Theresa Regan, Ph.D., is a rare combination of adult neuropsychologist (specialist in brain-behavior relationships), parent of an amazing child on the autism spectrum, and certified autism specialist with the IBCCES. She is deeply grateful to bring validation, hope, and purpose to individuals and their families living on the autism spectrum. With this mission at its core, she founded and directs the OSF HealthCare Adult Diagnostic Autism Clinic in central Illinois. Her books include Understanding Autism in Adults and Aging Adults and Understanding Autistic Behaviors. For more information and to join her new online autism community for free visit www.adultandgeriatricautism.com. Join her for podcast topics related to autism in the adult.
The opinions expressed are not necessarily those of her employer. All listeners are encouraged to research multiple opinions about the topics discussed before making their own decisions.
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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
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Autism in the Adult website
Resources for professionals
Video Visits
Video Courses
The Lifespan of a Household: Retirement and the Empty Nest (EP 71) (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
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The Lifespan of a Household: Parenting Teens and Young Adults (EP 70) (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
The Lifespan of a Household: Parenting Preteen Children (EP 69) (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
The Lifespan of a Household: Parenting Young Children (EP 68) (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
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Video Courses
The Lifespan of a Household: Preparing for Children (EP 67) (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
The Lifespan of a Household: Shared Living Space (EP 66) (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
The Lifespan of a Household: Physical Intimacy in Relationships (EP 65) (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
The Lifespan of a Household: Dating (EP 64) (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
Powerful Self-Care: Filling the Tank (EP 63) (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
Powerful Self-Care: Reducing the Drain (EP 62) (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
Powerful Self-Care: Awareness of the Internal (EP 61) (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
Communication Series: Using Communication to Tackle Tough Topics (EP 60) (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
Communication Series: Using Communication to Strengthen Relationships (EP 59) (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
Communication Series: Steps Toward Better Connections (EP 58) (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
Executive Function Series: Sticking, Releasing, and Switching Gears (EP 57) (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
Update and Links to Holiday Episodes (EP 56.5) (00:00:29)
The Holidays and Autism: Holding Fast and Letting Go
Planning a Merry Holiday on the Autism Spectrum
Executive Function Series: Speed, Working Memory, and Sequencing (EP 56) (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:
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Hello,
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everyone.
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This is Doctor Regan.
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I'm joining you for an episode of Autism in the adult podcast.
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For those of you.
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New to the podcast.
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I'm a neuropsychologist,
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a certified autism specialist,
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and the founder and director of an autism diagnostic clinic for adolescents,
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adults and aging adults in Central Illinois.
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And today you are listening to the second episode in a series on executive function.
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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.
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Before we dive into that topic for today,
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I'd like to thank Amanda who pointed out that my diagnostic terms in the first episode were imprecise.
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I use terms that are common in my day to day interactions with patients,
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families and physicians,
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which are the terms ADD and ADHD.
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However,
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the most precise and current terminology is ADHD predominantly inattentive presentation.
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ADHD predominantly hyperactive -
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impulsive presentation, or ADHD combined presentation.
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And I guess in reviewing that in my mind,
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I think it's similar with the term dementia,
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which is often still used in day to day language in clinical settings,
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even though the most recent and precise term is major neurocognitive disorder.
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So,
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thanks Amanda,
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I'll stick to being precise and specific in podcasts about the topic of ADHD
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And instead of using each of the subtypes,
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I will just use the term ADHD unless I'm speaking about specific features of one subtype. As we discussed in the first episode,
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executive function is really a broad term and it's includes multiple subfunctions or subcategories.
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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 ...
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how those relate or don't relate to each other.
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So the subcategories of executive function include things like attention,
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goal directed persistence,
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organization, response
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inhibition and several more.
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In fact,
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depending on what source you're using,
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there can be about 12 or so sub functions identified,
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even though there's really no complete agreement on how to list out the sub functions within executive function.
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There are two main developmental diagnoses with large executive function components and these include ADHD and autism,
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the ADHD criteria, as we talked about in the previous episode,
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only describe symptoms falling within about four of the subcategories.
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I would label these subcategories in the ADHD as organization,
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attention, response inhibition, and goal directed persistence. For example,
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"fails to give close attention to details or makes careless mistakes" is one of the criteria that can be met in ADHD.
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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
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subcategory of response inhibition.
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So is somebody able to inhibit or stop a response until they think it through?
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So autism will present with core executive function features in some combination as well across the totality of the 12 categories.
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And these features are some of the strengths and gifts within the autism presentation.
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and also some of the challenges. In this episode,
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we're going to focus on the executive function
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sub features of working memory, speed, and sequencing.
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And I've chosen these abilities to highlight together because we often use them together to accomplish daily tasks.
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And I'm hoping that in explaining them and presenting them together,
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you'll be able to watch yourself or watch other people in your life to see how these executive function abilities work for them.
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Similar to the last episode,
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I'm going to walk you through various levels of information.
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So stick with me.
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First, I want to make a comparison between the center of the brain, which is called the subcortical areas, and a conveyor belt.
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You'll,
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you've probably heard that the brain has both gray matter and white matter.
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The outside of the brain and
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certain areas in the center are gray and these gray matter sections are connected by white matter tracts.
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The color white comes from the fact that there's a fatty substance called myelin covering these neuron tracks.
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And the presence of the fatty covering allows the nerve signals to travel faster than without that covering.
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So the center of the brain impacts speed of thinking and processing.
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So in conditions like multiple sclerosis,
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for example,
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where you have demyelinating,
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that is the white matter starts to degrade,
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one of the features can be a slowing of processing.
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So the first point is that speed is a function of the subcortical pathways that impact executive function and several autistic characteristics.
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So we do want to focus on this subcategory of speed.
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Another subcategory is working memory.
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What is this part of executive function?
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Well,
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even though we call it working memory,
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a neuropsychologist or a cognitive scientist might say it's actually really more attention than memory
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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.
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So it usually doesn't end up in permanent memory.
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But we're able to hold information our in our attention.
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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.
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But most times a person can hold about five plus or minus two bits of information in their attention.
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This makes sense because if you were
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using phones in the old days where we didn't have cell phones and
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phone numbers in our phone ...
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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
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kind of rehearse it in our working memory while we dialed.
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So we held seven digits ... in those days...
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in our mind while we pushed in the information to the phone.
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So let me give another illustration.
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Working memory is what we use,
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for example,
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if we hear an instruction with ...
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let's say three parts to it and we go to carry it out.
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Our boss may ask us to print the schedule for the day,
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put a copy on her desk, and check the phone messages from overnight.
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So we have to keep these tasks in mind while doing them.
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We have to hold them in our mind.
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And although we may recall the sequence of requests later in the day,
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we're unlikely to remember them in a month or a year because we haven't memorized them.
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But while we're carrying them out.
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We may be able to keep them in mind because they're in our working memory.
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So the term working means that we keep things in mind while we're using them.
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I'm using this information of what the three tasks are while I'm accomplishing the tasks.
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Working memory is what we use when we walk into a room for something.
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And then sometimes if the information has left our working memory,
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we feel frustrated that oh,
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I walked into a room to get something and now it's gone.
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That's something that has slipped through our working memory.
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Similarly,
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we may say,
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oh,
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shoot,
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I was going to say something or ask something,
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but I forgot what it was.
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We were keeping it in our mind while the other person finished their sentence.
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But then by the time they were finished,
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our thought had slipped through our working memory.
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It wasn't held the way that we wanted it to be.
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And so we were unable to bring it back when the person,
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signaled that it was our turn.
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So to summarize our abilities within executive function stem anatomically from the center and the front part of the brain pathways,
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the subcortical pathways that connect with the frontal lobes.
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And these pathways include white matter which impacts how quickly someone can think,
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process and respond.
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And this part of the brain also impacts working memory,
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which is our ability to hold information in mind while we work with and use it.
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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,
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which is sequencing. A sequence of something is the order in which the things occur or they're arranged.
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And when we listened to our boss ask us to do three things,
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she presented them in a certain sequence.
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And when we listen to someone,
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the words and their meanings and concepts,
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these come toward our ears and into our brains as sequences of data. Picture that conveyor belt.
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Now,
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a conveyor belt is a surface that moves and it brings items to you.
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A person in a factory may work with items coming toward them on a moving surface.
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Perhaps they're employed to sort the items.
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For example,
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here come green and red candies.
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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,
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you add this piece,
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then you place it back on the moving belt and the next person will add the next piece and so forth.
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So items come to you in a sequence,
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one item after another,
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after another,
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the items also come with a particular speed on this moving surface and it can be increased .. like wow,
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the items are really coming quickly now... or slowed down.
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You can see that if the speed is set for a pace that most people can keep up with,
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there will be success in completing the task.
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But maybe there would even be a pace that would be too slow for the workers.
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For example,
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a worker might get bored.
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If the items aren't coming fast enough.
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a bored worker might have distraction and restlessness.
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Oh,
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my gosh.
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This is so slow.
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If the pace were too fast,
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the worker wouldn't be able to use all the items coming toward them.
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Things would get past them,
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things would get missed and only a portion of the items could be manipulated and used for that task.
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So the speed and the number of items coming at us needs to be at a just right spot.
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My favorite image for this is a classic,
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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.
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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.
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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.
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Now let's get back to the conveyor belt in our minds.
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So if my boss is giving me instructions with multiple details or steps,
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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
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in the comedy clip.
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The speed of the conveyor belt is how quickly she's speaking.
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And my perception of the speed is impacted by how quickly my brain can process and keep up.
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If my brain's conveyor belt is slower.
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If I have slower information
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processing, the speed that she's giving me information for the conveyor belt may be overwhelming to me.
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Or if I have really fast processing,
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I may get really bored and distracted while she's talking because there's just not enough that's new coming toward me.
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Let's take another example,
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this one involving a student in a class.
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So a teacher is presenting information to the class.
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The student is required to receive the bits of information at the speed they're presenting as if in the conveyor belt analogy.
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And here comes new information.
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Then the student must hold the information in mind while deciding what parts to write in their notebook or to type in their laptop.
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All of this must be done while the teacher is still speaking.
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And this is all executive function.
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So we'll touch on this in a different episode,
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but the student must use another piece of executive function in this task as well ...
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prioritization.
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So I'm receiving a lot of information on this conveyor belt from the teacher.
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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.
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For example,
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it's not necessary to write down every word
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the teacher is saying. What the efficient,
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just-right thing to do would be to pick out these most important things,
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these themes,
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these categories, definitions,
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dates,
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these are the things we need to jot down in our notes.
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And our executive function is what helps us with this whole process.
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Now,
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if it's working well,
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the student just does this automatically.
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If things are hard in that area of executive function,
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the person may feel like,
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gosh,
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I,
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I cannot,
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you know...
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note taking is very difficult for me.
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I just can't keep up.
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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.
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So it either is something that happens smoothly and automatically or it really becomes a very difficult thing.
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Let me give you a social example.
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Imagine a person at a social event where a group of people are speaking about a funny experience.
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An individual in the group will need to be taking in what multiple people are saying...
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So there are multiple conveyor belts and speeds all while holding parts of the conversation in mind.
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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.
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This example also involves those executive function abilities of working memory and speed and sequencing.
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Let me give you a life activity example,
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driving is a good example of a life activity that requires a person to take in multiple streams of information.
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In this case
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visual ... at varying speeds.
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Oh, this visual information is coming at me as I'm driving through the visual space.
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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.
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So one individual may feel like this all comes very automatically and at a speed that really works for them,
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another individual may feel overwhelmed by the amount of visual information coming at them in such a quick time...
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particularly because it's unpredictable and it involves safety issues.
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So if I can't keep on top of this visual information,
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I really might get in a situation that's really pretty dangerous.
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Other people while they're driving may feel concerned because they get bored.
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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...
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they just can't focus very well while they're driving.
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What is often the case is that for many on the autism spectrum,
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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.
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So going back to our episode,
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topics of speed, working memory, and sequencing,
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we've reviewed that an individual must adapt to the speed of incoming information,
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then sequence through the items coming toward them.
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Hold enough of the information in mind that is important while then doing something with or responding to the information.
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And this is all part of the subcortical frontal pathways of the brain and the ability that globally we call executive function.
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So far,
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we've emphasized information coming toward us on the conveyor belt.
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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.
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For example,
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how quickly do we produce a product or a response to questions from others?
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One person may be quick and efficient with tasks,
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but maybe they make a few errors on the way. Another person may finish the task more slowly,
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but to them,
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accuracy is really important and they notice a lot of detail.
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Neither of these executive function styles is inherently better than the other
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all the time.
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But the person whose executive function is more methodical and detail oriented in producing output may struggle in a job where the boss says,
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hey,
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the priority on this project is speed.
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I need this quickly. And vice versa.
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The individual who works quickly and decisively may really struggle at jobs where the smallest detail can make or break a project.
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Individuals who make decisions more slowly may show resistance when pressed for an answer or an action.
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Other people may almost feel this psychological opposition when they try to encourage the person to decide or to move on.
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Let's take an action.
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Let's stop thinking about it.
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One example could be adult children trying to press their dad to get his roof fixed. If he has executive function
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that's significant for being very slow,
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methodical...
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He may forever be saying things like "I'll think about that" or "I'll know when the time is right,"
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but there's never any real movement toward action.
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There's this stickiness,
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the conveyor belt toward decisiveness kind of gets stuck. Again,
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this approach to action is not right or wrong,
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but it's about whether it works for him in certain instances and against him and others.
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And when the roof is falling in,
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it's really likely working against him.
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Another factor that impacts whether something helps a situation or not is how extreme or inflexible the executive function reaction is in that situation.
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So for example,
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if we have this situation with the dad and his roof...
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a really extreme slow and resistant response to the need for action in that circumstance...
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well,
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that's creating safety,
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health,
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financial issues ... that it really could hurt the person.
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Ideally,
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our brain is supposed to help us have the just right amount of speed,
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(you know,
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not too quickly,
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not too slowly) and sequencing.
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I see details that are important but I can let other things go so that I can get to the best outcome.
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And when it's important to, you
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can adjust to the situation itself.
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Wow,
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I didn't expect this situation but I can adjust to that.
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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,
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whether it's speed or executive function or,
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or anything else in life ... rather than sometimes swinging to that too much extreme.
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One more example of the sequencing of output could be seen when multiple smaller actions are needed to complete a larger task.
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So a classic example of this would be the parental request that their child clean his room.
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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.
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It's almost like saying what are all the pieces I need to put on this conveyor belt,
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all the pieces that I need to to bring together for the whole action of having a clean room or the whole outcome.
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There's a first step,
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a second step,
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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...
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"Wow,
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there are so many actions or pieces to the task.
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I just don't know where to start.
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I'm stuck.
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I'm overwhelmed by the amount of possibility.
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I can't get my direction to navigate the task even though I could do all of these little pieces,
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where should I start?"
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And this is often the situation.
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And the parent may say,
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"Hey,
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start wherever you want,
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it doesn't matter."
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But that's not likely to help the child who actually needs someone to sequence the task with them.
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Tell me where to start.
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How can I get going with this task?
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And then after I do the task,
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... the first task,
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what's the second task I should do?
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How should I string things along without getting overwhelmed or stuck or lost?
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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.
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And so the parent who realizes this might take a picture representing each smaller task ... like a photo of clothes in the laundry basket,
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a photo of books on the bookshelf,
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a photo of the bed made ... whatever the five or seven steps to having a clean room might be.
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You can put these photos up in a place where the child can see them.
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The child then can look at the photos independently and see...
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Oh the first photo is clothes in the the clothes hamper.
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So I'm gonna do that first... and sometimes the child likes to take the photo down when the task is done.
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And so "I know that's done."
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That's just one way to help teach an executive function skill for someone who is overwhelmed and trying to do that independently.
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Knowing that the full anatomical maturity of executive function isn't complete until the age of 20 or 21 or so.
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The parent realizes that part of their role is to help the child learn strategies for approaching tasks
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requiring executive function ... and to assist in areas where the child is still really developing that ability.
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Additionally,
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as we noted in the previous episode,
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everyone will have individual strengths and struggles in executive function.
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If this is a child who grows up and continues to have a weakness
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organizing a sequence to complete a task,
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they can really benefit from a strategy approach to give their brain some assistance.
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So their strategy might be...
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What if I think about this task as seven smaller tasks?
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What would those be?
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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,
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working memory, or sequencing.
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Notice what's easy for you,
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what's difficult for you in these situations.
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This increased self-awareness can be a first step toward getting the best outcome in a variety of situations.
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You may realize "my nervous system default is to process information slowly.
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But this new job that I have requires speed in these areas.
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And how can I get a better outcome?"
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Well,
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the basic neurology of speed that your nervous system is set toward,
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you know,
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you may not be able to adjust that piece.
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But perhaps you could focus on strategies to reduce anything that would take away from the speed you're capable of neurologically.
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So perhaps you want to reduce distractions,
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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.
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As I noted in the previous episode,
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I like the book series Smart but Scattered when it comes to strategies for executive function,
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but you can choose whatever resources best fit your needs.
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And if you want to dive into more about executive function,
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learn about more strategies for success in areas that are causing you difficulty... by all means,
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reach out and find things that work well for you.
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I wanna thank you for joining me to learn about the executive function
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sub features of speed, sequencing, and working memory.
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And I hope it increases your understanding of what makes you tick. We'll be continuing our series on executive function next time.
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So I invite you to join me for that third episode.
Executive Function Series: EF, ADHD, and Autism (E 55) (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:
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Hi there.
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This is Doctor Regan joining you for an episode of Autism in the Adult podcast.
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I'm a neuropsychologist,
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the founder and director of an autism diagnostic clinic in Central Illinois and the parent of a teen on the spectrum.
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Today,
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you are joining me for the first episode in a new series about executive function.
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And I'm really excited for the series since announcing the topic.
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At the end of our last episode,
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I've received lots of emails from interested listeners before we dive into today's episode.
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Though,
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I wanna give a shout out to the clinicians and professionals who may be listening.
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I'm currently developing a master class with the continuing education platform called Zur Institute.
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This offering is unique for several reasons.
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One is the format,
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there will be four 2-hour webinars,
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one in each of September,
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October,
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November and December of 2023.
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And the first hour will be education while the second full hour will be reserved for discussion,
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question and answer and interaction with you about clinical questions and practice issues related to the topic for that day.
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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.
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If you are a clinician wanting beginner or intermediate courses,
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check out my other offerings on Zur or at my website,
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which is also linked through the show notes.
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All right,
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let's talk about executive function.
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I'll warn you that today's episode will require some executive function to get through.
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And I've spent a lot of time trying to make sure that I'm linking all of the themes together.
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So with that in mind,
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I want to start off with just a general definition of executive function.
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Later in our talks,
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we will cover a more precise and descriptive definition including sub elements and what we might call those.
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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.
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And the reason for the name,
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executive functioning is that executive is defined as having the power to put plans and actions into effect.
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So a CEO for example,
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is the chief executive officer of a business company and is in charge of directing the tiers of the company,
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the regional officers,
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managers,
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direct workers,
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directing all the pieces to work together toward the same goal.
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So these pathways of the brain help the parts of the brain work together to achieve a goal.
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Another image that I like is the symphony conductor,
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directing all the instruments in the orchestra,
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even if all the instruments are performing perfectly,
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if there's no conductor,
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there's no unified sound with melody and movement and this synchrony of sound.
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So the sounds don't come together to create a moving and meaningful piece of music without the conductor.
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So executive function is like the symphony conductor,
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it should bring all of the working parts of the brain together to perform.
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So that something meaningful happens.
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As I said,
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executive function is a set of brain skills,
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it's not one skill.
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And as we understand what the center of the brain,
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the subcortical areas of the brain and the connections through the center with the front of the brain,
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the frontal lobes.
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When we understand what these areas are in charge of,
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we refer to those set of abilities as executive function.
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So these executive function abilities hang together anatomically in the brain.
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So through that subcortical frontal system,
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so the number one point is that executive function refers to a series of skills,
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not one skill.
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And these skills are linked with anatomy,
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with the subcortical frontal systems of the brain.
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And the skills help the brain produce a meaningful synchronous um behavior or,
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or product.
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Now,
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let's talk about the diagnosis of AD D and A DH D and just for simplicity's sake,
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from now on,
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I'll really just refer to these as AD D but I'm referring to both diagnoses.
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This diagnosis was introduced in the diagnostic manual,
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the DSM - III in 1980 it was important because it described a developmental neurologic condition of executive function.
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So executive function was not a new concept,
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but the diagnosis of ADD was the one that captured this developmental piece.
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So here we have a diagnosis then that we can use to describe a difficulty that an individual has based on their developmental wiring.
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The way that the brain system has developed,
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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.
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So,
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anatomically,
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executive function is still developing until about that age.
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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.
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Now,
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I want to talk about the relationship between executive function and AD D executive function is not specific to ADD or ADHD.
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So the difficulties in that domain,
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they're not specific to this diagnosis.
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We're discussing executive function is one of the most sensitive brain functions to any kind of stress,
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whether that is physical or psychological.
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One of the first things to show difficulty is going to be executive function.
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It's often the first thing to become difficult and the last thing to resolve or heal after some type of challenge.
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For example,
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if an 80 year old has a bladder infection.
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What's probably the most sensitive cognitive function that's going to be disrupted first ... executive function.
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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.
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Well,
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that would be executive function as well.
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So there may be developmental differences in executive function and that's what we discuss
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when we talk about the diagnosis of ADD,
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there can also be acquired differences in executive function.
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This would include differences after,
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as we said,
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a traumatic brain injury,
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a stroke, within the context of a dementia... acquired
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meaning that this is not developmental.
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It's something that has occurred in the course of the life span.
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Executive function,
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difficulties can occur with acute or chronic medical problems.
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So an acute medical issue would be like an infection.
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For example,
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this is something that comes and then it goes,
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it's acute,
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it's new,
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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.
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So someone with kidney failure,
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for example,
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who's on dialysis,
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what's the most likely thing they're going to have some difficulties with in the cognitive domain.
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Well,
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that would be executive function,
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someone with sugar fluctuations in the context of diabetes,
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someone with metabolic differences like their sodium is too low.
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These can also cause a disruption in someone's executive function system,
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even differences in the load that the person is carrying with regard to stress,
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emotional pain,
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trauma,
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lack of sleep,
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and even just having too much on our schedule.
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These examples of things don't change the anatomy of the brain and how the parts of the brain are working.
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But it really does interfere with our access to using our full capacity,
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our full anatomic, biologic capacity for executive function.
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So,
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if we've had trauma,
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you know,
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our brain may just go offline if we dissociate.
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And even though our anatomy is working well to produce this executive function,
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we may experience a psychological process that takes us offline.
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In addition,
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even with normal aging,
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what's the first thing to start to show difficulty?
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Yes,
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it's executive function.
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And if you are aging really well,
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you're,
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you're really aging nicely.
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You don't have any additional medical issues,
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you haven't had an injury.
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The first thing you're gonna start to notice is some problem in the area of executive function.
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That's just the aging process and how it impacts that subcortical frontal system.
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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
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but you can't get it out.
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That's executive function.
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You may have to think more slowly or take in less information at a time.
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So all individuals are likely to experience executive function difficulty in these contexts.
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So consider this comparison,
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executive function is similar to fatigue,
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for example,
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in that it's a nonspecific feature of many different kinds of conditions.
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So if someone has fatigue,
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there would be hundreds... thousands of conditions that could produce fatigue,
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anything from lack of sleep to infection,
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autoimmune conditions.
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And so many more things.
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Similarly,
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executive function difficulty can be caused by so so many conditions and situations,
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trauma,
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aging,
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ADD,
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autoimmune conditions,
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delirium, autism, and many,
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many more.
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So the third point we've really focused on here so far is that executive function is not specific to ADD.
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So many many things can trigger this executive function problem.
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Therefore,
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if someone presents with executive function difficulty --
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so I'm having a hard time paying attention,
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I just can't take in information very well.
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I can't organize myself well --
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the clinician should consider differentials in the diagnostic process because so many things can present with those features.
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There should be this process of taking into account.
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What is this person's age?
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What is their recent life experience?
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What are their medical issues?
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When did the executive function issue start?
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But executive function difficulty does not automatically mean ADD.
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It does not equal ADD,
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it's not equivalent to ADD.
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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.
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So let's go over our first three points.
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Executive function refers to a series of skills,
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not one skill and these skills are linked anatomically within the same pathways --
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these subcortical frontal system pathways -- and they also work together to provide some meaningful and organized output from the brain.
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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.
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The third point is that executive function is not specific to ADD -- many many things can trigger executive function difficulty.
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And so we would never want to hear executive function difficulty and then translate that automatically into ADD.
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So we talked about how executive function refers to a series of skills.
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There's not a unanimous consensus about what constitutes all these subparts,
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how to number them and what to call them.
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But many conceptualizations may refer to about 12 to 15 components.
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Give or take.
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These often include things like organization, sequencing,
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processing speed,
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prioritizing, planning,
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task initiation,
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sustained attention, goal
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directed persistence,
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impulse control,
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time management,
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generation of ideas,
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working memory,
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flexibility and emotional regulation.
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So it's not important for you to know what those mean.
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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.
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But for now,
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wow,
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executive function is a broad category.
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ADD, which as we said describes a condition of developmental
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executive function difficulty, includes four areas as I would describe them.
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So someone may say,
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oh,
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I think it's more like five.
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so it doesn't matter,
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but it's a small subset.
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We've got attention,
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organization,
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goal directed
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persistence, and impulse control.
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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.
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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.
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This person's individual difficulty...
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I also want you to know that every single person,
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regardless of developmental neurology,
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health background,
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all humans will have a pattern of executive function,
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strengths and weaknesses.
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That's the normal way of our neurology.
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So out of those 12 to 15 subsets of skills,
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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.
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So a person who's really good in the areas of generating ideas and flexibility,
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this person might be called creative.
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All these ideas,
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they're very flexible,
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they go from here to there,
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but they may struggle with other areas of executive function,
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they may be impulsive,
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have difficulty with time management, organization...
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So everybody has their own pattern with an executive function.
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So let's go back here.
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We are setting up a discussion of the relationship between executive function and ADD.
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And one of the difficulties we currently have is that our understanding of executive function has evolved since 1980.
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But we have a diagnosis that covers only a small subset of how we currently conceptualize executive function.
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This creates difficulty in that someone may clearly have developmental executive function problems but not fit into the box of the ADD diagnostic criteria.
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Now,
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let's compare ADD and autism.
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Everyone on the autism spectrum will have executive function difficulty in some form or pattern.
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That's because of the neurology of autism.
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The term executive function is not specifically used in the autism criteria,
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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.
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So autism has this executive function component plus many nonexecutive function elements as well.
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So ADD is a diagnosis of four or so elements of executive function.
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Autism is a diagnosis that includes elements of executive function and elements outside of executive function.
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The diagnostic manual indicates that the diagnosis of ADD cannot be made if another diagnosis better accounts for the client's whole presentation.
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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.
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So let's regroup.
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Executive function,
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difficulties occur secondary to so many developmental,
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physical and psychological states.
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And ADD and autism are two developmental diagnoses that include executive function difficulty.
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ADD includes about four elements of the 12 to 15 sub elements of executive function that we generally think of.
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And autism includes some pattern of executive function difficulty across elements and also has nonexecutive function
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parts to the criteria.
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what should happen is that an individual presenting with developmental executive function difficulty would see a clinician who develops an appropriate differential,
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that is the person has developmental executive function difficulty,
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but that's not specific to ADD.
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So let's consider other developmental conditions like autism.
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And also let's consider other relevant information like the trauma history,
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medical conditions,
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intellectual abilities,
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learning disabilities,
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language processing ability.
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And let's figure out what the basis of this executive function problem is.
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But what actually happens is that a teacher, doctor, or clinician says,
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oh,
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this person has developmental executive function difficulty.
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Therefore,
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we're going to diagnose them with ADD.
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Then years later,
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they come to see a professional who does an evaluation and says,
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well,
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this person does have executive function problems,
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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.
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And so of course,
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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.
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Some of these individuals have executive function difficulty because they've been on the autism spectrum all along.
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But autism was never included in the differential process.
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So they've never been assessed for autism.
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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.
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Now,
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not everyone with fatigue is best served by a diagnosis of chronic fatigue syndrome.
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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.
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So even if the individual meets all the criteria for difficulty in those four subs skills,
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the diagnosis is not made if this executive function difficulty is better explained by autism or intellectual disability or learning disability,
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et cetera.
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So the question in the case of ADD diagnosis shouldn't just be,
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are the criteria met ... but are the criteria met
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and is this the diagnosis that best explains the whole presentation for this student or client or patient? In autism,
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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.
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They still have autism,
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they still have executive function difficulty as we would expect.
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But perhaps they're less likely to have a pairing of an ADD diagnosis.
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Another person on the autism spectrum may have all four of those difficulties in the ADD category and maybe a couple that aren't.
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And so they get these two diagnoses autism and ADD.
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However,
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if the executive function difficulty is not excessive for what we expect to see in autism,
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they shouldn't have that diagnosis.
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That second one,
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it's redundant.
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It's repetitive.
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So then do we take away the ADD diagnosis once someone has a diagnosis of autism?
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And it's not excessive?
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Well,
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we could,
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if we wanted to be precise,
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This is really what the manual talks about as making the most sense.
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However,
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practically speaking,
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this gets difficult.
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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.
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And many times after I see a
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a client for an autism evaluation,
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I'll tell them their diagnosis is autism spectrum disorder.
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And then they will ask,
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did you also check for ADD I think I have that too.
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And so it's a difficult thing to just answer with a couple sentences as you can see.
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Do they have executive function difficulty?
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Absolutely.
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Do they have executive function difficulty that fits into that four subset category that we have as our diagnosis for ADD? Possibly
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yes or possibly no.
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Depending on the case. And does the executive function difficulty exceed what is generally seen in autism? Really infrequently.
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Honestly,
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I have made both diagnoses,
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but I don't frequently see the executive function as really standing out higher than you know...
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the group of people that I see.
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So conceptually,
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to me,
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it makes no actual sense to talk about autism with and without ADD.
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In fact,
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at this stage,
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in our understanding of the nervous system,
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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.
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I would propose that it would make more sense to just have a diagnosis that says executive function disorder.
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And then you could say comma developmental or comma acquired or perhaps you could list the pattern ... like for this person,
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these are the strengths and these are the difficulties.
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It would be nice to increase the understanding that saying the diagnosis of autism automatically communicates that there are executive function difficulties present.
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That's not really our reality right now though.
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So even though that makes the most sense to me as a neuropsychologist,
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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,
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the individual can't get their attention medication,
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even if it has helped their executive function difficulty within the autism spectrum.
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Now,
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the medication is often not as effective on the spectrum as off the spectrum.
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But if someone has been helped by it,
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there's no reason to take it away because,
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you know,
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just because that ADD doesn't entirely fit.
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So practically speaking,
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they're gonna end up keeping that diagnosis because they understand what it means
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snd they don't understand what not having it means.
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And also they need medication or benefit from medication that requires that diagnosis.
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The other thing that's really a caution that I'd like you to think about...
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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...
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You know,
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people will say,
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well,
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you know what's really common for people with ADD,
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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.
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The
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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,
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but they haven't had much if any differential assessment.
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So we don't know if it's really true that individuals with a pure ADD often have these coexisting features.
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Because what makes a lot of sense is that within the ADD population,
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there's some subset of it autistic individuals who say I have ADD and I notice that I also have trouble reading social cues.
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Well,
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the difficulty reading social cues then becomes a
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"common feature" associated with ADD.
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But we don't know,
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does this person have autism?
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Have they been assessed?
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And,
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and if so,
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if we get this group of just really pure ADD diagnoses and nothing else explains those features better,
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I would love to know what ... kind of... is associated with that.
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But at this point,
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00:32:14,939 --> 00:32:21,119
we really don't know. The research using people diagnosed with ADD...
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They don't go through any differential process.
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00:32:24,780 --> 00:32:25,969
They just look and say,
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00:32:25,979 --> 00:32:27,739
oh you have a diagnosis,
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let's put you in the ADD group and study you.
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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,
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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,
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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?
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00:33:22,790 --> 00:33:23,760
Let me recap.
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00:33:23,770 --> 00:33:24,270
Again.
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00:33:24,750 --> 00:33:28,199
Executive function refers to a series of skills,
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00:33:28,209 --> 00:33:32,189
not one skill that are linked anatomically,
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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.
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00:33:51,060 --> 00:33:54,630
And that was really a good advancement at the time.
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00:33:56,219 --> 00:34:01,199
Executive function is not specific to ADD and many,
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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,
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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?
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00:34:40,849 --> 00:34:43,638
Has someone looked for an intellectual disability,
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00:34:43,648 --> 00:34:45,358
auditory processing problems,
425
00:34:45,368 --> 00:34:46,519
learning disability,
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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,
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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.
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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.
What Might That Look Like: A Decision Making Tool (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:
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Hi there.
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This is Doctor Regan joining you for an episode of Autism in the Adult podcast.
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I'm your host.
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I'm also a neuropsychologist, author and speaker,
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a certified autism specialist and the parent of a teen on the autism spectrum.
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You are joining me today for an episode entitled,
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"what might that look like?"
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One of the things that clients and families often ask me is,
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"should we plan on this" or "should I say yes to this?"
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Now,
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this could mean being the best man at a family wedding or taking a family vacation to a cabin in the woods.
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It could mean accepting a full time job in an office setting.
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Now,
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my response is rarely yes or no,
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but rather "what might that look like?"
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So before we jump into the topic for today,
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we are coming up to the third anniversary of this podcast,
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the first episode launched on August 7th 2020 it highlighted similarities and differences between autism and ADD or ADHD.
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Now,
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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,
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its presentation in autism and ADD, and resources for harnessing the power of executive function.
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Secondly,
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I want to inform clinicians about an upcoming master class.
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I'm offering through Zur Institute about autism across the lifespan.
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I received so many emails and messages through my website about people seeking autism informed clinicians to provide them with diagnostic input information,
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education and solutions for roadblocks they may have encountered.
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So the bottom line is that more clinicians are needed to serve individuals who are searching for this specialization.
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And my response has been to offer multiple courses through Zur Institute. It's a continuing education site for clinicians.
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My goal is to equip clinicians across various regions to assist individuals in their communities.
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When this type of service is needed,
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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.
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So let's jump into our topic for today.
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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.
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Perhaps the invitation is to travel.
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The invitation may be to lead a group such as being the best man at a family wedding or presenting research to professionals.
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My experience is that there's value in viewing the invitation not so much as a yes or no question.
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Do I accept this?
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Do I say no.
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But by asking ourselves,
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what might that look like?
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A yes,
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no view would be to see the invitation as a formed and complete package.
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So if I say yes to being the best man,
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I will plan the bachelor party,
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make a speech,
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toast,
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the couple at the reception,
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et cetera saying no to the invitation means I'll,
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I won't participate in these activities.
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But instead of a yes,
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no mindset,
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we can often talk through alternatives by asking,
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what might that look like?
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What might it look like to say?
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Yes,
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in a way that works for me and for the people around me.
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The first point to think about is what is the ultimate goal?
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What is the desired outcome?
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The goal for a vacation with family members may be to have relaxing experiences,
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to see natural landscapes that you've never seen and to connect with other family in a meaningful way.
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The goal for presenting your research to professionals may be to advance your career,
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make professional connections with others and highlight your role in the work that's been done.
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Identifying what a good outcome would look like is empowering because it helps us identify a handful of core foundational objectives.
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And when we work toward those objectives,
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we can release some of the trappings that may be part of the activity,
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but they're really not core to what we're going after for the individual,
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considering a full-time office job,
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he may decide that the foundational goals would be to have work stability.
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If he's currently doing consulting work,
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for example,
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he would,
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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.
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So the first step you can focus on is determining what would be a good outcome.
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What would it look like in this situation to really dive in and also to feel like things went well.
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The first step you should focus on is determining what a good outcome would look like in this situation.
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What would a good outcome for participating in the wedding look like?
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What about going on a family vacation or accepting an office job?
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The second part after we've identified what the core features we're going after are those core foundational goals?
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We can ask ourselves,
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what might it look like?
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What might the situation look like that would allow for those outcomes?
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So let's go back to the examples.
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The gentleman invited to be best man at an out of town family wedding.
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Let's call him Joe.
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He may realize his instinct is to say,
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no,
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he knows that he gets overwhelmed in crowds.
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He dislikes being the center of attention and he relies on routine and specific favorite activities to remain grounded in daily life.
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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.
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So Joe and his family may want to discuss,
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what would it look like for you to be best man?
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What might it look like for Joe to be best man in a relational,
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satisfying and meaningful way?
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But in a way that also offers him the freedom and the space to take care of his needs.
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So at this point,
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there is a commitment to the core goals and there is flexibility with the trappings that might otherwise go along with a wedding ceremony.
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In the case of the wedding,
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Joe may have a separate hotel room,
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so he has a quiet alone space to regroup as needed.
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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,
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rock climbing and bike riding.
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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.
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Joe also plans to use small noise canceling earbuds as needed just to shield himself from some of the noise in crowded areas.
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They're barely visible,
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they help him a lot and it'll be a step toward really increasing his comfort.
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Joe and his family agree that he won't attend the bachelor party,
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but still he'll have a time that evening where he and the groom have a private drink together to celebrate the union.
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Joe also decides to record a video of him toasting the couple rather than making a live toast.
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These things in combination with others really help him or regulate himself to have a relation,
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meaningful contribution at the ceremony and to also protect what his nervous system needs.
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The main points are that Joe and his family are thinking,
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what might this look like?
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What do we want to work toward and how can we best get there with a mindset toward getting everyone's needs met.
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Similarly,
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the researcher invited to present her work.
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Let's call her,
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Susan may avoid the invitation because handling unexpected situations during a presentation is very stressful to her.
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She also really shies away from being the center of attention and speaking in front of others.
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If she does present her goals would be to take credit for her work and to connect with like minded professionals.
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Perhaps her focus on what might this look like leads to the following plan,
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Susan and her mentor decide to present the information together with specific slides identified for each of them.
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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,
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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,
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this may be a good time to discuss your findings in the area of XY or Z.
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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.
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So the first thing we talked about was figuring out what's foundational in the goals and then figuring out how to get there,
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what might it look like to accommodate these goals and to let some other things go.
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The third thing to think about is when to say no.
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So having said all this,
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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,
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our best outcome,
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our best goals.
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Um So saying,
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no may be the best decision in that case,
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although there would be benefits to finding a compromise that meets the needs of multiple people.
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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.
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Let's take the consultants situation who's considering a full-time office job.
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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,
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his needs as an individual may be so far from what the job can offer him.
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That the best answer in this season is no.
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Alternatively,
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the answer may be no if he's doing well in his consulting work.
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But there are core features of the job that would prevent him from having the flexibility that he would really need to thrive.
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He may realize that he would need a hybrid work model,
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combining office work and remote work.
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He may have the self awareness that working on new business proposals keeps his interest level up,
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but he needs help maintaining interest in projects that feel like old hat that the work can get boring very quickly.
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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,
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but a lack of flexibility to kind of meet in the middle.
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He may need to say no to that invitation.
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Uh Based on what he knows about himself,
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an individual invited to come along for a family vacation.
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Let's call her MEREDITH.
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She may realize that no is the answer that makes the most sense in her season.
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After thinking through what might this look like,
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she can't envision any way that realistically meets her needs and achieves the goal of connecting with family on this trip.
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For example,
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she may have a really severe fear of flying and taking multiple planes is the only way to participate in the vacation as planned.
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MEREDITH may realize that her core goal is to connect with two family members in particular.
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So her next thought process might be,
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I'm going to have to say no to the invitation of the trip.
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But how else could I connect with those family members?
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Even I'm if I'm going to turn down this invitation,
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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.
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The decisions often don't need to be all or nothing.
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Although after thinking through what might this look like?
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We might see that some opportunities just aren't a good fit.
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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.
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Thank you for joining me today.
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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.
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I hope you can join me next time for our episode on Executive Function.
Autism and Intentional Living: Expanding Special Interests (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
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Hello,
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this is Doctor Regan joining you for the sixth episode of Our Living With Intention series on the Autism in the Adult podcast.
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I am the mom of a teen on the spectrum.
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I have a doctorate in the field of brain behavior relationships called neuropsychology.
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I'm also an author and speaker,
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a certified autism specialist and the founder and director of an autism diagnostic clinic in Central Illinois,
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serving adolescents,
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adults and aging adults.
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Before we jump into our topic for today,
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let's take a throwback to past episodes.
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Looking back to two years ago at this time,
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I published an episode about autism in women.
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It's been one of the most listened to episodes of the podcast.
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And one year ago at this time,
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we were in the midst of a series about how autism characteristics may shift somewhat across the lifespan during puberty across life,
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seasons in women and throughout the aging years,
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I'll go ahead and link these episodes in the show notes in case you miss them.
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Now,
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let's talk about our current episode in The Living With Intention series.
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I've named the series Living With Intention because sometimes as humans,
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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.
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And then to think about how to take small achievable steps on a path toward our intention.
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And so far,
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we've spoken about three areas of life that someone may have goals for such as improving regulation,
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that means feeling centered,
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calm and psychologically present.
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We talked about communicating and connecting and also about addressing issues of household culture.
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Today,
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we will look at the area of interests.
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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.
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For example,
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if someone is an artist,
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they may share that they think they would like to sell designs on Etsy,
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another person may share that they are immersed in sewing and this is so interesting and calming to them.
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They've developed quite a skill in this area and they're wondering if they could expand by doing some things in their community.
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Another may have an amazing brain for sports statistics and wish that they could get into sports casting as a niche in life.
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Again,
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it's important to emphasize that these are goals that the individual presents with.
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This is not an episode about what someone's goals should be,
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but rather to address the thought of gosh,
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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.
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So how does one start a path toward getting more involved in the area of an intense interest?
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So how to get started as we talked about in the second episode on this series,
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it is recommended that we take small defined achievable steps in the direction we would like to go.
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So one such step may be to gain some additional skills in the area of interest.
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For example,
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if someone produces a product and they would like to offer the product on the internet,
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they may wish to get training in things like basic marketing strategies using social media for sales and creating a website.
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Someone who creates a myriad of characters and stories,
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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.
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The individual may wish to take a formal course in creative writing.
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Now,
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I know taking a course can feel daunting but a wonderful place to learn.
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Some of these skills is on the internet and there are Myriads of free online courses in various areas.
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In fact,
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there are so many options that I just can't even list the top opportunities in the show note links.
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There are so many,
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but I'll share a few things about learning from the internet.
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Have you ever heard of a MOOC?
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That's M - O - O - C.
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It's a massive open online course - MOOC.
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And this is a free web-based distance learning program that's designed for huge numbers of people.
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Thus the word massive ... of geographically dispersed students.
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So open means that these are accessible to multiple levels of people very often,
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these are free and they're online.
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So this is all web based.
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I myself have been a student in several MOC courses to learn things that I can't learn locally.
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For example,
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I got to take a Behavioral Genetics course through the University of Minnesota.
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I took a neuroanatomy course through the University of Illinois Chicago.
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And what happens is that you earn a participation certificate from the course,
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which is free,
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but the benefits are both the information you learn and also having this on your resume as an area of self study.
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So the MOOC platforms also have developed paid versions of courses where you earn some type of verified credit or certificate.
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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.
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The particular site for MOOC courses that I used was Coursera.org and I'll put that in the show notes.
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But there are so many sites to choose from.
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I encourage you to use an internet search engine for free online courses in the area of your interest.
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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.
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In this context,
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you could learn things like video and audio editing,
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photography
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editing,
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how to use website design software...
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Podcast platforms like Podbean and others also provide podcasts about how to become and succeed as a podcaster in your area of interest.
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And they also offer blog posts and articles about all the things their sites offer to support your goals.
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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.
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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.
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So again,
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this doesn't need to be the end goal,
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you know,
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to be volunteering as the ultimate end,
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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.
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Someone who bakes may wish to donate cookies to the local elementary school open house with a nicely crafted sign about their business,
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including their contact information.
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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.
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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.
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This helps the person create contacts,
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get used to the tasks involved in doing the work and lets other people see their skills.
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There are other ways to use free venues to increase your credentials and get your work out there.
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Looking for free opportunities to get involved,
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advance your skills and get your work out.
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There is a really good way to step toward that intention of expansion.
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So for example,
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someone who's trying to develop creative writing skills may wish to enter their stories into contests.
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And once you have a body of work developed,
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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,
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these can be highlighted in your credentials on your website.
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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.
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For an individual who loves,
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loves,
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loves running and decides they may wish to do some personal training for other long distance runners locally or in their community,
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this person may wish to enter races and keep track of these credentials to market their services.
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Some races or events may be free and others may have a fee.
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But in the end,
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this could be a way of meeting people with similar interests,
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getting your name out there as someone who's actively pursuing running and training and getting some race placements to add to your credentials.
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The important things about these approaches are that they're small steps,
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they're toward your desired outcome.
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Whatever you've decided your intention is this is where I'd like to be in this area of my life.
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And these small steps help you get a feel for what your goal may feel like in the end.
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For example,
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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.
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So they get a taste of what it feels like to instruct a small group of adults or Children.
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They get a taste for some of the paperwork or the communication demands in between the actual classes and instruction.
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Some people who love a particular topic and they think they might want to teach,
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end up realizing after some of these volunteer opportunities that the actual process of teaching is not something they love.
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Another important thing about this approach is that for some of the options.
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There's really not a high demand for in-person contact or being in crowded classrooms.
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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.
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But this approach can harness all of the online opportunities for learning,
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for creating,
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for selling through the internet while engaging in certain community events that you choose.
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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?
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How much customer interaction do I want versus time to regroup in my own space?
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I'm a firm believer that your community needs your gifts,
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your knowledge,
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your passion and whatever area you find that in and finding ways to take steps to your passion,
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not only blesses you,
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but those around you and having ways of expressing that also is something that fills you up.
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I love creating.
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I love writing,
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I love running.
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I love sports statistics.
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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.
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Thank you so much for joining me for the sixth episode of the Living With Intention series.
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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.
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And I hope that you join me for the next podcast episode.
Autism and Intentional Living: Improving Household Culture (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
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Hi,
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everyone.
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This is Doctor Regan joining you for an episode of Autism in the Adult podcast.
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I'm the mom of a teen on the spectrum.
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I have a doctorate in neuropsychology.
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It's the field of brain behavior relationships.
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And I'm the director of an autism diagnostic clinic for adolescents,
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adults and aging adults in Central Illinois.
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Today,
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you're joining me for the fifth episode in a series about living with intention making goals,
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shifting in areas of life to get you closer to where you would like to be.
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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.
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We had episodes about improving regulation and about communicating and connecting.
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So today we have an episode focused on household living and the culture of the household.
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Now,
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before we dive into the topic for today,
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I want to invite you to check out the resources on my website at adult in geriatric autism dot com.
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There are posts and videos for many different types of listeners and learners including clinicians.
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Also,
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you may find one of my books helpful,
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many of you know,
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that my first book called Understanding Autism in Adults and Aging Adults is in the second edition.
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And if you don't know,
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I have a second book called Understanding Autistic Behaviors,
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which is more of a workbook format.
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So it explains the neurology ... kind of the neurologic-why of some of the behavioral patterns.
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And it outlines ways to work toward increased well-being if someone's in a season of struggle.
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So let's focus on household living.
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So I want to highlight this topic because many people talk to me about the complexities of living in a household with other people.
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Most often this has to do with spouses or partners or with couples who have Children.
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Not only is the individual trying to increase their own self awareness.
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You know,
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this is how I'm wired,
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this is what makes me tick,
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this is what I need.
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But in a household,
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this is really next level awareness because there's now this demand to be aware of yourself,
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multiple other people and the interplay between all of the people.
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And on top of that,
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the needs and interplay change from day to day and from life,
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season to life season.
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It's so so easy to default to this kind of household interaction.
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Stop doing that.
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Why are you doing that?
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I've told you 100 times to X Y Z.
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Oh my gosh,
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you are so loud,
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messy clingy and guess what this focus on telling people to be different every day is just not that effective.
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And that's why we find ourselves saying the same things every day over and over.
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And not only that,
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but these repetitive interactions cause a strain on the relationships in the household.
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And they create this kind of adversarial connection rather than a partnering connection.
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So the big message is I want you to be different now rather than I want to partner with you to make things better,
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better for you,
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better for me and better for the household.
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So let's talk about some specific areas of focus and strategy that might help.
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The first thing we're gonna talk about is focus on the other.
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Now,
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during the previous episode,
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we talked about the importance of expanding our awareness from only what do I need right now,
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which actually can be difficult to figure out to what does the other person need right now.
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And when we add that element,
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we can get away from this push and pull of,
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stop doing that to oh,
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things might be able to go smoother in this area.
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I wonder what the need is that's connected with that behavior and how could I support change?
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So as we're talking about households,
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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,
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especially if this becomes the culture of the household,
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meaning that this is how we do things it becomes more automatic.
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It becomes something that everyone's focusing on as best they can.
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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,
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he's had work demands but also lots of other layers of unexpected changes in his schedule,
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detours on the route home.
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There were lots of sensory overload moments and a disagreement with a work colleague.
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So he comes home and mom who is home with three kids is not on the spectrum,
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but she does have sensory processing sensitivities,
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stickiness,
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and kids hanging on her and noise.
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And she's getting to the point that that has been really overwhelming today.
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She is home with three kids.
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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,
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is melting down while doing his math homework.
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And another son is 15 and is playing loud music in his room with the door shut.
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So the first approach,
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the one that is our most typical go to may look like this.
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Dad walks in.
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Mom is yelling at her two youngest kids to be quiet.
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She's juggling hot food in the kitchen while trying to get food ready for dinner.
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The youngest daughter runs up to dad and wants to show off her tutu and her magic wand.
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And dad hears the loud music coming from upstairs and mom is thinking,
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thank goodness he is home.
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I need some help.
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I need some relief and dad is thinking I can't wait to get out of here and go for my bike ride.
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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,
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et cetera.
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So dad feels the pressure to make things right.
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He yells at his oldest son saying,
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why don't you turn off your music and come down and help your mother.
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And he yells at the middle son and says that math really isn't that hard and he should stop crying.
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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.
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Let's think about a second approach.
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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.
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Mom is overwhelmed with sensory inputs.
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She's drained from the whole day of being the only adult at home,
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which means that she has been the go to person for everyone's needs in the household.
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So she needs quiet alone time.
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She needs compliments,
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she needs support.
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The youngest daughter suddenly feeling better.
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She needs to run off some of her nonsick energy and be recognized as someone who's beautiful and magical with her wand.
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The middle son has also been very drained from the day.
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He gets overwhelmed with the social and sensory environment at school and he has a math learning disability.
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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.
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He's unable to get his bearings to calm,
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to reenter,
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he needs some regulation help.
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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.
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It establishes his identity as his own person.
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So that is a lot.
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In this case,
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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?
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The huddle is just a coming together to talk briefly about what are we gonna do next?
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What's going on and what are we gonna do?
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The status is really high chaos for everyone in this family right now.
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And sometimes families make up kind of humorous labels for levels of chaos or crisis.
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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.
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The status could also be a factual description.
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Bad day at work,
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really drained or bad day at home,
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really drained.
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And I'm at my breaking point at the highest level of chaos.
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Both mom and dad really need alone time.
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Now,
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what do the kids need?
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Well,
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you may have a quick family huddle,
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what do you need?
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Or the parents may have a sense already of what the kids would probably need to regulate and regroup.
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One helpful thing in this scenario might look like the following.
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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.
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They both really feel better after they get some pressure input,
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that's proprioceptive input and movement input,
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vestibular input.
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You can see our episode about sensory inputs for regulation.
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And this is why the bike ride is so important.
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If we tell dad not to go on the bike ride because the house is in chaos,
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he's not going to be able to regulate himself.
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So we want a dad who comes back,
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regulated centered calm.
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Um not at,
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at the breaking point.
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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,
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but we don't have to say anything and that's very calming and regulating for them.
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Perhaps in this scenario,
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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.
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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,
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the eight year old can spin and sing and walk with her wand and he gets to choose whatever he wants for,
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quote dessert for the family.
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He chooses lots of movie candy like now and laters,
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Mike and Ike and Swedish fish.
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And he lets his sister pick out a Princess Pez dispenser.
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Then they walk home,
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mom's done with their bath.
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Dad and son are home and this is a regrouping time that acknowledges as many people's needs as possible.
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And then there can be a huddle at that point about how the rest of the night might go.
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But we at least want to problem solve when as many people as possible are more centered and less close to the breaking point.
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So this focus and strategy is uh really pinpointing what other people need people in the household.
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And it uses the huddle concept to come together and make a plan.
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So it's a quick coming together.
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It's not like a family meeting,
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where we talk through things,
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it's what's going on and what do we need to do.
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Now,
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we all know that this doesn't make everything easy,
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but it often makes things better and it creates partnerships within the household rather than really strained relationships.
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Let's look at another approach to household culture.
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So the second one is focusing on tradition and structure in order to interact,
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individuals with autistic neurology,
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often prefer structured topic based activities rather than hanging out or sharing about their day or sharing about feelings.
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These are typically more enjoyable to them than just unstructured together time.
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It might involve harnessing their knowledge about something that they love.
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And once you know who in the family really likes this kind of interaction.
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And you can say,
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I know this is what we enjoy best.
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This awareness can help increase the number of nice family memories or interactions.
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So for example,
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let's take a family um who likes to socially connect at the dinner table by sharing about their day,
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how the practice went,
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how their soccer game?
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Did uh did your friend feel good about their science project?
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How is your boss's husband doing since his surgery,
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et cetera?
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In contrast to another family with neurodiversity,
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now,
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they may prefer something more structured and less about how people felt or responded,
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less open ended or broad questions about the day.
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So what might that look like?
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This family might start a tradition at the dinner table where they each share an interesting fact that they learned that day.
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So perhaps the eight year old learned that most fish don't have eyelids.
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The 15 year old learned that on average,
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every person on earth owns 86 Lego Bricks.
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Let's look at another example.
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Let's take a spouse.
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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.
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She's realized though that they can have a really good social interaction if it's structured about a topic.
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She's also noticed that they have a good time interacting if they take online quizzes or play trivia together during these times.
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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,
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they learn new things.
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It works out well.
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It's actually a really connecting time,
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uh much better than the silence of sitting together without interacting.
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Let's take a third family.
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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.
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You know,
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they don't like going to the zoo anymore.
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This family realized that structuring some traditions for activities has worked better than small talk.
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Like how with school they might have a Friday night tradition of board games and pizza or they might rotate,
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who gets to pick the Friday night activity.
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One teen may pick a movie and chooses the snacks next week,
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another chooses a board game and challenges kids against parents.
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And the next week mom chooses a Lock Drew mystery for the family to solve together.
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So this approach harnesses the fact that individuals with autistic neurology may really enjoy each other within the context of some structure,
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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.
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There's so much that goes into the culture of a household.
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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.
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Thank you for joining me today to talk about households and families,
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protecting the wellness of our family.
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Connections can help us feel more supported and resilient overall.
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And next time we will round out this series by focusing on adding meaning and growth to areas of special interest.
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I hope you can join me then.
Autism and Intentional Living: Communicating and Connecting (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:
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Hi there.
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This is Doctor Theresa Regan.
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I'm joining you for an episode of autism in the Adult podcast.
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I'm a neuropsychologist,
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the founder and director of an autism diagnostic clinic in Central Illinois.
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And I'm the parent of a teen on the spectrum.
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Did you know that I did a podcast series on talking about autism?
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This was in February of 2022.
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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.
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We cover topics about how to process and navigate the emotions of other people during conversations about autism.
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And we also reviewed how to talk to someone that you are familiar with --someone in your family,
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someone that you know -- about the possibility that they are on the spectrum.
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Maybe they haven't thought about it that way,
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but you recognize some characteristics in them.
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I'm going to put a link to this series talking about autism in the show notes.
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But today you are joining me for episode number four in a series about intentional living on the autism spectrum,
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we all get into rhythms and routines that have a life of their own.
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Sometimes our schedules,
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what we typically do,
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what we don't do... things that crop up in our lives.
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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.
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Are we choosing this life?
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Are we being swept away without really pausing to make some choices and decisions?
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And certainly we can't have the final say in everything that our life entails.
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But we really will be able to capture more of our dreams and visions for the future
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if we pause and make choices that line up with those...
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those goals that we have.
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This need to pause and reevaluate our intentions and choices is a universal human need.
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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,
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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.
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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.
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So in the first episode for this series,
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we talked about how to get to the point where you can actually choose a goal that is difficult in itself.
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We outlined several life categories that you could analyze to see if you would like to think of a goal in these categories.
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Now,
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the second episode was about how to make specific goals within a category.
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So we want the goal to help us shift from our current place and leave the boundaries of our comfort zone.
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But we don't want it to be overwhelming or self defeating because we picked a goal that's just too difficult,
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too big...
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feels insurmountable.
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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.
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And this is often a good place to start in our lives when we're trying to grow and challenge ourselves.
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Because if we're setting goals,
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this is really us setting a goal to do difficult things.
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And if we're not regulated when we start these goals,
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if we're not feeling grounded,
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centered,
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calm and psychologically present,
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attentive and rested,
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it's really difficult to leave our comfort zone in any other area to really have intentional living.
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So it is often nice to make sure that we're really well regulated before we jump into any other goals.
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So now today you are listening to the fourth episode and we're going to focus on intentional living within communication and relationships.
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And you may be asking why do I need to have social goals?
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Well,
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you don't,
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your communication and your social network don't have to match any particular template that others use.
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But at the same time,
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if you have a vision for your future,
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you may need to grow in certain areas of communication or connection so that you can meet the goals that you do have.
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For example,
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one person may want to become a history teacher because they love history.
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That is a great goal.
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It's a way of sharing your love of a topic with other people.
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But you'll also need to have some skills for communication,
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updates with your work team and with your students and families.
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Maybe about projects or grades,
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you'll have to have communication skills to interact with people who are really upset with you or disagree with you.
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Maybe you'll be put in charge of a major project for the school and you'll have to present on the topic.
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If you already have these skills,
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that's super,
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you don't need to grow in this area.
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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.
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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.
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So perhaps this person has a goal to connect in a more effective way.
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She may have a goal for communication and connecting in the home with this new life season of retirement.
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In contrast,
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you may be someone who's all set in this area.
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But in the future,
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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.
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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.
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And let's face it,
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you are probably already super good at communicating about topics,
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facts,
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details,
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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.
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Well,
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the trickier area of communication more often shows up when we're in an interaction and we start thinking,
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wow,
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what just happened here?
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What did this person react to in this conversation?
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I'm not even sure where they're coming from.
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I don't know what this person wants from me.
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After all,
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I was right about what I said.
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So why all this emotion or all this up and down?
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Let's look at a few areas of focus that can balance out that connection piece.
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First of all,
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I want to introduce and bring more into your awareness,
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this focus on the other.
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So when you are communicating with someone,
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whether that is a history teacher,
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talking to a parent or a woman who's just retired,
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talking to her partner.
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There is a difference between communication that's factually correct and communication that is effective.
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It helps to be correct.
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But we also want communication that's more than correct.
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We want it to be productive,
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helpful,
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valuable and fruitful.
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So remember what your goals are,
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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.
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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.
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And sometimes to be honest,
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this whole interaction happens and we never pause and we're a bit surprised and taken aback.
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And we process things after that's OK too.
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The goal eventually will be able to pause and process a bit during the interaction to adjust.
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But we may start by analyzing and thinking through things after the fact,
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focus on the other person.
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So ask yourself things like what does this person need from me right now?
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Other than being correct about the facts,
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I'm saying,
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what do they need from me in the social conversation?
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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.
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Now,
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these kinds of wonderings and kind of exploring these questions,
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this could be something that we do in a counseling or therapy session really in depth,
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right?
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So if you are trying to um process your relationship with your partner,
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maybe you process interactions with a therapist.
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But there are also probably a few things to say during these interactions that might help um you focus on the other,
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the other person's needs.
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So you could say things like,
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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,
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they're emotional,
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they're in really a confrontational moment.
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-- 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.
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What do you want me to know that you feel like I don't understand about what your experience is.
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What are your needs in this situation?
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Tell me what you need... or I really value you and I do want to be part of the solution,
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not the problem.
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Do you need to say these specific words?
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No,
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it's important to make them your own and to match them to the person that you're talking to in the context.
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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,
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support them,
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make things better.
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The basic idea is to pause and to ask for input about what they need in this situation.
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And it doesn't mean you have to change your opinion or your decisions.
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But in the midst of factual things like projects and chores making plans,
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there's still value that is found in recognizing the needs of the other during these interactions.
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And that can help bridge the gap from conversation that is factual to conversation,
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that is effective.
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The second thing I'd like you to keep in mind.
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And this is also a way of focusing on connecting with the other is the use of compliments and gratitude.
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This is another way that we can attend to the person and set the stage for the communication and the relationship.
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So some would say this person's only doing their job,
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why do I have to compliment them or thank them?
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I don't need that.
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I don't want that.
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I don't even like that.
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But this is a relatively easy thing that helps attend to what the other person needs even if you don't need it.
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So it sets the stage for people to understand how you view them.
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And when difficult things do happen in the relationship,
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the way that we interpret those may have to do with how this stage has been set in the past.
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For example,
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if is this a person who really knows for multiple examples in the past that you value them.
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And therefore this glitch in communication or this disagreement,
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it's tough,
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maybe it's unpleasant but it's not monumental.
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Or is this someone who really doesn't know that you value them?
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And therefore every communication glitch is really a big deal.
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So compliments and gratitude set the stage.
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This is how I think about you.
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This is how I think about our team.
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Again,
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I see you,
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I value you and it doesn't have to be mushy and emotional.
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It should fit the context and the person.
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But again,
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just a very uh brief uh effective way of adding to that connection during communication.
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Let's talk about two levels of compliment.
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One is a compliment about a skill or achievement and one is a compliment about a personal attribute.
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So the second one is really a higher level.
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Um and it gives a stronger message that I see you and I value you,
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not only do I see your product and I appreciate the product,
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but I see the person that produced that and,
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and I value your contribution.
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Now,
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they're both powerful and you can choose the type that you use based on how well you know the person,
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what your goal is in that social interaction and what else is happening in the context.
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For example,
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a partner who's trying to improve his relationship with his spouse could either say this is a delicious dinner.
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It's great to come home after all these pressured meetings to a really pleasant meal.
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And I thank you so much for fixing it.
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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.
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Now,
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if it's a partner use this next level of compliment,
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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.
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I so appreciate that about you.
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Compliments and thank yous this gratitude and acknowledgement of the other,
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what they've brought the skill sets,
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they have individual attributes.
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This can all help set the stage for a relationship that the other person feels safe and happy with.
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The third way of adding to this communication,
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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,
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even when they are not important to you,
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you really honestly don't care about them.
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But again,
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we're looking for communication that's effective.
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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.
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I do want to be able to be an effective teacher.
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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.
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What's their partner's name?
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What are their kids' names?
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What family are they interacting with?
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Who do they live with?
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Maybe they're talking about taking their son to his soccer tournament this weekend.
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This may be topics that they're passionate about but you are not.
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Maybe they love sci-fi movies or quilting might even be milestones in their life.
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It could be that they've had a birthday recently or a marriage anniversary.
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Maybe they've moved into a new apartment or purchased their first home.
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Even though these things are not important to you,
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they are important to the other and connecting in a more effective way with this person is part of your intentional life choice.
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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.
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You don't have to know about the topic in order to bring it up in conversation.
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So people will say,
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well,
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not only do I not know about sci-fi movies,
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but I'm really not at all interested and I don't know what I would say.
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Um That's ok,
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this is about them.
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The goal is not to add content and correct factual information.
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The goal is to connect effectively and to set the stage of connection and you can do that without any factual knowledge.
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So you could say I don't know much about that topic.
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Uh,
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what do you like most about it?
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What first got you interested in,
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in that area?
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What's coming up related to that topic?
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So,
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let's say this is the sci-fi lover and you might say,
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hey,
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any big movies coming up that you're gonna go see.
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I'm not,
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um,
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up on what's at the movie theater.
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Um,
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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,
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um,
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a real love for fish tanks and fish and little um villages in the fish tank that they build.
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Um You could say,
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hey,
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any new fish in your fish tank lately,
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what if you got that's new?
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Do you have a picture?
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So the purpose is not to contribute to a topic.
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The purpose is not to be correct.
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The purpose is to say,
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hey,
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I see you.
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I hear you.
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Um And I'm really acknowledging what's important to you.
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You could say,
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hey,
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how did the move to your new apartment go this weekend?
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Did you get hit with the rain?
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You can acknowledge what a big job it is to move and say,
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hey,
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I hope you feel settled in soon.
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You could say,
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how did your son's soccer tournament go?
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Did he feel good about it?
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Did you get to visit any interesting places or?
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I'm so glad you guys have that opportunity.
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What a big commitment that is,
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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,
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a follow up question once a week or three times a week and you're gonna rotate people.
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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.
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Now,
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there is so much we could cover about communicating and connecting.
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But hopefully this episode gives you some concrete things to use today in your relationships.
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We've reviewed the importance of pausing during an interaction to think about or ask the person what they need.
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We reviewed types of compliments and ways of expressing gratitude and how these can set the stage for helping with future interactions.
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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.
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If you want to dive deeper into communication and connection topics,
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there are great resources out there.
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Now,
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I don't have any financial interest in any of these products.
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I'm just offering some ideas of things that have helped or helped my clients in the past.
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I've linked some of my favorites in the show notes and one is a great book called The Science of Making Friends,
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which highlights strategies from the peers program that's out of U C L A.
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And there are chapters on finding and choosing good friends,
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elements of good conversations,
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dealing with arguments,
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handling and addressing,
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teasing and cyberbullying,
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minimizing rumors and gossip and changing a bad reputation.
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Now,
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this is a book that's focused on an audience of teens and young adults.
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I like to take those kind of books and apply the basic concepts to whatever age group I'm working with.
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But if you really don't relate to books in that way,
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and it's going to be distracting if people in the examples are from a different generation,
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that book may not be for you.
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There are also well known books such as Better Small Talk by Patrick King,
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How To Win Friends and Influence people by Dale Carnegie and Crucial Conversations by multiple people,
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Joseph Granny Carri Patterson,
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Ron mcmillan and Switzer.
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This book is a great tool to expand your skills at persuasion without being abrasive and to engage in conversations.
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Even when emotions are really running high,
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we're gonna need to know how to do that.
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If we're gonna be in connecting relationships that are really fruitful.
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There are many other great sources out there as well and I encourage you to find some that speak to you.
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Well,
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thanks again for joining me for this fourth episode of The Living With Intention Series.
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If you have goals that require you to expand your repertoire for communicating and connecting,
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I hope these tips and resources are a great place to start.
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Join me next time as we continue this series about intentional living on the autism spectrum.
Autism and Intentional Living: Using Sensory Inputs to Improve Regulation (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:
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Hi,
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everyone.
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This is Dr Regan, host of the podcast Autism in the Adult.
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I'm a neuropsychologist,
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a certified autism specialist and mom to a teen on the spectrum.
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It's my great pleasure to direct an autism diagnostic clinic in Central Illinois for adolescents,
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adults and aging adults.
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If you are a clinician wanting to increase your knowledge of autism,
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in order to better serve your clients,
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you may want to check out my courses at Zur Institute,
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Z U R Institute.
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The links will be in the show notes for this podcast episode.
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If you're a regular follower of the podcast,
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you will know that we are in the third episode in a series about living with intention on the spectrum.
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I would encourage you to listen to the first two episodes to get the most information.
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Although this episode can be stand alone as well.
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Today,
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we'll be talking about a goal within the area of health and wellness and specifically,
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we're going to focus on improving regulation using sensory inputs.
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Now,
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I have several other episodes about regulation and I'll link them in the show notes,
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but in short regulation refers to the ability to stay centered balanced to get that just right state to be both calm and attentive.
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At the same time,
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this regulation can look like a meltdown,
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a panic attack,
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an outburst or it could look like withdrawal from a place or activity.
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For example,
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I need to quit this conversation or I need to go to my room off by myself.
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I can't attend work today.
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I can't go to school.
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It can also look like freeze,
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like shutting down feeling offline or dissociating.
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And finally,
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disregulation can look like the experience of physical symptoms that are not rooted or at least not completely caused by a physical condition,
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injury or disease process.
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Individuals on the spectrum are more likely to struggle with dysregulation in some form.
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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.
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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,
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like relationships or working or other areas that we've discussed in the series.
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So far,
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the tricky thing is that there are often more limitations to the success of regulation strategies on the spectrum than for the neurotypical.
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And the go to strategies are often some combination of counseling or talking through the difficulty,
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maybe reasoning through problems,
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we might add medication for the support of regulation or use punishment and reward programs.
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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.
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However,
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if these are the only approaches we're relying on,
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there are likely to be some pretty big limitations.
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So let's think about how the nervous system works.
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If an infant is screaming,
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relentlessly crying,
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very upset,
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can't calm down.
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In other words,
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they can't regulate.
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We don't try to reason with them about how they're completely safe.
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They've just been fed,
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they're not in any danger or that their crying is really too loud.
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It's bedtime.
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We don't go reasoning through all that.
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We don't give them medication for depression or for anxiety.
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We don't use rewards or punishments in the traditional sense.
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Again,
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it's not that I don't recommend these approaches.
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I think they can be very helpful at times.
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But I'm pointing out that there is another way for humans to regulate their nervous system.
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And if you picture what we do for the infant,
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we hold them.
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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?
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Well,
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typically we rack them and this gives their brain some movement to input.
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This isn't always a magic way of calming an infant.
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But it often helps quite a bit as an approach to help the infant regulate,
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to center,
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to feel calm.
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Because the infant relies on the adult for regulation.
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This approach of using pressure,
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which we call proprioceptive inputs and movement.
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In this case,
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I'm talking about vestibular inputs.
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This approach of getting these inputs into the nervous system helps people of all ages and with all variations of nervous connections,
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nervous systems,
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uh whether you are neurotypical,
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whether you are neuro diverse,
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it doesn't matter we do.
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This is how our nervous system works.
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That's why therapists working with little kids on regulation may have them do heavy work like carrying or pushing something heavy.
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That's for the pressure input.
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It's why some individuals like weighted blankets for calming,
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that's pressure as well.
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Other individuals like to ride their bike after work or go jogging.
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Well,
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that's movement input.
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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.
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Today,
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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.
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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,
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you can get pressure in the muscles or the joints,
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proprioceptive inputs into the brain pressure in the muscles could be from a massage or laying in a hammock.
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You get that squeeze input,
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laying under a weighted blanket,
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draping over an exercise ball,
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curling up in a chair.
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When we say I just want to curl up and read a good book.
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That's when we're giving ourselves,
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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.
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Pressure into the joints could be from things like pushing,
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pulling,
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hanging,
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anything that offers resistance through the joints,
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hanging from a pull up bar,
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shoveling snow,
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swimming,
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stretching a Farrah band or resistance band,
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riding a bike pressure through the jaw by chewing,
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resistive foods can also be pressure input for the nervous system.
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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.
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You'll get the most input for the nervous system.
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When you're doing whole body activities,
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then when you're using the jaw or hands and feet,
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but we can't always do whole body activities.
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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.
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Input like the rocking baby gives vestibular input into the brain,
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the brain does not get vestibular input when we move our arms and legs,
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but we stand or sit still.
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There's no vestibular input.
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When we're on a treadmill,
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for example,
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or we're using a stationary bike,
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the fluid in our ears has to be moving.
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So when we're moving through space,
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like running through the neighborhood,
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swinging or riding a bike outside,
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then we're getting vestibular input.
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So those who say,
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oh,
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I love riding my bike,
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but I will not ride a stationary bike.
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What they may be saying is that their nervous system really needs that movement,
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that vestibular input through space.
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There are three types of vestibular input linear.
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So going in a relatively straight line,
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like if you're jumping up and down on a trampoline,
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swinging front and back or rocking left and right or front to back,
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rotary is spinning or twirling.
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That's the second kind of vestibular input.
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And the third kind are inversions which involves being upside down,
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like hanging upside down,
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doing a forward bend or doing a down dog position.
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In yoga.
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The movement inputs can be alerting or calming,
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intense or gentle as an individual.
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You can see what helps your nervous system at any given time.
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Someone who wants to feel calm or may want to rock in a rocking chair,
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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.
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Even when they were so upset when they were actually getting in the car,
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another person may really feel calmer when they've been swinging again.
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We have the swings for infants that they can rock in and get that gentle front and back motion.
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Someone who wants to feel more alert and activated like I need energy,
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I need momentum to get going.
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They may want to ride their bike down a hill or jump on a trampoline.
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That vigorous movement input is often more alerting.
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So someone might say,
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oh,
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now,
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now I'm really awake.
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Every nervous system though responds a bit uniquely to these different kinds of inputs.
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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.
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And when there are some activities that provide both pressure and movement input,
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riding a bike gives pressure through the joints as well as movement through space.
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Climbing,
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a rock wall provides really intense pressure in the joints as well as gentle movement up the wall,
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swimming provides resistance through the joints.
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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.
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Whether the person is going upside down.
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Are they diving off of a height or going down a water slide?
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If you think back to what you have really loved to do,
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you may get clues about what your nervous system prefers.
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One person may have a history of a love for diving and they've been on the swim team during school,
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but maybe they don't have any source of inputs since they graduated.
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They haven't even realized how important these inputs were to their regulation.
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Another person may have a love of roller coasters,
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fast motorcycles,
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skydiving,
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their system loves intense vestibular inputs.
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Another may love weightlifting,
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cracking their knuckles.
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This is another source of joint pressure and heavy work,
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like yard work,
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gardening,
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household projects involving a lot of lifting of supplies.
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If you can pinpoint what your system has liked,
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historically,
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you may have a place to start in experimenting with what your system needs.
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Now also take into account your current health,
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your physical abilities or restrictions and your doctor's advice.
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If you can't pinpoint what you've liked in the past,
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start making a list of things to try a little bit at a time.
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Perhaps some waits on one day,
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a walk through nature the next or swinging at the park.
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Once you identify an area of inputs that your system benefits from.
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And again,
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the benefit is feeling more centered,
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calm and fully present than before the activity,
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then start thinking,
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how else could I get inputs like this?
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If you love bike riding,
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perhaps try swinging for movement and pressure.
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If you love a way to blanket over you while rocking in a rocking chair,
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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.
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It can even spin in rotation.
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If you like weights,
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you might wanna try rock climbing for intense joint pressure.
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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.
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Be creative and develop some awareness of what your system responds positively toward and again,
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make sure you know,
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your own body,
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your limitations and any recommendations from your own physician.
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So let's regroup.
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So far,
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you've learned about pressure and movement inputs,
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the variations of intensity and exercise versus restorative based inputs.
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So exercise could be something like riding a bike,
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restorative,
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could be something like laying in a hammock swing or a hammock.
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You've considered what you have liked or not liked historically.
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And perhaps you have a list of things to try in order to build up a repertoire of options.
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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.
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This is crucial.
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Now,
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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.
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But what often happens for the autistic is that they feel great,
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great,
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great.
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And then they feel really off center.
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And a lot of times they'll say I just did not see that coming.
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So by the time they use their as needed inputs,
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they're already deregulated.
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So that's not the goal,
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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.
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So think about ways to give yourself centering inputs multiple times a day and that will be individual to you.
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Some people might do this three times a day,
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maybe at the beginning,
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middle and end,
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they may need some pressure and movement in the morning to wake up to become energized and to also feel calm and attentive,
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they may need inputs over the lunch hour or midday.
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And then again at night,
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perhaps restorative inputs like a rocking chair or a weighted blanket,
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maybe some nighttime yoga.
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Then when you do become deregulated on any given day,
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think ahead of time about what your as needed inputs might be.
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So when you're in the moment of disregulation,
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it's really difficult to figure out what you need.
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So you may be able to think to yourself ahead of time.
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You know,
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when I get dis regulated,
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this is what that looks and feels like.
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And when I start to see myself in that place,
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I can try these handful of things to see if it helps in that moment of crisis or kind of surprise.
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Uh,
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off centering,
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you may say,
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ok,
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I've had a particularly intense day.
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I'm feeling more off center than usual.
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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.
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This can be what as needed inputs look like.
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So you can see that like with the music and headphones,
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sometimes the regulating inputs could be also um a sensory input from another domain.
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What do you like to listen to?
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What scent do you like to smell like?
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Lavender or vanilla?
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But usually the big regulating inputs will involve movement and pressure.
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So today,
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we have chosen a growth area within health and wellness.
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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.
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Remember,
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the general approach we discussed in episode two when developing this program.
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So try to set up small reachable steps forward,
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use strategy to find your momentum.
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And once you've integrated the physical inputs into your daily routine,
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that momentum will kick in and it'll help you.
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Um not feel that this whole thing is effortful.
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It'll be just what you do on a regular basis.
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You'll also reap the benefits of having a more regulated nervous system.
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Be sure to check out the show notes,
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I have various links that we've mentioned here in the episode.
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One is a link to the Z Institute courses,
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Z U R for clinicians to learn more about autism in adolescents,
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adults and aging adults.
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I also have links to my podcast episodes about regulation if you'd like to do a deeper dive.
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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,
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to feel calmer and more attentive.
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There's also a link specifically for their for All Program alert program four.
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That's the number four,
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not the word all dot com alert program for all dot com.
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That is a self guided study.
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You can purchase for a deeper dive into your own nervous system,
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figuring out what kind of inputs help you regulate.
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And I will have all four of those links in the show notes.
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Thank you for joining me today.
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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.
Autism and Intentional Living: How to Make Goals and Achieve Them (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:
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Hi,
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everyone.
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This is your host,
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Dr.
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Theresa Regan,
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introducing this next episode of autism in the adult podcast.
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I'm a neuropsychologist.
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So I specialize in understanding how the health of the brain and the connections of the brain impact,
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thinking,
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skills,
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emotions,
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behavior,
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and personality.
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I've worked in hospitals for over 30 years and I'm the mother of a teen on the spectrum.
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And did you know that I have a series of three podcast episodes about momentum for activity.
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One is about exhaustion and finding balance in momentum.
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One of the episodes is about how to gain momentum for activity and the third is how to keep momentum for activity.
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You can find these three episodes as episodes number 21,
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and 23 In September and October of 2021.
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I'll put the link in the show notes.
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Today,
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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.
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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,
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uh whether we wanna grow or shift gears.
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So the previous episode was this introduction of thinking about where are we in our life right now?
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And if you can identify areas where you would like to find more meaning,
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uh a bit more challenge.
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If you'd like to change direction,
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then we're going to focus together on living intentionally.
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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.
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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,
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how am I wired and what does my system need?
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How do I interact with people?
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What do I find uh joy in,
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in life?
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What drains me and we have this elevated understanding of ourselves.
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Um That is part of that process.
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So I think after that process of self awareness,
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if we do identify areas where we would like to grow or expand in some way,
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one way to do that.
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And we covered this in the initial episode is to think of categories in our life.
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And I invited you to do this um to see where you might want to shift.
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One of the categories we talked about was within the area of a special interest.
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The second was within the area of health and wellness.
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The third was regulation,
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that means the ability to stay centered with things like alertness,
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attention and emotions.
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We also talked about 1/4 category,
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relationships.
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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.
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And the sixth would be something like family and household culture.
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So if you're living in a household with other people,
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and these are people who are wired differently than each other.
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Sometimes focusing on the culture of the household can be a rewarding area of growth.
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Today,
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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.
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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.
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We don't want to,
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to be like that,
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but we want you to have this intention towards something and to give you some structure of how big should the goal be and,
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and how quickly should I work toward it and all of these things,
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I just want to give you some framework to see if this framework helps you.
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The first thing I'd like you to do is to take stock of where you are now.
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So if you chose a health and wellness goal,
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if you chose a household culture goal,
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I just want you to think about where you are right now in this area.
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So don't focus on the end goal.
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Let's just focus on where you are.
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Someone may say for health and wellness.
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Well,
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where I'm at is that I probably walk 10 minutes after work twice a week.
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Another person in the area of everyday tasks may want to really stay on top of bill paying and financial management.
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And so they may say,
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well,
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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.
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So we're just taking stock whatever your category is for growth and meaning maybe take stock of where you are now.
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And um knowing that you would like to be in a different spot at some point in the future.
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The next step is to create a goal where you're just going to take that one step forward.
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Um What we want to do is to make this goal really achievable.
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We want to set ourselves up for success.
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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.
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One way to create this type of goal is to think about time spent toward your ultimate destination.
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For example,
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in the area of movement and exercise.
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Someone may realize that they're walking a certain amount after work every week and they may add time to that current routine.
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So someone who wants to have more movement in their life or to get outdoors more frequently,
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perhaps they say,
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well,
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I'm going to add 15 minutes a week to my current routine of being outside or of walking in the neighborhood and moving.
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Um,
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just getting that movement in,
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maybe that's their goal.
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Another person who wants to work toward achieving skills in a certain area,
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maybe they're working toward a promotion or they would like to learn a new skill for fun within perhaps within their special interests.
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The goal may be to spend a certain amount of time per week learning this new skill.
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If they're currently not learning anything about it,
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they might want to start with 20 minutes a week.
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If they're already doing 20,
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they might want to increase by 15,
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whatever the stepwise time goal might be for you,
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that would make sense in your area of interest.
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That may be a way that you'd like to construct what your actual goal is.
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You can also think of it as doing a certain fraction or a certain percentage of the work toward the ultimate goal.
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If someone would like to have intentionality in the area of their special interest,
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publishing,
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some of their short stories may be a goal where they're at currently is they have a collection of 50 short stories,
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most of which are within a science fiction genre.
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They've never taken a class on creative writing or on marketing for their own business.
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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.
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They may identify 10,
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15,
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20 steps.
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One might be taking a free online course in creative writing.
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Another might be joining a local writers group in their community to become part of a network for writers.
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Another goal might be learning how to create a website or how to publish their own material online.
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They would want to take one of these multiple steps.
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So if they've identified 20,
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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.
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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.
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If it's too big,
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you would want to break that task down.
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So the first step might be to investigate some free online options to choose from.
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If someone has a goal to participate in additional community activities or to get out of the house a bit more often,
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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.
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This just gives a bit of structure,
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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.
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So we should be able to see the end.
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We should know that it takes some effort that it takes us out of our comfort zone,
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but that we also are set up for success.
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The next step would be thinking of a timeline.
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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.
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They may determine that they'll watch how they do with their goal across two weeks.
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Perhaps their goal is to get up at the same time every day and after two weeks,
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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.
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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.
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But here comes the most important step we've looked at creating that step forward goal,
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creating a time frame.
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And this third part I would say is the most important this is picking a strategy to have success.
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What does not work is just saying,
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well,
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I'm going to do it.
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I've made the goal,
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I'm intentional about the goal and I have this time frame.
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I'm just going to do it this time,
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even though it's been really hard in the past.
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What happens with that is that we're able to spurt towards some goal,
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success there,
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but it's very difficult to maintain.
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So what I'd like you to do when you have a goal,
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you have a time frame,
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you have a little chunk that you're gonna work on.
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Say to yourself,
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what's my strategy for accomplishing this goal?
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Never move forward without a strategy.
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If you can't think of one,
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ask a friend or a family member,
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one strategy could be in the area of remembering how can I remember to take my supplies to school?
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How can I remember to do the dishes before I go to bed?
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Another strategy may have to do with adding fun to the task.
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How can I make this task less,
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boring,
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less mundane?
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Maybe I could do it while music is playing or an audio book,
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maybe I could make a race out of it to see if I can get it done within a certain amount of time.
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Perhaps there are ways that I could use a strategy to make the task easier learning about how to streamline the task,
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looking at other ways people do the task to make it easier,
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take up less time.
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Another strategy I could use is offering myself a reward for success.
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Maybe I say if I'm successful for eight weeks in a row,
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I get to buy myself this thing that is not too expensive,
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but usually,
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you know,
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that would be off limits for me.
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But I'm gonna reward myself after I reach this time frame.
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After you've chosen a strategy,
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you have a time frame,
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you have a small goal that you're set up for success with.
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Then it's time to put your plan into action after the week or two weeks.
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What you're going to do is to kind of have an evaluation and debriefing with yourself.
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The first part of the evaluation is I achieve my goal.
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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.
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You may decide that you're ready to add another step forward goal to your momentum.
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If you did 10% of the small task toward your goal,
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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.
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Remember to keep a strategy if you need to shift based on your new goal,
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your new step forward goal,
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be sure to do that.
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If you achieved your goal,
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but you pulled it off and are really tired and don't know if you could do that again,
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then you probably need to evaluate whether the goal is small enough,
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whether it's easy enough in the sense that we all have areas of our life that we would say,
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you know,
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for whatever reason,
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this area really wipes me out.
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I just have a huge struggle in this category of my life.
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Maybe you need to start in a different category.
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But if you can make the step forward goal easier,
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do that.
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If you can use a strategy that will help you more,
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go ahead and do that,
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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.
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I have momentum for it.
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It's built into my routine and then you don't have to effort as much to keep it going.
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That's when you add just a little bit more to it.
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What do you do if you did not meet your goal?
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Well,
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that's fine too.
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You would step back and evaluate why you may ask yourself.
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Did I use the strategy that I created for this goal?
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If you did and you were not successful with the goal,
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you probably have to reevaluate the strategy or you may need to add another strategy on top of that.
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Maybe you used a remembering goal,
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but that wasn't enough to give you the momentum.
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You need to just get that new behavioral set into your repertoire.
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Maybe you also need to make it easier,
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make it fun or give yourself a reward.
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Maybe you need someone to be accountable to,
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maybe that's your strategy.
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You should also ask yourself,
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did I use my strategy?
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If I didn't reach my goals?
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Maybe it was because I had the intention of using reminders or making it fun.
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But I didn't actually follow through with that.
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Well,
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then you would evaluate that as well.
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Is this strategy too hard?
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Is it too complex and involved in energy draining?
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What other strategies could you think of?
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Do you need to layer something in or do you have to scrap the first strategy and try again?
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What strategies do other people use or find successful?
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What ideas can you glean from other people?
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You're always able to say no to someone's suggestion of a strategy,
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but only if you have a counter offer.
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If your boss says,
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hey,
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this still isn't working.
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I'd like you to try this strategy.
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You can say no,
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I'd rather not use that strategy,
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but only if you have a counter offer.
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If you can say I've thought of this other strategy,
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then you can run with that.
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Now,
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the nice thing about this process is you're learning not only perhaps a new skill that is your goal.
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Um learning how to create a family culture that works in your home.
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Uh Learning how to stay regulated in a way that matches you.
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You're not only learning those things,
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but you're learning this process of growth.
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So I wish I were in a different place in this area of my life.
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How can I start that shift?
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How can I think about doing it without feeling overwhelmed or like,
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I just can't get any,
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um,
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I can't get any forward momentum toward change.
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Well,
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this is a way that you can practice a process for living with more intention.
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Where would I like to be?
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Where am I right now?
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How can I make small steps forward to guarantee that?
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I know I can have success.
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How can I create strategy and timelines and then evaluate what needs to be shifted?
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And what you'll notice too is you may get a great momentum for your goal.
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Maybe you are doing the dishes every night or you're moving for 15 minutes after work every day.
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What will happen is you'll have momentum for that for maybe a long period of time.
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Then at some point,
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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.
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And that's really part of that normal human process too.
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And because you know,
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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.
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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.
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We will continue to talk about living with intention,
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meaning growth and having success with all steps forward.
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Next time when we talk more about strategies and goals within these different categories,
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we mentioned special interests,
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health and wellness regulation,
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relationships,
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everyday tasks and family and household culture.
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I hope you'll join me then.
