Monday, June 6, 2011
Outsmarting Explosive Behavior: Interview with Judy Endow
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Positively Autism: Let’s start with your background. What lead you to the field of Autism and how did that inspire you to write Outsmarting Explosive Behavior, A Visual System of Support and Intervention for Individuals with Autism Spectrum Disorders?
Judy Endow: My son who was diagnosed with Asperger’s. His story is in Outsmarting Explosive Behavior near the front of the teacher manual. I myself grew up having difficulties and was in fact institutionalized for some years as a youngster, diagnosed with a smorgasboard of psychiatric labels. My brand of autism wasn’t understood back then. When my son was diagnosed with Asperger’s the doctor then turned to me and said we should talk about my autism. Autism describes me better than and accounts for all the other diagnosis over the course of my lifetime. To read my story please see Paper Words: Discovering an Living With My Autism (2009, AAPC) In addition, my professional background in the field. I have a masters degree in Social Work and used to work in a homeless shelter. Today I have a private practice devoted exclusively to autism. I continue to write and speak on a wide variety of autism related topics.
PA: Give us a brief overview of Outsmarting Explosive Behavior and how it works.
JE: Explosive behavior is defined as having four distinct stages, followed by a clearly defined recovery period. In addition, the physiological fight/flight mechanism is triggered immediately prior to the explosion.
In this model, the four stages of explosive behavior are the same for all experiencing explosive behavior and are depicted by four train cars called Starting Out, Picking Up Steam, Point of No Return, and Explosion. The idea is to try to prevent the train cars from hooking up because when they do we have a runaway train that ends in explosion.
Working backwards, the Explosion is the stage where the meltdown behavior is evident. Immediately prior to this is the Point of No Return, which is exactly what it implies -- there is no going back from the meltdown because this stage is where the fight/flight response is triggered. The pupils dilate, and breathing and heart rates increase. Physiologically, our bodies respond as if our very lives are at stake, and we automatically behave accordingly: We fight for our lives. It is entirely impossible to reason with anyone in this survival mode. As soon as you see the child’s identified Point of No Return behavior you can know the Explosion is coming and need to do your best to quickly create and maintain a safe environment.
The place to impact explosive behavior is ahead of when it occurs. In the Starting Out phase, whispers of behaviors are evident. The Picking Up Steam phase is just that—the whispers become louder. Though you can learn to successfully intervene at these stages, the most effective way to manage explosive behavior is proactively, before the whispers even start.
Strategies to Prevent Meltdowns Before They Start
An individual mix of three major supports and interventions is usually most effective in preventing the first stage of meltdown behavior from starting. These three major supports include proactive use of a sensory diet to maintain optimal sensory regulation, visual supports, and managing emotions that are too big (Endow, 2010).
People with AS usually do not have sensory systems that automatically regulate; instead, they must discover how to keep themselves regulated. This is most often accomplished by employing a sensory diet. A sensory diet for a person with autism is like insulin for a person with diabetes. It is easy to understand that a person with diabetes has a pancreas that is unable to regulate insulin effectively. We can measure blood sugar and know the exact state of affairs, and from there figure out how much insulin the person needs.
Sensory Diet: Unfortunately, medical science does not allow us to take a blood sample to measure sensory dysregulation. However, we can figure out and employ a sensory diet to prevent dysregulation, and just like insulin prevents serious consequences for a diabetic, a sensory diet prevents serious troubles for an individual with ASD. As an adult with autism, I spend time every day on sensory integration activities in order to be able to function well in my everyday life. A sensory diet employed proactively goes a long way in preventing the Starting Out stage of explosive behavior from ever occurring (Brack, 2004).
Visual Supports: Another crucial area of support to put in place proactively is that of visual supports. As an autistic, I can tell you the saying “A picture is worth a thousand words” is the monumental truth. Although each person with ASD has a unique experience, processing written and spoken words is not considered by most of us to be our “first language.” For me, the meaning I get from spoken words can drop out entirely when I am under stress, my sensory system is dysregulated or my felt emotions are too big. Visual supports can be anything that shows rather than tells. Visual schedules are very commonly used successfully with many individuals with ASD. Having a clear way to show beginnings and endings to the activities depicted on the visual schedule can support smooth transitions, thus keeping a meltdown at bay. For maximum effectiveness, visual supports need to be in place proactively rather than waiting until behavior unravels to pull them out.
Managing Felt Emotions: A third area in which many with ASD need proactive support is in managing felt emotions. Most often, felt feelings are way too big for the situation. An example in my life is when I discover the grocery store is out of a specific item; I get a visceral reaction very similar to the horror I felt when first hearing about the 9/11 tragedy. I know cognitively the two events have no comparison and, yet, my visceral reaction is present and I need to consciously bring my too big feelings down to something more workable in the immediate situation. Managing felt emotions does not come automatically, but can be learned over time with systematic instruction and visual supports such as The Incredible 5-Point Scale (Buron & Curtis, 2004).
The good news is that explosive behavior can be positively impacted. With proactive supports, explosive behavior can be outsmarted so individuals with ASD can move on to living purposeful and self-fulfilling lives.
Brack, J.C. (2004). Learn to Move, Move to Learn! Sensorimotor Early Childhood Activity Themes. Shawnee Mission, KS: Autism Asperger Publishing Company.
Buron, K.D., & Curtis, M. (2004). The Incredible 5-Point Scale. Shawnee Mission, KS: Autism Asperger Publishing Company.
Endow, J. (2009). Outsmarting Explosive Behavior: A Visual System of Support and Intervention for Individuals with Autism Spectrum Disorders. Shawnee Mission, KS: Autism Asperger Publishing Company.
Endow, J. (2011). Practical Strategies for Stabilizing Students With Classic Autism: Getting to Go. Shawnee Mission, KS: Autism Asperger Publishing Company
PA: What ages of students have used this system successfully? Does this system work best for students with any particular characteristics or needs?
JE: Among those I have worked with the youngest child was 3 and the oldest adult in his 50’s. This train model to outsmart explosive behavior has also been used by non-readers by constructing it totally in pictures rather than using words, as in the written book example, and it has been found to be effective in both the picture and the words versions. In addition, as the train model began appearing in classrooms, teachers noticed that students for whom the train was not originally intended began using it to show their teachers the difficult they were encountering. So, although Outsmarting Explosive Behavior Visual System was intended to be used when working with individuals with autism, it has been successfully used with individuals with other diagnosis who struggle with explosive behavior.
PA: One aspect of this program that I think is wonderful is that it may fit into a student’s special interest area. Many students on the autism spectrum (and kids in general) often enjoy trains. How would having a familiar or preferred item, such as a train, featured in a behavior support program help students learn to manage their behavior?
JE: We all attend more readily to those things we like. We gravitate towards those things that make us happy. This is how human beings are; people with autism are no different in this regard.
PA: What other tips do you have for parents or teachers of students who may have difficulties with “explosive” behavior?
JE: If the youngster has classic autism he will likely need to be stabilized before employing the explosive behavior train model. Please refer to Practical Solutions for Stabilizing Students With Classic Autism to Be Ready to Learn: Getting to Go (2011, AAPC) for more information on this.
PA: Do you have a website where readers can learn more about your publications?
PA: Thank you for sharing your time and expertise with Positively Autism!
JE: You are welcome!
Note from Positively Autism: This book is published by Autism Asperger Publishing.