upsetting. So again, I think the part I want to point out here is that that neurologic. Strain is very real for them. That's really a very difficult thing to do. And reasoning with the person about why you don't need these boxes anymore or the cleanliness of the area or the safety of the area, that's really not going to be that compelling to them. What might work a little bit better is number one, seeing if they can give some of the objects to a trusted person so that it has a good home, rather than just throwing it out or giving it away to an unknown person. Another thing that could work is compromising about a space where things can go. As we said, it could be a rented space, it could be an outbuilding, a place in the basement, and how much can be visible at one time. And it also could be compromise about spaces that are protected. So you have your space in this man cave here or whatever, and you get to put your objects in this space. But every other place in the house that's a family area, we compromise about. And then I get my space. And so I get to make decisions totally in my space about visual calm and being uncluttered. So we have some compromise space and some individualized space. Living in a household is complex because everyone has a nervous system. Everyone's system is a little bit different than the other person's. And the best place to start is self-awareness. And knowing that there's going to be this fluidity from day to day and from life season to life season. The things that are calming or soothing or upsetting and frustrating are going to be different to a two-year-old than they are to an 18-year-old than they are to a 50-year-old, etc. So this dynamic and moving thing that is a household is going to have these elements. So self-awareness, compromise, huddling up, making some decisions about the space and how the space can support the needs of the individuals, and really knowing what is legitimately very difficult for each person. I'm so glad you joined me today to talk about living in a household, sharing space, joining households. Households, and I hope you'll continue to listen to this series on the Lifespan of House

8. The Lifespan of a Household: Physical Intimacy in Relationships (EP 65)18.08.2024 (00:24:50)

   Dr. Regan continues the series about the lifespan of a relationship and/or household. The first episode focused on dating relationships, and this second episode focuses on sexual intimacy in relationships with an autistic partner.    Dr. Regan's Resources: Empowered Parenting Zur Institute courses for clinicians Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians

9. The Lifespan of a Household: Dating (EP 64)28.07.2024 (00:26:18)

   Dr. Regan begins a new series about the lifespan of a relationship and/or household. This first episode focuses on dating relationships. The episode provides practical insights and strategies to help you make informed and intentional choices in your relationships, ensuring they are fulfilling and sustainable for both partners. Dr. Regan's Resources: Empowered Parenting Zur Institute courses for clinicians Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians

10. Powerful Self-Care: Filling the Tank (EP 63)26.05.2024 (00:30:28)

    Join Dr. Regan for the final episode of the Powerful Self-Care Series. Rather than becoming the victim of an intense world, constantly in survival mode, learn strategies for self-care. This episode focuses on how to increase resilience in active and effective ways. Empowered Parenting   Dr. Regan's Resources: Zur Institute courses for clinicians Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians

11. Powerful Self-Care: Reducing the Drain (EP 62)29.04.2024 (00:29:23)

    Join Dr. Regan for this second episode of the Powerful Self-Care Series. Rather than becoming the victim of an intense world, constantly in survival mode, learn strategies to become effective with self-care. This episode focuses on how to reduce draining inputs in order to budget your resilience.  Explore Dr. Regan's new Learning and Equipping page and the specific course page for "Empowered Parenting."  Dr. Regan's Resources: Zur Institute courses for clinicians Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians

12. Powerful Self-Care: Awareness of the Internal (EP 61)07.04.2024 (00:26:51)

    Join Dr. Regan for this first episode of a new self-care series. Rather than becoming the victim of an intense world, constantly in survival mode, learn strategies to become powerful at self-care. The first step is self-awareness which can begin by noticing your fight, flight, freeze, and physical reactions to events and experiences.  Explore Dr. Regan's new Learning and Equipping page and the specific course page for "Empowered Parenting."  Dr. Regan's Resources: Zur Institute courses for clinicians Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians

13. Communication Series: Using Communication to Tackle Tough Topics (EP 60)10.03.2024 (00:23:40)

    Join Dr. Regan for the third and final episode of the Communication Series. This episode highlights ways to communicate while talking about challenging topics.    Explore Dr. Regan's new Learning and Equipping page and the specific course page for "Empowered Parenting."    Dr. Regan's Resources: Zur Institute courses for clinicians Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians

14. Communication Series: Using Communication to Strengthen Relationships (EP 59)18.02.2024 (00:22:15)

    Join Dr. Regan for the second episode in the Communication Series. This episode highlights ways to use communication to protect and grow relationships.    Dr. Regan's Resources: Zur Institute courses for clinicians Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians

15. Communication Series: Steps Toward Better Connections (EP 58)28.01.2024 (00:29:24)

    Join Dr. Regan for the first episode of the new Communication Series. This first episode highlights moments of connection, such as talking in the car, going out on date night, and catching up with a friend. Tune in to hear what to avoid and what to focus on to enhance connection.    Dr. Regan's Resources: Zur Institute courses for clinicians Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians

16. Executive Function Series: Sticking, Releasing, and Switching Gears (EP 57)07.01.2024 (00:31:51)

    In this third episode of the executive function series, Dr. Regan discusses sticking, releasing, and switching gears in everyday life.  Related resources: Podcast Episode: Autism and "Just Right" Podcast Episode: Gaining Momentum for Activities Amazon: Time Timer (I don't receive any income from your purchase)   Dr. Regan's Resources: Zur Institute courses for clinicians Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians

17. Update and Links to Holiday Episodes (EP 56.5)11.11.2023 (00:00:29)

    The Holidays and Autism: Holding Fast and Letting Go Planning a Merry Holiday on the Autism Spectrum

18. Executive Function Series: Speed, Working Memory, and Sequencing (EP 56)10.09.2023 (00:32:31)

    In this second episode of the executive function series, Dr. Regan breaks down how speed, working memory, and sequencing impact daily life.  I Love Lucy chocolate factory TV clip Executive Function Book Series by Dawson and Guare: Smart But Scattered (children's version) Smart But Scattered (Teen version) Smart But Scattered (adult version)   Dr. Regan's Master Class for Clinicians (Sept, Oct, Nov, Dec 2023) Zur Institute: Master Class   Dr. Regan's Resources Book: Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians Read the transcript:  1 00:00:05,570 --> 00:00:06,059 Hello, 2 00:00:06,070 --> 00:00:06,820 everyone. 3 00:00:06,829 --> 00:00:08,659 This is Doctor Regan. 4 00:00:08,670 --> 00:00:13,670 I'm joining you for an episode of Autism in the adult podcast. 5 00:00:14,020 --> 00:00:14,880 For those of you. 6 00:00:14,890 --> 00:00:16,260 New to the podcast. 7 00:00:16,270 --> 00:00:18,020 I'm a neuropsychologist, 8 00:00:18,030 --> 00:00:20,190 a certified autism specialist, 9 00:00:20,420 --> 00:00:25,180 and the founder and director of an autism diagnostic clinic for adolescents, 10 00:00:25,190 --> 00:00:28,940 adults and aging adults in Central Illinois. 11 00:00:29,549 --> 00:00:35,240 And today you are listening to the second episode in a series on executive function. 12 00:00:35,750 --> 00:00:47,139 And this is a topic we're covering because many of the strengths and challenges that go along with the autistic neurology fall within the realm of executive function. 13 00:00:48,849 --> 00:00:51,619 Before we dive into that topic for today, 14 00:00:51,759 --> 00:00:58,540 I'd like to thank Amanda who pointed out that my diagnostic terms in the first episode were imprecise. 15 00:00:58,830 --> 00:01:03,279 I use terms that are common in my day to day interactions with patients, 16 00:01:03,290 --> 00:01:04,819 families and physicians, 17 00:01:05,080 --> 00:01:07,900 which are the terms ADD and ADHD. 18 00:01:08,089 --> 00:01:09,099 However, 19 00:01:09,110 --> 00:01:16,800 the most precise and current terminology is ADHD predominantly inattentive presentation. 20 00:01:17,379 --> 00:01:21,389 ADHD predominantly hyperactive -  21 00:01:21,470 --> 00:01:26,199 impulsive presentation, or ADHD combined presentation. 22 00:01:27,379 --> 00:01:29,589 And I guess in reviewing that in my mind, 23 00:01:29,599 --> 00:01:32,720 I think it's similar with the term dementia, 24 00:01:32,730 --> 00:01:37,550 which is often still used in day to day language in clinical settings, 25 00:01:37,559 --> 00:01:42,690 even though the most recent and precise term is major neurocognitive disorder. 26 00:01:43,360 --> 00:01:43,650 So, 27 00:01:43,660 --> 00:01:44,410 thanks Amanda, 28 00:01:44,419 --> 00:01:51,279 I'll stick to being precise and specific in podcasts about the topic of ADHD 29 00:01:51,839 --> 00:01:55,230 And instead of using each of the subtypes, 30 00:01:55,239 --> 00:02:07,379 I will just use the term ADHD unless I'm speaking about specific features of one subtype. As we discussed in the first episode, 31 00:02:07,389 --> 00:02:16,580 executive function is really a broad term and it's includes multiple subfunctions or subcategories. 32 00:02:17,179 --> 00:02:33,800 And this is a series that I really encourage you to listen to the first episode before listening to subsequent episodes because it really went through a lot of layers of explaining executive function, ADHD, and autism ... 33 00:02:34,350 --> 00:02:37,160 how those relate or don't relate to each other. 34 00:02:38,539 --> 00:02:43,720 So the subcategories of executive function include things like attention, 35 00:02:43,990 --> 00:02:45,919 goal directed persistence, 36 00:02:45,929 --> 00:02:47,949 organization, response 37 00:02:47,960 --> 00:02:50,020 inhibition and several more. 38 00:02:50,440 --> 00:02:50,990 In fact, 39 00:02:51,000 --> 00:02:53,229 depending on what source you're using, 40 00:02:53,240 --> 00:02:57,669 there can be about 12 or so sub functions identified, 41 00:02:57,679 --> 00:03:06,410 even though there's really no complete agreement on how to list out the sub functions within executive function. 42 00:03:08,110 --> 00:03:17,000 There are two main developmental diagnoses with large executive function components and these include ADHD and autism, 43 00:03:18,710 --> 00:03:23,160 the ADHD criteria, as we talked about in the previous episode, 44 00:03:23,339 --> 00:03:28,899 only describe symptoms falling within about four of the subcategories. 45 00:03:29,720 --> 00:03:35,460 I would label these subcategories in the ADHD as organization, 46 00:03:35,500 --> 00:03:41,690 attention, response inhibition, and goal directed persistence. For example, 47 00:03:41,699 --> 00:03:50,500 "fails to give close attention to details or makes careless mistakes" is one of the criteria that can be met in ADHD. 48 00:03:50,919 --> 00:04:08,720 And I would say that, as a symptom, that falls within the subcategory of attention. "Blurts out answers before questions have been completed" is an ADHD symptom that falls within the executive function 49 00:04:08,729 --> 00:04:13,100 subcategory of response inhibition. 50 00:04:13,809 --> 00:04:20,420 So is somebody able to inhibit or stop a response until they think it through? 51 00:04:21,890 --> 00:04:31,679 So autism will present with core executive function features in some combination as well across the totality of the 12 categories. 52 00:04:31,959 --> 00:04:40,040 And these features are some of the strengths and gifts within the autism presentation. 53 00:04:40,049 --> 00:04:45,309 and also some of the challenges. In this episode, 54 00:04:45,320 --> 00:04:48,559 we're going to focus on the executive function  55 00:04:48,570 --> 00:04:53,600 sub features of working memory, speed, and sequencing. 56 00:04:54,100 --> 00:05:01,769 And I've chosen these abilities to highlight together because we often use them together to accomplish daily tasks. 57 00:05:02,059 --> 00:05:06,010 And I'm hoping that in explaining them and presenting them together, 58 00:05:06,049 --> 00:05:14,709 you'll be able to watch yourself or watch other people in your life to see how these executive function abilities work for them. 59 00:05:16,929 --> 00:05:18,720 Similar to the last episode, 60 00:05:18,730 --> 00:05:22,329 I'm going to walk you through various levels of information. 61 00:05:22,339 --> 00:05:24,940 So stick with me. 62 00:05:24,950 --> 00:05:34,839 First, I want to make a comparison between the center of the brain, which is called the subcortical areas, and a conveyor belt. 63 00:05:35,600 --> 00:05:36,329 You'll, 64 00:05:36,339 --> 00:05:41,320 you've probably heard that the brain has both gray matter and white matter. 65 00:05:42,929 --> 00:05:44,720 The outside of the brain and  66 00:05:45,089 --> 00:05:54,059 certain areas in the center are gray and these gray matter sections are connected by white matter tracts. 67 00:05:55,109 --> 00:06:04,440 The color white comes from the fact that there's a fatty substance called myelin covering these neuron tracks. 68 00:06:04,450 --> 00:06:13,290 And the presence of the fatty covering allows the nerve signals to travel faster than without that covering. 69 00:06:13,399 --> 00:06:19,579 So the center of the brain impacts speed of thinking and processing. 70 00:06:20,540 --> 00:06:23,829 So in conditions like multiple sclerosis, 71 00:06:23,839 --> 00:06:24,989 for example, 72 00:06:25,000 --> 00:06:27,869 where you have demyelinating, 73 00:06:28,410 --> 00:06:31,989 that is the white matter starts to degrade, 74 00:06:32,000 --> 00:06:37,029 one of the features can be a slowing of processing. 75 00:06:39,200 --> 00:06:51,100 So the first point is that speed is a function of the subcortical pathways that impact executive function and several autistic characteristics. 76 00:06:51,109 --> 00:06:55,640 So we do want to focus on this subcategory of speed. 77 00:06:57,649 --> 00:07:01,179 Another subcategory is working memory. 78 00:07:02,950 --> 00:07:05,600 What is this part of executive function? 79 00:07:05,869 --> 00:07:06,160 Well, 80 00:07:06,170 --> 00:07:08,880 even though we call it working memory, 81 00:07:09,239 --> 00:07:16,350 a neuropsychologist or a cognitive scientist might say it's actually really more attention than memory 82 00:07:16,829 --> 00:07:30,880 in that it has to do with the amount of information a person can hold within their attention without storing it by really memorizing it for later. 83 00:07:31,700 --> 00:07:35,589 So it usually doesn't end up in permanent memory. 84 00:07:35,929 --> 00:07:40,670 But we're able to hold information our in our attention. 85 00:07:41,549 --> 00:07:54,390 And some people have a really strong working memory and others really struggle with this. And you'll see different estimates probably about how large working memory generally is. 86 00:07:54,779 --> 00:08:02,779 But most times a person can hold about five plus or minus two bits of information in their attention. 87 00:08:03,679 --> 00:08:07,209 This makes sense because if you were 89 00:08:07,769 --> 00:08:12,690 using phones in the old days where we didn't have cell phones and 90 00:08:12,700 --> 00:08:14,670 phone numbers in our phone ... 91 00:08:14,970 --> 00:08:20,799 a lot of times someone would tell us their phone number or we'd look at it in a phone book and we'd have to 93 00:08:21,149 --> 00:08:26,350 kind of rehearse it in our working memory while we dialed. 94 00:08:26,359 --> 00:08:31,489 So we held seven digits ... in those days... 95 00:08:32,190 --> 00:08:38,090 in our mind while we pushed in the information to the phone. 96 00:08:40,789 --> 00:08:43,140 So let me give another illustration. 97 00:08:43,299 --> 00:08:45,469 Working memory is what we use, 98 00:08:45,479 --> 00:08:46,309 for example, 99 00:08:46,320 --> 00:08:48,609 if we hear an instruction with ... 100 00:08:48,619 --> 00:08:52,099 let's say three parts to it and we go to carry it out. 101 00:08:52,559 --> 00:08:57,010 Our boss may ask us to print the schedule for the day, 102 00:08:57,250 --> 00:09:01,809 put a copy on her desk, and check the phone messages from overnight. 103 00:09:02,929 --> 00:09:07,559 So we have to keep these tasks in mind while doing them. 104 00:09:07,570 --> 00:09:11,359 We have to hold them in our mind. 105 00:09:11,500 --> 00:09:15,849 And although we may recall the sequence of requests later in the day, 106 00:09:15,859 --> 00:09:22,320 we're unlikely to remember them in a month or a year because we haven't memorized them. 107 00:09:23,299 --> 00:09:25,190 But while we're carrying them out. 108 00:09:25,200 --> 00:09:31,179 We may be able to keep them in mind because they're in our working memory. 109 00:09:31,450 --> 00:09:37,469 So the term working means that we keep things in mind while we're using them. 110 00:09:37,479 --> 00:09:44,950 I'm using this information of what the three tasks are while I'm accomplishing the tasks. 111 00:09:46,280 --> 00:09:50,619 Working memory is what we use when we walk into a room for something. 112 00:09:50,900 --> 00:09:55,950 And then sometimes if the information has left our working memory, 113 00:09:55,960 --> 00:09:58,270 we feel frustrated that oh, 114 00:09:58,280 --> 00:10:01,869 I walked into a room to get something and now it's gone. 115 00:10:02,109 --> 00:10:05,489 That's something that has slipped through our working memory. 116 00:10:07,250 --> 00:10:08,229 Similarly, 117 00:10:08,239 --> 00:10:09,299 we may say, 118 00:10:09,309 --> 00:10:09,340 oh, 119 00:10:09,349 --> 00:10:10,219 shoot, 120 00:10:10,229 --> 00:10:12,599 I was going to say something or ask something, 121 00:10:12,609 --> 00:10:14,000 but I forgot what it was. 122 00:10:14,859 --> 00:10:21,489 We were keeping it in our mind while the other person finished their sentence. 123 00:10:21,500 --> 00:10:24,179 But then by the time they were finished, 124 00:10:24,229 --> 00:10:27,229 our thought had slipped through our working memory. 125 00:10:27,239 --> 00:10:30,789 It wasn't held the way that we wanted it to be. 126 00:10:30,799 --> 00:10:36,770 And so we were unable to bring it back when the person, 128 00:10:37,960 --> 00:10:39,789 signaled that it was our turn. 129 00:10:42,080 --> 00:10:51,950 So to summarize our abilities within executive function stem anatomically from the center and the front part of the brain pathways, 130 00:10:51,960 --> 00:10:55,780 the subcortical pathways that connect with the frontal lobes. 131 00:10:55,789 --> 00:11:01,719 And these pathways include white matter which impacts how quickly someone can think, 132 00:11:01,729 --> 00:11:03,340 process and respond. 133 00:11:03,900 --> 00:11:08,130 And this part of the brain also impacts working memory, 134 00:11:08,140 --> 00:11:14,349 which is our ability to hold information in mind while we work with and use it. 135 00:11:15,409 --> 00:11:26,900 So let's tie these concepts speed and working memory with the conveyor belt image that I mentioned earlier in the talk about the third piece for today, 136 00:11:26,909 --> 00:11:36,059 which is sequencing. A sequence of something is the order in which the things occur or they're arranged. 137 00:11:36,270 --> 00:11:41,020 And when we listened to our boss ask us to do three things, 138 00:11:41,030 --> 00:11:44,210 she presented them in a certain sequence. 139 00:11:44,219 --> 00:11:46,349 And when we listen to someone, 140 00:11:46,789 --> 00:11:50,820 the words and their meanings and concepts, 141 00:11:50,830 --> 00:12:00,309 these come toward our ears and into our brains as sequences of data. Picture that conveyor belt. 142 00:12:00,320 --> 00:12:01,109 Now, 143 00:12:01,440 --> 00:12:07,289 a conveyor belt is a surface that moves and it brings items to you. 144 00:12:07,809 --> 00:12:15,039 A person in a factory may work with items coming toward them on a moving surface. 145 00:12:15,380 --> 00:12:18,630 Perhaps they're employed to sort the items. 146 00:12:18,710 --> 00:12:19,869 For example, 147 00:12:19,880 --> 00:12:23,859 here come green and red candies. 148 00:12:23,869 --> 00:12:40,484 And I'm employed to take the green candies coming toward me and put them in the green box and to take the red candies and put them in the red box. Or maybe someone's employed to assemble something. As the item comes toward you, 149 00:12:40,494 --> 00:12:42,385 you add this piece, 150 00:12:42,395 --> 00:12:50,575 then you place it back on the moving belt and the next person will add the next piece and so forth. 151 00:12:50,585 --> 00:12:54,804 So items come to you in a sequence, 152 00:12:54,815 --> 00:12:57,205 one item after another, 153 00:12:57,215 --> 00:12:58,445 after another, 154 00:13:00,450 --> 00:13:09,960 the items also come with a particular speed on this moving surface and it can be increased .. like wow, 155 00:13:09,969 --> 00:13:14,260 the items are really coming quickly now... or slowed down. 156 00:13:15,520 --> 00:13:21,830 You can see that if the speed is set for a pace that most people can keep up with, 157 00:13:21,840 --> 00:13:24,900 there will be success in completing the task. 158 00:13:25,250 --> 00:13:31,169 But maybe there would even be a pace that would be too slow for the workers. 159 00:13:31,390 --> 00:13:32,489 For example, 160 00:13:32,500 --> 00:13:34,349 a worker might get bored. 161 00:13:34,539 --> 00:13:37,330 If the items aren't coming fast enough. 162 00:13:38,270 --> 00:13:42,039 a bored worker might have distraction and restlessness. 163 00:13:42,049 --> 00:13:42,059 Oh, 164 00:13:42,070 --> 00:13:42,969 my gosh. 165 00:13:42,979 --> 00:13:44,510 This is so slow. 166 00:13:45,080 --> 00:13:47,090 If the pace were too fast, 167 00:13:47,099 --> 00:13:50,770 the worker wouldn't be able to use all the items coming toward them. 168 00:13:50,780 --> 00:13:52,400 Things would get past them, 169 00:13:52,440 --> 00:13:59,609 things would get missed and only a portion of the items could be manipulated and used for that task. 170 00:14:00,659 --> 00:14:07,349 So the speed and the number of items coming at us needs to be at a just right spot. 171 00:14:08,780 --> 00:14:12,729 My favorite image for this is a classic, 172 00:14:12,739 --> 00:14:26,489 I love Lucy clip from the Chocolate Factory television episode. This episode aired in 1952 and it's considered one of the funniest of the whole comedy series. 173 00:14:26,760 --> 00:14:38,130 I've linked a clip of the Chocolate Factory scene with the conveyor belt in the show notes for those of you who would like to view it or who haven't seen it. 174 00:14:38,140 --> 00:14:51,250 It's a great demonstration of what can go wrong if the speed of the moving belt is too slow or too fast or if too many items are being sequenced on the conveyor belt at once. 175 00:14:54,169 --> 00:14:57,700 Now let's get back to the conveyor belt in our minds. 176 00:14:57,710 --> 00:15:03,270 So if my boss is giving me instructions with multiple details or steps, 177 00:15:03,739 --> 00:15:17,219 it is as if the words or chunks of information are coming toward me from her voice into my mind ... just like the little pieces of chocolate on the conveyor belt 178 00:15:17,229 --> 00:15:18,849 in the comedy clip. 179 00:15:19,080 --> 00:15:24,369 The speed of the conveyor belt is how quickly she's speaking. 180 00:15:24,780 --> 00:15:31,669 And my perception of the speed is impacted by how quickly my brain can process and keep up. 181 00:15:31,700 --> 00:15:35,340 If my brain's conveyor belt is slower. 182 00:15:35,349 --> 00:15:37,200 If I have slower information 183 00:15:37,210 --> 00:15:44,609 processing, the speed that she's giving me information for the conveyor belt may be overwhelming to me. 184 00:15:45,400 --> 00:15:48,559 Or if I have really fast processing, 185 00:15:48,750 --> 00:15:56,630 I may get really bored and distracted while she's talking because there's just not enough that's new coming toward me. 186 00:15:58,960 --> 00:16:01,130 Let's take another example, 187 00:16:01,229 --> 00:16:04,549 this one involving a student in a class. 188 00:16:04,630 --> 00:16:08,919 So a teacher is presenting information to the class. 189 00:16:08,950 --> 00:16:18,429 The student is required to receive the bits of information at the speed they're presenting as if in the conveyor belt analogy. 190 00:16:18,440 --> 00:16:20,369 And here comes new information. 191 00:16:20,380 --> 00:16:34,260 Then the student must hold the information in mind while deciding what parts to write in their notebook or to type in their laptop. 192 00:16:34,429 --> 00:16:38,099 All of this must be done while the teacher is still speaking. 193 00:16:38,489 --> 00:16:40,849 And this is all executive function. 194 00:16:40,859 --> 00:16:43,630 So we'll touch on this in a different episode, 195 00:16:43,640 --> 00:16:49,349 but the student must use another piece of executive function in this task as well ... 196 00:16:49,409 --> 00:16:50,909 prioritization. 197 00:16:51,440 --> 00:16:57,010 So I'm receiving a lot of information on this conveyor belt from the teacher. 198 00:16:57,020 --> 00:17:08,349 But what information is important for my notes and what is not important. To what do I give priority when there's a lot on the conveyor belt. 199 00:17:08,729 --> 00:17:09,668 For example, 200 00:17:09,678 --> 00:17:13,348 it's not necessary to write down every word 201 00:17:13,359 --> 00:17:16,668 the teacher is saying. What the efficient, 202 00:17:16,678 --> 00:17:22,529 just-right thing to do would be to pick out these most important things, 203 00:17:22,538 --> 00:17:23,409 these themes, 204 00:17:23,418 --> 00:17:25,529 these categories, definitions, 205 00:17:25,538 --> 00:17:26,188 dates, 206 00:17:26,239 --> 00:17:30,308 these are the things we need to jot down in our notes. 207 00:17:30,359 --> 00:17:35,668 And our executive function is what helps us with this whole process. 208 00:17:36,069 --> 00:17:36,520 Now, 209 00:17:36,530 --> 00:17:38,319 if it's working well, 210 00:17:38,449 --> 00:17:40,900 the student just does this automatically. 211 00:17:42,060 --> 00:17:45,949 If things are hard in that area of executive function, 212 00:17:46,329 --> 00:17:48,099 the person may feel like, 213 00:17:48,109 --> 00:17:48,540 gosh, 214 00:17:48,550 --> 00:17:48,560 I, 215 00:17:48,569 --> 00:17:49,760 I cannot, 216 00:17:50,729 --> 00:17:51,140 you know... 217 00:17:51,150 --> 00:17:53,500 note taking is very difficult for me. 218 00:17:53,510 --> 00:17:55,229 I just can't keep up. 219 00:17:55,239 --> 00:18:07,400 I can't keep the things in my mind while I'm writing because I either lose them because the teacher is still speaking or I lose what the teacher is now saying. 220 00:18:07,680 --> 00:18:15,839 So it either is something that happens smoothly and automatically or it really becomes a very difficult thing. 221 00:18:17,900 --> 00:18:20,290 Let me give you a social example. 222 00:18:20,579 --> 00:18:27,829 Imagine a person at a social event where a group of people are speaking about a funny experience. 223 00:18:28,300 --> 00:18:35,770 An individual in the group will need to be taking in what multiple people are saying... 224 00:18:35,890 --> 00:18:44,390 So there are multiple conveyor belts and speeds all while holding parts of the conversation in mind. 225 00:18:45,390 --> 00:18:59,500 And this person also then has to think about what they might say or contribute to the conversation and how to time what they're going to contribute and still keep up with the speed of the exchange. 226 00:19:01,930 --> 00:19:11,260 This example also involves those executive function abilities of working memory and speed and sequencing. 227 00:19:13,219 --> 00:19:15,989 Let me give you a life activity example, 228 00:19:16,770 --> 00:19:25,459 driving is a good example of a life activity that requires a person to take in multiple streams of information. 229 00:19:25,469 --> 00:19:26,040 In this case 230 00:19:26,050 --> 00:19:29,300 visual ... at varying speeds. 231 00:19:29,579 --> 00:19:36,520 Oh, this visual information is coming at me as I'm driving through the visual space. 232 00:19:36,920 --> 00:19:59,699 So the individual must first notice incoming visual details, adapt to unpredictable changes in the visual field (like, oh now I have less space in this lane than I did because the car is coming over toward me), and make quick safe decisions about how to respond. 233 00:20:00,310 --> 00:20:06,989 So one individual may feel like this all comes very automatically and at a speed that really works for them, 234 00:20:07,750 --> 00:20:15,699 another individual may feel overwhelmed by the amount of visual information coming at them in such a quick time... 235 00:20:15,839 --> 00:20:21,800 particularly because it's unpredictable and it involves safety issues. 236 00:20:21,810 --> 00:20:26,040 So if I can't keep on top of this visual information, 237 00:20:26,689 --> 00:20:31,400 I really might get in a situation that's really pretty dangerous. 238 00:20:32,479 --> 00:20:37,500 Other people while they're driving may feel concerned because they get bored. 239 00:20:37,729 --> 00:20:51,510 There's just not enough new information in the visual field to keep their mind on the road and they may find their mind wandering in a way that kind of makes them nervous and and leads them feeling like... 240 00:20:51,810 --> 00:20:54,469 they just can't focus very well while they're driving. 241 00:20:56,550 --> 00:21:00,859 What is often the case is that for many on the autism spectrum, 242 00:21:01,079 --> 00:21:18,439 they'll take longer to adjust to driving than their non autistic peers ... most often because they feel like things are really happening quickly and they can feel overwhelmed by the amount the speed and the unpredictability of information on that conveyor belt. 243 00:21:20,229 --> 00:21:22,069 So going back to our episode, 244 00:21:22,079 --> 00:21:25,569 topics of speed, working memory, and sequencing, 245 00:21:25,810 --> 00:21:31,199 we've reviewed that an individual must adapt to the speed of incoming information, 246 00:21:32,060 --> 00:21:35,949 then sequence through the items coming toward them. 247 00:21:36,479 --> 00:21:46,319 Hold enough of the information in mind that is important while then doing something with or responding to the information. 248 00:21:47,660 --> 00:21:57,680 And this is all part of the subcortical frontal pathways of the brain and the ability that globally we call executive function. 249 00:21:59,540 --> 00:22:00,479 So far, 250 00:22:00,489 --> 00:22:05,479 we've emphasized information coming toward us on the conveyor belt. 251 00:22:05,489 --> 00:22:15,589 But we can also think of executive function abilities for the information that we send out on conveyor belts to other people or to the environment. 252 00:22:16,900 --> 00:22:18,229 For example, 253 00:22:18,239 --> 00:22:25,199 how quickly do we produce a product or a response to questions from others? 254 00:22:26,219 --> 00:22:29,920 One person may be quick and efficient with tasks, 255 00:22:30,150 --> 00:22:37,920 but maybe they make a few errors on the way. Another person may finish the task more slowly,  256 00:22:37,930 --> 00:22:39,099 but to them, 257 00:22:39,109 --> 00:22:43,699 accuracy is really important and they notice a lot of detail. 258 00:22:45,390 --> 00:22:51,369 Neither of these executive function styles is inherently better than the other 259 00:22:51,380 --> 00:22:52,390 all the time. 260 00:22:52,630 --> 00:23:01,430 But the person whose executive function is more methodical and detail oriented in producing output may struggle in a job where the boss says, 261 00:23:01,439 --> 00:23:02,089 hey, 262 00:23:02,150 --> 00:23:05,020 the priority on this project is speed. 263 00:23:05,030 --> 00:23:08,130 I need this quickly. And vice versa. 264 00:23:08,140 --> 00:23:17,930 The individual who works quickly and decisively may really struggle at jobs where the smallest detail can make or break a project. 265 00:23:19,800 --> 00:23:27,930 Individuals who make decisions more slowly may show resistance when pressed for an answer or an action. 266 00:23:29,319 --> 00:23:37,910 Other people may almost feel this psychological opposition when they try to encourage the person to decide or to move on. 267 00:23:39,000 --> 00:23:40,500 Let's take an action. 268 00:23:40,510 --> 00:23:42,359 Let's stop thinking about it. 269 00:23:43,430 --> 00:23:52,579 One example could be adult children trying to press their dad to get his roof fixed. If he has executive function 270 00:23:52,589 --> 00:23:56,030 that's significant for being very slow, 271 00:23:56,040 --> 00:23:57,530 methodical... 272 00:23:57,680 --> 00:24:04,130 He may forever be saying things like "I'll think about that" or "I'll know when the time is right," 273 00:24:04,400 --> 00:24:07,439 but there's never any real movement toward action. 274 00:24:07,449 --> 00:24:09,099 There's this stickiness, 275 00:24:09,109 --> 00:24:15,680 the conveyor belt toward decisiveness kind of gets stuck. Again,  276 00:24:15,689 --> 00:24:19,260 this approach to action is not right or wrong, 277 00:24:19,270 --> 00:24:25,800 but it's about whether it works for him in certain instances and against him and others. 278 00:24:26,030 --> 00:24:28,219 And when the roof is falling in, 279 00:24:28,229 --> 00:24:31,219 it's really likely working against him. 280 00:24:32,000 --> 00:24:43,489 Another factor that impacts whether something helps a situation or not is how extreme or inflexible the executive function reaction is in that situation. 281 00:24:44,079 --> 00:24:45,949 So for example, 282 00:24:46,239 --> 00:24:51,810  if we have this situation with the dad and his roof... 284 00:24:51,839 --> 00:25:00,250 a really extreme slow and resistant response to the need for action in that circumstance... 285 00:25:00,260 --> 00:25:00,540 well, 286 00:25:00,550 --> 00:25:01,880 that's creating safety, 287 00:25:01,890 --> 00:25:02,530 health, 288 00:25:02,540 --> 00:25:05,930 financial issues ... that it really could hurt the person. 289 00:25:07,520 --> 00:25:08,349 Ideally, 290 00:25:08,359 --> 00:25:13,770 our brain is supposed to help us have the just right amount of speed, 291 00:25:14,359 --> 00:25:14,650 (you know, 292 00:25:14,660 --> 00:25:16,300 not too quickly, 293 00:25:16,310 --> 00:25:19,439 not too slowly) and sequencing. 294 00:25:19,790 --> 00:25:27,349 I see details that are important but I can let other things go so that I can get to the best outcome. 295 00:25:27,770 --> 00:25:30,199 And when it's important to, you 296 00:25:30,209 --> 00:25:33,510 can adjust to the situation itself. 297 00:25:33,520 --> 00:25:33,900 Wow, 298 00:25:33,910 --> 00:25:37,540 I didn't expect this situation but I can adjust to that. 299 00:25:39,459 --> 00:25:48,989 But sometimes the struggle that a person is having is really that it's hard to get to that just right spot for ... for anything, 300 00:25:49,000 --> 00:25:51,880 whether it's speed or executive function or, 301 00:25:51,890 --> 00:26:00,180 or anything else in life ... rather than sometimes swinging to that too much extreme. 302 00:26:02,329 --> 00:26:13,569 One more example of the sequencing of output could be seen when multiple smaller actions are needed to complete a larger task. 303 00:26:14,099 --> 00:26:20,699 So a classic example of this would be the parental request that their child clean his room. 304 00:26:21,680 --> 00:26:32,449 So the child has to think through all of the pieces of action that will need to be engaged with in order to get this finished product. 305 00:26:32,849 --> 00:26:37,989 It's almost like saying what are all the pieces I need to put on this conveyor belt, 306 00:26:38,020 --> 00:26:46,030 all the pieces that I need to to bring together for the whole action of having a clean room or the whole outcome. 307 00:26:47,310 --> 00:26:48,500 There's a first step, 308 00:26:48,510 --> 00:26:49,400 a second step, 309 00:26:49,410 --> 00:27:01,109 a third step ... all on the conveyor belt until a finished product is reached. Some ways in which this executive function task can get stuck would include... 310 00:27:01,400 --> 00:27:01,930 "Wow, 311 00:27:01,939 --> 00:27:06,599 there are so many actions or pieces to the task. 312 00:27:07,040 --> 00:27:10,829  I just don't know where to start. 313 00:27:11,949 --> 00:27:12,930 I'm stuck. 314 00:27:12,939 --> 00:27:16,599 I'm overwhelmed by the amount of possibility. 315 00:27:16,880 --> 00:27:23,709 I can't get my direction to navigate the task even though I could do all of these little pieces, 316 00:27:23,760 --> 00:27:25,310 where should I start?" 317 00:27:25,930 --> 00:27:28,400 And this is often the situation. 318 00:27:29,089 --> 00:27:31,959 And the parent may say, 319 00:27:31,969 --> 00:27:32,170 "Hey, 320 00:27:32,180 --> 00:27:33,369 start wherever you want, 321 00:27:33,380 --> 00:27:34,449 it doesn't matter." 322 00:27:35,349 --> 00:27:41,739 But that's not likely to help the child who actually needs someone to sequence the task with them. 323 00:27:42,089 --> 00:27:43,810 Tell me where to start. 324 00:27:43,829 --> 00:27:46,319 How can I get going with this task? 325 00:27:46,709 --> 00:27:49,630 And then after I do the task, 326 00:27:50,239 --> 00:27:51,619 ... the first task, 328 00:27:51,849 --> 00:27:53,739 what's the second task I should do? 329 00:27:53,750 --> 00:27:59,199 How should I string things along without getting overwhelmed or stuck or lost? 330 00:28:00,739 --> 00:28:11,000 The child knows how to do each little part of the task but doesn't have the sequencing ability to navigate this larger task without assistance. 331 00:28:11,010 --> 00:28:22,510 And so the parent who realizes this might take a picture representing each smaller task ... like a photo of clothes in the laundry basket, 332 00:28:23,010 --> 00:28:25,750 a photo of books on the bookshelf, 333 00:28:25,760 --> 00:28:34,650 a photo of the bed made ... whatever the five or seven steps to having a clean room might be. 334 00:28:34,920 --> 00:28:39,849 You can put these photos up in a place where the child can see them. 335 00:28:41,369 --> 00:28:45,739 The child then can look at the photos independently and see... 336 00:28:45,750 --> 00:28:50,199 Oh the first photo is clothes in the the clothes hamper. 337 00:28:50,209 --> 00:28:56,800 So I'm gonna do that first...  and sometimes the child likes to take the photo down when the task is done. 338 00:28:57,099 --> 00:28:58,959 And so "I know that's done." 339 00:29:01,010 --> 00:29:10,609 That's just one way to help teach an executive function skill for someone who is overwhelmed and trying to do that independently. 340 00:29:13,040 --> 00:29:21,750 Knowing that the full anatomical maturity of executive function isn't complete until the age of 20 or 21 or so. 341 00:29:21,959 --> 00:29:29,050 The parent realizes that part of their role is to help the child learn strategies for approaching tasks 342 00:29:29,060 --> 00:29:37,170 requiring executive function ... and to assist in areas where the child is still really developing that ability. 343 00:29:38,719 --> 00:29:39,479 Additionally, 344 00:29:39,489 --> 00:29:42,089 as we noted in the previous episode, 345 00:29:42,170 --> 00:29:47,069 everyone will have individual strengths and struggles in executive function. 346 00:29:47,880 --> 00:29:52,810 If this is a child who grows up and continues to have a weakness 347 00:29:52,819 --> 00:29:56,369 organizing a sequence to complete a task, 348 00:29:56,410 --> 00:30:02,300 they can really benefit from a strategy approach to give their brain some assistance. 349 00:30:02,780 --> 00:30:04,729 So their strategy might be... 350 00:30:04,739 --> 00:30:09,880 What if I think about this task as seven smaller tasks? 351 00:30:09,890 --> 00:30:10,979 What would those be? 352 00:30:12,170 --> 00:30:24,239 I would invite you to notice tasks in your everyday life that are easy or difficult for you and consider if they have executive function components like speed, 353 00:30:24,349 --> 00:30:26,500 working memory, or sequencing. 354 00:30:27,219 --> 00:30:29,000 Notice what's easy for you, 355 00:30:29,010 --> 00:30:31,890 what's difficult for you in these situations. 356 00:30:32,449 --> 00:30:40,930 This increased self-awareness can be a first step toward getting the best outcome in a variety of situations. 357 00:30:41,349 --> 00:30:48,170 You may realize "my nervous system default is to process information slowly. 358 00:30:48,719 --> 00:30:54,170 But this new job that I have requires speed in these areas. 359 00:30:54,380 --> 00:30:56,650 And how can I get a better outcome?" 360 00:30:57,750 --> 00:30:58,130 Well, 361 00:30:58,140 --> 00:31:03,170 the basic neurology of speed that your nervous system is set toward, 362 00:31:03,410 --> 00:31:03,890 you know, 363 00:31:03,900 --> 00:31:06,890 you may not be able to adjust that piece. 364 00:31:06,959 --> 00:31:16,819 But perhaps you could focus on strategies to reduce anything that would take away from the speed you're capable of neurologically. 365 00:31:17,160 --> 00:31:20,589 So perhaps you want to reduce distractions, 366 00:31:20,920 --> 00:31:32,089 maybe ask someone for input about what the most important thing to focus on is and really make sure that you're accountable to someone who can see the big picture a little better. 367 00:31:33,599 --> 00:31:36,140 As I noted in the previous episode, 368 00:31:36,189 --> 00:31:43,150 I like the book series Smart but Scattered when it comes to strategies for executive function, 369 00:31:43,160 --> 00:31:47,949 but you can choose whatever resources best fit your needs. 370 00:31:48,119 --> 00:31:52,010 And if you want to dive into more about executive function, 371 00:31:52,170 --> 00:31:58,609 learn about more strategies for success in areas that are causing you difficulty... by all means, 372 00:31:58,619 --> 00:32:01,969 reach out and find things that work well for you. 373 00:32:04,079 --> 00:32:08,390 I wanna thank you for joining me to learn about the executive function 374 00:32:08,400 --> 00:32:12,560 sub features of speed, sequencing, and working memory. 375 00:32:12,849 --> 00:32:21,650 And I hope it increases your understanding of what makes you tick. We'll be continuing our series on executive function next time. 376 00:32:21,660 --> 00:32:24,810 So I invite you to join me for that third episode.

19. Executive Function Series: EF, ADHD, and Autism (E 55)30.07.2023 (00:38:56)

    Do you understand what Executive Function (EF) refers to and why it is important? If you have EF difficulties, have you been diagnosed with ADHD? Do you wonder if you have a diagnosis of autism or if you should have a dual diagnosis of autism and ADHD? Dr. Regan breaks down the concepts and shares about the relationship between EF, ADHD, and autism.    Executive Function Book Series by Dawson and Guare: Smart But Scattered (children's version) Smart But Scattered (Teen version) Smart But Scattered (adult version)   Dr. Regan's Master Class for Clinicians: Zur Institute: Master Class   Dr. Regan's Resources Book: Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians   Read the transcript:   1 00:00:07,670 --> 00:00:08,560 Hi there. 2 00:00:08,569 --> 00:00:13,960 This is Doctor Regan joining you for an episode of Autism in the Adult podcast. 3 00:00:14,850 --> 00:00:16,670 I'm a neuropsychologist, 4 00:00:16,680 --> 00:00:24,350 the founder and director of an autism diagnostic clinic in Central Illinois and the parent of a teen on the spectrum. 5 00:00:25,180 --> 00:00:25,899 Today, 6 00:00:25,909 --> 00:00:31,610 you are joining me for the first episode in a new series about executive function. 7 00:00:31,989 --> 00:00:36,509 And I'm really excited for the series since announcing the topic. 8 00:00:36,520 --> 00:00:38,509 At the end of our last episode, 9 00:00:38,520 --> 00:00:45,709 I've received lots of emails from interested listeners before we dive into today's episode. 10 00:00:45,720 --> 00:00:45,990 Though, 11 00:00:46,000 --> 00:00:50,490 I wanna give a shout out to the clinicians and professionals who may be listening. 12 00:00:50,799 --> 00:01:00,610 I'm currently developing a master class with the continuing education platform called Zur Institute. 13 00:01:01,020 --> 00:01:04,010 This offering is unique for several reasons. 14 00:01:04,019 --> 00:01:05,449 One is the format, 15 00:01:06,050 --> 00:01:09,550 there will be four 2-hour webinars, 16 00:01:09,559 --> 00:01:11,949 one in each of September, 17 00:01:12,209 --> 00:01:13,099 October, 18 00:01:13,110 --> 00:01:16,180 November and December of 2023. 19 00:01:16,809 --> 00:01:23,629 And the first hour will be education while the second full hour will be reserved for discussion, 20 00:01:23,639 --> 00:01:32,519 question and answer and interaction with you about clinical questions and practice issues related to the topic for that day. 21 00:01:32,889 --> 00:01:44,419 Another unique feature of this offering will be the focus on advanced topics. So click on the link in the show notes to read more about the topics and how to sign up. 22 00:01:45,330 --> 00:01:49,569 If you are a clinician wanting beginner or intermediate courses, 23 00:01:49,599 --> 00:01:54,440 check out my other offerings on Zur or at my website, 24 00:01:54,449 --> 00:01:57,819 which is also linked through the show notes. 25 00:01:58,440 --> 00:01:59,040 All right, 26 00:01:59,050 --> 00:02:01,580 let's talk about executive function. 27 00:02:02,449 --> 00:02:07,800 I'll warn you that today's episode will require some executive function to get through. 28 00:02:08,350 --> 00:02:14,740 And I've spent a lot of time trying to make sure that I'm linking all of the themes together. 29 00:02:15,179 --> 00:02:16,649 So with that in mind, 30 00:02:16,800 --> 00:02:22,440 I want to start off with just a general definition of executive function. 31 00:02:24,440 --> 00:02:26,500 Later in our talks, 32 00:02:26,509 --> 00:02:34,229 we will cover a more precise and descriptive definition including sub elements and what we might call those. 33 00:02:35,020 --> 00:02:45,990 So executive function refers to a set of brain based abilities related to the functioning of the pathways connecting the center and the front of the brain. 34 00:02:46,679 --> 00:02:48,710 And the reason for the name, 35 00:02:48,720 --> 00:02:59,850 executive functioning is that executive is defined as having the power to put plans and actions into effect. 36 00:03:00,860 --> 00:03:04,710 So a CEO for example, 37 00:03:05,240 --> 00:03:14,669 is the chief executive officer of a business company and is in charge of directing the tiers of the company, 38 00:03:14,679 --> 00:03:16,250 the regional officers, 39 00:03:16,259 --> 00:03:17,059 managers, 40 00:03:17,070 --> 00:03:18,270 direct workers, 41 00:03:18,490 --> 00:03:24,440 directing all the pieces to work together toward the same goal. 42 00:03:24,970 --> 00:03:33,339 So these pathways of the brain help the parts of the brain work together to achieve a goal. 43 00:03:34,259 --> 00:03:38,360 Another image that I like is the symphony conductor, 44 00:03:38,899 --> 00:03:42,190 directing all the instruments in the orchestra, 45 00:03:42,199 --> 00:03:46,130 even if all the instruments are performing perfectly, 46 00:03:46,240 --> 00:03:48,300 if there's no conductor, 47 00:03:48,679 --> 00:03:56,179 there's no unified sound with melody and movement and this synchrony of sound. 48 00:03:56,399 --> 00:04:04,309 So the sounds don't come together to create a moving and meaningful piece of music without the conductor. 49 00:04:05,039 --> 00:04:09,100 So executive function is like the symphony conductor, 50 00:04:09,490 --> 00:04:14,199 it should bring all of the working parts of the brain together to perform. 51 00:04:14,210 --> 00:04:17,049 So that something meaningful happens. 52 00:04:18,998 --> 00:04:19,688 As I said, 53 00:04:19,699 --> 00:04:22,848 executive function is a set of brain skills, 54 00:04:22,859 --> 00:04:24,408 it's not one skill. 55 00:04:25,160 --> 00:04:29,929 And as we understand what the center of the brain, 56 00:04:30,109 --> 00:04:37,130 the subcortical areas of the brain and the connections through the center with the front of the brain, 57 00:04:37,140 --> 00:04:38,350 the frontal lobes. 58 00:04:38,809 --> 00:04:42,209 When we understand what these areas are in charge of, 59 00:04:42,220 --> 00:04:46,820 we refer to those set of abilities as executive function. 60 00:04:46,829 --> 00:04:53,149 So these executive function abilities hang together anatomically in the brain. 61 00:04:53,540 --> 00:04:56,640 So through that subcortical frontal system, 62 00:04:57,339 --> 00:05:04,059 so the number one point is that executive function refers to a series of skills, 63 00:05:04,070 --> 00:05:05,519 not one skill. 64 00:05:05,850 --> 00:05:10,190 And these skills are linked with anatomy, 65 00:05:10,200 --> 00:05:13,290 with the subcortical frontal systems of the brain. 66 00:05:13,609 --> 00:05:21,279 And the skills help the brain produce a meaningful synchronous um behavior or, 67 00:05:21,290 --> 00:05:22,489 or product. 68 00:05:24,070 --> 00:05:24,470 Now, 69 00:05:24,480 --> 00:05:32,950 let's talk about the diagnosis of AD D and A DH D and just for simplicity's sake, 70 00:05:32,959 --> 00:05:33,920 from now on, 71 00:05:33,929 --> 00:05:39,920 I'll really just refer to these as AD D but I'm referring to both diagnoses. 72 00:05:41,269 --> 00:05:45,839 This diagnosis was introduced in the diagnostic manual, 73 00:05:45,850 --> 00:05:57,970 the DSM - III in 1980 it was important because it described a developmental neurologic condition of executive function. 74 00:05:58,950 --> 00:06:02,820 So executive function was not a new concept, 75 00:06:02,989 --> 00:06:10,739 but the diagnosis of ADD was the one that captured this developmental piece. 76 00:06:11,190 --> 00:06:22,299 So here we have a diagnosis then that we can use to describe a difficulty that an individual has based on their developmental wiring. 77 00:06:22,309 --> 00:06:26,200 The way that the brain system has developed, 78 00:06:26,239 --> 00:06:38,600 the way they're wired in the executive function areas of the brain don't finish their anatomic development until about the age of 20 or 21. 79 00:06:38,980 --> 00:06:39,440 So, 80 00:06:39,450 --> 00:06:40,799 anatomically, 81 00:06:40,989 --> 00:06:45,730 executive function is still developing until about that age. 82 00:06:47,119 --> 00:07:02,500 So the number two point is that ADD was a notable addition to the diagnostic manual in 1980 because it represents a diagnosis for executive function difficulties that are developmental in nature. 83 00:07:04,059 --> 00:07:05,190 Now, 84 00:07:05,399 --> 00:07:19,910 I want to talk about the relationship between executive function and AD D executive function is not specific to ADD or ADHD. 85 00:07:20,690 --> 00:07:23,239 So the difficulties in that domain, 86 00:07:23,540 --> 00:07:26,559 they're not specific to this diagnosis. 87 00:07:26,570 --> 00:07:36,290 We're discussing executive function is one of the most sensitive brain functions to any kind of stress, 88 00:07:36,299 --> 00:07:39,619 whether that is physical or psychological. 89 00:07:40,049 --> 00:07:45,429 One of the first things to show difficulty is going to be executive function. 90 00:07:47,630 --> 00:07:56,119 It's often the first thing to become difficult and the last thing to resolve or heal after some type of challenge. 91 00:07:57,390 --> 00:07:58,829 For example, 92 00:07:59,089 --> 00:08:02,600 if an 80 year old has a bladder infection. 93 00:08:02,609 --> 00:08:11,040 What's probably the most sensitive cognitive function that's going to be disrupted first ... executive function. 94 00:08:11,739 --> 00:08:25,959 And if someone is recovering from a traumatic brain injury and they've gone through rehab and it's two or three months after ... what's probably the residual problem that's still kind of healing up. 95 00:08:25,970 --> 00:08:26,299 Well, 96 00:08:26,309 --> 00:08:28,679 that would be executive function as well. 97 00:08:31,179 --> 00:08:39,059 So there may be developmental differences in executive function and that's what we discuss 98 00:08:39,070 --> 00:08:41,969 when we talk about the diagnosis of ADD, 99 00:08:43,000 --> 00:08:47,960 there can also be acquired differences in executive function. 100 00:08:48,409 --> 00:08:51,690 This would include differences after, 101 00:08:51,700 --> 00:08:52,450 as we said, 102 00:08:52,460 --> 00:08:53,869 a traumatic brain injury, 103 00:08:53,880 --> 00:08:58,830 a stroke, within the context of a dementia... acquired 104 00:08:58,840 --> 00:09:02,070 meaning that this is not developmental. 105 00:09:02,080 --> 00:09:06,469 It's something that has occurred in the course of the life span. 106 00:09:08,809 --> 00:09:10,039 Executive function, 107 00:09:10,049 --> 00:09:15,609 difficulties can occur with acute or chronic medical problems. 108 00:09:15,619 --> 00:09:19,820 So an acute medical issue would be like an infection. 109 00:09:19,830 --> 00:09:20,599 For example, 110 00:09:20,609 --> 00:09:23,340 this is something that comes and then it goes, 111 00:09:23,609 --> 00:09:24,500 it's acute, 112 00:09:24,510 --> 00:09:25,460 it's new, 113 00:09:25,619 --> 00:09:35,299 it kind of can hit kind of hard and then heal up and go. Or executive function can be disrupted due to chronic medical problems. 114 00:09:35,330 --> 00:09:37,510 So someone with kidney failure, 115 00:09:37,520 --> 00:09:38,469 for example, 116 00:09:38,479 --> 00:09:40,090 who's on dialysis, 117 00:09:40,289 --> 00:09:45,484 what's the most likely thing they're going to have some difficulties with in the cognitive domain. 118 00:09:45,585 --> 00:09:45,955 Well, 119 00:09:45,965 --> 00:09:47,765 that would be executive function, 120 00:09:47,914 --> 00:09:52,255 someone with sugar fluctuations in the context of diabetes, 121 00:09:52,284 --> 00:09:56,525 someone with metabolic differences like their sodium is too low. 122 00:09:56,554 --> 00:10:02,385 These can also cause a disruption in someone's executive function system, 123 00:10:04,080 --> 00:10:10,169 even differences in the load that the person is carrying with regard to stress, 124 00:10:10,179 --> 00:10:11,530 emotional pain, 125 00:10:11,539 --> 00:10:12,330 trauma, 126 00:10:12,340 --> 00:10:13,679 lack of sleep, 127 00:10:13,710 --> 00:10:17,429 and even just having too much on our schedule. 128 00:10:17,780 --> 00:10:25,729 These examples of things don't change the anatomy of the brain and how the parts of the brain are working. 129 00:10:25,739 --> 00:10:32,450 But it really does interfere with our access to using our full capacity, 130 00:10:32,460 --> 00:10:37,109 our full anatomic, biologic capacity for executive function. 131 00:10:37,530 --> 00:10:37,880 So, 132 00:10:37,890 --> 00:10:39,359 if we've had trauma, 133 00:10:39,479 --> 00:10:39,830 you know, 134 00:10:39,840 --> 00:10:43,409 our brain may just go offline if we dissociate. 135 00:10:43,659 --> 00:10:50,400 And even though our anatomy is working well to produce this executive function, 136 00:10:50,750 --> 00:10:55,419 we may experience a psychological process that takes us offline. 137 00:10:56,520 --> 00:10:57,299 In addition, 138 00:10:57,309 --> 00:10:59,390 even with normal aging, 139 00:10:59,469 --> 00:11:02,750 what's the first thing to start to show difficulty? 140 00:11:02,830 --> 00:11:03,270 Yes, 141 00:11:03,280 --> 00:11:04,830 it's executive function. 142 00:11:05,200 --> 00:11:08,419 And if you are aging really well, 143 00:11:08,440 --> 00:11:08,900 you're, 144 00:11:08,909 --> 00:11:10,820 you're really aging nicely. 145 00:11:10,900 --> 00:11:13,380 You don't have any additional medical issues, 146 00:11:13,390 --> 00:11:14,719 you haven't had an injury. 147 00:11:15,059 --> 00:11:20,659 The first thing you're gonna start to notice is some problem in the area of executive function. 148 00:11:20,849 --> 00:11:26,770 That's just the aging process and how it impacts that subcortical frontal system. 149 00:11:27,210 --> 00:11:37,190 So you may walk into a room and you can't remember why, or you have this tip of the tongue phenomenon where you know what you wanna say 150 00:11:37,200 --> 00:11:38,549 but you can't get it out. 151 00:11:38,570 --> 00:11:40,049 That's executive function. 152 00:11:40,619 --> 00:11:45,500 You may have to think more slowly or take in less information at a time. 153 00:11:47,140 --> 00:11:53,719 So all individuals are likely to experience executive function difficulty in these contexts. 154 00:11:54,270 --> 00:11:56,609 So consider this comparison, 155 00:11:57,869 --> 00:12:01,799 executive function is similar to fatigue, 156 00:12:01,809 --> 00:12:02,739 for example, 157 00:12:02,750 --> 00:12:10,200 in that it's a nonspecific feature of many different kinds of conditions. 158 00:12:10,849 --> 00:12:12,820 So if someone has fatigue, 159 00:12:13,409 --> 00:12:18,700 there would be hundreds... thousands of conditions that could produce fatigue, 160 00:12:19,020 --> 00:12:22,039 anything from lack of sleep to infection, 161 00:12:22,109 --> 00:12:23,799 autoimmune conditions. 162 00:12:23,809 --> 00:12:25,440 And so many more things. 163 00:12:26,419 --> 00:12:27,340 Similarly, 164 00:12:27,349 --> 00:12:34,140 executive function difficulty can be caused by so so many conditions and situations, 165 00:12:34,150 --> 00:12:34,880 trauma, 166 00:12:34,890 --> 00:12:35,520 aging, 167 00:12:35,530 --> 00:12:36,320 ADD, 168 00:12:36,330 --> 00:12:37,780 autoimmune conditions, 169 00:12:37,789 --> 00:12:39,669 delirium, autism, and many, 170 00:12:39,679 --> 00:12:40,429 many more. 171 00:12:40,799 --> 00:12:49,750 So the third point we've really focused on here so far is that executive function is not specific to ADD. 172 00:12:50,080 --> 00:12:55,119 So many many things can trigger this executive function problem. 173 00:12:57,539 --> 00:12:58,150 Therefore, 174 00:12:58,159 --> 00:13:01,859 if someone presents with executive function difficulty -- 175 00:13:02,200 --> 00:13:05,030 so I'm having a hard time paying attention, 176 00:13:05,039 --> 00:13:07,700 I just can't take in information very well. 177 00:13:07,729 --> 00:13:10,349 I can't organize myself well -- 178 00:13:10,359 --> 00:13:20,570 the clinician should consider differentials in the diagnostic process because so many things can present with those features. 179 00:13:20,840 --> 00:13:24,369 There should be this process of taking into account. 180 00:13:24,630 --> 00:13:26,590 What is this person's age? 181 00:13:26,599 --> 00:13:28,750 What is their recent life experience? 182 00:13:28,760 --> 00:13:30,679 What are their medical issues? 183 00:13:30,690 --> 00:13:33,390 When did the executive function issue start? 184 00:13:34,210 --> 00:13:39,469 But executive function difficulty does not automatically mean ADD. 185 00:13:39,479 --> 00:13:41,549 It does not equal ADD, 186 00:13:41,559 --> 00:13:43,739 it's not equivalent to ADD. 187 00:13:45,469 --> 00:14:00,440 So we would consider a handful of things that could cause executive function problems in this person, and then would perform an evaluation to see what the most likely contributors are in this case. 188 00:14:01,289 --> 00:14:04,830 So let's go over our first three points. 189 00:14:05,109 --> 00:14:09,489 Executive function refers to a series of skills, 190 00:14:09,500 --> 00:14:16,190 not one skill and these skills are linked anatomically within the same pathways -- 191 00:14:16,200 --> 00:14:27,729 these subcortical frontal system pathways -- and they also work together to provide some meaningful and organized output from the brain. 192 00:14:29,229 --> 00:14:47,950 The second point is that ADD was added to the diagnostic manual in 1980 to describe developmental executive function differences, and that was really helpful to have a diagnosis for developmental differences in executive function. 193 00:14:49,669 --> 00:15:00,539 The third point is that executive function is not specific to ADD -- many many things can trigger executive function difficulty. 194 00:15:01,239 --> 00:15:10,909 And so we would never want to hear executive function difficulty and then translate that automatically into ADD. 195 00:15:15,289 --> 00:15:20,659 So we talked about how executive function refers to a series of skills. 196 00:15:21,270 --> 00:15:28,479 There's not a unanimous consensus about what constitutes all these subparts, 197 00:15:28,489 --> 00:15:30,979 how to number them and what to call them. 198 00:15:31,090 --> 00:15:37,080 But many conceptualizations may refer to about 12 to 15 components. 199 00:15:37,090 --> 00:15:38,039 Give or take. 200 00:15:39,330 --> 00:15:44,460 These often include things like organization, sequencing, 201 00:15:44,469 --> 00:15:46,020 processing speed, 202 00:15:46,030 --> 00:15:48,260 prioritizing, planning, 203 00:15:48,270 --> 00:15:49,960 task initiation, 204 00:15:50,070 --> 00:15:52,130 sustained attention, goal 205 00:15:52,140 --> 00:15:53,510 directed persistence, 206 00:15:53,520 --> 00:15:54,859 impulse control, 207 00:15:54,869 --> 00:15:56,099 time management, 208 00:15:56,109 --> 00:15:57,640 generation of ideas, 209 00:15:57,650 --> 00:15:58,739 working memory, 210 00:15:58,750 --> 00:16:01,880 flexibility and emotional regulation. 211 00:16:03,119 --> 00:16:06,030 So it's not important for you to know what those mean. 212 00:16:06,250 --> 00:16:14,309 But I want you to get the sense that there are these multiple components and we'll look at each of these later in our series. 213 00:16:14,320 --> 00:16:15,559 But for now, 214 00:16:15,570 --> 00:16:16,150 wow, 215 00:16:16,159 --> 00:16:19,669 executive function is a broad category. 216 00:16:22,250 --> 00:16:28,020 ADD, which as we said describes a condition of developmental 217 00:16:28,030 --> 00:16:36,700 executive function difficulty, includes four areas as I would describe them. 218 00:16:36,710 --> 00:16:38,880 So someone may say, 219 00:16:38,890 --> 00:16:38,909 oh, 220 00:16:38,919 --> 00:16:40,869 I think it's more like five. 221 00:16:40,940 --> 00:16:42,520 so it doesn't matter, 222 00:16:42,530 --> 00:16:44,270 but it's a small subset. 223 00:16:44,280 --> 00:16:45,679 We've got attention, 224 00:16:45,909 --> 00:16:47,119 organization, 225 00:16:47,130 --> 00:16:47,940 goal directed 226 00:16:47,950 --> 00:16:50,109 persistence, and impulse control. 227 00:16:51,869 --> 00:17:09,130 The diagnostic criteria for ADD only describe four areas of executive function even though our current understanding is that there are probably more like 12 to 15 components. 228 00:17:10,900 --> 00:17:28,949 So you can see that someone could have significant difficulty with executive function developmentally and not meet the criteria for ADD because these four specific areas included may not be the ones that are causing this problem. 229 00:17:29,290 --> 00:17:31,949 This person's individual difficulty... 230 00:17:33,109 --> 00:17:36,160 I also want you to know that every single person, 231 00:17:37,189 --> 00:17:40,119 regardless of developmental neurology, 232 00:17:40,130 --> 00:17:41,920 health background, 233 00:17:42,130 --> 00:17:46,449 all humans will have a pattern of executive function, 234 00:17:46,630 --> 00:17:48,839 strengths and weaknesses. 235 00:17:49,040 --> 00:17:51,599 That's the normal way of our neurology. 236 00:17:52,329 --> 00:17:56,780 So out of those 12 to 15 subsets of skills, 237 00:17:56,959 --> 00:18:11,640 you can kind of imagine this graph across the all of these different points and sometimes we'll have ups and downs there that can help inform us what we struggle with and what we're really finding easy. 238 00:18:12,449 --> 00:18:18,640 So a person who's really good in the areas of generating ideas and flexibility, 239 00:18:18,650 --> 00:18:21,339 this person might be called creative. 240 00:18:21,349 --> 00:18:22,920 All these ideas, 241 00:18:22,930 --> 00:18:24,140 they're very flexible, 242 00:18:24,150 --> 00:18:25,579 they go from here to there, 243 00:18:25,839 --> 00:18:29,609 but they may struggle with other areas of executive function, 244 00:18:30,040 --> 00:18:31,959 they may be impulsive, 245 00:18:32,000 --> 00:18:35,979 have difficulty with time management, organization... 246 00:18:36,180 --> 00:18:41,780 So everybody has their own pattern with an executive function. 247 00:18:43,069 --> 00:18:45,640 So let's go back here. 248 00:18:45,650 --> 00:18:52,219 We are setting up a discussion of the relationship between executive function and ADD. 249 00:18:52,819 --> 00:19:01,339 And one of the difficulties we currently have is that our understanding of executive function has evolved since 1980. 250 00:19:01,780 --> 00:19:12,500 But we have a diagnosis that covers only a small subset of how we currently conceptualize executive function. 251 00:19:13,349 --> 00:19:25,880 This creates difficulty in that someone may clearly have developmental executive function problems but not fit into the box of the ADD diagnostic criteria. 252 00:19:28,280 --> 00:19:29,010 Now, 253 00:19:29,849 --> 00:19:33,420 let's compare ADD and autism. 254 00:19:35,489 --> 00:19:43,300 Everyone on the autism spectrum will have executive function difficulty in some form or pattern. 255 00:19:45,040 --> 00:19:48,290 That's because of the neurology of autism. 256 00:19:50,880 --> 00:19:57,329 The term executive function is not specifically used in the autism criteria, 257 00:19:57,359 --> 00:20:09,849 but many of the criteria describe behavioral patterns that tap into that neurology and that reflect difficulty in executive function and that subcortical frontal system. 258 00:20:11,849 --> 00:20:21,040 So autism has this executive function component plus many nonexecutive function elements as well. 259 00:20:22,930 --> 00:20:28,709 So ADD is a diagnosis of four or so elements of executive function. 260 00:20:29,219 --> 00:20:37,819 Autism is a diagnosis that includes elements of executive function and elements outside of executive function. 261 00:20:39,469 --> 00:20:52,160 The diagnostic manual indicates that the diagnosis of ADD cannot be made if another diagnosis better accounts for the client's whole presentation. 262 00:20:54,359 --> 00:21:15,699 The diagnostic manual says about autism that ADD can also be in diagnosed along with autism when attentional difficulties or hyperactivity exceeds that typically seen in autism. 263 00:21:19,569 --> 00:21:21,280 So let's regroup. 264 00:21:21,969 --> 00:21:23,310 Executive function, 265 00:21:23,319 --> 00:21:28,189 difficulties occur secondary to so many developmental, 266 00:21:28,199 --> 00:21:30,339 physical and psychological states. 267 00:21:30,859 --> 00:21:39,660 And ADD and autism are two developmental diagnoses that include executive function difficulty. 268 00:21:40,829 --> 00:21:49,989 ADD includes about four elements of the 12 to 15 sub elements of executive function that we generally think of. 269 00:21:50,359 --> 00:22:02,369 And autism includes some pattern of executive function difficulty across elements and also has nonexecutive function 270 00:22:02,680 --> 00:22:04,239 parts to the criteria. 271 00:22:06,560 --> 00:22:18,890 what should happen is that an individual presenting with developmental executive function difficulty would see a clinician who develops an appropriate differential, 272 00:22:19,770 --> 00:22:24,810 that is the person has developmental executive function difficulty, 273 00:22:24,839 --> 00:22:27,569 but that's not specific to ADD. 274 00:22:27,579 --> 00:22:33,810 So let's consider other developmental conditions like autism. 275 00:22:33,819 --> 00:22:40,819 And also let's consider other relevant information like the trauma history, 276 00:22:40,829 --> 00:22:42,640 medical conditions, 277 00:22:42,670 --> 00:22:44,229 intellectual abilities, 278 00:22:44,239 --> 00:22:45,839 learning disabilities, 279 00:22:45,849 --> 00:22:47,810 language processing ability. 280 00:22:48,040 --> 00:22:53,819 And let's figure out what the basis of this executive function problem is. 281 00:22:56,089 --> 00:23:02,239 But what actually happens is that a teacher, doctor, or clinician says, 282 00:23:02,359 --> 00:23:02,979 oh, 283 00:23:02,989 --> 00:23:06,750 this person has developmental executive function difficulty. 284 00:23:07,010 --> 00:23:07,900 Therefore, 285 00:23:07,910 --> 00:23:10,280 we're going to diagnose them with ADD. 286 00:23:11,709 --> 00:23:13,319 Then years later, 287 00:23:13,569 --> 00:23:17,390 they come to see a professional who does an evaluation and says, 288 00:23:17,400 --> 00:23:18,050 well, 289 00:23:18,469 --> 00:23:21,589 this person does have executive function problems, 290 00:23:21,599 --> 00:23:32,270 but the root of their attention problem is that they have an intellectual disability and nobody's ever checked or they can't process language well. 291 00:23:32,280 --> 00:23:33,239 And so of course, 292 00:23:33,250 --> 00:23:42,689 they can't attend in the classroom... or they have a learning disability so they can't attend if they can't understand what they're learning. 293 00:23:44,040 --> 00:23:52,050 Some of these individuals have executive function difficulty because they've been on the autism spectrum all along. 294 00:23:52,060 --> 00:23:56,359 But autism was never included in the differential process. 295 00:23:56,890 --> 00:24:00,250 So they've never been assessed for autism. 296 00:24:01,310 --> 00:24:11,819 It's kind of like hearing that someone has difficulty with fatigue and then assigning a diagnosis of chronic fatigue syndrome without thinking through any differential. 297 00:24:12,660 --> 00:24:12,880 Now, 298 00:24:12,890 --> 00:24:18,630 not everyone with fatigue is best served by a diagnosis of chronic fatigue syndrome. 299 00:24:18,829 --> 00:24:40,849 And not everyone with executive function difficulty is best described by a diagnosis of ADD. ADD should be given if another diagnosis or condition does not more fully explain the full constellation of characteristics. 300 00:24:42,290 --> 00:24:51,180 So even if the individual meets all the criteria for difficulty in those four subs skills, 301 00:24:52,859 --> 00:25:04,869 the diagnosis is not made if this executive function difficulty is better explained by autism or intellectual disability or learning disability, 302 00:25:04,880 --> 00:25:05,550 et cetera. 303 00:25:05,630 --> 00:25:11,089 So the question in the case of ADD diagnosis shouldn't just be, 304 00:25:11,099 --> 00:25:15,319 are the criteria met ... but are the criteria met 305 00:25:15,329 --> 00:25:29,270 and is this the diagnosis that best explains the whole presentation for this student or client or patient? In autism, 306 00:25:29,280 --> 00:25:41,550 executive function difficulties for one individual may include maybe two of those four subs skills that are in our definition of ADD and maybe three other executive function skills. 307 00:25:42,910 --> 00:25:44,500 They still have autism, 308 00:25:44,619 --> 00:25:48,989 they still have executive function difficulty as we would expect. 309 00:25:49,260 --> 00:25:54,510 But perhaps they're less likely to have a pairing of an ADD diagnosis. 310 00:25:56,579 --> 00:26:06,150 Another person on the autism spectrum may have all four of those difficulties in the ADD category and maybe a couple that aren't. 311 00:26:06,500 --> 00:26:12,170 And so they get these two diagnoses autism and ADD. 312 00:26:14,069 --> 00:26:14,900 However, 313 00:26:14,910 --> 00:26:22,260 if the executive function difficulty is not excessive for what we expect to see in autism, 314 00:26:22,640 --> 00:26:24,650 they shouldn't have that diagnosis. 315 00:26:24,660 --> 00:26:25,869 That second one, 316 00:26:26,209 --> 00:26:27,239 it's redundant. 317 00:26:27,250 --> 00:26:28,500 It's repetitive. 318 00:26:29,599 --> 00:26:37,270 So then do we take away the ADD diagnosis once someone has a diagnosis of autism? 319 00:26:37,640 --> 00:26:39,449 And it's not excessive? 320 00:26:39,760 --> 00:26:40,099 Well, 321 00:26:40,109 --> 00:26:40,989 we could, 322 00:26:41,130 --> 00:26:42,829 if we wanted to be precise, 323 00:26:42,839 --> 00:26:47,369 This is really what the manual talks about as making the most sense. 324 00:26:48,699 --> 00:26:49,250 However, 325 00:26:49,260 --> 00:26:50,390 practically speaking, 326 00:26:50,400 --> 00:26:51,790 this gets difficult. 327 00:26:51,800 --> 00:27:02,290 So one reason is that people don't understand the context of this ADD diagnosis and what it means and what it doesn't mean. 328 00:27:03,219 --> 00:27:04,930 And many times after I see a 329 00:27:04,939 --> 00:27:07,349 a client for an autism evaluation, 330 00:27:07,359 --> 00:27:11,079 I'll tell them their diagnosis is autism spectrum disorder. 331 00:27:11,239 --> 00:27:12,719 And then they will ask, 332 00:27:12,729 --> 00:27:15,910 did you also check for ADD I think I have that too. 333 00:27:16,800 --> 00:27:21,949 And so it's a difficult thing to just answer with a couple sentences as you can see. 334 00:27:22,489 --> 00:27:25,150 Do they have executive function difficulty? 335 00:27:25,160 --> 00:27:26,359 Absolutely. 336 00:27:26,719 --> 00:27:36,709 Do they have executive function difficulty that fits into that four subset category that we have as our diagnosis for ADD? Possibly  337 00:27:36,719 --> 00:27:37,790 yes or possibly no. 338 00:27:37,800 --> 00:27:48,400 Depending on the case. And does the executive function difficulty exceed what is generally seen in autism?  Really infrequently. 339 00:27:48,410 --> 00:27:49,260 Honestly, 340 00:27:49,670 --> 00:27:52,079 I have made both diagnoses, 341 00:27:52,089 --> 00:28:00,579 but I don't frequently see the executive function as really standing out higher than you know... 342 00:28:00,589 --> 00:28:02,369 the group of people that I see. 343 00:28:03,780 --> 00:28:04,890 So conceptually, 344 00:28:04,900 --> 00:28:05,640 to me, 345 00:28:05,959 --> 00:28:11,540 it makes no actual sense to talk about autism with and without ADD. 346 00:28:11,979 --> 00:28:12,589 In fact, 347 00:28:12,599 --> 00:28:13,339 at this stage, 348 00:28:13,349 --> 00:28:15,630 in our understanding of the nervous system, 349 00:28:15,949 --> 00:28:27,680 it doesn't make sense to talk about a diagnosis that is ADD that only includes four or so subsets of the executive function skills. 350 00:28:29,040 --> 00:28:36,209 I would propose that it would make more sense to just have a diagnosis that says executive function disorder. 351 00:28:37,050 --> 00:28:45,969 And then you could say comma developmental or comma acquired or perhaps you could list the pattern ... like for this person, 352 00:28:45,979 --> 00:28:48,920 these are the strengths and these are the difficulties. 353 00:28:49,760 --> 00:29:00,569 It would be nice to increase the understanding that saying the diagnosis of autism automatically communicates that there are executive function difficulties present. 354 00:29:02,079 --> 00:29:04,569 That's not really our reality right now though. 355 00:29:05,920 --> 00:29:11,339 So even though that makes the most sense to me as a neuropsychologist, 356 00:29:12,650 --> 00:29:22,829 one of the practical difficulties (aside from people not understanding the terms) is that if we take away the ADD diagnosis for an autistic client, 357 00:29:23,229 --> 00:29:26,390 the individual can't get their attention medication, 358 00:29:26,719 --> 00:29:32,670 even if it has helped their executive function difficulty within the autism spectrum. 359 00:29:33,890 --> 00:29:34,699 Now, 360 00:29:34,709 --> 00:29:41,439 the medication is often not as effective on the spectrum as off the spectrum. 361 00:29:41,619 --> 00:29:44,380 But if someone has been helped by it, 362 00:29:44,500 --> 00:29:47,099 there's no reason to take it away because, 363 00:29:47,390 --> 00:29:47,619 you know, 364 00:29:47,630 --> 00:29:50,670 just because that ADD doesn't entirely fit. 365 00:29:51,239 --> 00:29:54,130 So practically speaking, 366 00:29:54,569 --> 00:30:01,030 they're gonna end up keeping that diagnosis because they understand what it means 367 00:30:01,310 --> 00:30:04,770 snd they don't understand what not having it means. 368 00:30:04,979 --> 00:30:11,170 And also they need medication or benefit from medication that requires that diagnosis. 369 00:30:12,540 --> 00:30:17,469 The other thing that's really a caution that I'd like you to think about... 370 00:30:20,109 --> 00:30:33,630 I really advise a lot of caution when reading things and listening to people speak about ADD and ADHD because we'll start to hear things... 371 00:30:33,640 --> 00:30:34,609 You know, 372 00:30:34,619 --> 00:30:35,489 people will say, 373 00:30:35,500 --> 00:30:35,930 well, 374 00:30:35,939 --> 00:30:38,969 you know what's really common for people with ADD, 375 00:30:39,140 --> 00:30:49,670 it's common that they become hyper focussed or it's common that they have difficulty with social interactions or it's common that they have sensory processing difficulties. 376 00:30:51,680 --> 00:30:52,030 The 377 00:30:52,040 --> 00:31:07,280 the problem with these statements is that the individuals who have received diagnoses of ADD often receive this just because they've had executive function difficulty, 378 00:31:07,900 --> 00:31:11,900 but they haven't had much if any differential assessment. 379 00:31:13,010 --> 00:31:25,439 So we don't know if it's really true that individuals with a pure ADD often have these coexisting features. 380 00:31:26,739 --> 00:31:33,219 Because what makes a lot of sense is that within the ADD population, 381 00:31:33,229 --> 00:31:42,439 there's some subset of it autistic individuals who say I have ADD and I notice that I also have trouble reading social cues. 382 00:31:43,380 --> 00:31:44,109 Well, 383 00:31:44,219 --> 00:31:47,780 the difficulty reading social cues then becomes a 384 00:31:47,790 --> 00:31:51,130 "common feature" associated with ADD. 385 00:31:51,140 --> 00:31:53,239 But we don't know, 386 00:31:53,780 --> 00:31:55,880 does this person have autism? 387 00:31:55,890 --> 00:31:57,150 Have they been assessed? 388 00:31:57,160 --> 00:31:57,520 And, 389 00:31:57,869 --> 00:31:58,770 and if so, 390 00:31:58,780 --> 00:32:08,359 if we get this group of just really pure ADD diagnoses and nothing else explains those features better, 391 00:32:08,650 --> 00:32:12,369 I would love to know what ... kind of... is associated with that. 392 00:32:13,420 --> 00:32:14,670 But at this point, 393 00:32:14,939 --> 00:32:21,119 we really don't know. The research using people diagnosed with ADD... 394 00:32:21,520 --> 00:32:24,770 They don't go through any differential process. 395 00:32:24,780 --> 00:32:25,969 They just look and say, 396 00:32:25,979 --> 00:32:27,739 oh you have a diagnosis, 397 00:32:27,750 --> 00:32:30,670 let's put you in the ADD group and study you. 398 00:32:31,280 --> 00:32:33,890 So you see why this is a huge problem. 399 00:32:34,050 --> 00:32:36,270 It's a very messy group, 400 00:32:36,280 --> 00:32:43,810 a mixed group of people who have executive function problems from childhood. 401 00:32:45,310 --> 00:33:08,609 But it hasn't really been distinguished as to whether other contributors to executive function difficulty may have actually been there rather than just a pure developmental difficulty within these four categories or subtypes/subsets within that executive function definition. 402 00:33:10,469 --> 00:33:15,219 So that was a long meandering explanation, 403 00:33:15,229 --> 00:33:16,660 but really important. 404 00:33:16,670 --> 00:33:19,959 And I'm glad you followed me through those twists and turns. 405 00:33:20,719 --> 00:33:22,780 What do I want you to walk away with? 406 00:33:22,790 --> 00:33:23,760 Let me recap. 407 00:33:23,770 --> 00:33:24,270 Again. 408 00:33:24,750 --> 00:33:28,199 Executive function refers to a series of skills, 409 00:33:28,209 --> 00:33:32,189 not one skill that are linked anatomically, 410 00:33:32,199 --> 00:33:41,599 they hang together in the subcortical frontal systems of the brain and they work together to help us make a cohesive and meaningful product. 411 00:33:42,540 --> 00:33:51,050 ADD was added to the diagnostic manual in 1980 to describe developmental executive function differences. 412 00:33:51,060 --> 00:33:54,630 And that was really a good advancement at the time. 413 00:33:56,219 --> 00:34:01,199 Executive function is not specific to ADD and many, 414 00:34:01,209 --> 00:34:05,250 many things can trigger executive function difficulty. 415 00:34:05,959 --> 00:34:09,209 So we would never want to hear... 416 00:34:09,219 --> 00:34:15,669 executive function difficulty ...and translate that automatically into ADD. 417 00:34:17,688 --> 00:34:25,579 This is where the differential diagnostic process should come in someone presenting with executive function difficulty. 418 00:34:26,089 --> 00:34:27,579 Then we would say, 419 00:34:27,589 --> 00:34:27,878 well, 420 00:34:27,888 --> 00:34:35,039 what conditions that could produce this kind of difficulty may present in the specific student, 421 00:34:35,049 --> 00:34:36,269 client, or patient? 422 00:34:36,519 --> 00:34:40,648 And what would be most likely do they have a medical condition? 423 00:34:40,849 --> 00:34:43,638 Has someone looked for an intellectual disability, 424 00:34:43,648 --> 00:34:45,358 auditory processing problems, 425 00:34:45,368 --> 00:34:46,519 learning disability, 426 00:34:47,399 --> 00:34:47,739 you know, 427 00:34:47,750 --> 00:34:57,810 perhaps an older individual presents with concerns that they have ADD and yet they have some medical issues, 428 00:34:57,820 --> 00:34:58,850 normal aging, 429 00:34:58,860 --> 00:34:59,860 some trauma. 430 00:35:00,270 --> 00:35:02,590 So what has the differential been, 431 00:35:02,820 --> 00:35:04,909 has there been a differential? 432 00:35:06,429 --> 00:35:10,280 What often happens instead is that especially during childhood, 433 00:35:10,290 --> 00:35:12,189 adolescence and young adulthood, 434 00:35:12,340 --> 00:35:26,300 someone presents with executive function difficulty and they're given a diagnosis of ADD without ruling out autism or other possible contributors to the inattention and other features. 435 00:35:27,939 --> 00:35:56,770 This leads to personal stories and articles and research studies about common features in ADD that are actually describing features in this huge mix of individuals with a variety of factors impacting their executive function rather than a research study with a group of people who have features specific to our definition of ADD and do not have other diagnostic conditions like autism. 436 00:35:58,129 --> 00:35:58,739 To me, 437 00:35:58,750 --> 00:36:03,409 it rarely makes sense to describe both ADD and autism. 438 00:36:03,649 --> 00:36:13,639 Usually the ADD diagnosis is describing these four subs skills of executive function when actually there are more like 12 to 15. 439 00:36:14,030 --> 00:36:22,580 And they're describing it in autism where executive function difficulty is always present in some form. 440 00:36:24,379 --> 00:36:40,040 And the diagnostic manual says that ADD should only be diagnosed when it's the diagnosis that explains the features the best you don't diagnose it just because the criteria are met, 441 00:36:40,300 --> 00:36:46,689 you diagnose it if the criteria are met and other things are not better explanations. 442 00:36:47,669 --> 00:36:56,580 I rarely see executive function difficulties in clients that extend beyond what I would expect for the autism profile. 443 00:36:56,800 --> 00:36:59,919 I have seen it certainly and I have diagnosed it. 444 00:37:00,179 --> 00:37:01,739 But by definition, 445 00:37:01,750 --> 00:37:04,139 if it's more than you'd expect, 446 00:37:04,149 --> 00:37:04,459 it's, 447 00:37:04,469 --> 00:37:07,500 it's not going to be common. To me, 448 00:37:07,510 --> 00:37:08,979 it makes sense to talk about 449 00:37:08,989 --> 00:37:18,189 executive function as including a series of sub abilities of which we can look at patterns of strengths and weaknesses in everyone, 450 00:37:18,459 --> 00:37:20,260 including those on the spectrum. 451 00:37:20,879 --> 00:37:22,129 But for now, 452 00:37:22,250 --> 00:37:37,090 we have this tiny subset of executive function characteristics in the DSM five called ADD that I would suggest should be expanded to reflect all of the executive function characteristics with, 453 00:37:37,100 --> 00:37:39,770 with specifiers like developmental. 454 00:37:40,610 --> 00:37:42,959 Thank you for listening to the recap. 455 00:37:42,969 --> 00:37:48,899 Thank you for going on this pathway of information with me today about executive function, 456 00:37:48,909 --> 00:37:50,540 ADD, and autism. 457 00:37:50,800 --> 00:37:51,919 In future episodes, 458 00:37:51,929 --> 00:37:57,370 we will break down some of the subsets of executive function and talk more about those. 459 00:37:58,219 --> 00:38:07,370 My favorite book series on Executive Function is The Smart But Scattered series which I will link in the show notes. 460 00:38:07,979 --> 00:38:09,439 Now there are many, 461 00:38:09,449 --> 00:38:16,669 many good books and resources on executive function and I certainly have not read or reviewed them all. 462 00:38:16,909 --> 00:38:20,729 You are encouraged to use the resources that best meet your needs. 463 00:38:20,979 --> 00:38:23,530 So look for the link for the smart but scattered. 464 00:38:23,540 --> 00:38:26,449 If you don't already have a series that meets your need, 465 00:38:26,889 --> 00:38:34,830 I do want to say that I don't get any financial compensation for recommending any of the resources that I list for you in my podcast episodes. 466 00:38:34,939 --> 00:38:39,370 These are just recommendations from things that have helped me in the past. 467 00:38:39,379 --> 00:38:47,659 I hope you have a great few weeks, and I look forward to you joining me for our next episode on Executive Function.

20. What Might That Look Like: A Decision Making Tool09.07.2023 (00:16:50)

    Have you ever struggled over whether to accept an invitation or opportunity? Should I say yes, or no? Join Dr. Regan as she discusses the importance of identifying goals and asking "what might that look like" before making a final decision.    Previous podcast episodes mentioned: Attention Deficit Disorder and Autism: Similarities and Differences Dr. Regan's Master Class for Clinicians: Zur Institute: Master Class   Dr. Regan's Resources Book: Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians   Read the transcript: 1 00:00:07,670 --> 00:00:08,520 Hi there. 2 00:00:08,529 --> 00:00:13,520 This is Doctor Regan joining you for an episode of Autism in the Adult podcast. 3 00:00:13,760 --> 00:00:15,029 I'm your host. 4 00:00:15,039 --> 00:00:18,739 I'm also a neuropsychologist, author and speaker, 5 00:00:19,000 --> 00:00:24,719 a certified autism specialist and the parent of a teen on the autism spectrum. 6 00:00:25,850 --> 00:00:29,040 You are joining me today for an episode entitled, 7 00:00:29,049 --> 00:00:30,620 "what might that look like?" 8 00:00:30,909 --> 00:00:35,240 One of the things that clients and families often ask me is, 9 00:00:35,250 --> 00:00:39,909 "should we plan on this" or "should I say yes to this?" 10 00:00:40,189 --> 00:00:40,669 Now, 11 00:00:40,680 --> 00:00:48,659 this could mean being the best man at a family wedding or taking a family vacation to a cabin in the woods. 12 00:00:49,419 --> 00:00:53,509 It could mean accepting a full time job in an office setting. 13 00:00:54,299 --> 00:00:55,029 Now, 14 00:00:55,529 --> 00:00:58,509 my response is rarely yes or no, 15 00:00:58,520 --> 00:01:01,270 but rather "what might that look like?" 16 00:01:02,590 --> 00:01:05,519 So before we jump into the topic for today, 17 00:01:05,529 --> 00:01:09,559 we are coming up to the third anniversary of this podcast, 18 00:01:09,879 --> 00:01:19,639 the first episode launched on August 7th 2020 it highlighted similarities and differences between autism and ADD or ADHD. 19 00:01:20,050 --> 00:01:20,379 Now, 20 00:01:20,389 --> 00:01:33,279 this premiere episode is one of the most popular of the podcast and I plan to expand this topic into a series after today's episode which will further define executive function, 21 00:01:33,550 --> 00:01:41,050 its presentation in autism and ADD, and resources for harnessing the power of executive function. 22 00:01:42,199 --> 00:01:43,089 Secondly, 23 00:01:43,099 --> 00:01:46,930 I want to inform clinicians about an upcoming master class. 24 00:01:46,940 --> 00:01:52,069 I'm offering through Zur Institute about autism across the lifespan. 25 00:01:53,190 --> 00:02:04,459 I received so many emails and messages through my website about people seeking autism informed clinicians to provide them with diagnostic input information, 26 00:02:04,470 --> 00:02:08,919 education and solutions for roadblocks they may have encountered. 27 00:02:09,649 --> 00:02:17,270 So the bottom line is that more clinicians are needed to serve individuals who are searching for this specialization. 28 00:02:17,600 --> 00:02:28,779 And my response has been to offer multiple courses through Zur Institute. It's a continuing education site for clinicians. 29 00:02:29,330 --> 00:02:36,809 My goal is to equip clinicians across various regions to assist individuals in their communities. 30 00:02:36,860 --> 00:02:39,320 When this type of service is needed, 31 00:02:39,979 --> 00:02:51,729 the master class offering will focus on advanced topics and it starts in September space is limited and I'll have the link in the show notes. 32 00:02:52,360 --> 00:02:55,449 So let's jump into our topic for today. 33 00:02:56,380 --> 00:03:10,369 The autistic individual may have opportunities to accept or decline invitations and the invitation may be to enter an advanced academic program rather than the basic program. 34 00:03:10,789 --> 00:03:13,770 Perhaps the invitation is to travel. 35 00:03:14,429 --> 00:03:24,199 The invitation may be to lead a group such as being the best man at a family wedding or presenting research to professionals. 36 00:03:25,720 --> 00:03:33,619 My experience is that there's value in viewing the invitation not so much as a yes or no question. 37 00:03:33,889 --> 00:03:35,369 Do I accept this? 38 00:03:35,380 --> 00:03:36,580 Do I say no. 39 00:03:36,759 --> 00:03:38,880 But by asking ourselves, 40 00:03:38,889 --> 00:03:40,410 what might that look like? 41 00:03:41,149 --> 00:03:41,710 A yes, 42 00:03:41,720 --> 00:03:47,160 no view would be to see the invitation as a formed and complete package. 43 00:03:47,289 --> 00:03:51,080 So if I say yes to being the best man, 44 00:03:51,089 --> 00:03:53,080 I will plan the bachelor party, 45 00:03:53,089 --> 00:03:54,240 make a speech, 46 00:03:54,380 --> 00:03:55,020 toast, 47 00:03:55,029 --> 00:03:56,509 the couple at the reception, 48 00:03:56,520 --> 00:04:00,869 et cetera saying no to the invitation means I'll, 49 00:04:00,880 --> 00:04:03,440 I won't participate in these activities. 50 00:04:03,990 --> 00:04:05,360 But instead of a yes, 51 00:04:05,369 --> 00:04:06,589 no mindset, 52 00:04:07,100 --> 00:04:11,199 we can often talk through alternatives by asking, 53 00:04:11,210 --> 00:04:12,919 what might that look like? 54 00:04:13,300 --> 00:04:14,990 What might it look like to say? 55 00:04:15,000 --> 00:04:15,729 Yes, 56 00:04:16,170 --> 00:04:19,630 in a way that works for me and for the people around me. 57 00:04:22,149 --> 00:04:26,200 The first point to think about is what is the ultimate goal? 58 00:04:26,209 --> 00:04:28,320 What is the desired outcome? 59 00:04:29,779 --> 00:04:36,600 The goal for a vacation with family members may be to have relaxing experiences, 60 00:04:36,660 --> 00:04:43,480 to see natural landscapes that you've never seen and to connect with other family in a meaningful way. 61 00:04:44,829 --> 00:04:50,709 The goal for presenting your research to professionals may be to advance your career, 62 00:04:50,720 --> 00:04:57,040 make professional connections with others and highlight your role in the work that's been done. 63 00:04:58,730 --> 00:05:09,549 Identifying what a good outcome would look like is empowering because it helps us identify a handful of core foundational objectives. 64 00:05:10,029 --> 00:05:12,640 And when we work toward those objectives, 65 00:05:12,649 --> 00:05:17,220 we can release some of the trappings that may be part of the activity, 66 00:05:17,230 --> 00:05:23,959 but they're really not core to what we're going after for the individual, 67 00:05:23,970 --> 00:05:26,440 considering a full-time office job, 68 00:05:26,470 --> 00:05:31,089 he may decide that the foundational goals would be to have work stability. 69 00:05:31,510 --> 00:05:34,140 If he's currently doing consulting work, 70 00:05:34,149 --> 00:05:35,200 for example, 71 00:05:35,290 --> 00:05:35,769 he would, 72 00:05:35,779 --> 00:05:45,109 he may want more of a predictable salary and to have his name associated with a company that has a respected reputation in his field. 73 00:05:46,239 --> 00:05:53,489 So the first step you can focus on is determining what would be a good outcome. 74 00:05:54,480 --> 00:06:02,549 What would it look like in this situation to really dive in and also to feel like things went well. 75 00:06:04,519 --> 00:06:10,970 The first step you should focus on is determining what a good outcome would look like in this situation. 76 00:06:11,589 --> 00:06:15,779 What would a good outcome for participating in the wedding look like? 77 00:06:16,140 --> 00:06:21,519 What about going on a family vacation or accepting an office job? 78 00:06:22,910 --> 00:06:32,970 The second part after we've identified what the core features we're going after are those core foundational goals? 79 00:06:33,179 --> 00:06:35,000 We can ask ourselves, 80 00:06:35,010 --> 00:06:36,459 what might it look like? 81 00:06:36,470 --> 00:06:41,559 What might the situation look like that would allow for those outcomes? 82 00:06:42,480 --> 00:06:44,950 So let's go back to the examples. 83 00:06:45,410 --> 00:06:49,690 The gentleman invited to be best man at an out of town family wedding. 84 00:06:49,700 --> 00:06:51,200 Let's call him Joe. 85 00:06:51,790 --> 00:06:54,510 He may realize his instinct is to say, 86 00:06:54,519 --> 00:06:55,160 no, 87 00:06:55,679 --> 00:06:58,809 he knows that he gets overwhelmed in crowds. 88 00:06:58,820 --> 00:07:09,809 He dislikes being the center of attention and he relies on routine and specific favorite activities to remain grounded in daily life. 89 00:07:10,170 --> 00:07:24,489 He feels pulled in different directions because he wants to support his family member and he knows that it's really an honor to be asked to connect with the couple in this way at the ceremony. 90 00:07:25,890 --> 00:07:28,390 So Joe and his family may want to discuss, 91 00:07:28,399 --> 00:07:31,570 what would it look like for you to be best man? 92 00:07:31,809 --> 00:07:36,630 What might it look like for Joe to be best man in a relational, 93 00:07:36,640 --> 00:07:38,899 satisfying and meaningful way? 94 00:07:38,940 --> 00:07:44,929 But in a way that also offers him the freedom and the space to take care of his needs. 95 00:07:45,790 --> 00:07:46,920 So at this point, 96 00:07:46,929 --> 00:07:57,320 there is a commitment to the core goals and there is flexibility with the trappings that might otherwise go along with a wedding ceremony. 97 00:07:59,109 --> 00:08:00,369 In the case of the wedding, 98 00:08:00,380 --> 00:08:02,769 Joe may have a separate hotel room, 99 00:08:02,779 --> 00:08:07,369 so he has a quiet alone space to regroup as needed. 100 00:08:08,350 --> 00:08:20,239 Joe may know that he is grounded and centered when he gets pressure inputs in his muscles and joints and he gets these inputs at home with a weighted blanket, 101 00:08:20,260 --> 00:08:22,339 rock climbing and bike riding. 102 00:08:23,239 --> 00:08:36,650 He's decided to choose a hotel that has a swimming pool and an elliptical machine so that he can get these pressure inputs in ways that will still feel grounding to him. 103 00:08:38,489 --> 00:08:48,789 Joe also plans to use small noise canceling earbuds as needed just to shield himself from some of the noise in crowded areas. 104 00:08:48,968 --> 00:08:50,289 They're barely visible, 105 00:08:50,299 --> 00:08:55,698 they help him a lot and it'll be a step toward really increasing his comfort. 106 00:08:56,940 --> 00:09:00,880 Joe and his family agree that he won't attend the bachelor party, 107 00:09:01,150 --> 00:09:09,630 but still he'll have a time that evening where he and the groom have a private drink together to celebrate the union. 108 00:09:11,020 --> 00:09:18,960 Joe also decides to record a video of him toasting the couple rather than making a live toast. 109 00:09:19,409 --> 00:09:26,979 These things in combination with others really help him or regulate himself to have a relation, 110 00:09:27,010 --> 00:09:33,950 meaningful contribution at the ceremony and to also protect what his nervous system needs. 111 00:09:34,820 --> 00:09:38,260 The main points are that Joe and his family are thinking, 112 00:09:38,450 --> 00:09:39,950 what might this look like? 113 00:09:39,960 --> 00:09:47,789 What do we want to work toward and how can we best get there with a mindset toward getting everyone's needs met. 114 00:09:49,020 --> 00:09:50,140 Similarly, 115 00:09:50,150 --> 00:09:53,250 the researcher invited to present her work. 116 00:09:53,260 --> 00:09:54,030 Let's call her, 117 00:09:54,039 --> 00:10:03,669 Susan may avoid the invitation because handling unexpected situations during a presentation is very stressful to her. 118 00:10:04,080 --> 00:10:10,799 She also really shies away from being the center of attention and speaking in front of others. 119 00:10:11,409 --> 00:10:19,219 If she does present her goals would be to take credit for her work and to connect with like minded professionals. 120 00:10:20,369 --> 00:10:26,169 Perhaps her focus on what might this look like leads to the following plan, 121 00:10:27,190 --> 00:10:35,840 Susan and her mentor decide to present the information together with specific slides identified for each of them. 122 00:10:36,559 --> 00:11:02,320 So this plan allows Susan to have an experienced partner to guide her through unexpected glitches and it also ensures that Susan can count on presenting specific material but also have expected breaks while her mentor is speaking during the question and answer section at the end of the presentation, 123 00:11:02,539 --> 00:11:13,679 Susan will take the lead on questions she feels comfortable with and her mentor may cue and structure her thoughts by adding prompts like saying Susan, 124 00:11:13,690 --> 00:11:19,400 this may be a good time to discuss your findings in the area of XY or Z. 125 00:11:21,340 --> 00:11:37,650 So what might that look like process allowed Susan to work toward her desired goals without taking an all or nothing approach to all of the trappings that may typically accompany a professional presentation. 126 00:11:38,219 --> 00:11:47,140 So the first thing we talked about was figuring out what's foundational in the goals and then figuring out how to get there, 127 00:11:47,150 --> 00:11:52,770 what might it look like to accommodate these goals and to let some other things go. 128 00:11:54,070 --> 00:11:57,070 The third thing to think about is when to say no. 129 00:11:57,840 --> 00:11:59,729 So having said all this, 130 00:11:59,739 --> 00:12:12,960 there will be times when what might this look like when that process leads to the conclusion that really this is probably unlikely to help achieve our best, 131 00:12:12,969 --> 00:12:14,179 our best outcome, 132 00:12:14,190 --> 00:12:15,369 our best goals. 133 00:12:16,030 --> 00:12:17,479 Um So saying, 134 00:12:17,489 --> 00:12:20,460 no may be the best decision in that case, 135 00:12:21,900 --> 00:12:27,979 although there would be benefits to finding a compromise that meets the needs of multiple people. 136 00:12:27,989 --> 00:12:45,590 The process may be unrealistic in a particular situation and that may be because the individual's needs at that time are so high in this season of struggle or it may be because features of the situation just can't be adjusted. 137 00:12:47,289 --> 00:12:53,179 Let's take the consultants situation who's considering a full-time office job. 138 00:12:53,390 --> 00:13:15,960 Let's call him a the best answer for him may be no if he is in an unusual season of struggle and maybe he's having difficulty consistently getting his consulting work done and to then switch to a setting that would be more challenging for him may really not be good timing, 139 00:13:16,719 --> 00:13:22,520 his needs as an individual may be so far from what the job can offer him. 140 00:13:22,770 --> 00:13:25,729 That the best answer in this season is no. 141 00:13:27,179 --> 00:13:28,309 Alternatively, 142 00:13:28,320 --> 00:13:32,619 the answer may be no if he's doing well in his consulting work. 143 00:13:32,830 --> 00:13:42,119 But there are core features of the job that would prevent him from having the flexibility that he would really need to thrive. 144 00:13:42,809 --> 00:13:47,280 He may realize that he would need a hybrid work model, 145 00:13:47,289 --> 00:13:50,280 combining office work and remote work. 146 00:13:51,070 --> 00:13:57,289 He may have the self awareness that working on new business proposals keeps his interest level up, 147 00:13:57,650 --> 00:14:06,549 but he needs help maintaining interest in projects that feel like old hat that the work can get boring very quickly. 148 00:14:06,640 --> 00:14:21,630 And the consulting job allows him to pick and choose the types of projects that he does and for things not to get stale if the office job offers him stability in one sense, 149 00:14:21,729 --> 00:14:26,719 but a lack of flexibility to kind of meet in the middle. 150 00:14:27,530 --> 00:14:30,950 He may need to say no to that invitation. 151 00:14:31,330 --> 00:14:33,929 Uh Based on what he knows about himself, 152 00:14:38,130 --> 00:14:42,099 an individual invited to come along for a family vacation. 153 00:14:42,239 --> 00:14:44,090 Let's call her MEREDITH. 154 00:14:44,460 --> 00:14:49,940 She may realize that no is the answer that makes the most sense in her season. 155 00:14:50,799 --> 00:14:53,890 After thinking through what might this look like, 156 00:14:53,900 --> 00:15:02,969 she can't envision any way that realistically meets her needs and achieves the goal of connecting with family on this trip. 157 00:15:04,080 --> 00:15:05,250 For example, 158 00:15:05,260 --> 00:15:14,809 she may have a really severe fear of flying and taking multiple planes is the only way to participate in the vacation as planned. 159 00:15:16,049 --> 00:15:23,179 MEREDITH may realize that her core goal is to connect with two family members in particular. 160 00:15:23,880 --> 00:15:26,580 So her next thought process might be, 161 00:15:27,229 --> 00:15:30,859 I'm going to have to say no to the invitation of the trip. 162 00:15:30,929 --> 00:15:34,429 But how else could I connect with those family members? 163 00:15:34,500 --> 00:15:37,849 Even I'm if I'm going to turn down this invitation, 164 00:15:39,489 --> 00:15:55,979 this process of evaluating invitations and opportunities by asking what might that look like can help us identify what our core goals and needs are while adjusting or releasing things that really aren't foundational. 165 00:15:57,039 --> 00:15:59,809 The decisions often don't need to be all or nothing. 166 00:15:59,820 --> 00:16:03,750 Although after thinking through what might this look like? 167 00:16:03,940 --> 00:16:08,150 We might see that some opportunities just aren't a good fit. 168 00:16:10,030 --> 00:16:22,359 I hope you have invitations that help you grow toward your goals and that your decision making process can also reflect your values and your needs at all seasons of your life. 169 00:16:22,460 --> 00:16:24,500 Thank you for joining me today. 170 00:16:24,750 --> 00:16:36,599 The next episode will launch our new series on Executive Function and clinicians ... check out the link to the master class opportunity with Zur Institute coming up in the fall.  171 00:16:36,690 --> 00:16:41,710 I hope you can join me next time for our episode on Executive Function.

21. Autism and Intentional Living: Expanding Special Interests18.06.2023 (00:15:39)

    Do you want to live with more intention to achieve your goals? In this 6th episode in a series on Intentional Living, Dr. Regan discusses ways to grow in areas of interest by expanding skills and using free or low cost methods of networking and introducing products or services to others.  Previous podcast episodes mentioned: Shifting Autistic Characteristics Across the Lifespan Autism in Women Coursera (online courses)   Dr. Regan's Resources Book: Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians Read the transcript: 1 00:00:06,019 --> 00:00:06,829 Hello, 2 00:00:06,840 --> 00:00:16,920 this is Doctor Regan joining you for the sixth episode of Our Living With Intention series on the Autism in the Adult podcast. 3 00:00:17,290 --> 00:00:20,159 I am the mom of a teen on the spectrum. 4 00:00:20,459 --> 00:00:26,180 I have a doctorate in the field of brain behavior relationships called neuropsychology. 5 00:00:26,440 --> 00:00:28,549 I'm also an author and speaker, 6 00:00:28,559 --> 00:00:36,279 a certified autism specialist and the founder and director of an autism diagnostic clinic in Central Illinois, 7 00:00:36,290 --> 00:00:38,000 serving adolescents, 8 00:00:38,009 --> 00:00:40,060 adults and aging adults. 9 00:00:42,180 --> 00:00:45,069 Before we jump into our topic for today, 10 00:00:45,090 --> 00:00:48,250 let's take a throwback to past episodes. 11 00:00:48,619 --> 00:00:51,790 Looking back to two years ago at this time, 12 00:00:51,869 --> 00:00:54,779 I published an episode about autism in women. 13 00:00:55,299 --> 00:00:59,330 It's been one of the most listened to episodes of the podcast. 14 00:00:59,779 --> 00:01:02,270 And one year ago at this time, 15 00:01:02,279 --> 00:01:13,699 we were in the midst of a series about how autism characteristics may shift somewhat across the lifespan during puberty across life, 16 00:01:13,709 --> 00:01:17,879 seasons in women and throughout the aging years, 17 00:01:19,120 --> 00:01:23,569 I'll go ahead and link these episodes in the show notes in case you miss them. 18 00:01:24,989 --> 00:01:25,199 Now, 19 00:01:25,209 --> 00:01:30,139 let's talk about our current episode in The Living With Intention series. 20 00:01:32,319 --> 00:01:37,309 I've named the series Living With Intention because sometimes as humans, 21 00:01:37,319 --> 00:01:53,690 we just kind of get swept up in the demands of daily life or we get stuck in some areas and it can help to pause and consider where we would like to be in various areas of our lives. 22 00:01:54,370 --> 00:02:02,739 And then to think about how to take small achievable steps on a path toward our intention. 23 00:02:03,839 --> 00:02:04,629 And so far, 24 00:02:04,639 --> 00:02:13,050 we've spoken about three areas of life that someone may have goals for such as improving regulation, 25 00:02:13,539 --> 00:02:15,539 that means feeling centered, 26 00:02:15,550 --> 00:02:18,619 calm and psychologically present. 27 00:02:19,720 --> 00:02:27,210 We talked about communicating and connecting and also about addressing issues of household culture. 28 00:02:28,750 --> 00:02:29,449 Today, 29 00:02:29,460 --> 00:02:32,679 we will look at the area of interests. 30 00:02:32,690 --> 00:02:44,070 Many people that I work with share that they're so captivated by a certain topic or activity that they would love to expand this in their life. 31 00:02:44,100 --> 00:02:45,500 For example, 32 00:02:45,509 --> 00:02:47,470 if someone is an artist, 33 00:02:47,710 --> 00:02:52,380 they may share that they think they would like to sell designs on Etsy, 34 00:02:54,000 --> 00:03:01,710 another person may share that they are immersed in sewing and this is so interesting and calming to them. 35 00:03:02,210 --> 00:03:09,970 They've developed quite a skill in this area and they're wondering if they could expand by doing some things in their community. 36 00:03:11,270 --> 00:03:21,240 Another may have an amazing brain for sports statistics and wish that they could get into sports casting as a niche in life. 37 00:03:23,399 --> 00:03:23,929 Again, 38 00:03:23,940 --> 00:03:29,149 it's important to emphasize that these are goals that the individual presents with. 39 00:03:29,360 --> 00:03:33,800 This is not an episode about what someone's goals should be, 40 00:03:33,949 --> 00:03:37,210 but rather to address the thought of gosh, 41 00:03:37,220 --> 00:03:48,089 I love this stuff and I would love to do more or use it in a way that reaches a wider area or a wider audience. 42 00:03:49,759 --> 00:03:58,970 So how does one start a path toward getting more involved in the area of an intense interest? 43 00:04:00,710 --> 00:04:07,130 So how to get started as we talked about in the second episode on this series, 44 00:04:07,399 --> 00:04:14,979 it is recommended that we take small defined achievable steps in the direction we would like to go. 45 00:04:15,850 --> 00:04:22,579 So one such step may be to gain some additional skills in the area of interest. 46 00:04:22,869 --> 00:04:23,880 For example, 47 00:04:23,890 --> 00:04:29,679 if someone produces a product and they would like to offer the product on the internet, 48 00:04:29,920 --> 00:04:39,200 they may wish to get training in things like basic marketing strategies using social media for sales and creating a website. 49 00:04:40,209 --> 00:04:44,359 Someone who creates a myriad of characters and stories, 50 00:04:44,549 --> 00:04:59,209 this individual may want to write fiction books in order to bridge the gap from having great ideas and wonderful creativity to bringing together some stories into a book. 51 00:04:59,239 --> 00:05:03,730 The individual may wish to take a formal course in creative writing. 52 00:05:06,600 --> 00:05:07,010 Now, 53 00:05:07,019 --> 00:05:12,209 I know taking a course can feel daunting but a wonderful place to learn. 54 00:05:12,220 --> 00:05:20,209 Some of these skills is on the internet and there are Myriads of free online courses in various areas. 55 00:05:21,209 --> 00:05:21,739 In fact, 56 00:05:21,750 --> 00:05:28,390 there are so many options that I just can't even list the top opportunities in the show note links. 57 00:05:28,399 --> 00:05:29,690 There are so many, 58 00:05:30,160 --> 00:05:34,279 but I'll share a few things about learning from the internet. 59 00:05:35,190 --> 00:05:37,279 Have you ever heard of a MOOC? 60 00:05:38,040 --> 00:05:41,059 That's M - O - O - C. 61 00:05:41,480 --> 00:05:46,750 It's a massive open online course - MOOC. 62 00:05:47,040 --> 00:05:54,359 And this is a free web-based distance learning program that's designed for huge numbers of people. 63 00:05:54,369 --> 00:05:59,869 Thus the word massive ... of geographically dispersed students. 64 00:06:00,049 --> 00:06:08,380 So open means that these are accessible to multiple levels of people very often, 65 00:06:08,390 --> 00:06:11,929 these are free and they're online. 66 00:06:11,940 --> 00:06:13,820 So this is all web based. 67 00:06:15,440 --> 00:06:21,950 I myself have been a student in several MOC courses to learn things that I can't learn locally. 68 00:06:22,079 --> 00:06:23,089 For example, 69 00:06:23,100 --> 00:06:28,390 I got to take a Behavioral Genetics course through the University of Minnesota. 70 00:06:28,609 --> 00:06:33,429 I took a neuroanatomy course through the University of Illinois Chicago. 71 00:06:34,790 --> 00:06:39,619 And what happens is that you earn a participation certificate from the course, 72 00:06:39,630 --> 00:06:41,079 which is free, 73 00:06:41,910 --> 00:06:50,410 but the benefits are both the information you learn and also having this on your resume as an area of self study. 74 00:06:50,839 --> 00:07:00,309 So the MOOC platforms also have developed paid versions of courses where you earn some type of verified credit or certificate. 75 00:07:00,739 --> 00:07:16,459 And they also have programs that are kind of compilation certificates... like, take seven writing courses and get this advanced writing certificate or a grouping of computer courses for an IT specialization certificate. 76 00:07:18,709 --> 00:07:25,670 The particular site for MOOC courses that I used was Coursera.org and I'll put that in the show notes. 77 00:07:25,899 --> 00:07:29,600 But there are so many sites to choose from. 78 00:07:30,920 --> 00:07:38,549 I encourage you to use an internet search engine for free online courses in the area of your interest. 79 00:07:41,500 --> 00:07:57,809 Another opportunity for learning more skills in your area of interest would be youtube tutorials and also programs like Adobe that offer video instruction to become more expert in their program offerings. 80 00:07:58,720 --> 00:07:59,809 In this context, 81 00:07:59,820 --> 00:08:03,690 you could learn things like video and audio editing, 82 00:08:03,700 --> 00:08:04,609 photography 83 00:08:04,619 --> 00:08:05,399 editing, 84 00:08:05,459 --> 00:08:08,390 how to use website design software... 85 00:08:08,799 --> 00:08:19,959 Podcast platforms like Podbean and others also provide podcasts about how to become and succeed as a podcaster in your area of interest. 86 00:08:20,200 --> 00:08:27,609 And they also offer blog posts and articles about all the things their sites offer to support your goals. 87 00:08:27,619 --> 00:08:52,500 So there's a lot of free learning opportunities in the form of videos, in the form of programs that offer their own education about their products and also podcasts that just talk about how to develop your niche in addition to increasing skills in your area. 88 00:08:52,780 --> 00:09:09,849 Another way to take a step toward your goal of expanding your interest would be to start doing some things on a volunteer basis or to provide giveaways or free products as promotions to highlight your work or skills. 89 00:09:10,549 --> 00:09:11,380 So again, 90 00:09:11,390 --> 00:09:14,409 this doesn't need to be the end goal, 91 00:09:14,489 --> 00:09:14,799 you know, 92 00:09:14,809 --> 00:09:18,950 to be volunteering as the ultimate end, 93 00:09:19,299 --> 00:09:28,400 but it can be one step to help you become more comfortable in this area to gain experience and also to get your offerings out there. 94 00:09:30,989 --> 00:09:40,159 Someone who bakes may wish to donate cookies to the local elementary school open house with a nicely crafted sign about their business, 95 00:09:40,169 --> 00:09:42,229 including their contact information. 96 00:09:42,630 --> 00:09:51,179 They could even put a QR code on the sign so parents can scan the sign and save their contact information in their website location. 97 00:09:52,320 --> 00:10:03,489 The individual who loves sports statistics and wants to become a sportscaster may wish to volunteer time to local sports teams as the sports announcer during the games. 98 00:10:04,450 --> 00:10:07,229 This helps the person create contacts, 99 00:10:07,510 --> 00:10:13,479 get used to the tasks involved in doing the work and lets other people see their skills. 100 00:10:15,929 --> 00:10:24,049 There are other ways to use free venues to increase your credentials and get your work out there. 101 00:10:27,109 --> 00:10:30,419 Looking for free opportunities to get involved, 102 00:10:30,440 --> 00:10:32,510 advance your skills and get your work out. 103 00:10:32,520 --> 00:10:38,219 There is a really good way to step toward that intention of expansion. 104 00:10:38,539 --> 00:10:39,739 So for example, 105 00:10:39,750 --> 00:10:45,809 someone who's trying to develop creative writing skills may wish to enter their stories into contests. 106 00:10:46,270 --> 00:10:48,960 And once you have a body of work developed, 107 00:10:49,119 --> 00:11:02,169 you might find it fairly straightforward to enter appropriate work in various contests for review and as your work earns mentions or comments or awards, 108 00:11:02,280 --> 00:11:06,270 these can be highlighted in your credentials on your website. 109 00:11:09,760 --> 00:11:21,210 Someone who loves making characters and writing may also want to write fan fiction on the internet as a way of using a resource to get their work out there. 110 00:11:23,190 --> 00:11:25,659 For an individual who loves, 111 00:11:25,669 --> 00:11:26,229 loves, 112 00:11:26,239 --> 00:11:35,909 loves running and decides they may wish to do some personal training for other long distance runners locally or in their community, 113 00:11:36,080 --> 00:11:42,500 this person may wish to enter races and keep track of these credentials to market their services. 114 00:11:43,030 --> 00:11:47,200 Some races or events may be free and others may have a fee. 115 00:11:47,250 --> 00:11:48,000 But in the end, 116 00:11:48,010 --> 00:11:52,440 this could be a way of meeting people with similar interests, 117 00:11:52,460 --> 00:12:02,169 getting your name out there as someone who's actively pursuing running and training and getting some race placements to add to your credentials. 118 00:12:05,869 --> 00:12:12,099 The important things about these approaches are that they're small steps, 119 00:12:12,640 --> 00:12:14,979 they're toward your desired outcome. 120 00:12:14,989 --> 00:12:22,760 Whatever you've decided your intention is this is where I'd like to be in this area of my life. 121 00:12:23,669 --> 00:12:30,200 And these small steps help you get a feel for what your goal may feel like in the end. 122 00:12:31,190 --> 00:12:32,320 For example, 123 00:12:32,330 --> 00:12:46,000 someone who thinks that they might want to become a teacher will gain a lot of information about teaching by volunteering to teach a course at the community center every Saturday for four weeks. 124 00:12:46,400 --> 00:12:53,440 So they get a taste of what it feels like to instruct a small group of adults or Children. 125 00:12:54,250 --> 00:13:03,460 They get a taste for some of the paperwork or the communication demands in between the actual classes and instruction. 126 00:13:04,229 --> 00:13:10,000 Some people who love a particular topic and they think they might want to teach, 127 00:13:10,030 --> 00:13:19,200 end up realizing after some of these volunteer opportunities that the actual process of teaching is not something they love. 128 00:13:22,530 --> 00:13:28,270 Another important thing about this approach is that for some of the options. 129 00:13:28,609 --> 00:13:35,520 There's really not a high demand for in-person contact or being in crowded classrooms. 130 00:13:36,059 --> 00:13:52,239 Some individuals may feel that expanding their interests into well formed skills or offerings is most daunting because they really can't imagine themselves opening a whole storefront or running a restaurant full of people. 131 00:13:52,640 --> 00:13:58,770 But this approach can harness all of the online opportunities for learning, 132 00:13:58,780 --> 00:13:59,909 for creating, 133 00:13:59,919 --> 00:14:05,880 for selling through the internet while engaging in certain community events that you choose. 134 00:14:06,159 --> 00:14:16,099 You get to decide how much uh event based activity do I want to do in the community or how much do I want to travel? 135 00:14:16,229 --> 00:14:23,330 How much customer interaction do I want versus time to regroup in my own space? 136 00:14:26,590 --> 00:14:31,000 I'm a firm believer that your community needs your gifts, 137 00:14:31,010 --> 00:14:32,159 your knowledge, 138 00:14:32,169 --> 00:14:40,070 your passion and whatever area you find that in and finding ways to take steps to your passion, 139 00:14:40,080 --> 00:14:42,229 not only blesses you, 140 00:14:42,440 --> 00:14:49,280 but those around you and having ways of expressing that also is something that fills you up. 141 00:14:49,619 --> 00:14:50,969 I love creating. 142 00:14:50,979 --> 00:14:51,929 I love writing, 143 00:14:51,940 --> 00:14:52,909 I love running. 144 00:14:52,919 --> 00:14:54,690 I love sports statistics. 145 00:14:54,960 --> 00:15:06,270 We like to have some balanced way of allowing you to learn and grow in this area to feed that passion and to serve your community. 146 00:15:09,030 --> 00:15:16,119 Thank you so much for joining me for the sixth episode of the Living With Intention series. 147 00:15:16,349 --> 00:15:27,099 And I invite you to check out the show notes for links to opportunities mentioned in this episode and for links to other offerings on my website. 148 00:15:27,349 --> 00:15:31,880 And I hope that you join me for the next podcast episode.

22. Autism and Intentional Living: Improving Household Culture29.05.2023 (00:19:50)

    Do you want to live with more intention to achieve your goals? In this 5th episode in a series on Intentional Living, Dr. Regan identifies ways to improve household interactions by attending to the needs of the group and establishing traditions and structured activities.    Dr. Regan's Resources Book: Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians   Read the transcript here: 1 00:00:06,139 --> 00:00:06,480 Hi, 2 00:00:06,489 --> 00:00:07,110 everyone. 3 00:00:07,119 --> 00:00:12,170 This is Doctor Regan joining you for an episode of Autism in the Adult podcast. 4 00:00:12,489 --> 00:00:14,970 I'm the mom of a teen on the spectrum. 5 00:00:14,979 --> 00:00:17,500 I have a doctorate in neuropsychology. 6 00:00:17,700 --> 00:00:20,790 It's the field of brain behavior relationships. 7 00:00:20,909 --> 00:00:25,649 And I'm the director of an autism diagnostic clinic for adolescents, 8 00:00:25,659 --> 00:00:29,149 adults and aging adults in Central Illinois. 9 00:00:30,010 --> 00:00:30,459 Today, 10 00:00:30,469 --> 00:00:38,180 you're joining me for the fifth episode in a series about living with intention making goals, 11 00:00:38,189 --> 00:00:43,500 shifting in areas of life to get you closer to where you would like to be. 12 00:00:44,240 --> 00:00:55,540 So there were two episodes about how to choose an area of life to target and how to approach change with some specific goals and strategies. 13 00:00:56,009 --> 00:01:02,369 We had episodes about improving regulation and about communicating and connecting. 14 00:01:02,979 --> 00:01:09,629 So today we have an episode focused on household living and the culture of the household. 15 00:01:10,400 --> 00:01:10,690 Now, 16 00:01:10,699 --> 00:01:13,250 before we dive into the topic for today, 17 00:01:13,260 --> 00:01:20,519 I want to invite you to check out the resources on my website at adult in geriatric autism dot com. 18 00:01:20,959 --> 00:01:28,410 There are posts and videos for many different types of listeners and learners including clinicians. 19 00:01:29,019 --> 00:01:29,529 Also, 20 00:01:29,540 --> 00:01:31,610 you may find one of my books helpful, 21 00:01:31,620 --> 00:01:32,580 many of you know, 22 00:01:32,589 --> 00:01:39,069 that my first book called Understanding Autism in Adults and Aging Adults is in the second edition. 23 00:01:39,500 --> 00:01:40,589 And if you don't know, 24 00:01:40,599 --> 00:01:44,550 I have a second book called Understanding Autistic Behaviors, 25 00:01:44,559 --> 00:01:47,250 which is more of a workbook format. 26 00:01:47,540 --> 00:01:55,809 So it explains the neurology ... kind of the neurologic-why of some of the behavioral patterns. 27 00:01:55,819 --> 00:02:02,110 And it outlines ways to work toward increased well-being if someone's in a season of struggle. 28 00:02:04,419 --> 00:02:07,430 So let's focus on household living. 29 00:02:07,470 --> 00:02:16,449 So I want to highlight this topic because many people talk to me about the complexities of living in a household with other people. 30 00:02:16,949 --> 00:02:22,330 Most often this has to do with spouses or partners or with couples who have Children. 31 00:02:22,690 --> 00:02:27,350 Not only is the individual trying to increase their own self awareness. 32 00:02:27,360 --> 00:02:27,559 You know, 33 00:02:27,570 --> 00:02:29,050 this is how I'm wired, 34 00:02:29,059 --> 00:02:30,529 this is what makes me tick, 35 00:02:30,539 --> 00:02:31,770 this is what I need. 36 00:02:32,059 --> 00:02:33,830 But in a household, 37 00:02:33,860 --> 00:02:41,160 this is really next level awareness because there's now this demand to be aware of yourself, 38 00:02:41,169 --> 00:02:46,289 multiple other people and the interplay between all of the people. 39 00:02:46,500 --> 00:02:47,630 And on top of that, 40 00:02:47,639 --> 00:02:52,100 the needs and interplay change from day to day and from life, 41 00:02:52,110 --> 00:02:53,770 season to life season. 42 00:02:54,789 --> 00:03:00,240 It's so so easy to default to this kind of household interaction. 43 00:03:00,449 --> 00:03:02,039 Stop doing that. 44 00:03:02,050 --> 00:03:03,440 Why are you doing that? 45 00:03:03,449 --> 00:03:08,440 I've told you 100 times to X Y Z. 46 00:03:08,860 --> 00:03:09,800 Oh my gosh, 47 00:03:09,809 --> 00:03:12,440 you are so loud, 48 00:03:12,449 --> 00:03:21,630 messy clingy and guess what this focus on telling people to be different every day is just not that effective. 49 00:03:21,960 --> 00:03:27,679 And that's why we find ourselves saying the same things every day over and over. 50 00:03:27,690 --> 00:03:28,770 And not only that, 51 00:03:28,910 --> 00:03:35,339 but these repetitive interactions cause a strain on the relationships in the household. 52 00:03:35,369 --> 00:03:40,940 And they create this kind of adversarial connection rather than a partnering connection. 53 00:03:41,330 --> 00:03:50,050 So the big message is I want you to be different now rather than I want to partner with you to make things better, 54 00:03:50,110 --> 00:03:51,339 better for you, 55 00:03:51,350 --> 00:03:53,839 better for me and better for the household. 56 00:03:54,520 --> 00:04:01,009 So let's talk about some specific areas of focus and strategy that might help. 57 00:04:01,820 --> 00:04:05,509 The first thing we're gonna talk about is focus on the other. 58 00:04:05,889 --> 00:04:06,199 Now, 59 00:04:06,210 --> 00:04:07,690 during the previous episode, 60 00:04:07,699 --> 00:04:14,910 we talked about the importance of expanding our awareness from only what do I need right now, 61 00:04:14,919 --> 00:04:22,100 which actually can be difficult to figure out to what does the other person need right now. 62 00:04:22,399 --> 00:04:24,170 And when we add that element, 63 00:04:24,420 --> 00:04:28,109 we can get away from this push and pull of, 64 00:04:28,119 --> 00:04:31,769 stop doing that to oh, 65 00:04:31,779 --> 00:04:35,309 things might be able to go smoother in this area. 66 00:04:35,660 --> 00:04:42,910 I wonder what the need is that's connected with that behavior and how could I support change? 67 00:04:43,250 --> 00:04:46,109 So as we're talking about households, 68 00:04:46,119 --> 00:05:00,899 this concept of focus on the other then becomes expanded and that makes things a little more complex but also much more important and potentially really helpful, 69 00:05:00,950 --> 00:05:04,730 especially if this becomes the culture of the household, 70 00:05:04,760 --> 00:05:09,079 meaning that this is how we do things it becomes more automatic. 71 00:05:09,089 --> 00:05:13,880 It becomes something that everyone's focusing on as best they can. 72 00:05:14,980 --> 00:05:28,660 Let's imagine that a gentleman who's on the autism spectrum is also a dad and a husband and he's coming home from work after what's been a really draining and complex day, 73 00:05:29,059 --> 00:05:36,130 he's had work demands but also lots of other layers of unexpected changes in his schedule, 74 00:05:36,140 --> 00:05:38,230 detours on the route home. 75 00:05:38,600 --> 00:05:43,970 There were lots of sensory overload moments and a disagreement with a work colleague. 76 00:05:44,750 --> 00:05:51,579 So he comes home and mom who is home with three kids is not on the spectrum, 77 00:05:51,589 --> 00:05:55,070 but she does have sensory processing sensitivities, 78 00:05:55,200 --> 00:05:56,220 stickiness, 79 00:05:56,230 --> 00:05:58,529 and kids hanging on her and noise. 80 00:05:58,540 --> 00:06:02,600 And she's getting to the point that that has been really overwhelming today. 81 00:06:03,359 --> 00:06:05,149 She is home with three kids. 82 00:06:05,160 --> 00:06:21,200 A daughter who is eight has been home from school with the stomach flu but is feeling better and is now running around the house in her tutu singing and spinning and waving her magic wand around an autistic son who is 11, 83 00:06:22,160 --> 00:06:25,049 is melting down while doing his math homework. 84 00:06:25,070 --> 00:06:32,630 And another son is 15 and is playing loud music in his room with the door shut. 85 00:06:34,019 --> 00:06:35,790 So the first approach, 86 00:06:35,799 --> 00:06:41,040 the one that is our most typical go to may look like this. 87 00:06:41,549 --> 00:06:42,899 Dad walks in. 88 00:06:43,059 --> 00:06:46,480 Mom is yelling at her two youngest kids to be quiet. 89 00:06:46,660 --> 00:06:51,549 She's juggling hot food in the kitchen while trying to get food ready for dinner. 90 00:06:52,700 --> 00:06:58,130 The youngest daughter runs up to dad and wants to show off her tutu and her magic wand. 91 00:06:58,540 --> 00:07:03,549 And dad hears the loud music coming from upstairs and mom is thinking, 92 00:07:03,559 --> 00:07:06,059 thank goodness he is home. 93 00:07:06,220 --> 00:07:07,549 I need some help. 94 00:07:07,559 --> 00:07:14,130 I need some relief and dad is thinking I can't wait to get out of here and go for my bike ride. 95 00:07:16,299 --> 00:07:23,519 So mom and dad get in a fight about how he comes home and goes off by himself and she's been there all day, 96 00:07:23,529 --> 00:07:24,309 et cetera. 97 00:07:25,209 --> 00:07:28,279 So dad feels the pressure to make things right. 98 00:07:28,510 --> 00:07:30,950 He yells at his oldest son saying, 99 00:07:30,959 --> 00:07:34,070 why don't you turn off your music and come down and help your mother. 100 00:07:34,390 --> 00:07:40,850 And he yells at the middle son and says that math really isn't that hard and he should stop crying. 101 00:07:42,920 --> 00:07:55,970 We all get that right like we are at the end of our rope and we just want to make the chaos stop and calm down and we want other people to do their part. 102 00:07:58,119 --> 00:08:00,250 Let's think about a second approach. 103 00:08:01,019 --> 00:08:17,299 This is increased awareness that all of these people have really legitimate needs and a realization that there needs to be a way to figure out what they are and then to try to work together to do something. 104 00:08:19,170 --> 00:08:22,100 Mom is overwhelmed with sensory inputs. 105 00:08:22,109 --> 00:08:26,929 She's drained from the whole day of being the only adult at home, 106 00:08:27,079 --> 00:08:33,700 which means that she has been the go to person for everyone's needs in the household. 107 00:08:34,559 --> 00:08:37,588 So she needs quiet alone time. 108 00:08:37,838 --> 00:08:39,598 She needs compliments, 109 00:08:39,609 --> 00:08:41,059 she needs support. 110 00:08:41,900 --> 00:08:44,830 The youngest daughter suddenly feeling better. 111 00:08:45,239 --> 00:08:54,210 She needs to run off some of her nonsick energy and be recognized as someone who's beautiful and magical with her wand. 112 00:08:55,409 --> 00:08:59,330 The middle son has also been very drained from the day. 113 00:08:59,669 --> 00:09:06,080 He gets overwhelmed with the social and sensory environment at school and he has a math learning disability. 114 00:09:06,719 --> 00:09:17,369 So he has gone from a draining environment to a draining environment and he's doing a task that he just knows he can't have success with. 115 00:09:18,260 --> 00:09:21,840 He's unable to get his bearings to calm, 116 00:09:22,059 --> 00:09:23,469 to reenter, 117 00:09:23,479 --> 00:09:25,869 he needs some regulation help. 118 00:09:27,960 --> 00:09:39,880 The oldest son is feeling the angst of being a teen and this comes with easy irritation thinking his parents don't know anything and the loud music releases some of his irritability. 119 00:09:40,000 --> 00:09:43,450 It establishes his identity as his own person. 120 00:09:43,619 --> 00:09:46,969 So that is a lot. 121 00:09:49,590 --> 00:09:51,229 In this case, 122 00:09:51,900 --> 00:10:07,090 it often helps to have some type of planned huddle uh between the couple or with the family about what is the status right now and what do you need? 123 00:10:09,809 --> 00:10:18,659 The huddle is just a coming together to talk briefly about what are we gonna do next? 124 00:10:18,900 --> 00:10:20,820 What's going on and what are we gonna do? 125 00:10:21,979 --> 00:10:26,710 The status is really high chaos for everyone in this family right now. 126 00:10:27,979 --> 00:10:35,590 And sometimes families make up kind of humorous labels for levels of chaos or crisis. 127 00:10:35,880 --> 00:10:50,049 One family might use a color code where a code red is the most chaos or sometimes a movie related code where the most chaos is the Lord of the Rings scene where the orcs come. 128 00:10:51,070 --> 00:10:54,030 The status could also be a factual description. 129 00:10:54,190 --> 00:10:55,340 Bad day at work, 130 00:10:55,349 --> 00:10:57,619 really drained or bad day at home, 131 00:10:57,630 --> 00:10:58,539 really drained. 132 00:10:58,710 --> 00:11:02,919 And I'm at my breaking point at the highest level of chaos. 133 00:11:02,929 --> 00:11:05,309 Both mom and dad really need alone time. 134 00:11:05,669 --> 00:11:06,280 Now, 135 00:11:06,289 --> 00:11:07,820 what do the kids need? 136 00:11:08,450 --> 00:11:08,929 Well, 137 00:11:08,940 --> 00:11:11,000 you may have a quick family huddle, 138 00:11:11,320 --> 00:11:12,780 what do you need? 139 00:11:13,210 --> 00:11:21,960 Or the parents may have a sense already of what the kids would probably need to regulate and regroup. 140 00:11:22,349 --> 00:11:27,219 One helpful thing in this scenario might look like the following. 141 00:11:27,840 --> 00:11:36,130 Dad could go on his bike ride but also take the 11 year old son who's on the autism spectrum on the ride as well. 142 00:11:37,150 --> 00:11:42,070 They both really feel better after they get some pressure input, 143 00:11:42,080 --> 00:11:45,929 that's proprioceptive input and movement input, 144 00:11:45,940 --> 00:11:47,330 vestibular input. 145 00:11:47,669 --> 00:11:53,450 You can see our episode about sensory inputs for regulation. 146 00:11:54,070 --> 00:11:57,539 And this is why the bike ride is so important. 147 00:11:57,760 --> 00:12:03,200 If we tell dad not to go on the bike ride because the house is in chaos, 148 00:12:03,599 --> 00:12:07,409 he's not going to be able to regulate himself. 149 00:12:07,590 --> 00:12:09,849 So we want a dad who comes back, 150 00:12:09,859 --> 00:12:12,979 regulated centered calm. 151 00:12:13,239 --> 00:12:14,640 Um not at, 152 00:12:14,650 --> 00:12:15,890 at the breaking point. 153 00:12:16,539 --> 00:12:30,619 This bike ride also gives time for their mind to settle and it's a kind of together activity where they actually don't have to talk So it's the thing they like to do and we're together, 154 00:12:30,630 --> 00:12:36,780 but we don't have to say anything and that's very calming and regulating for them. 155 00:12:38,750 --> 00:12:40,349 Perhaps in this scenario, 156 00:12:40,359 --> 00:12:51,559 mom chooses a bubble bath with headphones and music and gives the 15 year old a task to keep him busy and to acknowledge his independence. 157 00:12:52,200 --> 00:13:01,650 So there's a small corner store about three blocks away and she gives him $15 to walk to the corner store and to take the eight year old, 158 00:13:03,049 --> 00:13:11,119 the eight year old can spin and sing and walk with her wand and he gets to choose whatever he wants for, 159 00:13:11,130 --> 00:13:13,539 quote dessert for the family. 160 00:13:14,460 --> 00:13:18,489 He chooses lots of movie candy like now and laters, 161 00:13:18,500 --> 00:13:21,059 Mike and Ike and Swedish fish. 162 00:13:21,070 --> 00:13:25,109 And he lets his sister pick out a Princess Pez dispenser. 163 00:13:25,700 --> 00:13:27,390 Then they walk home, 164 00:13:27,400 --> 00:13:29,330 mom's done with their bath. 165 00:13:29,340 --> 00:13:38,270 Dad and son are home and this is a regrouping time that acknowledges as many people's needs as possible. 166 00:13:38,609 --> 00:13:44,409 And then there can be a huddle at that point about how the rest of the night might go. 167 00:13:46,419 --> 00:13:54,750 But we at least want to problem solve when as many people as possible are more centered and less close to the breaking point. 168 00:13:57,289 --> 00:14:06,520 So this focus and strategy is uh really pinpointing what other people need people in the household. 169 00:14:06,869 --> 00:14:12,479 And it uses the huddle concept to come together and make a plan. 170 00:14:12,849 --> 00:14:14,979 So it's a quick coming together. 171 00:14:14,989 --> 00:14:16,690 It's not like a family meeting, 172 00:14:16,700 --> 00:14:18,739 where we talk through things, 173 00:14:18,859 --> 00:14:21,580 it's what's going on and what do we need to do. 174 00:14:23,190 --> 00:14:23,679 Now, 175 00:14:23,690 --> 00:14:26,760 we all know that this doesn't make everything easy, 176 00:14:26,780 --> 00:14:35,969 but it often makes things better and it creates partnerships within the household rather than really strained relationships. 177 00:14:40,070 --> 00:14:44,280 Let's look at another approach to household culture. 178 00:14:44,419 --> 00:14:51,020 So the second one is focusing on tradition and structure in order to interact, 179 00:14:52,859 --> 00:14:55,090 individuals with autistic neurology, 180 00:14:55,099 --> 00:15:04,099 often prefer structured topic based activities rather than hanging out or sharing about their day or sharing about feelings. 181 00:15:04,510 --> 00:15:10,869 These are typically more enjoyable to them than just unstructured together time. 182 00:15:12,219 --> 00:15:16,950 It might involve harnessing their knowledge about something that they love. 183 00:15:19,450 --> 00:15:25,099 And once you know who in the family really likes this kind of interaction. 184 00:15:25,109 --> 00:15:26,320 And you can say, 185 00:15:26,479 --> 00:15:29,049 I know this is what we enjoy best. 186 00:15:29,380 --> 00:15:35,059 This awareness can help increase the number of nice family memories or interactions. 187 00:15:35,380 --> 00:15:37,239 So for example, 188 00:15:37,250 --> 00:15:46,159 let's take a family um who likes to socially connect at the dinner table by sharing about their day, 189 00:15:46,380 --> 00:15:47,929 how the practice went, 190 00:15:47,940 --> 00:15:49,409 how their soccer game? 191 00:15:49,419 --> 00:15:53,669 Did uh did your friend feel good about their science project? 192 00:15:53,679 --> 00:15:56,809 How is your boss's husband doing since his surgery, 193 00:15:56,820 --> 00:15:57,510 et cetera? 194 00:15:58,900 --> 00:16:02,880 In contrast to another family with neurodiversity, 195 00:16:02,890 --> 00:16:03,359 now, 196 00:16:03,369 --> 00:16:10,299 they may prefer something more structured and less about how people felt or responded, 197 00:16:10,780 --> 00:16:14,119 less open ended or broad questions about the day. 198 00:16:14,340 --> 00:16:15,919 So what might that look like? 199 00:16:17,909 --> 00:16:25,080 This family might start a tradition at the dinner table where they each share an interesting fact that they learned that day. 200 00:16:25,159 --> 00:16:30,159 So perhaps the eight year old learned that most fish don't have eyelids. 201 00:16:30,580 --> 00:16:33,000 The 15 year old learned that on average, 202 00:16:33,010 --> 00:16:36,739 every person on earth owns 86 Lego Bricks. 203 00:16:40,210 --> 00:16:42,320 Let's look at another example. 204 00:16:42,330 --> 00:16:44,059 Let's take a spouse. 205 00:16:44,400 --> 00:16:56,059 We're looking at a woman who feels dissatisfied because her husband doesn't engage in conversations during times like car rides or while at a restaurant and waiting on their meal. 206 00:16:56,739 --> 00:17:03,609 She's realized though that they can have a really good social interaction if it's structured about a topic. 207 00:17:04,250 --> 00:17:12,939 She's also noticed that they have a good time interacting if they take online quizzes or play trivia together during these times. 208 00:17:13,660 --> 00:17:22,630 So the passenger in the car can ask the driver trivia questions and then they can switch and she notices that they really end up laughing, 209 00:17:22,640 --> 00:17:24,089 they learn new things. 210 00:17:24,099 --> 00:17:25,530 It works out well. 211 00:17:25,540 --> 00:17:28,380 It's actually a really connecting time, 212 00:17:28,689 --> 00:17:34,829 uh much better than the silence of sitting together without interacting. 213 00:17:37,680 --> 00:17:39,530 Let's take a third family. 214 00:17:39,619 --> 00:17:53,829 This family has teens and it's been struggling because the kids are a bit more moody than they were as youngsters and they're too old for some of the things that they used to do as a family when they were younger. 215 00:17:54,099 --> 00:17:54,380 You know, 216 00:17:54,390 --> 00:17:57,170 they don't like going to the zoo anymore. 217 00:17:58,119 --> 00:18:05,349 This family realized that structuring some traditions for activities has worked better than small talk. 218 00:18:05,359 --> 00:18:13,849 Like how with school they might have a Friday night tradition of board games and pizza or they might rotate, 219 00:18:13,859 --> 00:18:16,530 who gets to pick the Friday night activity. 220 00:18:16,979 --> 00:18:21,810 One teen may pick a movie and chooses the snacks next week, 221 00:18:21,819 --> 00:18:26,089 another chooses a board game and challenges kids against parents. 222 00:18:26,579 --> 00:18:31,229 And the next week mom chooses a Lock Drew mystery for the family to solve together. 223 00:18:32,780 --> 00:18:43,729 So this approach harnesses the fact that individuals with autistic neurology may really enjoy each other within the context of some structure, 224 00:18:43,739 --> 00:18:53,310 topic and activity rather than these loose connecting moments or open ended questions like how is your day and what's going on in your life. 225 00:18:56,209 --> 00:19:00,420 There's so much that goes into the culture of a household. 226 00:19:00,790 --> 00:19:18,670 But these two tips of helping people get their needs met and coming together with structure and topic focused activities can be part of what helps shift things in a good direction for many families and it really protects those partnering kinds of relationships. 227 00:19:19,989 --> 00:19:24,660 Thank you for joining me today to talk about households and families, 228 00:19:24,819 --> 00:19:27,060 protecting the wellness of our family. 229 00:19:27,069 --> 00:19:32,709 Connections can help us feel more supported and resilient overall. 230 00:19:33,530 --> 00:19:42,430 And next time we will round out this series by focusing on adding meaning and growth to areas of special interest. 231 00:19:42,619 --> 00:19:44,219 I hope you can join me then.

23. Autism and Intentional Living: Communicating and Connecting07.05.2023 (00:25:24)

    Do you want to live with more intention to achieve your goals? In this 4th episode in a series on Intentional Living, Dr. Regan identifies ways to use communication to create connection and help you achieve the life goals you aim for.   Resources mentioned in the podcast:  Talking About Autism podcast series The Science of Making Friends: book Better Small Talk: book Crucial Conversations: book   Dr. Regan's Resources Book: Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians   Read the transcript here: 1 00:00:03,809 --> 00:00:04,659 Hi there. 2 00:00:04,670 --> 00:00:06,679 This is Doctor Theresa Regan. 3 00:00:06,969 --> 00:00:11,510 I'm joining you for an episode of autism in the Adult podcast. 4 00:00:11,800 --> 00:00:13,619 I'm a neuropsychologist, 5 00:00:13,859 --> 00:00:19,120 the founder and director of an autism diagnostic clinic in Central Illinois. 6 00:00:19,290 --> 00:00:21,959 And I'm the parent of a teen on the spectrum. 7 00:00:22,680 --> 00:00:27,440 Did you know that I did a podcast series on talking about autism? 8 00:00:27,659 --> 00:00:30,420 This was in February of 2022. 9 00:00:30,559 --> 00:00:43,909 It had three episodes where I covered things like how to talk to other people about your journey to seek a diagnostic evaluation or how to tell people that you've received a new diagnosis of autism. 10 00:00:44,340 --> 00:00:53,270 We cover topics about how to process and navigate the emotions of other people during conversations about autism. 11 00:00:53,909 --> 00:01:01,279 And we also reviewed how to talk to someone that you are familiar with --someone in your family, 12 00:01:01,290 --> 00:01:05,739 someone that you know -- about the possibility that they are on the spectrum. 13 00:01:06,089 --> 00:01:08,930 Maybe they haven't thought about it that way, 14 00:01:08,940 --> 00:01:12,319 but you recognize some characteristics in them. 15 00:01:13,010 --> 00:01:18,069 I'm going to put a link to this series talking about autism in the show notes. 16 00:01:18,599 --> 00:01:26,940 But today you are joining me for episode number four in a series about intentional living on the autism spectrum, 17 00:01:28,309 --> 00:01:33,629 we all get into rhythms and routines that have a life of their own. 18 00:01:33,900 --> 00:01:36,000 Sometimes our schedules, 19 00:01:36,010 --> 00:01:37,540 what we typically do, 20 00:01:37,550 --> 00:01:41,440 what we don't do... things that crop up in our lives. 21 00:01:41,449 --> 00:01:56,860 They catch us up in their momentum and sometimes it's just nice to pause and to step back and really see if the life that we're living lines up with where we'd like to be in the future. 22 00:01:57,389 --> 00:02:01,150 Are we choosing this life? 23 00:02:01,160 --> 00:02:07,860 Are we being swept away without really pausing to make some choices and decisions? 24 00:02:08,440 --> 00:02:14,639 And certainly we can't have the final say in everything that our life entails. 25 00:02:14,649 --> 00:02:22,020 But we really will be able to capture more of our dreams and visions for the future 26 00:02:22,029 --> 00:02:27,259 if we pause and make choices that line up with those... 27 00:02:27,690 --> 00:02:29,339 those goals that we have. 28 00:02:31,770 --> 00:02:38,740 This need to pause and reevaluate our intentions and choices is a universal human need. 29 00:02:39,470 --> 00:02:49,300 But we're spending some time talking about this in the context of autism because sometimes the individual on the spectrum will struggle more with this, 30 00:02:49,750 --> 00:03:03,759 possibly because they have difficulty switching gears from the typical routine or maybe this individual has problems finding the energy or the momentum to get going with something new. 31 00:03:04,820 --> 00:03:12,910 This person may feel like it's challenging to get out of the hyper focus of the moment and to try to think long term. 32 00:03:13,919 --> 00:03:16,889 So in the first episode for this series, 33 00:03:16,899 --> 00:03:25,009 we talked about how to get to the point where you can actually choose a goal that is difficult in itself. 34 00:03:26,360 --> 00:03:35,020 We outlined several life categories that you could analyze to see if you would like to think of a goal in these categories. 35 00:03:35,940 --> 00:03:36,190 Now, 36 00:03:36,199 --> 00:03:41,110 the second episode was about how to make specific goals within a category. 37 00:03:41,990 --> 00:03:50,080 So we want the goal to help us shift from our current place and leave the boundaries of our comfort zone. 38 00:03:50,440 --> 00:03:58,820 But we don't want it to be overwhelming or self defeating because we picked a goal that's just too difficult, 39 00:03:58,830 --> 00:03:59,720 too big... 41 00:03:59,960 --> 00:04:02,059 feels insurmountable. 42 00:04:03,929 --> 00:04:16,660 The third episode in this series about living with intention had to do with strategies to reach goals within the area of health and wellness specifically with regulation. 43 00:04:17,278 --> 00:04:25,069 And this is often a good place to start in our lives when we're trying to grow and challenge ourselves. 44 00:04:25,079 --> 00:04:29,028 Because if we're setting goals, 45 00:04:29,199 --> 00:04:34,989 this is really us setting a goal to do difficult things. 46 00:04:35,290 --> 00:04:39,399 And if we're not regulated when we start these goals, 47 00:04:39,410 --> 00:04:41,750 if we're not feeling grounded, 48 00:04:41,760 --> 00:04:42,859 centered, 49 00:04:42,869 --> 00:04:45,609 calm and psychologically present, 50 00:04:45,750 --> 00:04:47,880 attentive and rested, 52 00:04:48,480 --> 00:04:56,290 it's really difficult to leave our comfort zone in any other area to really have intentional living. 53 00:04:56,619 --> 00:05:04,480 So it is often nice to make sure that we're really well regulated before we jump into any other goals. 54 00:05:05,790 --> 00:05:16,679 So now today you are listening to the fourth episode and we're going to focus on intentional living within communication and relationships. 55 00:05:17,359 --> 00:05:21,399 And you may be asking why do I need to have social goals? 56 00:05:21,570 --> 00:05:22,010 Well, 57 00:05:22,019 --> 00:05:22,950 you don't, 58 00:05:23,149 --> 00:05:30,350 your communication and your social network don't have to match any particular template that others use. 59 00:05:30,420 --> 00:05:32,489 But at the same time, 60 00:05:32,500 --> 00:05:35,619 if you have a vision for your future, 61 00:05:36,269 --> 00:05:44,089 you may need to grow in certain areas of communication or connection so that you can meet the goals that you do have. 62 00:05:45,309 --> 00:05:46,640 For example, 63 00:05:46,649 --> 00:05:52,359 one person may want to become a history teacher because they love history. 64 00:05:52,959 --> 00:05:54,299 That is a great goal. 65 00:05:54,309 --> 00:05:59,600 It's a way of sharing your love of a topic with other people. 66 00:06:00,269 --> 00:06:04,579 But you'll also need to have some skills for communication, 67 00:06:04,589 --> 00:06:08,549 updates with your work team and with your students and families. 68 00:06:08,579 --> 00:06:11,079 Maybe about projects or grades, 69 00:06:11,350 --> 00:06:18,500 you'll have to have communication skills to interact with people who are really upset with you or disagree with you. 70 00:06:19,329 --> 00:06:26,329 Maybe you'll be put in charge of a major project for the school and you'll have to present on the topic. 71 00:06:27,269 --> 00:06:29,600 If you already have these skills, 72 00:06:29,609 --> 00:06:30,709 that's super, 73 00:06:30,720 --> 00:06:32,869 you don't need to grow in this area. 74 00:06:33,239 --> 00:06:43,220 But if you don't focusing on this area of growth may help you in the future as you take your path toward your ultimate goals. 75 00:06:44,989 --> 00:06:55,670 Another example would be someone who's just retired and maybe they're finding it difficult to connect or get along with their partner now that they're both at home a lot. 76 00:06:56,190 --> 00:07:01,600 So perhaps this person has a goal to connect in a more effective way. 77 00:07:01,709 --> 00:07:09,320 She may have a goal for communication and connecting in the home with this new life season of retirement. 78 00:07:11,369 --> 00:07:12,309 In contrast, 79 00:07:12,320 --> 00:07:15,920 you may be someone who's all set in this area. 80 00:07:16,170 --> 00:07:17,190 But in the future, 81 00:07:17,200 --> 00:07:26,429 you may want to have some things tucked away for different tasks or goals that crop up along the way this episode may be for you. 82 00:07:27,339 --> 00:07:39,309 So let's focus on three things to keep in mind that may help you reach a goal for more effective communication and connection in a particular area of your life. 83 00:07:40,220 --> 00:07:41,350 And let's face it, 84 00:07:41,359 --> 00:07:46,690 you are probably already super good at communicating about topics, 85 00:07:46,700 --> 00:07:47,929 facts, 86 00:07:47,940 --> 00:07:49,149 details, 87 00:07:49,380 --> 00:07:58,790 things like teaching about history or telling your partner that we're out of milk and somebody's got to get this supply at the store. 88 00:07:59,600 --> 00:07:59,910 Well, 89 00:07:59,920 --> 00:08:07,660 the trickier area of communication more often shows up when we're in an interaction and we start thinking, 90 00:08:07,670 --> 00:08:08,250 wow, 91 00:08:08,260 --> 00:08:10,339 what just happened here? 92 00:08:10,920 --> 00:08:16,299 What did this person react to in this conversation? 93 00:08:16,309 --> 00:08:18,799 I'm not even sure where they're coming from. 94 00:08:18,970 --> 00:08:21,399 I don't know what this person wants from me. 95 00:08:22,059 --> 00:08:23,109 After all, 96 00:08:23,119 --> 00:08:25,549 I was right about what I said. 97 00:08:26,040 --> 00:08:29,429 So why all this emotion or all this up and down? 98 00:08:30,100 --> 00:08:36,469 Let's look at a few areas of focus that can balance out that connection piece. 99 00:08:36,989 --> 00:08:38,070 First of all, 100 00:08:38,080 --> 00:08:42,669 I want to introduce and bring more into your awareness, 101 00:08:42,679 --> 00:08:45,349 this focus on the other. 102 00:08:46,200 --> 00:08:49,210 So when you are communicating with someone, 103 00:08:49,219 --> 00:08:51,409 whether that is a history teacher, 104 00:08:51,419 --> 00:08:55,380 talking to a parent or a woman who's just retired, 105 00:08:55,390 --> 00:08:56,710 talking to her partner. 106 00:08:57,080 --> 00:09:05,799 There is a difference between communication that's factually correct and communication that is effective. 107 00:09:07,400 --> 00:09:09,309 It helps to be correct. 108 00:09:10,020 --> 00:09:13,549 But we also want communication that's more than correct. 109 00:09:13,559 --> 00:09:15,630 We want it to be productive, 110 00:09:15,739 --> 00:09:16,489 helpful, 111 00:09:16,500 --> 00:09:18,710 valuable and fruitful. 112 00:09:19,380 --> 00:09:21,880 So remember what your goals are, 113 00:09:22,369 --> 00:09:36,729 is your goal to strengthen your relationship with your partner? is your goal to be a history teacher? ...and all these other goals you might have where communication and connection are important to meet that goal. 114 00:09:37,030 --> 00:09:52,440 One way to improve the effectiveness of our communication is to be able to pause during an interaction and focus on the other person rather than on the topic. 115 00:09:53,280 --> 00:09:55,710 And sometimes to be honest, 116 00:09:56,559 --> 00:10:03,530 this whole interaction happens and we never pause and we're a bit surprised and taken aback. 117 00:10:03,710 --> 00:10:08,690 And we process things after that's OK too. 118 00:10:09,489 --> 00:10:16,400 The goal eventually will be able to pause and process a bit during the interaction to adjust. 119 00:10:16,760 --> 00:10:22,270 But we may start by analyzing and thinking through things after the fact, 120 00:10:23,789 --> 00:10:26,580 focus on the other person. 121 00:10:26,590 --> 00:10:32,859 So ask yourself things like what does this person need from me right now? 122 00:10:33,369 --> 00:10:37,549 Other than being correct about the facts, 123 00:10:37,559 --> 00:10:38,150 I'm saying, 124 00:10:38,159 --> 00:10:44,359 what do they need from me in the social conversation? 125 00:10:46,299 --> 00:11:04,739 Maybe they need to feel heard or they need you to understand how difficult their day has been or they need you to know and really recognize their contribution to the team even though you've decided to take the work project in another direction. 126 00:11:05,359 --> 00:11:05,830 Now, 127 00:11:05,840 --> 00:11:11,169 these kinds of wonderings and kind of exploring these questions, 128 00:11:11,179 --> 00:11:17,400 this could be something that we do in a counseling or therapy session really in depth, 129 00:11:17,409 --> 00:11:17,979 right? 130 00:11:18,250 --> 00:11:24,849 So if you are trying to um process your relationship with your partner, 131 00:11:24,979 --> 00:11:29,270 maybe you process interactions with a therapist. 132 00:11:29,719 --> 00:11:38,489 But there are also probably a few things to say during these interactions that might help um you focus on the other, 133 00:11:38,669 --> 00:11:40,450 the other person's needs. 134 00:11:41,150 --> 00:11:43,260 So you could say things like, 135 00:11:43,510 --> 00:11:51,989 tell me more about how you're doing and what I can do to help? if somebody has come up to you and they're upset, 136 00:11:52,010 --> 00:11:53,450 they're emotional, 137 00:11:53,700 --> 00:11:56,630 they're in really a confrontational moment. 138 00:11:57,479 --> 00:12:05,929 -- Letting them know that you'd like to know how they're doing and what you can do to help ... can be a connecting moment. 139 00:12:07,650 --> 00:12:14,340 What do you want me to know that you feel like I don't understand about what your experience is. 140 00:12:15,489 --> 00:12:18,020 What are your needs in this situation? 141 00:12:18,030 --> 00:12:25,270 Tell me what you need... or I really value you and I do want to be part of the solution, 142 00:12:25,280 --> 00:12:26,530 not the problem. 143 00:12:28,989 --> 00:12:32,109 Do you need to say these specific words? 144 00:12:32,169 --> 00:12:32,840 No, 145 00:12:33,109 --> 00:12:40,169 it's important to make them your own and to match them to the person that you're talking to in the context. 146 00:12:40,179 --> 00:12:54,169 But the sentiment is there that you want good things to come out of this conversation that you want to know where they're coming from and what you can do um to advance things, 147 00:12:54,179 --> 00:12:54,849 support them, 148 00:12:54,859 --> 00:12:56,070 make things better. 149 00:12:58,150 --> 00:13:05,010 The basic idea is to pause and to ask for input about what they need in this situation. 150 00:13:05,380 --> 00:13:09,359 And it doesn't mean you have to change your opinion or your decisions. 151 00:13:09,369 --> 00:13:16,159 But in the midst of factual things like projects and chores making plans, 152 00:13:16,169 --> 00:13:23,619 there's still value that is found in recognizing the needs of the other during these interactions. 153 00:13:24,030 --> 00:13:31,809 And that can help bridge the gap from conversation that is factual to conversation, 154 00:13:31,820 --> 00:13:33,460 that is effective. 155 00:13:33,909 --> 00:13:36,419 The second thing I'd like you to keep in mind. 156 00:13:36,429 --> 00:13:45,219 And this is also a way of focusing on connecting with the other is the use of compliments and gratitude. 157 00:13:46,400 --> 00:13:55,640 This is another way that we can attend to the person and set the stage for the communication and the relationship. 158 00:13:56,309 --> 00:14:00,119 So some would say this person's only doing their job, 159 00:14:00,130 --> 00:14:03,520 why do I have to compliment them or thank them? 160 00:14:03,830 --> 00:14:05,400 I don't need that. 161 00:14:05,460 --> 00:14:06,460 I don't want that. 162 00:14:06,469 --> 00:14:07,859 I don't even like that. 163 00:14:09,039 --> 00:14:17,140 But this is a relatively easy thing that helps attend to what the other person needs even if you don't need it. 164 00:14:17,489 --> 00:14:22,489 So it sets the stage for people to understand how you view them. 165 00:14:23,099 --> 00:14:26,729 And when difficult things do happen in the relationship, 166 00:14:26,750 --> 00:14:33,030 the way that we interpret those may have to do with how this stage has been set in the past. 167 00:14:33,179 --> 00:14:34,150 For example, 168 00:14:34,159 --> 00:14:40,770 if is this a person who really knows for multiple examples in the past that you value them. 169 00:14:41,070 --> 00:14:45,000 And therefore this glitch in communication or this disagreement, 170 00:14:45,289 --> 00:14:46,669 it's tough, 171 00:14:47,150 --> 00:14:50,669 maybe it's unpleasant but it's not monumental. 172 00:14:51,500 --> 00:14:56,039 Or is this someone who really doesn't know that you value them? 173 00:14:56,049 --> 00:15:00,760 And therefore every communication glitch is really a big deal. 174 00:15:01,109 --> 00:15:04,580 So compliments and gratitude set the stage. 175 00:15:04,590 --> 00:15:07,260 This is how I think about you. 176 00:15:07,270 --> 00:15:09,419 This is how I think about our team. 177 00:15:09,479 --> 00:15:10,080 Again, 178 00:15:10,090 --> 00:15:11,140 I see you, 179 00:15:11,200 --> 00:15:16,099 I value you and it doesn't have to be mushy and emotional. 180 00:15:16,109 --> 00:15:18,840 It should fit the context and the person. 181 00:15:19,070 --> 00:15:19,789 But again, 182 00:15:19,799 --> 00:15:28,119 just a very uh brief uh effective way of adding to that connection during communication. 183 00:15:29,119 --> 00:15:32,179 Let's talk about two levels of compliment. 184 00:15:32,419 --> 00:15:40,890 One is a compliment about a skill or achievement and one is a compliment about a personal attribute. 185 00:15:41,530 --> 00:15:44,820 So the second one is really a higher level. 186 00:15:45,080 --> 00:15:52,830 Um and it gives a stronger message that I see you and I value you, 187 00:15:52,900 --> 00:15:56,789 not only do I see your product and I appreciate the product, 188 00:15:56,799 --> 00:16:00,590 but I see the person that produced that and, 189 00:16:00,599 --> 00:16:03,210 and I value your contribution. 190 00:16:04,179 --> 00:16:04,440 Now, 191 00:16:04,450 --> 00:16:11,880 they're both powerful and you can choose the type that you use based on how well you know the person, 192 00:16:11,890 --> 00:16:17,549 what your goal is in that social interaction and what else is happening in the context. 193 00:16:18,559 --> 00:16:19,530 For example, 194 00:16:19,539 --> 00:16:26,830 a partner who's trying to improve his relationship with his spouse could either say this is a delicious dinner. 195 00:16:26,840 --> 00:16:33,270 It's great to come home after all these pressured meetings to a really pleasant meal. 196 00:16:33,280 --> 00:16:35,549 And I thank you so much for fixing it. 197 00:16:36,700 --> 00:16:47,549 That would be a really nice way to set the relationship stage that you see the work that went into this and you've enjoyed the meal and you're grateful. 198 00:16:48,489 --> 00:16:48,900 Now, 199 00:16:48,909 --> 00:16:53,099 if it's a partner use this next level of compliment, 200 00:16:53,559 --> 00:17:04,060 he may have said you are such a great cook and you seem to know just what would help me unwind from a long and pressured day at work. 201 00:17:04,069 --> 00:17:06,140 I so appreciate that about you. 202 00:17:07,819 --> 00:17:14,420 Compliments and thank yous this gratitude and acknowledgement of the other, 203 00:17:14,739 --> 00:17:17,199 what they've brought the skill sets, 204 00:17:17,209 --> 00:17:19,609 they have individual attributes. 205 00:17:19,930 --> 00:17:27,670 This can all help set the stage for a relationship that the other person feels safe and happy with. 206 00:17:32,109 --> 00:17:36,300 The third way of adding to this communication, 207 00:17:36,310 --> 00:17:49,010 that's not only factual but also effective is to think about to identify and discuss topics and life events that are important to the other person, 208 00:17:49,290 --> 00:17:51,800 even when they are not important to you, 209 00:17:51,810 --> 00:17:54,119 you really honestly don't care about them. 210 00:17:55,420 --> 00:17:56,170 But again, 211 00:17:56,180 --> 00:17:59,310 we're looking for communication that's effective. 212 00:17:59,349 --> 00:18:11,849 And you're choosing those moments when you are really working toward your longer term goals that I do want to have a better work team relationship. 213 00:18:11,859 --> 00:18:16,250 I do want to be able to be an effective teacher. 214 00:18:16,569 --> 00:18:29,770 So listen for things that are important to the other person and this might be things about their family it's good to know with people that you see or work with on a regular basis. 215 00:18:29,780 --> 00:18:31,449 What's their partner's name? 216 00:18:31,459 --> 00:18:32,829 What are their kids' names? 217 00:18:32,839 --> 00:18:35,770 What family are they interacting with? 218 00:18:35,780 --> 00:18:37,280 Who do they live with? 219 00:18:37,420 --> 00:18:41,880 Maybe they're talking about taking their son to his soccer tournament this weekend. 220 00:18:43,329 --> 00:18:47,650 This may be topics that they're passionate about but you are not. 221 00:18:48,040 --> 00:18:55,550 Maybe they love sci-fi movies or quilting might even be milestones in their life. 222 00:18:55,560 --> 00:18:59,459 It could be that they've had a birthday recently or a marriage anniversary. 223 00:18:59,910 --> 00:19:04,699 Maybe they've moved into a new apartment or purchased their first home. 224 00:19:05,670 --> 00:19:08,849 Even though these things are not important to you, 225 00:19:09,140 --> 00:19:18,819 they are important to the other and connecting in a more effective way with this person is part of your intentional life choice. 226 00:19:19,500 --> 00:19:27,630 You may consider making an effort to interact with this person once a week or once a month just to ask about things that are important to them. 227 00:19:28,849 --> 00:19:34,180 You don't have to know about the topic in order to bring it up in conversation. 228 00:19:34,329 --> 00:19:35,579 So people will say, 229 00:19:35,589 --> 00:19:36,119 well, 230 00:19:36,150 --> 00:19:39,599 not only do I not know about sci-fi movies, 231 00:19:39,609 --> 00:19:44,859 but I'm really not at all interested and I don't know what I would say. 232 00:19:45,969 --> 00:19:47,300 Um That's ok, 233 00:19:47,829 --> 00:19:49,219 this is about them. 234 00:19:49,229 --> 00:19:54,540 The goal is not to add content and correct factual information. 235 00:19:54,550 --> 00:20:03,560 The goal is to connect effectively and to set the stage of connection and you can do that without any factual knowledge. 236 00:20:04,680 --> 00:20:08,869 So you could say I don't know much about that topic. 237 00:20:09,329 --> 00:20:09,349 Uh, 238 00:20:09,359 --> 00:20:11,550 what do you like most about it? 239 00:20:11,729 --> 00:20:13,750 What first got you interested in, 240 00:20:14,270 --> 00:20:15,489 in that area? 241 00:20:16,180 --> 00:20:18,310 What's coming up related to that topic? 242 00:20:18,319 --> 00:20:18,410 So, 243 00:20:18,420 --> 00:20:22,829 let's say this is the sci-fi lover and you might say, 244 00:20:22,839 --> 00:20:23,369 hey, 245 00:20:23,510 --> 00:20:26,630 any big movies coming up that you're gonna go see. 246 00:20:27,290 --> 00:20:28,660 I'm not, 247 00:20:28,670 --> 00:20:28,920 um, 248 00:20:28,930 --> 00:20:30,920 up on what's at the movie theater. 249 00:20:31,260 --> 00:20:31,579 Um, 250 00:20:31,589 --> 00:20:42,010 so then this invites them to talk about their favorite topic And then later you could ask them how the movie was or someone who has, 251 00:20:42,020 --> 00:20:42,319 um, 252 00:20:42,329 --> 00:20:52,209 a real love for fish tanks and fish and little um villages in the fish tank that they build. 253 00:20:52,219 --> 00:20:53,170 Um You could say, 254 00:20:53,180 --> 00:20:53,420 hey, 255 00:20:53,430 --> 00:20:55,920 any new fish in your fish tank lately, 256 00:20:55,930 --> 00:20:57,229 what if you got that's new? 257 00:20:57,239 --> 00:20:58,510 Do you have a picture? 258 00:20:59,290 --> 00:21:04,520 So the purpose is not to contribute to a topic. 259 00:21:04,530 --> 00:21:06,969 The purpose is not to be correct. 260 00:21:07,000 --> 00:21:09,329 The purpose is to say, 261 00:21:09,339 --> 00:21:09,739 hey, 262 00:21:09,750 --> 00:21:10,500 I see you. 263 00:21:10,510 --> 00:21:11,500 I hear you. 264 00:21:11,839 --> 00:21:16,969 Um And I'm really acknowledging what's important to you. 265 00:21:17,359 --> 00:21:18,319 You could say, 266 00:21:18,329 --> 00:21:18,540 hey, 267 00:21:18,550 --> 00:21:21,260 how did the move to your new apartment go this weekend? 268 00:21:21,270 --> 00:21:22,959 Did you get hit with the rain? 269 00:21:24,160 --> 00:21:28,770 You can acknowledge what a big job it is to move and say, 270 00:21:28,780 --> 00:21:29,140 hey, 271 00:21:29,150 --> 00:21:31,209 I hope you feel settled in soon. 272 00:21:31,859 --> 00:21:33,250 You could say, 273 00:21:33,260 --> 00:21:35,650 how did your son's soccer tournament go? 274 00:21:35,969 --> 00:21:37,550 Did he feel good about it? 275 00:21:38,199 --> 00:21:41,689 Did you get to visit any interesting places or? 276 00:21:41,699 --> 00:21:44,109 I'm so glad you guys have that opportunity. 277 00:21:44,219 --> 00:21:45,790 What a big commitment that is, 278 00:21:45,800 --> 00:21:56,670 but I'm sure you'll have lots of great memories and perhaps you set a goal where you're going to ask someone on your work team, 279 00:21:56,680 --> 00:22:04,550 a follow up question once a week or three times a week and you're gonna rotate people. 280 00:22:05,400 --> 00:22:16,810 This is a way to make the goal real and to keep that intentionality in mind while working toward the goals that you do have. 281 00:22:17,229 --> 00:22:17,579 Now, 282 00:22:17,589 --> 00:22:22,260 there is so much we could cover about communicating and connecting. 283 00:22:22,599 --> 00:22:29,119 But hopefully this episode gives you some concrete things to use today in your relationships. 284 00:22:29,380 --> 00:22:36,319 We've reviewed the importance of pausing during an interaction to think about or ask the person what they need. 285 00:22:36,790 --> 00:22:45,790 We reviewed types of compliments and ways of expressing gratitude and how these can set the stage for helping with future interactions. 286 00:22:46,280 --> 00:22:57,229 And we reviewed that acknowledging what topics and life events are important to the other person can also really increase the value and fruitfulness of an interaction. 287 00:22:58,829 --> 00:23:03,979 If you want to dive deeper into communication and connection topics, 288 00:23:04,199 --> 00:23:06,560 there are great resources out there. 289 00:23:07,050 --> 00:23:07,420 Now, 290 00:23:07,430 --> 00:23:11,130 I don't have any financial interest in any of these products. 291 00:23:11,170 --> 00:23:16,859 I'm just offering some ideas of things that have helped or helped my clients in the past. 292 00:23:17,619 --> 00:23:25,219 I've linked some of my favorites in the show notes and one is a great book called The Science of Making Friends, 293 00:23:25,250 --> 00:23:30,760 which highlights strategies from the peers program that's out of U C L A. 294 00:23:31,160 --> 00:23:34,910 And there are chapters on finding and choosing good friends, 295 00:23:35,339 --> 00:23:37,579 elements of good conversations, 296 00:23:37,949 --> 00:23:39,680 dealing with arguments, 297 00:23:39,689 --> 00:23:41,290 handling and addressing, 298 00:23:41,300 --> 00:23:43,569 teasing and cyberbullying, 299 00:23:43,890 --> 00:23:48,239 minimizing rumors and gossip and changing a bad reputation. 300 00:23:48,589 --> 00:23:48,959 Now, 301 00:23:48,969 --> 00:23:53,699 this is a book that's focused on an audience of teens and young adults. 302 00:23:54,239 --> 00:24:00,270 I like to take those kind of books and apply the basic concepts to whatever age group I'm working with. 303 00:24:00,489 --> 00:24:03,550 But if you really don't relate to books in that way, 304 00:24:03,560 --> 00:24:09,130 and it's going to be distracting if people in the examples are from a different generation, 305 00:24:09,199 --> 00:24:10,989 that book may not be for you. 306 00:24:11,479 --> 00:24:16,920 There are also well known books such as Better Small Talk by Patrick King, 307 00:24:17,319 --> 00:24:25,550 How To Win Friends and Influence people by Dale Carnegie and Crucial Conversations by multiple people, 308 00:24:25,560 --> 00:24:27,959 Joseph Granny Carri Patterson, 309 00:24:28,000 --> 00:24:30,569 Ron mcmillan and Switzer. 310 00:24:31,390 --> 00:24:40,640 This book is a great tool to expand your skills at persuasion without being abrasive and to engage in conversations. 311 00:24:40,650 --> 00:24:44,439 Even when emotions are really running high, 312 00:24:44,770 --> 00:24:46,979 we're gonna need to know how to do that. 313 00:24:46,989 --> 00:24:51,859 If we're gonna be in connecting relationships that are really fruitful. 314 00:24:52,339 --> 00:24:58,449 There are many other great sources out there as well and I encourage you to find some that speak to you. 315 00:24:58,530 --> 00:24:58,839 Well, 316 00:24:58,849 --> 00:25:04,819 thanks again for joining me for this fourth episode of The Living With Intention Series. 317 00:25:04,849 --> 00:25:10,410 If you have goals that require you to expand your repertoire for communicating and connecting, 318 00:25:10,589 --> 00:25:15,030 I hope these tips and resources are a great place to start. 319 00:25:15,819 --> 00:25:22,310 Join me next time as we continue this series about intentional living on the autism spectrum.

24. Autism and Intentional Living: Using Sensory Inputs to Improve Regulation15.04.2023 (00:21:37)

    Want to live with more intention in order to achieve your goals? You may wish to start with steps to improve your core resilience so you can challenge yourself in other life areas. In this third episode in a series on intentional living, Dr. Regan identifies ways to improve resilience by using physical inputs to calm and center the nervous system.    As referenced in the current episode:  Dr. Regan's Zur Institute courses for clinicians Autism in the Adult regulation series- episode one The Alert Program The Alert Program: Your Best Self Online Course   Dr. Regan's Resources Book: Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians   Read the transcript here: 1 00:00:05,710 --> 00:00:06,119 Hi, 2 00:00:06,130 --> 00:00:06,800 everyone. 3 00:00:06,809 --> 00:00:11,319 This is Dr Regan, host of the podcast Autism in the Adult. 4 00:00:11,539 --> 00:00:13,239 I'm a neuropsychologist, 5 00:00:13,250 --> 00:00:17,729 a certified autism specialist and mom to a teen on the spectrum. 6 00:00:18,149 --> 00:00:25,360 It's my great pleasure to direct an autism diagnostic clinic in Central Illinois for adolescents, 7 00:00:25,370 --> 00:00:27,360 adults and aging adults. 8 00:00:27,790 --> 00:00:32,139 If you are a clinician wanting to increase your knowledge of autism, 9 00:00:32,150 --> 00:00:34,259 in order to better serve your clients, 10 00:00:34,490 --> 00:00:38,250 you may want to check out my courses at Zur Institute, 11 00:00:38,349 --> 00:00:40,409 Z U R Institute. 12 00:00:40,759 --> 00:00:44,880 The links will be in the show notes for this podcast episode. 13 00:00:45,520 --> 00:00:48,130 If you're a regular follower of the podcast, 14 00:00:48,139 --> 00:00:54,569 you will know that we are in the third episode in a series about living with intention on the spectrum. 15 00:00:55,400 --> 00:01:00,009 I would encourage you to listen to the first two episodes to get the most information. 16 00:01:00,139 --> 00:01:03,849 Although this episode can be stand alone as well. 17 00:01:04,300 --> 00:01:04,750 Today, 18 00:01:04,760 --> 00:01:10,569 we'll be talking about a goal within the area of health and wellness and specifically, 19 00:01:10,580 --> 00:01:16,230 we're going to focus on improving regulation using sensory inputs. 20 00:01:16,389 --> 00:01:16,699 Now, 21 00:01:16,709 --> 00:01:21,449 I have several other episodes about regulation and I'll link them in the show notes, 22 00:01:21,900 --> 00:01:33,330 but in short regulation refers to the ability to stay centered balanced to get that just right state to be both calm and attentive. 23 00:01:33,339 --> 00:01:34,349 At the same time, 24 00:01:35,419 --> 00:01:38,050 this regulation can look like a meltdown, 25 00:01:38,059 --> 00:01:39,209 a panic attack, 26 00:01:39,220 --> 00:01:44,309 an outburst or it could look like withdrawal from a place or activity. 27 00:01:44,319 --> 00:01:45,230 For example, 28 00:01:45,239 --> 00:01:50,510 I need to quit this conversation or I need to go to my room off by myself. 29 00:01:50,519 --> 00:01:52,180 I can't attend work today. 30 00:01:52,190 --> 00:01:53,519 I can't go to school. 31 00:01:54,300 --> 00:01:56,809 It can also look like freeze, 32 00:01:57,209 --> 00:02:01,470 like shutting down feeling offline or dissociating. 33 00:02:02,309 --> 00:02:03,080 And finally, 34 00:02:03,089 --> 00:02:13,020 disregulation can look like the experience of physical symptoms that are not rooted or at least not completely caused by a physical condition, 35 00:02:13,250 --> 00:02:15,520 injury or disease process. 36 00:02:16,020 --> 00:02:21,479 Individuals on the spectrum are more likely to struggle with dysregulation in some form. 37 00:02:21,789 --> 00:02:30,639 Although what the dysregulation looks like can be different from one person to the next and can also change over the lifespan of the individual. 38 00:02:30,649 --> 00:02:52,699 So we can see how important the wellness topic of regulation is and why we're talking about regulation as a goal first because for some people on the spectrum regulation needs to improve before they can experience enough resiliency to get out of their comfort zone in other areas of life, 39 00:02:52,710 --> 00:02:58,130 like relationships or working or other areas that we've discussed in the series. 40 00:02:58,139 --> 00:02:58,860 So far, 41 00:02:59,470 --> 00:03:08,910 the tricky thing is that there are often more limitations to the success of regulation strategies on the spectrum than for the neurotypical. 42 00:03:09,089 --> 00:03:17,360 And the go to strategies are often some combination of counseling or talking through the difficulty, 43 00:03:17,369 --> 00:03:20,089 maybe reasoning through problems, 44 00:03:20,339 --> 00:03:27,479 we might add medication for the support of regulation or use punishment and reward programs. 45 00:03:28,350 --> 00:03:38,270 It's not that there's anything wrong with these approaches and they can be helpful as part of a layer in an overall program to help with regulation. 46 00:03:38,279 --> 00:03:39,470 However, 47 00:03:39,750 --> 00:03:42,919 if these are the only approaches we're relying on, 48 00:03:42,970 --> 00:03:46,100 there are likely to be some pretty big limitations. 49 00:03:47,050 --> 00:03:49,550 So let's think about how the nervous system works. 50 00:03:49,559 --> 00:03:52,699 If an infant is screaming, 51 00:03:52,710 --> 00:03:54,500 relentlessly crying, 52 00:03:54,509 --> 00:03:55,500 very upset, 53 00:03:55,509 --> 00:03:57,029 can't calm down. 54 00:03:57,320 --> 00:03:58,039 In other words, 55 00:03:58,050 --> 00:03:59,660 they can't regulate. 56 00:04:00,460 --> 00:04:05,610 We don't try to reason with them about how they're completely safe. 57 00:04:05,619 --> 00:04:07,509 They've just been fed, 58 00:04:07,520 --> 00:04:12,589 they're not in any danger or that their crying is really too loud. 59 00:04:12,600 --> 00:04:13,869 It's bedtime. 60 00:04:14,690 --> 00:04:17,260 We don't go reasoning through all that. 61 00:04:17,998 --> 00:04:23,368 We don't give them medication for depression or for anxiety. 62 00:04:23,959 --> 00:04:28,348 We don't use rewards or punishments in the traditional sense. 63 00:04:28,799 --> 00:04:29,239 Again, 64 00:04:29,248 --> 00:04:31,928 it's not that I don't recommend these approaches. 65 00:04:31,938 --> 00:04:34,588 I think they can be very helpful at times. 66 00:04:34,598 --> 00:04:40,098 But I'm pointing out that there is another way for humans to regulate their nervous system. 67 00:04:40,378 --> 00:04:43,428 And if you picture what we do for the infant, 68 00:04:44,070 --> 00:04:46,149 we hold them. 69 00:04:46,359 --> 00:05:02,649 Sometimes we swaddle the infant in a blanket and the holding or swaddling gives them pressure inputs that gives them this snug hug and then what do we do? 70 00:05:02,660 --> 00:05:02,920 Well, 71 00:05:02,929 --> 00:05:09,059 typically we rack them and this gives their brain some movement to input. 72 00:05:10,410 --> 00:05:13,260 This isn't always a magic way of calming an infant. 73 00:05:13,269 --> 00:05:18,619 But it often helps quite a bit as an approach to help the infant regulate, 74 00:05:18,630 --> 00:05:19,820 to center, 75 00:05:19,920 --> 00:05:21,470 to feel calm. 76 00:05:21,630 --> 00:05:26,179 Because the infant relies on the adult for regulation. 77 00:05:26,730 --> 00:05:29,140 This approach of using pressure, 78 00:05:29,420 --> 00:05:34,540 which we call proprioceptive inputs and movement. 79 00:05:34,579 --> 00:05:35,579 In this case, 80 00:05:35,589 --> 00:05:38,799 I'm talking about vestibular inputs. 81 00:05:39,170 --> 00:05:48,589 This approach of getting these inputs into the nervous system helps people of all ages and with all variations of nervous connections, 82 00:05:48,600 --> 00:05:49,859 nervous systems, 83 00:05:50,410 --> 00:05:53,359 uh whether you are neurotypical, 84 00:05:53,369 --> 00:05:55,850 whether you are neuro diverse, 85 00:05:55,859 --> 00:05:57,380 it doesn't matter we do. 86 00:05:57,390 --> 00:05:59,890 This is how our nervous system works. 87 00:06:00,049 --> 00:06:08,470 That's why therapists working with little kids on regulation may have them do heavy work like carrying or pushing something heavy. 88 00:06:08,690 --> 00:06:10,679 That's for the pressure input. 89 00:06:11,630 --> 00:06:15,489 It's why some individuals like weighted blankets for calming, 90 00:06:15,750 --> 00:06:17,679 that's pressure as well. 91 00:06:18,480 --> 00:06:22,820 Other individuals like to ride their bike after work or go jogging. 92 00:06:22,970 --> 00:06:23,279 Well, 93 00:06:23,290 --> 00:06:25,179 that's movement input. 94 00:06:25,290 --> 00:06:34,579 So we all tap into some of these inputs without really realizing why we like them or what role they have in helping us feel centered. 95 00:06:34,790 --> 00:06:35,309 Today, 96 00:06:35,320 --> 00:06:47,570 we'll focus on increasing your awareness of what your nervous system may need as far as physical inputs to help with regulation as well as how and when to use them. 97 00:06:48,450 --> 00:06:58,929 One place to start can be to think about what you have historically been drawn to perhaps as a child or in school or most recently, 98 00:06:59,600 --> 00:07:03,250 you can get pressure in the muscles or the joints, 99 00:07:03,260 --> 00:07:11,390 proprioceptive inputs into the brain pressure in the muscles could be from a massage or laying in a hammock. 100 00:07:11,399 --> 00:07:13,579 You get that squeeze input, 101 00:07:14,049 --> 00:07:16,429 laying under a weighted blanket, 102 00:07:16,779 --> 00:07:20,070 draping over an exercise ball, 103 00:07:20,679 --> 00:07:22,609 curling up in a chair. 104 00:07:22,619 --> 00:07:25,950 When we say I just want to curl up and read a good book. 105 00:07:26,320 --> 00:07:28,140 That's when we're giving ourselves, 106 00:07:28,149 --> 00:07:43,269 that kind of squeeze input being in the fetal position helps us have that squeeze hugs or bear hugs can give us that input laying on the ground or flapping on the ground. 107 00:07:43,869 --> 00:07:48,160 Pressure into the joints could be from things like pushing, 108 00:07:48,190 --> 00:07:49,000 pulling, 109 00:07:49,010 --> 00:07:49,950 hanging, 110 00:07:50,329 --> 00:07:54,200 anything that offers resistance through the joints, 111 00:07:54,829 --> 00:07:56,970 hanging from a pull up bar, 112 00:07:56,980 --> 00:07:58,559 shoveling snow, 113 00:07:58,709 --> 00:07:59,750 swimming, 114 00:08:00,019 --> 00:08:03,670 stretching a Farrah band or resistance band, 115 00:08:04,079 --> 00:08:08,959 riding a bike pressure through the jaw by chewing, 116 00:08:08,970 --> 00:08:14,140 resistive foods can also be pressure input for the nervous system. 117 00:08:14,459 --> 00:08:29,549 Maybe somebody loves to attack some beef jerky or crunchy food or chew gum pressure through the hands or feet by using a stress ball or rolling your foot over a tennis ball. 118 00:08:30,959 --> 00:08:34,729 You'll get the most input for the nervous system. 119 00:08:34,770 --> 00:08:37,530 When you're doing whole body activities, 120 00:08:37,539 --> 00:08:40,890 then when you're using the jaw or hands and feet, 121 00:08:41,119 --> 00:08:44,390 but we can't always do whole body activities. 122 00:08:44,789 --> 00:08:56,200 Maybe we're in a classroom and all we can do is have some gum that we're gonna chew on and maybe squeeze a stress ball under the desk movement. 123 00:08:56,210 --> 00:09:02,099 Input like the rocking baby gives vestibular input into the brain, 124 00:09:02,789 --> 00:09:08,140 the brain does not get vestibular input when we move our arms and legs, 125 00:09:08,150 --> 00:09:10,619 but we stand or sit still. 126 00:09:11,049 --> 00:09:13,049 There's no vestibular input. 127 00:09:13,059 --> 00:09:14,479 When we're on a treadmill, 128 00:09:14,489 --> 00:09:15,590 for example, 129 00:09:15,880 --> 00:09:18,700 or we're using a stationary bike, 130 00:09:19,299 --> 00:09:22,369 the fluid in our ears has to be moving. 131 00:09:22,559 --> 00:09:24,739 So when we're moving through space, 132 00:09:24,750 --> 00:09:26,719 like running through the neighborhood, 133 00:09:26,729 --> 00:09:29,450 swinging or riding a bike outside, 134 00:09:29,530 --> 00:09:32,059 then we're getting vestibular input. 135 00:09:32,849 --> 00:09:34,700 So those who say, 136 00:09:34,710 --> 00:09:34,900 oh, 137 00:09:34,909 --> 00:09:36,539 I love riding my bike, 138 00:09:36,549 --> 00:09:39,349 but I will not ride a stationary bike. 139 00:09:39,520 --> 00:09:44,690 What they may be saying is that their nervous system really needs that movement, 140 00:09:44,700 --> 00:09:47,890 that vestibular input through space. 141 00:09:48,950 --> 00:09:53,469 There are three types of vestibular input linear. 142 00:09:54,030 --> 00:09:57,369 So going in a relatively straight line, 143 00:09:57,380 --> 00:10:00,690 like if you're jumping up and down on a trampoline, 144 00:10:00,840 --> 00:10:06,750 swinging front and back or rocking left and right or front to back, 145 00:10:07,650 --> 00:10:10,919 rotary is spinning or twirling. 146 00:10:10,929 --> 00:10:14,020 That's the second kind of vestibular input. 147 00:10:14,710 --> 00:10:19,919 And the third kind are inversions which involves being upside down, 148 00:10:19,929 --> 00:10:21,840 like hanging upside down, 149 00:10:21,849 --> 00:10:26,429 doing a forward bend or doing a down dog position. 150 00:10:26,440 --> 00:10:27,080 In yoga. 151 00:10:27,900 --> 00:10:31,719 The movement inputs can be alerting or calming, 152 00:10:31,859 --> 00:10:35,929 intense or gentle as an individual. 153 00:10:35,940 --> 00:10:40,390 You can see what helps your nervous system at any given time. 154 00:10:40,799 --> 00:10:45,210 Someone who wants to feel calm or may want to rock in a rocking chair, 155 00:10:45,940 --> 00:10:57,330 sometimes people like to ride in the car and that just helps them feel centered and calm babies or little kids might fall asleep in the car. 156 00:10:57,340 --> 00:11:01,530 Even when they were so upset when they were actually getting in the car, 157 00:11:01,809 --> 00:11:07,580 another person may really feel calmer when they've been swinging again. 158 00:11:07,590 --> 00:11:15,320 We have the swings for infants that they can rock in and get that gentle front and back motion. 159 00:11:17,619 --> 00:11:24,390 Someone who wants to feel more alert and activated like I need energy, 160 00:11:24,400 --> 00:11:26,809 I need momentum to get going. 161 00:11:27,169 --> 00:11:31,609 They may want to ride their bike down a hill or jump on a trampoline. 162 00:11:31,940 --> 00:11:35,349 That vigorous movement input is often more alerting. 163 00:11:35,909 --> 00:11:37,250 So someone might say, 164 00:11:37,260 --> 00:11:37,630 oh, 165 00:11:37,640 --> 00:11:38,820 now, 166 00:11:38,900 --> 00:11:40,669 now I'm really awake. 167 00:11:41,099 --> 00:11:46,719 Every nervous system though responds a bit uniquely to these different kinds of inputs. 168 00:11:46,809 --> 00:11:57,619 So it's really important to know your own system to try different things safely and to gradually develop your own insight about what you need. 169 00:11:57,630 --> 00:12:03,809 And when there are some activities that provide both pressure and movement input, 170 00:12:04,169 --> 00:12:09,510 riding a bike gives pressure through the joints as well as movement through space. 171 00:12:10,119 --> 00:12:10,890 Climbing, 172 00:12:10,900 --> 00:12:18,349 a rock wall provides really intense pressure in the joints as well as gentle movement up the wall, 173 00:12:19,200 --> 00:12:22,619 swimming provides resistance through the joints. 174 00:12:22,640 --> 00:12:32,409 Some mild pressure on the muscles from the water pressure and some movement which could be mild or more intense depending on the speed of movement. 175 00:12:32,419 --> 00:12:35,530 Whether the person is going upside down. 176 00:12:35,570 --> 00:12:39,450 Are they diving off of a height or going down a water slide? 177 00:12:39,700 --> 00:12:43,289 If you think back to what you have really loved to do, 178 00:12:43,869 --> 00:12:47,750 you may get clues about what your nervous system prefers. 179 00:12:48,280 --> 00:12:54,820 One person may have a history of a love for diving and they've been on the swim team during school, 180 00:12:55,140 --> 00:12:59,880 but maybe they don't have any source of inputs since they graduated. 181 00:13:00,510 --> 00:13:05,349 They haven't even realized how important these inputs were to their regulation. 182 00:13:06,130 --> 00:13:09,520 Another person may have a love of roller coasters, 183 00:13:09,530 --> 00:13:10,880 fast motorcycles, 184 00:13:10,890 --> 00:13:11,989 skydiving, 185 00:13:12,150 --> 00:13:15,780 their system loves intense vestibular inputs. 186 00:13:16,440 --> 00:13:18,479 Another may love weightlifting, 187 00:13:18,489 --> 00:13:20,289 cracking their knuckles. 188 00:13:20,489 --> 00:13:25,159 This is another source of joint pressure and heavy work, 189 00:13:25,169 --> 00:13:26,219 like yard work, 190 00:13:26,229 --> 00:13:26,799 gardening, 191 00:13:26,809 --> 00:13:30,750 household projects involving a lot of lifting of supplies. 192 00:13:31,570 --> 00:13:34,270 If you can pinpoint what your system has liked, 193 00:13:34,280 --> 00:13:35,260 historically, 194 00:13:35,359 --> 00:13:40,359 you may have a place to start in experimenting with what your system needs. 195 00:13:40,369 --> 00:13:44,599 Now also take into account your current health, 196 00:13:44,609 --> 00:13:49,640 your physical abilities or restrictions and your doctor's advice. 197 00:13:49,690 --> 00:13:53,020 If you can't pinpoint what you've liked in the past, 198 00:13:53,030 --> 00:13:57,380 start making a list of things to try a little bit at a time. 199 00:13:58,010 --> 00:14:00,520 Perhaps some waits on one day, 200 00:14:00,530 --> 00:14:03,979 a walk through nature the next or swinging at the park. 201 00:14:04,760 --> 00:14:09,630 Once you identify an area of inputs that your system benefits from. 202 00:14:09,859 --> 00:14:10,429 And again, 203 00:14:10,440 --> 00:14:12,690 the benefit is feeling more centered, 204 00:14:12,700 --> 00:14:16,710 calm and fully present than before the activity, 205 00:14:16,849 --> 00:14:18,380 then start thinking, 206 00:14:18,390 --> 00:14:21,510 how else could I get inputs like this? 207 00:14:22,090 --> 00:14:23,549 If you love bike riding, 208 00:14:23,559 --> 00:14:27,130 perhaps try swinging for movement and pressure. 209 00:14:27,489 --> 00:14:32,530 If you love a way to blanket over you while rocking in a rocking chair, 210 00:14:32,630 --> 00:14:44,960 you may want to investigate a whole body swing that can be hung from the ceiling and just envelops you like a cocoon in the fabric while you move gently or vigorously. 211 00:14:45,330 --> 00:14:47,799 It can even spin in rotation. 212 00:14:48,840 --> 00:14:50,289 If you like weights, 213 00:14:50,299 --> 00:14:53,820 you might wanna try rock climbing for intense joint pressure. 214 00:14:54,159 --> 00:15:03,729 Some people who like vestibular input like to join aerial fitness gyms that allow them to hang upside down in a safe and controlled environment. 215 00:15:04,440 --> 00:15:11,190 Be creative and develop some awareness of what your system responds positively toward and again, 216 00:15:11,200 --> 00:15:12,010 make sure you know, 217 00:15:12,020 --> 00:15:13,140 your own body, 218 00:15:13,150 --> 00:15:17,669 your limitations and any recommendations from your own physician. 219 00:15:18,309 --> 00:15:19,960 So let's regroup. 220 00:15:19,969 --> 00:15:20,719 So far, 221 00:15:20,729 --> 00:15:23,570 you've learned about pressure and movement inputs, 222 00:15:24,140 --> 00:15:30,710 the variations of intensity and exercise versus restorative based inputs. 223 00:15:30,979 --> 00:15:34,809 So exercise could be something like riding a bike, 224 00:15:35,000 --> 00:15:35,919 restorative, 225 00:15:35,929 --> 00:15:40,580 could be something like laying in a hammock swing or a hammock. 226 00:15:42,780 --> 00:15:46,979 You've considered what you have liked or not liked historically. 227 00:15:46,989 --> 00:15:52,630 And perhaps you have a list of things to try in order to build up a repertoire of options. 228 00:15:53,479 --> 00:16:03,950 The next key to growing in the area of regulation is this don't wait to do the activities until you feel like you need it. 229 00:16:04,440 --> 00:16:05,950 This is crucial. 230 00:16:06,200 --> 00:16:06,770 Now, 231 00:16:06,780 --> 00:16:14,489 this doesn't mean that you shouldn't listen to your body if you're ill or injured and not able to do a specific activity that day. 232 00:16:14,909 --> 00:16:18,929 But what often happens for the autistic is that they feel great, 233 00:16:18,940 --> 00:16:19,500 great, 234 00:16:19,510 --> 00:16:20,330 great. 235 00:16:20,609 --> 00:16:23,299 And then they feel really off center. 236 00:16:23,309 --> 00:16:26,880 And a lot of times they'll say I just did not see that coming. 237 00:16:27,359 --> 00:16:32,650 So by the time they use their as needed inputs, 238 00:16:32,919 --> 00:16:35,169 they're already deregulated. 239 00:16:35,489 --> 00:16:37,250 So that's not the goal, 240 00:16:37,260 --> 00:16:53,179 the goal is to do the activities and give regular nervous system inputs that are regulating so that the episodes of disregulation decrease in number and they're easier to recover from. 241 00:16:53,919 --> 00:17:01,450 So think about ways to give yourself centering inputs multiple times a day and that will be individual to you. 242 00:17:02,090 --> 00:17:04,979 Some people might do this three times a day, 243 00:17:04,989 --> 00:17:06,239 maybe at the beginning, 244 00:17:06,250 --> 00:17:07,300 middle and end, 245 00:17:07,660 --> 00:17:16,099 they may need some pressure and movement in the morning to wake up to become energized and to also feel calm and attentive, 246 00:17:16,780 --> 00:17:20,349 they may need inputs over the lunch hour or midday. 247 00:17:20,359 --> 00:17:21,689 And then again at night, 248 00:17:22,069 --> 00:17:26,869 perhaps restorative inputs like a rocking chair or a weighted blanket, 249 00:17:27,050 --> 00:17:28,910 maybe some nighttime yoga. 250 00:17:30,459 --> 00:17:34,349 Then when you do become deregulated on any given day, 251 00:17:34,359 --> 00:17:39,810 think ahead of time about what your as needed inputs might be. 252 00:17:40,310 --> 00:17:43,000 So when you're in the moment of disregulation, 253 00:17:43,010 --> 00:17:46,089 it's really difficult to figure out what you need. 254 00:17:46,760 --> 00:17:50,150 So you may be able to think to yourself ahead of time. 255 00:17:50,489 --> 00:17:50,829 You know, 256 00:17:50,839 --> 00:17:52,619 when I get dis regulated, 257 00:17:52,630 --> 00:17:55,239 this is what that looks and feels like. 258 00:17:55,459 --> 00:17:59,160 And when I start to see myself in that place, 259 00:17:59,170 --> 00:18:08,060 I can try these handful of things to see if it helps in that moment of crisis or kind of surprise. 260 00:18:08,119 --> 00:18:08,260 Uh, 261 00:18:08,270 --> 00:18:09,579 off centering, 262 00:18:10,239 --> 00:18:11,290 you may say, 263 00:18:11,300 --> 00:18:11,729 ok, 264 00:18:11,739 --> 00:18:14,099 I've had a particularly intense day. 265 00:18:14,109 --> 00:18:16,609 I'm feeling more off center than usual. 266 00:18:16,699 --> 00:18:26,630 I'm going to walk around my work building three times or I'm going to do forward bends and shake my head back and forth or listen to music with my headphones. 267 00:18:26,910 --> 00:18:30,449 This can be what as needed inputs look like. 268 00:18:30,880 --> 00:18:34,569 So you can see that like with the music and headphones, 269 00:18:34,579 --> 00:18:41,739 sometimes the regulating inputs could be also um a sensory input from another domain. 270 00:18:41,770 --> 00:18:43,790 What do you like to listen to? 271 00:18:43,800 --> 00:18:46,810 What scent do you like to smell like? 272 00:18:46,819 --> 00:18:48,550 Lavender or vanilla? 273 00:18:48,920 --> 00:18:54,790 But usually the big regulating inputs will involve movement and pressure. 274 00:18:56,229 --> 00:18:57,680 So today, 275 00:18:57,689 --> 00:19:02,069 we have chosen a growth area within health and wellness. 276 00:19:02,099 --> 00:19:16,849 This may be a good place for you to start as you live life with intention because feeling more grounded can help you feel more resilient as you try to stretch your comfort zone in other areas. 277 00:19:17,270 --> 00:19:18,060 Remember, 278 00:19:18,069 --> 00:19:23,439 the general approach we discussed in episode two when developing this program. 279 00:19:23,900 --> 00:19:28,569 So try to set up small reachable steps forward, 280 00:19:28,859 --> 00:19:31,849 use strategy to find your momentum. 281 00:19:32,339 --> 00:19:37,130 And once you've integrated the physical inputs into your daily routine, 282 00:19:37,469 --> 00:19:41,599 that momentum will kick in and it'll help you. 283 00:19:41,609 --> 00:19:45,550 Um not feel that this whole thing is effortful. 284 00:19:45,560 --> 00:19:49,010 It'll be just what you do on a regular basis. 285 00:19:49,599 --> 00:19:54,290 You'll also reap the benefits of having a more regulated nervous system. 286 00:19:55,109 --> 00:19:57,050 Be sure to check out the show notes, 287 00:19:57,060 --> 00:20:01,969 I have various links that we've mentioned here in the episode. 288 00:20:02,020 --> 00:20:06,089 One is a link to the Z Institute courses, 289 00:20:06,099 --> 00:20:11,619 Z U R for clinicians to learn more about autism in adolescents, 290 00:20:11,630 --> 00:20:13,489 adults and aging adults. 291 00:20:14,020 --> 00:20:21,680 I also have links to my podcast episodes about regulation if you'd like to do a deeper dive. 292 00:20:22,030 --> 00:20:39,989 And I'm also including links to the alert program put together by occupational therapists who have expertise in teaching people about using sensory inputs like movement or pressure to help regulate the nervous system, 293 00:20:40,000 --> 00:20:42,310 to feel calmer and more attentive. 294 00:20:43,599 --> 00:20:51,569 There's also a link specifically for their for All Program alert program four. 295 00:20:51,579 --> 00:20:52,880 That's the number four, 296 00:20:52,890 --> 00:20:57,469 not the word all dot com alert program for all dot com. 297 00:20:57,800 --> 00:20:59,890 That is a self guided study. 298 00:20:59,900 --> 00:21:05,400 You can purchase for a deeper dive into your own nervous system, 299 00:21:05,410 --> 00:21:08,469 figuring out what kind of inputs help you regulate. 300 00:21:08,890 --> 00:21:13,630 And I will have all four of those links in the show notes. 301 00:21:15,270 --> 00:21:17,359 Thank you for joining me today. 302 00:21:17,489 --> 00:21:34,439 I hope you will be able to enjoy the benefits of a more regulated nervous system and be sure to listen to our next episode as we continue this series on living with intention making goals and leaving our comfort zone.

25. Autism and Intentional Living: How to Make Goals and Achieve Them26.03.2023 (00:23:31)

    You may feel dissatisfaction or discomfort in some realm of life that you want to shift. But where to start and how to succeed? In this second episode in a series on intentional living, Dr. Regan identifies ways to create steps toward a goal, identify strategies, and monitor success.    As referenced in the current episode:  First Episode in Momentum for Behavior series   Dr. Regan's Resources Course for Clinicians - Interventions in Autism: Helping Clients Stay Centered, Connect with Others, and Engage in Life Course for Clinicians: ASD Differential Diagnoses and Associated Characteristics Book: Understanding Autism in Adults and Aging Adults, 2nd ed Audiobook Book: Understanding Autistic Behaviors Autism in the Adult website homepage Website Resources for Clinicians   Read the transcript below:   1 00:00:01,830 --> 00:00:02,250 Hi, 2 00:00:02,259 --> 00:00:02,960 everyone. 3 00:00:02,970 --> 00:00:04,380 This is your host, 4 00:00:04,389 --> 00:00:04,829 Dr. 5 00:00:04,840 --> 00:00:05,980 Theresa Regan, 6 00:00:06,250 --> 00:00:11,579 introducing this next episode of autism in the adult podcast. 7 00:00:11,939 --> 00:00:13,779 I'm a neuropsychologist. 8 00:00:13,789 --> 00:00:20,729 So I specialize in understanding how the health of the brain and the connections of the brain impact, 9 00:00:20,739 --> 00:00:21,370 thinking, 10 00:00:21,379 --> 00:00:22,020 skills, 11 00:00:22,030 --> 00:00:22,700 emotions, 12 00:00:22,709 --> 00:00:23,319 behavior, 13 00:00:23,329 --> 00:00:24,569 and personality. 14 00:00:24,790 --> 00:00:30,540 I've worked in hospitals for over 30 years and I'm the mother of a teen on the spectrum. 15 00:00:31,649 --> 00:00:39,250 And did you know that I have a series of three podcast episodes about momentum for activity. 16 00:00:39,619 --> 00:00:43,869 One is about exhaustion and finding balance in momentum. 17 00:00:44,189 --> 00:00:53,000 One of the episodes is about how to gain momentum for activity and the third is how to keep momentum for activity. 18 00:00:53,430 --> 00:00:59,430 You can find these three episodes as episodes number 21, 19 00:00:59,650 --> 00:01:04,489 and 23 In September and October of 2021. 20 00:01:05,000 --> 00:01:07,410 I'll put the link in the show notes. 21 00:01:09,010 --> 00:01:09,449 Today, 22 00:01:09,459 --> 00:01:23,959 we have our second episode of a series about finding some intentionality in um areas of our life where we'd like to grow and maybe challenge ourselves. 23 00:01:23,970 --> 00:01:42,660 Sometimes life is so fast and furious and we get in survival mode or we just get used to living a certain way that we realize we're not really making choices in all the areas of where we put our attention, 24 00:01:42,989 --> 00:01:46,269 uh whether we wanna grow or shift gears. 25 00:01:46,650 --> 00:01:56,300 So the previous episode was this introduction of thinking about where are we in our life right now? 26 00:01:56,650 --> 00:02:02,059 And if you can identify areas where you would like to find more meaning, 27 00:02:02,449 --> 00:02:04,260 uh a bit more challenge. 28 00:02:04,269 --> 00:02:06,160 If you'd like to change direction, 29 00:02:06,370 --> 00:02:10,770 then we're going to focus together on living intentionally. 30 00:02:11,520 --> 00:02:23,789 The first episode covered a few things and one is that I think the first step toward being intentional is having this increased self-awareness. 31 00:02:24,149 --> 00:02:37,429 And I feel like that's one of the greatest blessings of understanding our neurology and going through the diagnostic process about autism to see what, 32 00:02:37,440 --> 00:02:41,460 how am I wired and what does my system need? 33 00:02:41,779 --> 00:02:43,649 How do I interact with people? 34 00:02:43,660 --> 00:02:46,210 What do I find uh joy in, 35 00:02:46,220 --> 00:02:46,770 in life? 36 00:02:46,779 --> 00:02:54,289 What drains me and we have this elevated understanding of ourselves. 37 00:02:54,300 --> 00:02:57,289 Um That is part of that process. 38 00:02:58,300 --> 00:03:02,229 So I think after that process of self awareness, 39 00:03:02,699 --> 00:03:09,410 if we do identify areas where we would like to grow or expand in some way, 40 00:03:09,919 --> 00:03:11,309 one way to do that. 41 00:03:11,320 --> 00:03:17,339 And we covered this in the initial episode is to think of categories in our life. 42 00:03:17,380 --> 00:03:24,490 And I invited you to do this um to see where you might want to shift. 43 00:03:26,479 --> 00:03:32,490 One of the categories we talked about was within the area of a special interest. 44 00:03:33,270 --> 00:03:37,470 The second was within the area of health and wellness. 45 00:03:38,250 --> 00:03:40,559 The third was regulation, 46 00:03:40,889 --> 00:03:46,699 that means the ability to stay centered with things like alertness, 47 00:03:46,889 --> 00:03:49,880 attention and emotions. 48 00:03:50,809 --> 00:03:53,380 We also talked about 1/4 category, 49 00:03:53,389 --> 00:03:54,729 relationships. 50 00:03:55,169 --> 00:04:04,699 1/5 as everyday tasks kind of like staying on top of those chores and daily things that can be hard to get a rhythm for. 51 00:04:05,130 --> 00:04:10,600 And the sixth would be something like family and household culture. 52 00:04:10,880 --> 00:04:14,130 So if you're living in a household with other people, 53 00:04:14,350 --> 00:04:19,170 and these are people who are wired differently than each other. 54 00:04:19,179 --> 00:04:26,690 Sometimes focusing on the culture of the household can be a rewarding area of growth. 55 00:04:29,399 --> 00:04:30,410 Today, 56 00:04:30,420 --> 00:04:38,470 I would like you to bring your thoughts of what areas you would like to find more meaning in and to have more intention for. 57 00:04:38,730 --> 00:05:01,500 And we're going to talk about some basic um guidelines for making goals that you can stick with and that you can see change um in these areas without feeling overwhelmed and without kind of stopping in the middle and like our um New Year's resolutions. 58 00:05:01,510 --> 00:05:01,980 We don't want to, 59 00:05:02,059 --> 00:05:03,109 to be like that, 60 00:05:03,440 --> 00:05:12,369 but we want you to have this intention towards something and to give you some structure of how big should the goal be and, 61 00:05:12,779 --> 00:05:16,399 and how quickly should I work toward it and all of these things, 62 00:05:16,410 --> 00:05:20,869 I just want to give you some framework to see if this framework helps you. 63 00:05:21,730 --> 00:05:26,579 The first thing I'd like you to do is to take stock of where you are now. 64 00:05:27,059 --> 00:05:30,279 So if you chose a health and wellness goal, 65 00:05:30,290 --> 00:05:33,709 if you chose a household culture goal, 66 00:05:33,799 --> 00:05:40,970 I just want you to think about where you are right now in this area. 67 00:05:41,260 --> 00:05:45,100 So don't focus on the end goal. 68 00:05:45,109 --> 00:05:47,350 Let's just focus on where you are. 69 00:05:49,690 --> 00:05:53,500 Someone may say for health and wellness. 70 00:05:53,510 --> 00:05:53,980 Well, 71 00:05:53,989 --> 00:06:00,299 where I'm at is that I probably walk 10 minutes after work twice a week. 72 00:06:00,989 --> 00:06:13,000 Another person in the area of everyday tasks may want to really stay on top of bill paying and financial management. 73 00:06:13,010 --> 00:06:14,989 And so they may say, 74 00:06:15,000 --> 00:06:15,279 well, 75 00:06:15,290 --> 00:06:26,760 where I'm at right now is that I tend to um go overboard and spend more than I have in my bank account about four times a month. 76 00:06:26,989 --> 00:06:38,209 So we're just taking stock whatever your category is for growth and meaning maybe take stock of where you are now. 77 00:06:39,250 --> 00:06:47,000 And um knowing that you would like to be in a different spot at some point in the future. 78 00:06:48,059 --> 00:06:55,269 The next step is to create a goal where you're just going to take that one step forward. 79 00:06:56,130 --> 00:07:02,420 Um What we want to do is to make this goal really achievable. 80 00:07:02,429 --> 00:07:05,779 We want to set ourselves up for success. 81 00:07:05,790 --> 00:07:13,829 We want to be able to see the end of the goal and we want the goal to be on the lower side of effort. 82 00:07:14,720 --> 00:07:23,880 One way to create this type of goal is to think about time spent toward your ultimate destination. 83 00:07:26,269 --> 00:07:27,730 For example, 84 00:07:27,739 --> 00:07:32,179 in the area of movement and exercise. 85 00:07:32,190 --> 00:07:44,149 Someone may realize that they're walking a certain amount after work every week and they may add time to that current routine. 86 00:07:44,700 --> 00:07:50,730 So someone who wants to have more movement in their life or to get outdoors more frequently, 87 00:07:50,869 --> 00:07:52,529 perhaps they say, 88 00:07:52,540 --> 00:07:52,869 well, 89 00:07:52,880 --> 00:08:04,049 I'm going to add 15 minutes a week to my current routine of being outside or of walking in the neighborhood and moving. 90 00:08:04,290 --> 00:08:04,570 Um, 91 00:08:04,579 --> 00:08:06,829 just getting that movement in, 92 00:08:06,839 --> 00:08:08,549 maybe that's their goal. 93 00:08:10,040 --> 00:08:16,630 Another person who wants to work toward achieving skills in a certain area, 94 00:08:16,640 --> 00:08:26,850 maybe they're working toward a promotion or they would like to learn a new skill for fun within perhaps within their special interests. 95 00:08:27,929 --> 00:08:35,580 The goal may be to spend a certain amount of time per week learning this new skill. 96 00:08:36,440 --> 00:08:39,690 If they're currently not learning anything about it, 97 00:08:39,700 --> 00:08:42,750 they might want to start with 20 minutes a week. 98 00:08:43,030 --> 00:08:45,190 If they're already doing 20, 99 00:08:45,200 --> 00:08:48,049 they might want to increase by 15, 100 00:08:48,849 --> 00:08:54,260 whatever the stepwise time goal might be for you, 101 00:08:54,270 --> 00:08:57,780 that would make sense in your area of interest. 102 00:08:58,530 --> 00:09:02,979 That may be a way that you'd like to construct what your actual goal is. 103 00:09:04,049 --> 00:09:13,780 You can also think of it as doing a certain fraction or a certain percentage of the work toward the ultimate goal. 104 00:09:14,739 --> 00:09:20,969 If someone would like to have intentionality in the area of their special interest, 105 00:09:21,580 --> 00:09:22,479 publishing, 106 00:09:22,489 --> 00:09:32,570 some of their short stories may be a goal where they're at currently is they have a collection of 50 short stories, 107 00:09:33,049 --> 00:09:36,549 most of which are within a science fiction genre. 108 00:09:37,950 --> 00:09:45,770 They've never taken a class on creative writing or on marketing for their own business. 109 00:09:46,549 --> 00:09:58,960 What they might do is sit down with a friend and talk about all the steps that they might want to take to make this publishing goal most successful. 110 00:10:00,289 --> 00:10:02,719 They may identify 10, 111 00:10:02,729 --> 00:10:03,460 15, 112 00:10:03,469 --> 00:10:04,760 20 steps. 113 00:10:05,460 --> 00:10:10,059 One might be taking a free online course in creative writing. 114 00:10:11,330 --> 00:10:20,020 Another might be joining a local writers group in their community to become part of a network for writers. 115 00:10:22,270 --> 00:10:29,919 Another goal might be learning how to create a website or how to publish their own material online. 116 00:10:30,919 --> 00:10:35,179 They would want to take one of these multiple steps. 117 00:10:35,239 --> 00:10:37,679 So if they've identified 20, 118 00:10:38,179 --> 00:10:49,909 they may just want to take one goal then they'd have to figure out is this goal small enough that I can see the end. 119 00:10:50,270 --> 00:11:05,979 I know I can have success and it doesn't feel too effortful if they're going to sign up for a free online class in creative writing that may feel super easy or it may feel too big. 120 00:11:07,239 --> 00:11:08,880 If it's too big, 121 00:11:09,049 --> 00:11:13,400 you would want to break that task down. 122 00:11:13,739 --> 00:11:23,239 So the first step might be to investigate some free online options to choose from. 123 00:11:25,359 --> 00:11:37,309 If someone has a goal to participate in additional community activities or to get out of the house a bit more often, 124 00:11:38,000 --> 00:11:57,130 they may make a goal to attend one community event per month uh with a friend Or they may make a goal to spend 15 minutes at a community event before they decide whether they want to come home. 125 00:11:57,559 --> 00:12:00,200 This just gives a bit of structure, 126 00:12:00,309 --> 00:12:12,630 but the whole process is meant to just help make one step forward and not to have a goal that's too big or too effortful. 127 00:12:12,679 --> 00:12:14,849 So we should be able to see the end. 128 00:12:14,859 --> 00:12:19,989 We should know that it takes some effort that it takes us out of our comfort zone, 129 00:12:20,000 --> 00:12:23,359 but that we also are set up for success. 130 00:12:24,559 --> 00:12:27,710 The next step would be thinking of a timeline. 131 00:12:29,359 --> 00:12:41,849 If someone has a goal in the area of regulation and they identify that they would like to be more intentional about their sleep wake cycle. 132 00:12:43,400 --> 00:12:50,000 They may determine that they'll watch how they do with their goal across two weeks. 133 00:12:50,690 --> 00:12:58,320 Perhaps their goal is to get up at the same time every day and after two weeks, 134 00:12:58,330 --> 00:13:10,919 they can evaluate how easy or difficult that goal was to achieve for someone who's wanting to stay on top of the dishes every day. 135 00:13:11,250 --> 00:13:24,380 They may also pick a week or two weeks as a time frame that they can monitor their success or stop and reevaluate if the stepwise goal feels like it's been too difficult. 136 00:13:24,880 --> 00:13:32,059 But here comes the most important step we've looked at creating that step forward goal, 137 00:13:32,710 --> 00:13:34,520 creating a time frame. 138 00:13:35,140 --> 00:13:43,190 And this third part I would say is the most important this is picking a strategy to have success. 139 00:13:44,140 --> 00:13:47,270 What does not work is just saying, 140 00:13:47,280 --> 00:13:47,630 well, 141 00:13:47,640 --> 00:13:48,880 I'm going to do it. 142 00:13:49,159 --> 00:13:50,630 I've made the goal, 143 00:13:50,640 --> 00:13:54,690 I'm intentional about the goal and I have this time frame. 144 00:13:54,700 --> 00:13:56,710 I'm just going to do it this time, 145 00:13:57,039 --> 00:13:59,890 even though it's been really hard in the past. 146 00:14:00,559 --> 00:14:04,690 What happens with that is that we're able to spurt towards some goal, 147 00:14:04,700 --> 00:14:05,919 success there, 148 00:14:05,929 --> 00:14:08,090 but it's very difficult to maintain. 149 00:14:09,590 --> 00:14:12,719 So what I'd like you to do when you have a goal, 150 00:14:12,729 --> 00:14:14,099 you have a time frame, 151 00:14:14,109 --> 00:14:16,359 you have a little chunk that you're gonna work on. 152 00:14:17,320 --> 00:14:18,630 Say to yourself, 153 00:14:18,640 --> 00:14:22,549 what's my strategy for accomplishing this goal? 154 00:14:23,780 --> 00:14:26,390 Never move forward without a strategy. 155 00:14:26,659 --> 00:14:28,349 If you can't think of one, 156 00:14:28,359 --> 00:14:30,710 ask a friend or a family member, 157 00:14:34,210 --> 00:14:42,869 one strategy could be in the area of remembering how can I remember to take my supplies to school? 158 00:14:42,979 --> 00:14:46,979 How can I remember to do the dishes before I go to bed? 159 00:14:48,650 --> 00:14:53,409 Another strategy may have to do with adding fun to the task. 160 00:14:53,770 --> 00:14:56,340 How can I make this task less, 161 00:14:56,349 --> 00:14:57,260 boring, 162 00:14:57,270 --> 00:14:58,750 less mundane? 163 00:14:59,320 --> 00:15:04,469 Maybe I could do it while music is playing or an audio book, 164 00:15:04,760 --> 00:15:11,419 maybe I could make a race out of it to see if I can get it done within a certain amount of time. 165 00:15:12,340 --> 00:15:22,229 Perhaps there are ways that I could use a strategy to make the task easier learning about how to streamline the task, 166 00:15:22,289 --> 00:15:26,640 looking at other ways people do the task to make it easier, 167 00:15:26,650 --> 00:15:28,140 take up less time. 168 00:15:30,210 --> 00:15:35,460 Another strategy I could use is offering myself a reward for success. 169 00:15:36,200 --> 00:15:40,710 Maybe I say if I'm successful for eight weeks in a row, 170 00:15:40,969 --> 00:15:46,030 I get to buy myself this thing that is not too expensive, 171 00:15:46,039 --> 00:15:47,179 but usually, 172 00:15:47,340 --> 00:15:47,630 you know, 173 00:15:47,640 --> 00:15:49,510 that would be off limits for me. 174 00:15:49,520 --> 00:15:54,429 But I'm gonna reward myself after I reach this time frame. 175 00:15:55,450 --> 00:15:57,719 After you've chosen a strategy, 176 00:15:58,099 --> 00:15:59,659 you have a time frame, 177 00:15:59,669 --> 00:16:03,179 you have a small goal that you're set up for success with. 178 00:16:03,190 --> 00:16:08,789 Then it's time to put your plan into action after the week or two weeks. 179 00:16:08,799 --> 00:16:15,830 What you're going to do is to kind of have an evaluation and debriefing with yourself. 180 00:16:15,840 --> 00:16:21,020 The first part of the evaluation is I achieve my goal. 181 00:16:21,190 --> 00:16:36,049 Also think about how effortful was it to achieve what I did achieve if you achieve the goal and you were consistent about it across two weeks and it did not feel too hard or effortful. 182 00:16:36,229 --> 00:16:42,700 You may decide that you're ready to add another step forward goal to your momentum. 183 00:16:43,010 --> 00:16:47,739 If you did 10% of the small task toward your goal, 184 00:16:47,750 --> 00:16:58,530 you could add on another 10% goal or you could add on another 15 minutes of the type of task you were doing to meet your goal. 185 00:16:58,539 --> 00:17:05,660 Remember to keep a strategy if you need to shift based on your new goal, 186 00:17:05,670 --> 00:17:07,530 your new step forward goal, 187 00:17:07,540 --> 00:17:08,949 be sure to do that. 188 00:17:12,650 --> 00:17:16,459 If you achieved your goal, 189 00:17:16,699 --> 00:17:23,500 but you pulled it off and are really tired and don't know if you could do that again, 190 00:17:24,098 --> 00:17:30,218 then you probably need to evaluate whether the goal is small enough, 191 00:17:30,229 --> 00:17:37,869 whether it's easy enough in the sense that we all have areas of our life that we would say, 192 00:17:38,509 --> 00:17:39,088 you know, 193 00:17:39,098 --> 00:17:40,489 for whatever reason, 194 00:17:40,499 --> 00:17:42,909 this area really wipes me out. 195 00:17:42,918 --> 00:17:48,759 I just have a huge struggle in this category of my life. 196 00:17:48,769 --> 00:17:51,568 Maybe you need to start in a different category. 197 00:17:52,280 --> 00:17:55,569 But if you can make the step forward goal easier, 198 00:17:55,930 --> 00:17:56,930 do that. 199 00:17:57,510 --> 00:18:00,780 If you can use a strategy that will help you more, 200 00:18:00,849 --> 00:18:02,089 go ahead and do that, 201 00:18:05,170 --> 00:18:18,390 you wouldn't want to add on to your plan until you got that goal achieved in a way that starts to feel pretty effortless like I'm doing this because this is what I do. 202 00:18:18,560 --> 00:18:19,979 I have momentum for it. 203 00:18:19,989 --> 00:18:27,150 It's built into my routine and then you don't have to effort as much to keep it going. 204 00:18:27,479 --> 00:18:30,609 That's when you add just a little bit more to it. 205 00:18:32,439 --> 00:18:35,170 What do you do if you did not meet your goal? 206 00:18:35,209 --> 00:18:35,530 Well, 207 00:18:35,540 --> 00:18:36,859 that's fine too. 208 00:18:37,020 --> 00:18:42,079 You would step back and evaluate why you may ask yourself. 209 00:18:42,089 --> 00:18:46,449 Did I use the strategy that I created for this goal? 210 00:18:46,459 --> 00:18:52,020 If you did and you were not successful with the goal, 211 00:18:52,089 --> 00:19:00,119 you probably have to reevaluate the strategy or you may need to add another strategy on top of that. 212 00:19:01,040 --> 00:19:04,150 Maybe you used a remembering goal, 213 00:19:04,310 --> 00:19:06,969 but that wasn't enough to give you the momentum. 214 00:19:06,979 --> 00:19:12,750 You need to just get that new behavioral set into your repertoire. 215 00:19:13,130 --> 00:19:15,849 Maybe you also need to make it easier, 216 00:19:15,859 --> 00:19:19,030 make it fun or give yourself a reward. 217 00:19:19,500 --> 00:19:21,829 Maybe you need someone to be accountable to, 218 00:19:21,839 --> 00:19:23,589 maybe that's your strategy. 219 00:19:24,430 --> 00:19:26,130 You should also ask yourself, 220 00:19:26,140 --> 00:19:28,089 did I use my strategy? 221 00:19:28,859 --> 00:19:30,949 If I didn't reach my goals? 222 00:19:30,959 --> 00:19:38,089 Maybe it was because I had the intention of using reminders or making it fun. 223 00:19:38,209 --> 00:19:41,680 But I didn't actually follow through with that. 224 00:19:43,589 --> 00:19:44,130 Well, 225 00:19:44,140 --> 00:19:46,849 then you would evaluate that as well. 226 00:19:47,130 --> 00:19:49,209 Is this strategy too hard? 227 00:19:49,910 --> 00:19:54,449 Is it too complex and involved in energy draining? 228 00:19:54,800 --> 00:19:57,290 What other strategies could you think of? 229 00:19:57,599 --> 00:20:03,280 Do you need to layer something in or do you have to scrap the first strategy and try again? 230 00:20:04,209 --> 00:20:08,239 What strategies do other people use or find successful? 231 00:20:08,869 --> 00:20:12,020 What ideas can you glean from other people? 232 00:20:12,030 --> 00:20:16,920 You're always able to say no to someone's suggestion of a strategy, 233 00:20:16,949 --> 00:20:19,640 but only if you have a counter offer. 234 00:20:19,800 --> 00:20:21,000 If your boss says, 235 00:20:21,010 --> 00:20:21,260 hey, 236 00:20:21,270 --> 00:20:22,839 this still isn't working. 237 00:20:22,959 --> 00:20:25,199 I'd like you to try this strategy. 238 00:20:25,619 --> 00:20:26,540 You can say no, 239 00:20:26,550 --> 00:20:28,660 I'd rather not use that strategy, 240 00:20:28,670 --> 00:20:31,339 but only if you have a counter offer. 241 00:20:32,189 --> 00:20:37,089 If you can say I've thought of this other strategy, 242 00:20:37,099 --> 00:20:38,729 then you can run with that. 243 00:20:39,609 --> 00:20:40,020 Now, 244 00:20:40,030 --> 00:20:49,469 the nice thing about this process is you're learning not only perhaps a new skill that is your goal. 245 00:20:49,479 --> 00:20:54,829 Um learning how to create a family culture that works in your home. 246 00:20:55,229 --> 00:20:59,780 Uh Learning how to stay regulated in a way that matches you. 247 00:21:00,430 --> 00:21:02,199 You're not only learning those things, 248 00:21:02,209 --> 00:21:06,890 but you're learning this process of growth. 249 00:21:07,150 --> 00:21:12,650 So I wish I were in a different place in this area of my life. 250 00:21:13,739 --> 00:21:17,280 How can I start that shift? 251 00:21:17,290 --> 00:21:22,510 How can I think about doing it without feeling overwhelmed or like, 252 00:21:22,520 --> 00:21:24,689 I just can't get any, 253 00:21:25,069 --> 00:21:25,939 um, 254 00:21:26,219 --> 00:21:30,790 I can't get any forward momentum toward change. 255 00:21:30,910 --> 00:21:31,410 Well, 256 00:21:31,420 --> 00:21:38,089 this is a way that you can practice a process for living with more intention. 257 00:21:38,510 --> 00:21:40,420 Where would I like to be? 258 00:21:40,430 --> 00:21:42,500 Where am I right now? 259 00:21:42,819 --> 00:21:47,060 How can I make small steps forward to guarantee that? 260 00:21:47,069 --> 00:21:48,959 I know I can have success. 261 00:21:49,459 --> 00:21:56,979 How can I create strategy and timelines and then evaluate what needs to be shifted? 262 00:21:57,729 --> 00:22:03,819 And what you'll notice too is you may get a great momentum for your goal. 263 00:22:03,829 --> 00:22:10,810 Maybe you are doing the dishes every night or you're moving for 15 minutes after work every day. 264 00:22:11,079 --> 00:22:17,500 What will happen is you'll have momentum for that for maybe a long period of time. 265 00:22:18,290 --> 00:22:19,839 Then at some point, 266 00:22:19,849 --> 00:22:31,000 something in your life will change and you'll realize that now the strategies you were using aren't really gonna work quite as well anymore. 267 00:22:31,170 --> 00:22:34,630 And that's really part of that normal human process too. 268 00:22:34,920 --> 00:22:36,369 And because you know, 269 00:22:36,380 --> 00:22:49,859 the process of creating strategies of evaluating things of making these small steps forward that can be successful when you do need to reevaluate and get back on board with the goal. 270 00:22:50,290 --> 00:23:00,040 That's something that you can go back to that skill in itself is something you keep with you and you can use in lots of different areas of life. 271 00:23:00,050 --> 00:23:03,780 We will continue to talk about living with intention, 272 00:23:03,790 --> 00:23:09,844 meaning growth and having success with all steps forward. 273 00:23:09,954 --> 00:23:17,564 Next time when we talk more about strategies and goals within these different categories, 274 00:23:17,574 --> 00:23:20,025 we mentioned special interests, 275 00:23:20,035 --> 00:23:22,135 health and wellness regulation, 276 00:23:22,194 --> 00:23:23,255 relationships, 277 00:23:23,265 --> 00:23:26,785 everyday tasks and family and household culture. 278 00:23:27,255 --> 00:23:28,785 I hope you'll join me then.