Dr. Debra Moore, a psychologist who has worked extensively with children, teens and adults on the autism spectrum, talks with Dr. Temple Grandin about how to provide ‘loving pushes’ so kids with autism can become successful adults.
Dr. Moore (D ):
As a psychologist, I ran into lots of spectrum teens and young adults who were “stuck.” Even if they were higher functioning, verbal, and made it through high school, they didn’t have the basic skills necessary for the next stage of life. Their parents were frustrated and afraid, and the kids were unmotivated and hopeless. When you and I first spoke, it became apparent that we were both seeing this.
Dr. Grandin (TG):
Yes, I am getting far too many parents coming up to me at my talks saying their kid is stuck in his bedroom playing video games. The moms don’t know what to do. They know their kid isn’t going to change anything themselves. But they are afraid to push them. This is a huge concern for me and it is a disservice to the child.
DM: So you and I decided to collaborate on a book about this problem and to approach it in a positive way so that readers would come away with both hope and concrete strategies.
TG: It was very important for me that the book was positive. Parents hear enough that is negative already. The people who told their stories in the book are inspiring and real, and their families offered tips that other parents can use. We need to teach our kids practical, sensible ways to succeed as adults. They won’t get there without our help.
The schools aren’t preparing them anymore. They don’t teach skilled trades these days, which are a great fit for lots of kids with autism. Plenty of the folks I work with in the cattle industry – builders, welders, and machine operators – are probably on the spectrum. They look like old hippies! They do a great job and lead independent lives. They got there because they were exposed to these skills. You have got to get a kid out into the world and show them different jobs.
DM: Every single one of the eight people we profiled talked about how valuable exposure had been to them. Whether it was a parent, a teacher, or in one case a neighbor, what they had in common was a belief in the child and the approach of stretching them just outside their comfort zone.
TG: That’s right. You can’t expect a child to progress unless you show them how. My mother knew this instinctually. But also that was in the ‘50s, and kids had more freedom and parents didn’t hover as much back then. We never had the term helicopter parent, that’s for sure!
Kids who are fully verbal are often overprotected. It’s well intentioned but it harms the child. We should never do for a child what they can do for themselves.
At conferences, I’ll have moms speak for their kid even though they are verbal. I tell the moms to stop talking. I ask the their child to talk to me directly. They can do it and they feel good about themselves afterwards. That is how you build competency.
You find the zone of pushing just enough to help them grow but not so much that you overwhelm them. You take one step at a time and give clear instructions. If you want your kid to learn to shop you don’t drop them off at the store. You take them shopping with you and you explain what you are doing. You pick one task and have them try it. Show them how to push a shopping cart without banging into other people. Next time you have them add another task. They push the cart and you show them how to put the items in it in a way that stuff doesn’t get smashed.
You absolutely cannot give ASD kids a long string of verbal instructions and expect them to succeed. You have to pretend they are an airline pilot and you have to provide them the sort of written checklist all pilots have to go through before each flight. Make it in the form of bullet points. Put them in the exact sequence you want them done. Then your child can be successful.
When I was in graduate school I worked at a dairy. It was my job to set up the milking equipment, milk the cows, and then clean up. There are a lot of steps involved in those tasks. The dairy had a checklist on the wall with all the steps spelled out. That saved me. I would have been in big trouble without it!
DM: There weren’t video games when you were a child but now all kids love them and are often exposed to them even as toddlers. I know you share my concerns about the amount of time kids spend on them.
TG: It’s not that I’m an old fogey! Kids are spending entirely too much of their lives in front of the computer. Unless they are learning marketable skills, this should be a minor part of their day, and should only happen after daily responsibilities are taken care of.
We know that video games can be addicting – the research is solid, and we know the autistic brain is extra vulnerable. I stay away from them because I know I would get addicted!
Parents have to set strict limits and get their kids out of their bedrooms and interacting with the rest of the family. By high school they should have a small part-time job, or be doing volunteer work, even if it’s just helping out at church or in the neighborhood. Find a neighbor who will agree to have your kid mow their lawn or walk their dog. Kids benefit from doing a work experience outside their home. They have to learn to take instructions from somebody other than their family. They have to learn working skills.
Kids on the spectrum often don’t get the exercise they need either. They usually don’t like organized sports, so we have to find them something else. Routine is good – maybe a nightly walk after dinner or a specific set of exercises you do with them. I hate exercise, but every single night I do 100 sit-ups. I made it a routine and I stick to it. I don’t have to like it.
DM: You’ve also talked before about how helpful medication has been for you. In the book we devoted a chapter to what to do when your kid is chronically anxious. It is such a common issue. Many of the individuals we profiled said they had periods when they were pretty much immobilized by anxiety and that medication really helped them move forward in their lives. What do you say to parents who are wary of medication for their child?
TG: Anxiety commonly co-exists with autism. I’ve always said my main emotion is fear. It got really bad when I was a young adult but since I started taking a low dose of medication it hasn’t been a problem. Lots of kids could cope better if their nervous system was better regulated. Read the chapter Believer in Biochemistry in my book “Thinking in Pictures” which is about my own personal experiences with successful use of antidepressant medication.
Make sure you use a doctor who is familiar with autism. We are sensitive to medication and usually only need a low dose. I plan to stay on medication the rest of my life.
If your kid is always overwhelmed it’s going to be hard for them to concentrate or to be with people. It will get in the way of a job. Treat the anxiety and then they’ll be willing and able to try more things.
DM: Do you have any final thoughts about stretching our kids so they can succeed?
TG: Fully verbal kids who are capable of being independent should be. Parents need to stretch them from an early age and expose them to the world. Build on their special interest – if Johnny is interested in trains take him to a train museum. Let him talk to a conductor. Go online and find the closest factory where they make trains or parts. Build the family vacation around it. Teach him about trains all over the world so he learns geography. Use trains in his math problems. Have him write and read about trains. Have him build a model train set and go to a model railroad club. The older guys there will take him under their wing.
We have to get really creative because the kids aren’t getting hands-on classes in school anymore. It’s up to parents now. Get them off the video games and out in the world.
The Internet is like a vast, lush garden. It contains healthy, beautiful flowers, and you’ll sometimes find extraordinary and rare butterflies in it. But it also contains weeds and lots of dirt and nasty stuff. Kids with autism tend to get fixated on things and the Internet has lots of bad things we don’t want them getting into. We don’t want them there so long it becomes their world.
Stretching your child is the greatest gift you can give them.
Dr. Temple Grandin was born in Boston, Massachusetts. At age two, she had speech delays as well as other signs of severe autism. Many hours of speech therapy and intensive training enable Temple ultimately to speak. Mentoring by a high school science teacher and her aunt on her ranch in Arizona motivated Temple to pursue a career as a scientist and livestock equipment designer. Her most recent book, coauthored with Dr. Debra Moore, is The Loving Push (Future Horizons, 2016).
Debra Moore, Ph.D. is a psychologist who has worked extensively with children, teens and adults on the autism spectrum. She started the groups “Autism Spectrum Across the Lifespan”, and “Autism Spectrum HELPING HANDS Mentors” at https://www.linkedin.com/groups/1646967
She has contributed chapters to The Nine Degrees of Autism (Routledge, 2015), a look at what those diagnosed as adults often experience, and Internet Addiction in Children and Adolescents (forthcoming, Springer Publishers).
This article was featured in Issue 48 – Connecting and Communicating with Autism