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CBT for ASD (mainly for children with high-functioning ASD) (tools to use…
CBT for ASD (mainly for children with high-functioning ASD)
LEARNING PROFILE ASSOCIATED WITH ASD
EXECUTIVE FUNCTIONING
difficulties sustaining in attention + difficulties in shifting attetion
consider duration of sessions
use a token economy system
medicine: atypical antipsychotics, stimulant methylphenidate
problems with organizing, planning, working memory, time management
parents + clinician need to supervise the between session projects
CBT program needs to be highly structured, with short discrete activities and assignments broken down into smaller units
reduce envronmental distractions
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highlight relevant information, repeat instructions clear rules
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ONE-TRACK MIND
difficulties in thinking flexibly and problem solving - continue to use incorrect strategies
encourage flexible thinking
provide multiple-choice options
role-play, behvaioral rehearsal etc. to transfer skills into real life
FEAR OF MAKING MISTAKES
notice details and errors
fear of looking stupid infront of others
can criticize others
therapist mus take suggestions without criticism
reframe failure
CONSISTENCY AND CERTAINTY
kids with ASD like routines and predictability
make a schedule of the upcoming therapy activities, with clear info, objectives and duration
SPECIAL INTERESTS AND TALENTS
develop restricted interests
can be incorporated as an antidote for feeling sad or anxious
can be used to improve motivation, attention and conceptualization + affective eduucation
Harry Potter - a hero that copes with adversity
ALEXITHYMIA + DEFICITS IN FACIAL EMOTIONAL RECOGNITION
alexithymia = diminished vocabulary to describe different levels of emotional experience
affective education
improve vocabulary
quantify degree of expression through use of thermometer/scales
decreased functional connectivity among multiple brain regions in response to emotional faces
encourage/teach cognitive-analytical processing of faces and social situations
CONVERTING THOUGHT AND EMOTIONS TO SPEECH
difficulty in describing their thoughts and emotions in f2f conversations
e-mails, txt messages
drawing
music
tools to use in therapy
written text + written instructions
computer programs
visual aids
drawing
music
role-play
demonstration
hands-on activities
tools need to be chosen and adjusted to the client. Generally children with ASD prefer concrete tools, as they have challenges in different cognitive areas (socioemotional processing, memory for sequintal information, processing information in a new context etc.)
woorkbook
between session projects
always include parents in the treatment process and talk to them after each session
LANGUAGE PROFILE ASSOCIATED WITH ASD
high-functioning ASD: not so much issues in language delays or deficits in speech, BUT difficulties with pragmatics of language
pragmatics = use of language in social contexts and the ways people produce and comprehend meanings through language
inappropriate initation
talking repetitively about things that others may not be interested in
talking to anyone
lack of coherence
difficulty providing a clear explanation of events
can go off topic
remind them about what the topic of discussion was
stereotyped language
overprecise information
turning the conversation to a favorite theme
poor use of context
being overliteral
misinterpreting situations
not understanding sarcasm or metaphors
don't understand how intonation and emphasis on a word can affect meaning
use visual aids as supplements to make sure they have understood instructions
difficulty with rapport
ignoring conversational initiations by others
not using facial expressions to convey meaning
training in conversational skills
INTERPERSONAL AND SOCIAL ABILITIES ASSOCIATED WITH ASD
deficits in social communication and social interaction across contexts
social emotional reciprocity
non verbal communicative behaviors
developing and maintaining relationships appropriate for developmental level
teach
mind reading = ability to read non verbal cues that indicate the emotions or intentions of others, and how to use nonverbal communication to convey emotions
computer programs
words and expressions
SENSORY PROFILE ASSOCIATED WITH ASD
sensory issues can contribute to emotional dyscontrol
arrange the therapy environment so that it is tolreated by the client