Here's another interesting post on Bill Nason's Facebook page, Autism Discussion Page
Get me started, but let me finish!
Many children on the
spectrum suffer from “self initiation” and “sustained attention”
difficulties. These two functions are part of the “executive
functioning” skills located in the frontal cortex of the brain. This
explains why many kids appear to “lack motivation” and need to be jump
started to do everything. The ability to initiate an action, especially
if it is task related, is often
impaired. For these children, they have difficulty taking the first
step to get started. They tend to blank out and freeze. However, once
the first step is made then they move forward with the action/task.
This is the person that needs to be continually prompted to get up and
“doing.” Unfortunately, such children are labeled as “lazy”,
“unmotivated”, or worse yet, “incapable.”
Many of these same
children also have problems with “sustaining attention”; staying on
course until the task is completed. They become distracted very easily,
and have difficulty concentrating long enough to follow through with
sequential tasks. Again, they are often labeled as “lazy”,
“unmotivated”, and worse yet “incapable.” Unfortunately, reinforcing
these labels, is the child’s ability to “initiate” and “sustain
attention” for the video games, and other special interests. “He can
sit in front of video games for hours, so I know he can initiate and
sustain attention!” The reason for this paradox is because the
preferred interest is highly stimulating; alerting the executive
functioning part of the brain, allowing it to focus. The problem comes
when tasks are (1) low level of excitement, and (2) not a preferred
activity.
Both of the above problems are also augmented by another
executive functioning issue call “shifting gears.” This is the ability
to leave one activity and transition to another. This is overlaps with
the “initiating” function. This is especially evident when it comes to
ending a preferred activity (video game) to do a nonpreferred activity
(feed the dog). Not only does the child have a hard time starting an
activity, but also stopping the activity. So, not only do you have to
“nag” them to do something, you may also need to “nag” them to stop.
So, the message is don’t assume “incompetence or laziness” because you
child needs to be supported to start doing everything. Stop “nagging”
and getting angry. Most importantly don’t assume your child is
incapable of “doing” and stop jump starting them. Try the following:
1. Try to build a structured schedule into your child’s day, so many
of his routines stay consistent from day to day. This builds structure
and predictability for the child. Over time develop picture, or
written, schedules and task lists, so the child has a visual reminder of
what they are doing, and what is coming up next. Checking off each
task, when finished, cues them into what they are to do next. Task
lists (or picture routines) can also help cue the child into the steps
for each task.
2. To help the child stop one activity and move
to the next (shifting gears), prepare the child with a warning. First
get used to letting the child know what is coming up next, after
completing the current task. “First you can watch T.V., and then it
will be shower.” Then with three minutes left to go with the current
task, remind the child “In three minutes we will be ending ___ and doing
____.” Then remind again with one minute left. This helps prepare the
brain for what is coming up.
3. For children that have
“initiation” problems, assist them in starting the first step, to jump
start their participation. Try not to give repeated verbal prompts
(nagging). If they do not respond on the first try, use a visual (hand
them the tooth brush, if brushing is up next.) Provide support as
needed.
4. If they have problems with “sustaining attention”
you may need to stay nearby and provide occasional prompts to move from
one step to another. For new tasks, until they learn the steps, try
doing it together, assisting as needed, but expecting them to actively
participate. By turning the tasks into “we-do” activities, you can
bridge the brain difficulties until the task becomes automatic.
Over time, as the routines become more automatic, you can fade out many
of the supports. However, these functions (initiation, sustained
attention, and shifting gears) will always be weaknesses. The person
will need to use such techniques to learn new routines. However, as
they get older they learn to use lists and schedules to keep them
organized.
In conclusion, do not lower your expectations, just
provide the supports to compensate for the brain weaknesses that
interfere with your child’s participation. Always expect active
participation, and foster independence. “Help them get started, but let
them finish!”
