Below find a review of ADHD best treatment practices which include the following:

• Self-esteem
• Cognitive-Behavioral Therapy
• Behavioral Therapy and Parent Training
• Organizational and Planning Skills
• Coping Skills- Emotional Awareness and Self-control
• Social and Social Thinking Skills
• Executive Skills
• Lifestyle Strategies
• Sensory Integration, Proprioception, Fine Motor Intervention
• Comorbid Anxiety, Depression, Dyslexia, Dysgraphia, CAPD
• New FDA approved device
• Video Games

Self-esteem ADHD Best Treatment Practices

Studies show that the greatest risk ADHD poses to someone with ADHD is the development of a low self-esteem. Our self-esteem gives us confidence to persevere and cope with disappointments and frustration. Psychoeducation means we can teach the mechanics and meaning of ADHD, review an individuals profile of strengths and weaknesses, and explain that ADHD does not mean you are lazy, crazy, or stupid. People with ADHD often excel in thinking outside the box, creative and artistic endeavors, inventions, and business entrepreneurship.

Recently I worked with a little boy who drew this picture. Up to this point he stated that he saw himself as half-good and half-bad. His teacher said she could always tell at the start of the day if he was going to have a good day or a bad day. So I initiated conversation with him about his inherent goodness, his challenges and efforts, created a graph to visually represent the amount or ratio of time he was good.

He made this dragon-graph 1-5 scale (below) as a morning check-in so he could easily indicate his readiness to be a good and calm learner. If he wasn’t at a 1 or 2, he could take a little time to draw and settle down to be ready. Two weeks later, his teacher reported he had been great, having some near-perfect five-star days. His parent reported great improvement at home. Our thoughts about ourselves can greatly influence how we conduct ourselves.

Cognitive-Behavioral Therapy

Often called CBT for short, this type of ADHD best treatment practice involves building awareness of self-defeating and destructive thought patterns. This can help build self-awareness, abate procrastination (“I can do this later”), assist with attitude and emotional control, and maintain a positive self-esteem despite struggles setbacks and negative feedback from caregivers.

There are categories of thinking errors that can be learned, and practice replacing negative or irrational thoughts can happen in the office and at home. These categories include such illogical automatic thought patterns as psychic predicting (I know what is going to happen, and it’s going to be bad), overgeneralization (I never do anything right), and extremism or polarized thinking (If it’s not perfect it’s terrible).

Behavioral Therapy and Parent Training

Yep, you guessed it. The success of behavioral therapy is largely dependent on what parents and teachers do either before or after target behaviors occur. This means parents or teachers are given training in how to train behavior! Expected behaviors are written down, checklists may be used, rewards identified as well as consequences.

Charts may be used to track progress or token economies such as a credit system may be implemented. People with ADHD commonly get more negative feedback than their neurotypical peers, so special attention is placed on rewards and encouraging words. Parents can ask questions and review responses to new ideas tried for fine-tuning and replacements for what doesn’t work.

In my 30 years of researching and providing ADHD best treatment practices, behavioral therapy can be one of the fastest and largest treatment effects. Why? Because we are working to create motivation and encourage effort. When someone is very motivated, they can at least for a short while overcome whatever obstacles and do well. With repeated practice the skills used for success become stronger and more automatic.

Organization and Planning Skills

ADHD best treatment practice will usually place some attention on developing better organization and planning. This may include getting one planner that includes all assignments and events and when they are due, or using a smart phone, and planning when items will be worked on and finished with automated reminders.

In addition, setting a timer to go off every 15-30 minutes may be used for a self check-in to notice if one is on track and working as intended or distracted, building greater self-awareness and attention. A parent can assist by working with a student to review assignments and tasks, have the student estimate how long each will take, setting a timer, and recording how long each task actually takes, building time management and task monitor skills.

A general rule of thumb is plan to do the worst first and save the best or easiest for last. This is because willpower and persistence fade over time. Breaks can be planned and timed, rewards for completion identified. The study space should remain the same place because people with ADHD tend to be stimulus bound- the environment triggers certain behavioral sets.

Distractors such as video games and social media can be removed. A student can experiment with which sort of lighting is preferred, type of body position; chair, beanbag with a clipboard, laying on stomach. Working with background sounds such as classical music or silence can be tried as well as scents that help with calm or alertness. Backpacks and study areas can be organized. Often people with ADHD start well with a new plan but they fall off after a week or two. A coach can be utilized who may call or text a few times weekly to help monitor and keep a person on track as intended.

Coping Skills for Emotions

Having ADHD can be stressful. Often people with ADHD can be quite sensitive to setbacks and criticism. ADHD best treatment practice can include teaching emotional recognition and management skills. We can make a plan for recovering from a bad moment so it doesn’t turn into a tantrum or bad day.

Tools for fixing unwanted feelings can be assembled in a menu or toolbox by categories such as thinking tools (It’s not a big problem it’s a little problem, it’s okay I CAN handle this, everybody makes mistakes), social tools, activity tools, relaxation tools, and inappropriate tools- things the person may do sometimes that don’t fix the problem or make things worse. We may choose from menus what our stress triggers are and stress signs, meaning how do we know when a stress response is beginning before it escalates and is too late.

I like to use 1-5 scales to identify these domains in gradations, and help notice when we are at a 2 or 3 because once we get to a 5 the fight or flight response is triggered, our thinking gets impaired, and we probably will need some recovery time before we can go back and reason through the triggering problem.

https://intensivecareforyou.com/category/emotional-control-anger-anxiety/

Social and Social Thinking Skills

Sometimes someone with ADHD has difficulty socializing and behaving in a group in expected ways. This can result in others being surprised and confused by unexpected behavior, resulting in weird and uncomfortable thoughts, then others may not be very nice or exclude the person who fails to behave in expected ways. Many of the rules and expectations for social behavior are “hidden rules,” not written or normally explicitly taught, which we can explain, illustrate, and practice.

It can be for some people with ADHD as if they have a learning disability in social skills. They may exhibit some but not all traits of Autism. Basically social skills mean you learn to monitor others for how they are thinking and feeling about you, and you modify your behavior to keep others having good thoughts and feelings about you. I learned some of this language from Michelle Garcia-Winner, she has great instructional materials and curricula on her website socialthinking.com.

It is my belief that having friends with age-peers involving face-to-face interactions, and feeling like we are part of a group, even if it’s small, is key to having good mental health. No friends, no group = no mental health. And sorry but no, I don’t believe online friends count. Better than nothing, but not enough.

Sometimes I have greater success teaching social thinking concepts using a comic book format filling in each progressive box starting with a problem, an unexpected behavior, or an expected behavior, using thought bubbles and speech bubbles and prompting my person to predict how others will think and feel based on their behavior, the consequences they experience, and how they feel about the consequences. I call these success stories and sometimes start a binder to keep genuine success stories where obstacles are overcome for later review to emphasize the success and progress.

Executive Skills

ADHD best treatment practices may also place some focus on identifying underdeveloped executive skills. These are the thinking skills involved in organizing behavior in the pursuit of a goal. Like the conductor of the orchestra of your behavior. Executive skills, or sometimes called executive functions, can include the following:

• inhibition or impulse control
• attention
• working (short-term) memory
• planning
• organization
• metacognition- the ability to think about what you are thinking about
• task initiation
• flexibility
• time management
• perseverance

Identified underdeveloped executive skills can be either compensated or remediated. For example, poor working memory can be supported with a checklist of tasks to complete before, say, leaving for school, this would be a compensatory strategy. A remediation approach would involve short daily sessions exercising and building short-term memory. Research strongly supports these skills are not fixed, they can be fixed, or improved, resulting in much greater academic achievement results.

Lifestyle Strategies

Lifestyle strategies for ADHD and related conditions consist of habits or everyday proactive practices that put us in a better place to begin with for dealing with demands and stress. The three main pillars of our health are sleep hygiene, diet, and exercise. Think of a stool with three legs. Knock one out and the whole thing falls.

Did you know that clinical trials have demonstrated that 25 minutes of aerobic exercise three times per week are equally effective for treating anxiety and depression symptoms as any pill you can take? Plus the side effects are more energy, feelings of well-being, physical health, improved brain function, and longer life. A healthy diet means avoiding processed foods, regular meals and snacks, fruits and vegetables. Organic please, studies show that as many as 46 different pesticides can be on fruits and vegetables you buy at the grocery store, which have been directly linked to the formation of ADHD.

Supplements like fish oil, B vitamins, and magnesium can help. Sleep hygiene means going to bed and waking the same time every day. Additional practices shown to help manage ADHD symptoms include meditation, yoga, getting out in nature. Socializing, play, and the pursuit of a hobby or passion such as music can also improve quality of life and overall well-being.

Sensory Integration, Proprioception, Fine Motor Intervention

While there are some things a counselor can advise parents and educators to do to help with these problems, the best therapy if these issues are prominent is occupational therapy. People with ADHD can have sensory hyper or hypo sensitivities to sound, light, textures, touch, tastes, or smells. We can make accommodations like noise-cancelling headphones for sound sensitivity.

Sensory integration means the brain’s ability to receive sensory inputs and organize them into meaningful categories and packets. Poor sensory integration can result in a person becoming easily overwhelmed and very disorganized in stimulating environments such as a classroom for of people. It may also mean difficulties with balance, fine motor control, trunk strength. One accommodation would be to program some heavy work activities into the daily schedule.

Proprioception is how we know where are bodies are located in relation to objects and people, and if we are safely positioned. Signs of difficulties include dragging a hand on the wall when walking down a hall, stepping on the heels or toes of others, falling out of chairs, constantly touching everything around, rolling around on the floor instead of sitting upright and still. A weighted vest or blanket may be used to provide more sensory input so the brain gets enough to know it is safely and comfortably positioned. Sensory Screener https://sensorykids.ie/en/sensory-integration/sensory-integration-screening-questionnare/

Comorbid Anxiety, Depression, Dyslexia, Dysgraphia, CAPD

Because these can often present along with ADHD, ADHD best treatmenmt practices should involve some awareness and evaluation for the presence and treatment of these conditions. If signs are present a referral for more formal evaluation and intervention may be in order. Of course if you tended to be impulsive and distractable, making silly errors, and being criticized or laughed at, you would be more prone to developing anxiety or depression.

Some signs of dyslexia would be refusal to read out loud, poor progress in reading, headaches, car sickness, very slow reading speed, inconsistent spelling patterns, and left-right confusion. Like ADHD it could be important to point out that being dyslexic does not mean you are stupid.

Dysgraphia means having difficulty with letter formation and written expression. Poor legibility, very large letters, words run together without consistent and proper spacing, failing to complete written assignments would be signs. Occupational therapists also can help develop fine motor skills, the Handwriting Without Tears curriculum can be implemented, and typing or talk-to-text can be allowed.

CAPD or central auditory processing deficit means having difficulty discriminating speech sounds into meaning in the presence of background sounds. Speech therapists can assist with this and there are programs to develop this ability such as Fast Forward.

New FDA Approved Device eTNS System

Available by prescription only, this device provides low level electrical stimulation via electrodes attached to the forehead during sleep stimulating the trigeminal nerve. Intended for children aged 7-12, a clinical trial of four weeks yielded a significant reduction in ADHD symptoms. More than half of the children experienced some side effects such as fatigue, headache, increased appetite, some weight gain, and increased heart rate. See the link to an article with more information at the end of this article.

Video Games and ADHD Best Treatment Practices

ADHD best treatment practices would be remiss to dodge this problem. I say problem because frankly, the majority of problems and conflicts reported in my private practice revolve around video games. I could write a book about this issue and have made a documentary about the impact of digital culture on human development you can see on Amazon or your Amazon Prime account or participate in a video course.

I’ll keep it short here. It appears that people with ADHD are especially susceptible to the distraction of video games and digital media distractions. In addition more prone to becoming addicted. This means they are foregoing socialization, chores, work or school work, sneaking devices and off-limits access, disrupting family relationships and often becoming aggressive, abusive, self-harming, or making suicidal gestures efforts and statements all to get access, or, in addiction language, use. So do I think this is potentially a risky problem, yes.

Sometimes this becomes the only reinforcer someone will work for, or they simply demand to have it and refuse to do anything to earn it. Counseling can help navigate these stormy waters. Video games are often used as a way to encourage desired behaviors, I think they do disrupt social opportunities and development, the ability to delay gratification, and weaken attention span. At some point parents may find themselves asking if they should just take them away completely and end the recurring conflicts, but they have become dependent on them sometimes as well and they fear how a child or teen will respond if they do.

https://www.verywellmind.com/types-of-therapy-for-adhd-5272434

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5014388/

Link to article about eTNS

https://www.apa.org/monitor/2019/07-08/adhd-children

I hope you enjoyed this article about ADHD best treatment practices. Questions or comments? Feel free to email me.

Brad Mason, LPC, LPA, LSSP

Brad@intensivecareforyou.com

The post ADHD Best Treatment Practices appeared first on Intensive Care for You.

Did you know metacognition instruction has been identified and validated as a key method for improving self-esteem, self-regulation, academic success, and test scores?

I have this little book called Mr. Daydream I sometimes read to children who seem to daydream in school and miss instruction. It’s pretty short and I ask questions to make sure my young listener understands the concept of daydreaming. Often as I’m reading they will look out the window. And keep looking.

I’ll say “Hey, are you with me?”

They say “What? Oh, uh, yeah.”

I say “What were you thinking about just then?”

They say “Nothing,” or “I don’t know.”

Sometimes I wish I could make my mind stop thinking, but so far I have not been successful. What I’m saying is, a person can lack awareness of what they are thinking about.

In this article “Metacognition for self-esteem, self-regulation, academic success” you will find; Signs of underdeveloped metacognition, What is metacognition, Teaching metacognition and self-talk for self-esteem, self-control, and emotional regulation, How to teach metacognition for greater academic success.

Ever had an experience where a kid does something inappropriate right in front of you?

You say, “Why did you do that?” Or maybe you say, “Don’t do that.”

They say “I didn’t do it.”

Or maybe they have done something inappropriate, and afterwards:

You say “What were you thinking?”

They say “I don’t know.”

That’s metacognition, the ability to think about what you are thinking about. While this thinking skill can be taught, and developed, some people don’t have it. Maybe when they get in trouble, they fail to connect an awareness of their behavior with the consequence. They just think you are being mean and unfair.

Signs and consequences of poor metacognitive skill development

Lacking self-talk skills to internally coach oneself to control emotions and reactions.

Poor awareness of context and changing expectations for behavior in different settings with different people. For example, telling a joke that may be appropriate with friends but NOT within earshot of the teacher or parent, and then getting in trouble.

Difficulty with problem solving, may fail to adapt and try a new strategy and continue trying something that is not working.

Trouble with flexible thinking and behavior, such as adapting to unexpected changes in routine and transitions. You tell them it’s time to turn of the video game and go to bed, and they have a defiant tantrum every time. Groundhog day.

Poor empathy and perspective-taking skills. Maybe they think they should go first or be line-leader every single time, neglecting to share the privilege with others.

Trouble with showing their work in complex Math problems as normally required in Algebra.

Trouble with Math word problems- they either see the answer right away or they can’t solve it.

Persisting in making the same error in spite of repeatedly being disciplined for it.

Difficulty with making and keeping friends.

Having a hard time organizing thoughts to write an essay.

May tend to say “I can’t do it,” stay stuck, and repeatedly neglect to ask for help.

Problems coping with and quieting their own negative self-talk.

Knowledge illusions whereby the individual thinks their knowledge is greater than it is or they have learned more than they actually have. May come across as arrogant or insist they don’t need practice to perform in a sport or with a musical instrument.

When you ask them what they were thinking, they say “I don’t know.”

They see you seeing them as they misbehave and yet insist they didn’t do it.

You catch them daydreaming, ask what they were thinking, and they say “Nothing” or “I don’t know.”

Their behavior does not match the rest of the group or is inappropriate for the context/audience.

Failure to notice off-task behaviors and self-correct.

Metacognition is having awareness of one’s own thought processes and an understanding of the patterns behind them.

1. Planning your approach to a learning task.
2. Use of appropriate skills and strategies to solve a problem.
3. Monitoring your own comprehension of text and and task requirements.
4. Self-awareness and self-evaluation resulting in self-correction
5. Evaluation of progress towards task completion.
6. Awareness of distractions.

What is the role of metacognition in regulating emotions, behaviors, and social interactions in successful and expected ways? Metacognition is a key thinking skill for self-esteem, self-regulation, and academic success.

Teaching self-talk

Would it sound strange if I said that some people don’t think in words? Google it up, you will find it’s true. What would be the impact on metacognition if someone were say, a picture thinker? Can they process in multiple windows this way, like a computer? Could they create an image or video in their mind that was an analysis of their primary thought process? Thinking in words makes this much easier. You can have a thought in words, and then a second thought about that thought- is this really true, would this action be a good idea, is what I’m doing to solve this problem working or should I try a different way?

Thinking in words is like a shortcut relative to images. Not only do we need to think this way to develop metacognition, we also need to think this way to inhibit inappropriate impulses and bad ideas before we act on them. Do people with poorly developed metacognition also often tend to be impulsive? You bet. Sometimes we call that ADHD.

So if we are working with someone who is great with legos and engineering problems, but struggles with self-control and expected behaviors in a group or social setting, what can we do to help them learn to have internal dialogue? We can do this by asking questions before a social situation or learning task is presented. What are expected behaviors while waiting in the doctor’s office? When your friend comes over, what will you do if you want to do one thing and they want to do something else? Later in this article questions for learning tasks will be listed.

You can also teach by modeling your internal dialogue, or thought process, speaking your thoughts out loud as you problem-solve or make plans. You can narrate what kids are doing as they play and solve their own problems. Are you getting frustrated? Has your strategy to make this work been working? Could there be other ways you could try?

Cognitve Behavioral Therapy (CBT)

Self-talk, Self-esteem, and Self-control

Ahhh! I never win!

I can’t do anything right!

You never let me do anything I want to do!

CBT is one of the most common and research-validated methods of counseling. It involves teaching that our minds are making thoughts all the time. Some of these thoughts are true (rational), and some are not (irrational). Some feel good, some feel bad. Our thoughts create our feelings, our experience of reality. We often can’t control others or what happens around us, but we do have some power over our thoughts about what happens, in turn regulating our feelings about what happens.

There are categories of thinking errors we can teach. For a young child, we might start with boo-boo thoughts and smiling thoughts, then teach how to make bandage thoughts for the boo-boo thoughts. As children become late elementary or middle school aged, we have categories of thinking errors we can teach. They can become more adapt at catching their thinking errors, and talking back to them or replacing them with smarter ways to think that usually also feel better.

Statements like “I never do anything right” can be challenged. “Never” is a keyword indicating the category of thinking error called overgeneralization. When I get started teaching CBT to a youngster, I may play a game where I read a list of thoughts and they tell me if the thought is true, or rational, or not true, irrational. And yes, when I read “I never do anything right” they often say “true.” I say, “Really? Hmmm. Let’s see. Your shoes are on the right feet. Your pants aren’t on backwards. You probably got from your car into my office without falling down. How many times today have you blinked in time so your eyeballs didn’t dry out? How many breaths have you taken so you stay alive? Didn’t you say your grades were all passing, so wouldn’t that mean you got it right most of the time?”

I might also read them my Garden of the Mind metaphor, to illustrate the power of thought, and our tendency to focus on negative and worry thoughts.

Next I may play a kid-friendly game that involves reading thoughts on cards made by a person in situation. We practice identifying the type of thinking error the person had, and a smarter or better way to think. Finally, ideally they take the list of thinking errors home for practice, and use my thought record form to build awareness of self-talk and develop skills in detecting unwanted, untrue thoughts and replacing them with smarter, better-feeling thoughts.

The link below summarizes research about children’s awareness of the link between thoughts and feelings and they types of metacognitive strategies they can understand and utilize for emotional regulation.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2916181/

You can click the terms below if you want to see these forms and templates for yourself. They come from my book Counseling Tools for Kids in Schools.

Self-talk, Self-esteem, Self-control Video Course

Success Stories for teaching Metacognition for self-esteem, self-regulation, academic success

It makes sense that if a person has trouble with metacognition, or thinking about what they are thinking about, they would also have trouble thinking about what others are thinking about. Ergo difficulty recognizing others may have different emotions, thoughts, beliefs, opinions, and predicting others’ plans, feelings, and reactions.

In the literature about Autism this is often called perspective-taking or theory of mind. Sometimes it is called empathy. In the literature and treatment protocols for personality disorders, such as Borderline or Narcissistic, it’s called mentalizing. Mentalizing in this context refers to the ability to form concepts about one’s own emotional state and the emotional states of others.

Another way I use to teach mentalizing, perspective-taking, and CBT, is to use Success Stories. These are like comic strips with boxes showing people in a situation, what they are saying, doing, feeling, and thinking. We may just draw stick figures with thought bubbles and speaking bubbles. I have templates for you below. The templates have descriptions for what goes in each empty box. This is a visual strategy to assist the learner in anticipating and mapping out how they will feel based what kind of thoughts they are making, how to make better thoughts and feel better (CBT template). The perspective-taking template helps them predict how others will have different feelings and reactions to what the learner does; how they will likely respond to the learner, and how the learner ends up feeling about this consequence.

A little background on executive skills, ADHD, and Autism

Metacognition is one category of executive skills, sometimes called executive functions. These are thinking skills that enable us to coordinate the orchestra of our behavior in the pursuit of a goal. Executive skills include:

Metacognition

Inhibition or impulse control

Shift

Emotional control or stress tolerance

Time Management

Self and task monitor

Working (short-term) memory

Planning/prioritization

Goal-directed persistence

Organization

Flexibility

When someone has ADHD or Autism, they have some poorly developed executive skills relative to most age-peers. I think this is also true in reverse. Enough delays in development of executive skills can result in a diagnosis of ADHD or Autism. Can college students and adults still have underdeveloped metacognitve skills and learn to improve? Absolutely.

Learn more about executive skills here.

How to Teach Metacognition for Academic Success

https://lincs.ed.gov/state-resources/federal-initiatives/teal/guide/metacognitive

The information in the above link advises us to “encourage students to engage in “metacognitive conversations with themselves so they can talk with themselves about their learning, their challenges, and ways they can self-correct and continue learning.” People who have a variety of metacognitive skills perform better on exams and complete work more efficiently. Research clearly shows these skills can be taught by asking learners to think about what they are doing and what they should do next. In other words, don’t be the genius and tell them, instead ask. (Don’t tell ask article link) Even college students and adults can lack good development of metacognitive skills, learn to apply them, and improve their performance significantly.

How metacognition can be taught in the learning environment for improved performance:

1. Develop a plan for a learning task.
2. Monitor your approach and create new strategies when progress or meaning falters.
3. Evaluate how they thought about the task after completion.

Questions to ask yourself or be prompted to ask yourself at each of the above three phases:

1. Planning Phase: What am I supposed to learn? What do I already know that will help me? What am I looking for in the text? How much time do I have? What direction should I be thinking in?
2. Monitoring Phase: How am I doing? Am I on the right track? What is important to remember? Am I doing this the best way? Should I change direction/strategies? Should I slow down or speed up? What can I do if I don’t understand?
3. Evaluation Phase: How did I do? What did I learn? Did this come out as expected? Could I have done something differently? Could I use what I learned in different situations? Is there anything I still don’t understand? Do I need to review the task to see what I missed?

Reading: Model thinking out loud and asking questions during reading. Ask them questions as they read to you out loud and teach them to ask themselves often if they are understanding what they are reading. Teach note taking or highlighting while asking themselves “Why am I highlighting this and why am I not highlighting that?

Writing: Model prewriting strategies for organizing thoughts such as brainstorming using a word web or graphic organizer to put main ideas in paragraphs with the main idea at the top and supporting ideas below.

Social Studies and Science: Teach the importance of using organizers such as Venn diagrams, concept maps, anticipation/reaction charts to sort information and understand content and key relationships between concepts. Use organizers to focus attention on what is already known and identify what they want to learn. Venn diagrams can be used to understand similarities and differences between related concepts.

Math: Use mnemonics to memorize lists and steps in a process such as order in Mathematical operations. Model inner dialogue by thinking out loud your thoughts about solving problems as you go. Ask them to paraphrase word problems, restating the text in their own words to help them process the meaning of the question and correct operations to perform.

How to improve metacognition:

https://www.edutopia.org/blog/8-pathways-metacognition-in-classroom-marilyn-price-mitchell

https://www.globalmetacognition.com/post/emotions-metacognition

https://blog.innerdrive.co.uk/eight-ways-to-develop-metacognitive-skills

https://www.learningscientists.org/blog/2017/3/30-1

I hope you enjoyed this article “Metacognition for self-esteem, self-regulation, academic success“

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Thinking in pictures vs. thinking in words; what is the difference? How would this impact communication and self-regulation skills? I find that many people with autism, engineers, and people with ADHD report that they think in pictures. Teachers mostly say they think in words.
When I’m doing a live workshop I like to ask people “What are your thoughts?” Then I get more specific- “I mean, are your thoughts pictures or words, when you think, is it like a movie in your mind, or more like just feeling, or is it talking in your head, and if it’s talking, whose voice is it? Do you have conversations with other people in your head when you think, do you combine this with feelings and images?”

So if you are thinking in pictures or a video stream, how do you step outside your video to make another video to analyze the first video- in other words, how do you think about what you are thinking about to analyze how reasonable your thoughts are and if your thinking about what you intend to think about or are supposed to think about?

(This passage is an excerpt from the book Diagnosis Autism or Aspergers: Now What?)

If you are thinking in words, you can do this, you can think to yourself, “That makes me mad, I’d like to kick her- whoops, no, I better not, that would be mean, and I could get in trouble.” See, wala! We have self-monitor and inhibition skills! Language in the form of words make this possible, words are a shortcut. If I am thinking in words, it’s easy for me to say those words to someone else and they will probably understand what I am trying to represent with the words. But I can’t upload a video from my head to yours.

Remember those primitive TRS80 computers that came out in the early 80’s? The first games, like Gilgamesh’s Tavern, they were script, or words running down the screen. Then we started using games with more graphics, and we needed a LOT more processing power and memory. It may be like this for our brains, too, thinking in words only uses a little capacity, pictures or graphics take a lot more. Words are a shortcut that bridge understanding from me to you. What if I was trying to communicate to you with pictures and we didn’t share a common lexicon?
People with autism, engineers, and those with ADHD tend to say they think in pictures; teachers, in words, and when a word-thinker hears that there are those who think not in words, but pictures, they often are flabbergasted, taken aback, and have a hard time bending their mind around this alien thought form.
An engineer can look at something and instantly grasp how it works or how to put it together. What happens when they try to explain it? They get frustrated, because it’s so obvious to them, it’s right there in plain sight, but finding the words for the picture-thinker to explain it to the word-thinker is a daunting task. Two different languages. Mac and PC.
We use self talk or inner language to regulate emotions and problem solve.
This is why I encourage the use of visual supports- they don’t need to be fancy, like drawing stick figures with thought and word bubbles to convey a message about social expectations and outcomes, because often people on the spectrum have difficulty forming concepts that words are meant to represent. Put it in a visual to help build understanding and use as a prompt or reminder again later in a teachable moment.

When we see repetitive behaviors this often signals that the child’s brain is unable to assimilate the perceptual patterns into a meaningful whole, so they are stuck repeating, this also explains how some kids can repeat the sound patterns of a passage they read or video they heard but are unable to answer comprehension questions about what they have memorized. They have the pattern but not the concepts that are symbolized. Also when they are in an environment that becomes non-meaningful they may engage in repetitive and even disruptive behaviors such as shrieking, they are trying to create a pattern they know to drown out the nonsense, which could be the background noise of other people quietly talking or an air conditioner running.

How do you teach someone with autism or an engineer to begin using their inner language to self-regulate and problem-solve, to become a more fluent user of word-based language? You can narrate what they are doing as they do it- “Oh, now you are trying to make the blue one balance on top of the yellow block.” You can narrate your own experience, and do your thinking out loud, “Hmm, well this key is not unlocking the door. I could try and force it but it might break. Let me try one of the other keys to see if it works better.” Finally, get the child to re-state a word problem out loud and in their own words, and talk their way out loud through possible paths to solutions. “So, you have 11 apples to start, and you take away 3 because 2 are given away and you eat one, so… that would be like 11-3, I’m supposed to say how many are left, that would be 8 apples left.

If you really want to dive into more ways to teach self-talk, check out my video courses Self-talk, Self-esteem, and Self-Control, and the courses Anger and Children, Anxiety and Children. You could also sign up for the free Mindgarden mini-course, focusing on the use of self-talk and emotional control: click here to sign up.

Verbal vs. Nonverbal Communication

Pragmatics is the use of language in social situations. A person can have a highly developed vocabulary and still not communicate effectively with others. Social skills groups and speech therapy in small groups can help.

Research indicates that only 7% of a person’s message is communicated by the words they say- the other 93% of the message is conveyed by nonverbal cues such as tone, expression, and body posture. Try playing charade games that require the use and interpretation of nonverbal communication only. There are several Cranium games that incorporate charades, sculpting, and drawing to guess a word, such as Cranium Conga, which is perfect, because it is a “guess what I am thinking” game, which is exactly what we want our kids to be in the habit of doing when they share space with others- to monitor them closely at all times for clues- mostly nonverbal- about what they are thinking and planning.

You can find related blog posts via the menu at the top of this page. Just hover your curser over “Blog” on the top menu bar for a drop-down index and scroll through topics.

I also have a resources for free page with free brief course on related topics as well as numerous documents, links, and additional content that I hope will help you help someone you care about who struggles. https://intensivecareforyou.com/resources-for-free/

You can also check out my books and video courses here on my site.

Autism Asperger Understanding From the Inside Out Video Course

Update: Telemedicine virtual online counseling now available here: https://www.bradmasoncounselor.com/

I hope you enjoyed “Autism, Engineers, Thinking in Pictures or Words?” and this will help you understand and possibly assist someone you care about.

Here are some related links for more info:

https://www.psychologytoday.com/blog/fulfillment-any-age/201309/make-your-self-talk-work-you

http://www.npr.org/sections/health-shots/2014/10/07/353292408/why-saying-is-believing-the-science-of-self-talk

http://www.grandin.com/inc/visual.thinking.html

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Find out how inconsistency is the most powerful motivator in behavior management techniques. Being consistent is boring. People respond the most often and intensely when they never know when they will get rewarded, how often, or how big or what the reward will be.

Take a slot machine, for instance. The best science has to offer about human behavior is put to use, maximizing the number of lever pulls, thus the amount of money collected. If you knew it was every 18th, or 37th, pull, that gave the reward, who would ever start putting money in? And then there’s the part where, you know, regardless of the odds, you might get the really huge jackpot? If they never know when the reward will come, or how big it will be, the desired response level remains highest.

Children overcome all kinds of obstacles when properly motivated.

Great, so what are some ways to put this idea into action?

Dot-to-dot: This one is fun. Get yourself some Crayola Changeable markers. Copy some dot-to-dots in the students preferred themes. With the clear end of the changeable marker, make stars over some of the numbered dots, and make them at random intervals- put two or three in a row, skip 7, and so on.
Every time you catch the student meeting their goal, or not having the problem behavior, and you could have a special signal for this, or tap them on the left shoulder, the student connects one more dot with the colored side of the changeable marker. When they make a line through the dot with the star, it will change color. This can mean an instant reward, credit towards a reward, or a chance to draw from a lottery of possible rewards. Hint: The orange one doesn’t change as visibly as the darker markers.

Lottery: Lotteries are great because you can really leverage your rewards and the randomization is automated. Random is much better than predictable when it comes to behavior management. The only thing you want to be consistent with is your expectation. Adult expectations have consistently been shown to have a very powerful effect on kids behavior and learning. Most of us have heard of the study where the teachers were told that the blue eyed students were smarter than the brown eyed students. At the end of the grading period, guess what happened? The blue-eyed students had higher grades and scored higher on their standardized academic testing. Talk about your thoughts being so powerful they create your reality! Whew! If you have one really big prize, it doesn’t matter how slim the odds are of winning, it will motivate human behavior anyway. So then you can mix a bunch of smaller rewards like those on the “praise ways” document or just no-winner drawings. It’s pretty easy for you to “rig” these things, too. Make it look like an accident that the prize got awarded to this certain kid at this particular time when it’s well-deserved and needed.

Credit System: What if you get control over their access to preferred materials and activities, and then sell them time with those things? Then you print off some “money” in different denominations, mostly 1’s and 5’s, but some 20’s, 50’s, and 100’s, and then, when you want to catch them being good, you hand them a bill, or put it in a jar they can see. They have a menu of rewards. You make a list of rules and expectations. Now they never know when you will notice them doing well, or how big the reward will be. The menu of rewards is ever-changing. The behavior is the best it can be.

If you can find the best way to motivate an Autistic ADHD child, they can overcome all kinds of obstacles and give their best.

Diagnosis Autism or Aspergers: Now What?

(Book by Brad Mason, LPC, LSSP, LPA 2018)

For more ideas click here and opt-in for the 5-email series Behavior Management Tips and Tools Giveaway with ideas, forms, and short videos.

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Silly question, right? How can you ever have enough to stop the madness when it comes to the ways adults often interact with children who have differences?

We can make it better. We can train adults in more loving and effective methods, and we can teach children emotional coping skills, social skills, and better ways to behave so they get more of what they really need.

And hey, it’s not rocket science. We can all get better at what we do, making the world a better place for children, so that each successive generation is healthier than the last, making the world better by making more healthy loving people.

I hope you will sign up to join me in learning and sharing by clicking here

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Ever wonder why people get “stuck?” Is it fear of change? Staying in the comfort zone of what you have gotten used to, even if it’s not really what you want and dream of? Listening to the internal critic and pessimism, resigning yourself to helplessness, in effect giving away your power to change? Or maybe it’s blaming someone or something for holding you back- not enough time, money, energy, nobody helps you, somebody is keeping you this way, believing things are static and can’t change, this is just the way it is?

There are many ways people can give away their power, the power to change, to create something new, to feel or think the way you really want to, to act differently or react differently.

Our stories about ourselves, our children, and our lives are very powerful. They inform us about how to think, feel, and act. They tell us what we can and can not do. We tell our stories to others who will listen and agree with our story. If they didn’t agree, or offered another explanation, it is as if they are denying us our reality, the one we are invested in, perhaps the one that explains why we have no power to be different, to feel different, to think and act differently to get a new outcome. So we tend to seek those who agree with us, and become angry with those who do not, denying their message and our own power for change. This is tribal power. This is how we maintain our “illness.”

Children learn this from us at an early age.

“He makes me get mad and have a fit.”

“My parents don’t let me play enough video games and just leave me alone, and that’s the only thing that makes me happy, I can’t live and be happy without them, my parents just want to control me, I’m miserable because of my parents, or because of school.”

“I can’t stand it when things aren’t fair.”

“School is just too boring. I can’t do it.”

“I can’t concentrate because I have…(ADHD, don’t care,…”

“I’m just lazy, that’s why I don’t do homework.”

“My parents care more about ________ than me.”

The list goes on and on.

About a thousand years ago, there was an old man sitting by a road in the dirt. It was hot, and dry, and dusty. As he sat there, a traveler approached. The man walking looked sweaty and burdened by the pack on his back, his head hung as he watched his feet moving slowly through the dust. Clump, clump, clump.

When he got to the old man sitting, he looked up and said, “Tell me about the next town I am coming to. The one I came from is horrible. The people treated me badly, there was no justice, no love, and no way to make a decent living. Is the next town any better, is it a place I should go?”

The old man frowned and shook his head sadly. “No,” he said, “You will find the same thing in the next town, you should just keep going.”

About an hour later, another man came walking down the dusty road. This man carried himself erect, looked straight ahead, and smiled when he saw the old man. “Tell me,” he said, “I have just come from a town that was wonderful, the people were all nice to me, I was able to earn a decent living, the town was overall a very fair and just place to live. I am so sad to leave it. Will this next town be anything like the last, will people be nice and fair?”

The old man smiled and nodded his head. “You should definitely go and stay in the next town, it will be just the same, and you will be happy there.”

The “placebo effect” is another way our stories and beliefs inform us about how to think and feel and behave. We believe in the curing power of the pill, and we get better. Just like that.

All of the stories about the hero’s journey have common elements. There has to be weakness, darkness, struggle, seemingly insurmountable foes or odds holding them back. It takes courage to face the obstacles, the trolls under the bridges. It takes hope, investment, and a dream of better and different. Something or someone worthwhile to save. The hero struggles through a dark time, not knowing will he live or die, or ever finish her quest. The hero decides to try in spite of the fears, becomes stronger, overcomes obstacles, finds resources within and without,  learns skills, finds allies to help, and against all odds, emerges victorious in the end.

Star Wars has many such stories. The latest even has a heroine. We can use these stories as metaphors to help ourselves and our children overcome obstacles within and without to change and emerge victorious, to heal, to conquer, to “get better.” We can do this by referencing a story they know, a movie you just watched together, and compare them to the hero, comparing the obstacles and foes in the story to our or their obstacles and foes, we can elicit from them their story about what ails them, and help them construct a story where, like the hero, they become the hero in their own story.

“I wonder how and when you, like Luke, might overcome Darth Vader and the dark side, to use your force for good, and make your life and the lives of others better.” You can become the hero in your story. All you need is to first imagine the possibility and then have a little hope.

Get a free video and mini-course to help kids recognize and reconstruct their faulty thoughts and stories, and quit giving away their power to succeed and feel okay when faced with obstacles, criticism, and teasing here.

I’d love to hear your story, and after reviewing I can post stories and my responses to stories here on this post page.

Take the free 5 day challenge to change your story and become the hero by signing up here.

Brad Mason, LPC

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Autism Aspergers Syndrome PDD-NOS Book

I read some years ago in my NASP(National Association of School Psychologists http://www.nasponline.org/resources/ ) handbook that “autism is a lifelong disease. “ I think this is misleading from two standpoints. First, it’s not a disease. It doesn’t get worse as time goes on, it doesn’t mean the person is sick, and you can’t die from it. Second, while there may or may not be a “cure,” the symptoms of high functioning autism or PDD-NOS can and usually do improve over time and with effort. Rather than viewing autism as a disease, I would encourage you to think of it as a difference that may at times cause some “dis-ease,” and at other times may produce miracles of innovation and creativity.

I made this book for you. I wrote this to spread understanding, acceptance, and appropriate assistance for all the people who have symptoms of autism or asperger syndrome, and I created this text to accompany my video by the same title and for the same purposes. The video has interviews with some special people who have overcome a great many challenges, with help and special parenting, to find themselves comfortable with who they are and reconciled with the criticisms and judgements they received from others. I want you to become that person for someone else that always has compassion, always thinks well of them, continues to encourage and support even when unexpected behaviors are occurring. Hopefully you had at least one person in your life who you knew always saw you that way, and helped you see yourself as good, lifted you to your better possible self.

I think God made people different for a reason. Look at Einstein and Edison, DaVinci and Mozart.

Who do you think came up with and designed rockets and computers, anyway?

Either you or someone you know has autism. I hope this will help you expand your limits and overcome obstacles. You have no idea how much you have to offer and how far you and those you love can go until you stop limiting. With understanding, love, and therapeutic social connections we can all transform and leap into a happy, healthy, and purposeful life. I’ve seen this happen over and over in my practice.

This is not intended to be the be-all end-all manual for autism and asperger syndrome, it is meant to give a quick overview that explains why people with this condition have the difficulties and unexpected behaviors they display, and some resources and techniques for getting started on making it better. You should come away with an overview of the characteristics of autism spectrum disorder and have some practical strategies and good resources to help you remediate or compensate for these difficulties and help those on the spectrum do what is expected more often and enjoy a higher quality of life.

Mindblindness- Theory of Mind

Theory of mind, or TOM, means understanding that other people have their own agendas, feelings, and ideas that are separate from yours- their own mind with different plans, opinions, preferences, and experiences. So someone with disruptions in the development of TOM may tend to view the world as if we are all participating in the same stream of consciousness- theirs. This explains why a person on the spectrum may start a conversation somewhere in the middle without providing an introduction or context. Why they might be upset if your plan or opinion differs from theirs. Why they might at times treat others as if they should perform their will as if the separate person were an extension of the spectrum person’s body, like one of their hands. Wouldn’t you be frustrated if one of your arms or legs suddenly quit working and wouldn’t follow your instructions?
On the milder end we may have insistence that an opinion is a fact, neglecting to ask for help (because they don’t think about the fact that others may know things they don’t) and trouble with perspective-taking. On the severe end of disrupted development of TOM we could have a person who doesn’t recognize others as beings to interact with at all.
Characteristics of poorly developed theory of mind could include difficulty with the following;

-literal- Concrete and fail to interpret figures of speech/idioms, tend to split hairs such as arguing that it is not 4:00 yet it’s only 3:58.
-empathy- May not notice how others are feeling or may not modify their behavior to keep others feeling good.
-perspective taking- May stay stuck in their perspective and insist others are wrong if they don’t agree, may even try to make others agree they are right.
-persuading- May demand and insist rather than using tact and diplomacy to influence others.
-compromise- Exactly my way or the highway.
-honest to a fault- How much food did you have to eat to get that fat?
-conflict resolution- Lacking diplomacy and tact needed for resolving interpersonal problems.
-get overwhelmed- being around others because they are working so hard to figure them out rather than using intuition.

You may also notice the following characteristics:
-not know when to be embarrassed
-have trouble predicting how others will feel or react to them
-may appear rude and disrespectful
-may be paranoid because others seem so unpredictable
-trouble understanding deception
-starting in the middle of a conversation- think you know what they know
-don’t realize or read the cues that others aren’t interested in monologues

What are some ways to help a person develop better perspective-taking skills, more empathy, greater consideration of how they impact and shape the experience and feelings of the people with whom they share space?

To help with being overly literal and splitting hairs, I like to teach the kids what splitting hairs means, have them think about trying to split a hair, and show them on a clock with hands and numbers the difference between 3:58 and 4:00, and encourage the parents to use these keywords and anchoring experiences when their kid is “making a mountain out of a molehill” again. It can be fun to conjure and draw images to go with idioms for fun- a “brook chuckling over it’s stoney bed,” “hurting like fire,” “can we get on the same page here?” After laughing we can think about what does this phrase REALLY mean? Apples to Apples is a game that makes you look at how unidentical terms could be somewhat the same, even though not exactly so.

More importantly you can ask kids to make inferences based on nonverbal clues as to what a person’s plan might be. For instance, if two people are talking, standing close to one another, and a third person approaches and stands closely watching them but not speaking, what is the silent person’s intention? That’s right, they want to say or ask something, they are using their body position to give the speaking people awareness that they want something from them without verbally interrupting. You can watch for these teachable moments while at home or in the community, and you can use cartoons as well, pausing on a character before they speak or do something, and asking the child to use the clues to guess what the character is thinking or feeling.
Getting someone with a literal thinking style to make guesses can be tough because many of these folks do not like gray areas- and you can’t REALLY know what someone is thinking or planning but you are expected to make a guess or ask if you are not sure. Socializing is really based on a lot of guesswork, much of which you can’t be completely sure of. Most of us do it automatically without thinking about it, but without this guesswork and scaffolding of assumptions, we really can’t socialize effectively at all. You have to be willing and able to watch people and make guesses about their thoughts, feelings, and intentions.
You are a Social Detective is a good book to teach younger children- from developmental age of about 4-8 years- how to use what they see and hear to do what is expected and how doing what is unexpected can impact how others feel about them in a negative way.

I also teach kids to defer, which means to allow other people to think they are right even when you think they are wrong- just let it go and don’t continue to insist or argue. Sometimes it’s better to allow someone to think they are right even though you don’t agree so the play or conversation can move forward.
Getting someone who is not in the habit of thinking about how others are thinking about them and modifying their behavior to keep others having good thoughts about them will often take many, many repeated trials. Using behavior modification techniques to increase motivation will help too. (How would this look? Please see my video Behavior Management at it’s Best, and take some valuable concepts and techniques that can help you every day).
For greater grasp of deception I like to give kids in my groups some real money and teach them to play poker. I explain bluffing, ways to recognize a bluff and how to manage your nonverbal communication to make a bluff, and I explain that people out there in the world will try to deceive you to get your money. There are also some games you can play with them, such as Fib or Not and Fact or Crap. In Fib or Not the kids have to either tell a story that is true but try to convince their playmates the story is a lie, or they have to tell a story that is a lie but convince playmates it is true.

Video Preview: https://vimeo.com/user15018735/review/130643900/c1e53d2f16

More info from the National Institute of Mental Health http://www.nimh.nih.gov/health/publications/autism-listing.shtml

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There’s a problem inherent in counseling people about their problems. The risk is that we are modeling and training to notice and focus on failures and problems. As soon as one gets better another is chosen or created. One way to overcome this risk is to be solution focused. In solution focused brief therapy the person is not the problem they are bothered by the problem and the person who discusses the problem. We make subtle but important shifts as counselors when we meet with our clients, asking when they were not bothered by the problem, how will they know, or what will they seem themselves doing differently when the problem is getting better, and discussing what they are doing right and successes.

Here is how we can use language to facilitate people taking action to meet goals:

People have resources to solve their own problems. “Wow- how did you do that?” “Who else noticed you?” “When this problem is not happening, what will you see yourself doing?”
Change is inevitable. Focus the conversation on how things will be different rather than on how things are the same. “What is different about the times when you get your work done and stay in class?” “How did you help them not have the problem?” How are you keeping things from getting worse?”
Your job is to call out and expand the changes. Find what is working, when the problem is not happening, call it out as important and valuable.

“What have you done that went well or wasn’t a problem?” “Remember how you were this time last year? Can you see how different you are now, the progress you have made?” “If you keep going at this rate, I wonder what you will be doing 6 months from now?”
History and thorough analysis of the problem is not necessary. “Can you remember a time when this problem was not bothering you? How can you make that happen again?”
Why the problem happened is not necessary. If you are working with kids whose executive functions, especially metacognition, are delayed, they don’t know what they did let alone why, ditto for the memory of all people for events that occurred while they were very upset. “How much of the day were you not angry today?” “How do you limit the number of times you blurt out without being called on?”
Small changes can lead to bigger global changes. Optimism, confidence, and motivation can help a person overcome all kinds of obstacles. Trust me, I’ve seen miracle shifts in demeanor, behavior, and family systems happen in days after years of suffering. “What has happened since last time that you would like to continue?” How do you keep yourself from ________ so much of the time?” “What other areas have you noticed good things you have done?”
Even if they are a kid, and have IEP goals, let them define some of their own goals. If you as a therapist and your client have not agreed on explicit and clearly stated goals, you may have no therapeutic alliance. You are not on the same team. What would you like to see happening in your life as a result of us working together?” What is the problem that most bothers you that you would like help with first?” “Would you be okay with learning how to use your smart brain in even smarter ways and feeling the way you want to more often?”
Big changes fast are possible. Only problems are hard. Solutions can be easy. Once you know the solution, you say, “Oh, of course!” “What will you be doing when this problem no longer bothers you at all?” “Who would you have to be if you gave up this (thought, feeling, behavior)?” “On a scale from 1-10, how confident do you feel that you will be able to do better this week now?” If they give an encouraging number, say, “That feels good, right?” while you nod your head, trying to get them to mirror your nod, and when they say yes, keep nodding and say “Really good.”

“How much progress do you think you have made, on a scale from 1-10? How will you keep that going?” “How worry did you feel, from 1-10, when we first started? How about now? And if you were to move up just a point or two on that scale, what would you see yourself doing differently, or how would you know?” (In my private practice, when I first started, I had a number of folks who only came in once.

I was worried about this, and wanted to find out what I was doing wrong, so I sent out surveys after my second year of practice to about 600 families. I asked them to rate their experience and improvement with questions and 1-5 scales- Likert scales, and let them include notes on the back, gave them a stamped envelope to send it back in. I got 462 back, and man, was I gritting my teeth to hear the criticism. There was no criticism, in fact, quite the opposite- and many people said they got the changes they were looking for from meeting one time. How about that?)
There is no one right way to think about things. We are in no position to judge how hard things are for someone else or what their experience might be like. We borrow a trick from the consultation model by not minimizing or contradicting a clients’ report of how severe things are. “How do you know the difference between hatred and annoyance?” “What is the difference between depression and feeling a little down?” “When you have a panic attack, what happens?”
We do not focus on what we cannot change. “We can’t control the person who is “making you” mad, we can’t make school go away.” What you can influence and manage is how you think and feel, and how bothered you become about the things you can’t change. Nobody can make you do anything without your permission and cooperation. “How do you do well with other people or in other settings, and how can you use those strategies in this situation?”

If it works don’t fix it. If everything you are trying is not working, do something completely different. Keep it simple. Approach each session as if it were your last and only. Failure is a success at ruling out what doesn’t work.

https://en.wikipedia.org/wiki/Solution_focused_brief_therapy

Sources
Berg, I. K. (1994). Family Based Services: A Solution-focused Approach. New York:Norton.
Bonnington, S. B. (1993). Soution-focused brief therapy: Helpful interventions for school counselors. School Counselor, 41, 126-128.
Metcalf, L. (1995). Counseling Toward Solutions: A practical solution-focused program for working with students, teachers, and parents. Englewood Cliffs, NJ: Center for Applied Research in Education.

Dream Book

This is a beautiful way for a student to establish a sense of purpose and start planting the seeds of what they want to grow in the garden of their mind (Please also read “Garden of the Mind).

Ideally, a dream book will be a special and leather-bound book so it will last, even and especially when it’s owner falls asleep with it in bed.

The Dream Book’s user should be instructed as follows:

1.) On each page, as you think of one, write a dream you have for yourself.

2.) Go to Google Images, or other source of images, such as your own photos, or even better you can create your own symbol or drawing to represent each of the dreams written in your dreambook and tape or paste it into the page with your written description.

3.) At night right before you go to sleep, review your dreams, and try to take a few moments as you arise in the morning to see yourself living the dreams you want.

Rationale:
1.) Writing your goals and focusing on a specific image of the goal helps you be clear and specific about your vision and intention,

2.) Regular dream review helps you stay focused and encourages accountability,
in addition to replacing negative and discouraging thoughts that can be obstacles

Focusing your conscious attention on what you want to create rather than your fears and what you are afraid might happen helps you harness that 95% of mental activity that we are not aware of and put it to work for us. We remember best what we studied right before we went to sleep and as we walk through daily life we can prime ourselves to notice opportunities to realize our dreams and evidence that they are already true or are in the process of becoming true.

Try this yourself for a week and send me an email to tell me what you notice. I think you will be amazed at how quickly your experience and perspective can change.

My Dreambook has all kinds of dreams in it- from materialism and vanity to goals of lofty nobility. For example, the first image and dream I put in my book was a 2014 Mustang that was lowered and had staggered wheels. That image is on the left, and within a few months, the one on the right is mine, and it’s way cooler than the one I imagined! I also have goals to be a great and loving husband, and
“I am
successful helping thousands heal.”

Check out the book, Your Dream Book, here on my site. Not only is it inspirational and motivating, it is a beautiful work of art.

Sign up for the free mini-course; get more resources, videos, and instruction: click here.

http://www2.nami.org/content/navigationmenu/hearts_and_minds/resources195/mygoalsworksheet.pdf

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(scroll down the page for the related service counseling IEP goals menu)

Update: Telemedicine virtual online counseling now available here: https://www.bradmasoncounselor.com/

Coronavirus Kid Care Kit detailing how to reassure kids in crisis by age group, structuring their day, menu of offline at-home activities, and managing technology use. Children with special needs and behavior problems stuck at home without structure can push their parents to the edge. Send them this free resource.

Counseling Services
IDEA defines related service counseling as follows:
(2) Counseling services means services provided by qualified social workers, psychologists, guidance counselors, or other qualified personnel. [§300.34(c)(2)]
According to the American School Counselor Association (2007), counseling services are intended to help all children in the areas of academic achievement, personal/social development and career development. This can include helping children with personal and social concerns such as developing self-knowledge, making effective decisions, learning health choices, and improving responsibility. Counselors may also help children with future planning related to setting and reaching academic goals, developing a positive attitude toward learning, and recognizing and utilizing academic strengths.
Note that IDEA’s list of related services includes other counseling services—parent counseling and training; and rehabilitation counseling (that is, counseling specific to career development and employment preparation). These are defined separately in IDEA and are clearly different from counseling services (which are also not to be confused with psychological services).

§300.34  Related services.
(a) General. Related services means transportation and such developmental, corrective, and other supportive services as are required to assist a child with a disability to benefit from special education, and includes….
This beginning represents the core of how IDEA defines related services. The term related services is typically spoken in the same breath as special education (similar to how “peas and carrots” and “ham and eggs” go together) and, when used in IDEA, will always have the same meaning, including the part of the definition we haven’t shown you yet, which picks up where the beginning leaves off…
…and includes speech-language pathology and audiology services, interpreting services, psychological services, physical and occupational therapy, recreation, including therapeutic recreation, early identification and assessment of disabilities in children, counseling services, including rehabilitation counseling, orientation and mobility services, and medical services for diagnostic or evaluation purposes. Related services also include school health services and school nurse services, social work services in schools, and parent counseling and training.
Clearly, the list of related services is extensive–and, as already mentioned, the list is not exhaustive. These are just the services that IDEA specifically mentions. As states respond to the requirements of federal law,
– See more at: http://www.wrightslaw.com/info/relsvcs.faqs.htm#sthash.GpWU1BUV.dpuf

Parent Counseling and Training
Parent counseling and training is an important related service that can help parents enhance the vital role they play in the lives of their children. Its definition is found at §300.34(c)(8) and reads:
(8)(i) Parent counseling and training means assisting parents in understanding the special needs of their child;
(ii) Providing parents with information about child development; and
(iii) Helping parents to acquire the necessary skills that will allow them to support the implementation of their child’s IEP or IFSP.
The first two parts of this definition are longstanding in IDEA. The last part—regarding helping parents acquire the necessary skills that will allow them to support the implementation of their child’s IEP or IFSP—was added in IDEA ’97 “to recognize the more active role of parents as participants in the education of their children” (71 Fed. Reg. at 46573) and is retained in IDEA 2004. As with all related services, parent counseling and training would only be provided to parents “if  a child’s IEP team determines that it is necessary for the child to receive FAPE” (Id.).

IEP Behavioral and Counseling IEP Goals Menu

Aggression

_________ will demonstrate being mad the right way ___% of observed trials.

_________ will use appropriate strategies to calm themselves with prompts ___% of observed trials.

_________ will allow themselves to be mad or frustrated without hurting 90% of observed opportunities.

_________ will refrain from physical aggression (i.e. kicking, hitting, pushing, tripping) across all environments in school, for 4 consecutive weeks, with all adults and children as measured by event data.

_________ will refrain from aggression (i.e. hitting, kicking, pushing) 100% of the day, across all environments, with all adults and children as measured by special education event data, over 8 consecutive weeks.
Class Participation

_______ will demonstrate raising her hand to participate in whole class and/or small group instruction, 80% of the time in 5 out of 5 intervals, as measured by teacher observations.

_______ will respond when called upon 80% of observed trials.

Coping Skills/ Emotional Regulation/ Self-Regulation

In the classroom environment, ______ will utilize positive self-talk and coping strategies to handle stressful situations or work demands in which he/she manifests anxious or withdrawn behavior (i.e. putting head down, saying he/she can’t do something), demonstrated by engaging in the 30 minute activity or situation in a calm and positive manner with one prompt on 2/3 occasions.

In counseling sessions, _______ will accurately identify feelings and appropriate coping strategies when presented with real or imagined situations with 80% accuracy on 4 out of 5 trials.

When _____ becomes upset, frustrated, or angry, he will use a self-regulation/coping strategy (movement break, deep breathing, quiet space break, deep pressure/heavy work activity, etc.) to avoid engaging in an unexpected behavior, with one reminder, on 4 out of 5 opportunities, as measured by observations and documentation.
__________ will improve his self-regulation skills as demonstrated through utilizing a tool (e.g. inner coach, sensory support, calming break) to aid in regulating to an expected emotional state (e.g. green zone – which is when we feel calm, happy, content, and focused) with one adult reminder on 8 out of 10 instances in a small group setting, as measured over two week period

______ will improve insight on regulation as demonstrated by identifying the instances where he/she could have benefited from utilizing a tool to aid in regulation and determine what tool would have been beneficial for each instance with 80% accuracy.

When presented with a problem (non-preferred task, frustrating situation, criticism/correction), ______ will accurately determine the size of the problem (big problem, little problem) and determine the appropriate emotional response (take a break, talk with teacher, take a deep breath, replace frustration with good thoughts, etc.) and return to task at hand in 4 out of 5 trials as measured by teacher charted data.

When given a frustrating situation (i.e. undesired task, demand, and/or undesired peer behavior), with one prompt ________ will utilize coping strategies (i.e. take a break, deep breaths, etc.) and return to and remain on task with a calm body and mind for a minimum of 10 minutes with an average of 95% over 8 consecutive school weeks, across all classroom environments.

When presented with a situation known by ______ to be anxiety or frustration producing for him (i.e. non-prefered task, unexpected obstacle such as ______, tasks perceived as too difficult, unfamiliar adult, and non-preferred adult), he will independently demonstrate an appropriate emotional response through finding a solution to his problem or using a strategy to regulate back to an expected emotional state (take a break, talk with teacher, etc.) and return to task at hand within 2 minutes, for an average of 80% of instances both throughout all environments and within each environment.

Self-Monitoring

_______ will demonstrate the ability to recognize expected and unexpected behaviors as well as rate his own behavior as part of his self-monitoring system with 80% accuracy as compared to teacher ratings of behavior.

______ will demonstrate the ability to accurately recognize her level of anxiety through the use of a visual self-rating system (e.g. feelings thermometer) with 80% accuracy, as compared to teacher observations and data.

Self -Control

_______ will show self-control of his/her body and voice (good personal space, keeping hands/arms/legs  near body, and appropriate voice level) in relation to the expected levels of the classroom and peers around him for 80% of a 20 minute period.

________ will demonstrate self-control in the classroom through raising his/her hand and waiting to be called on by the teacher when he/she has a question in class, with 80% accuracy in 5 out of 5 trials, as measured by teacher observation and data collection.

IEP Goals for Anxiety

(blue underlined text indicates clickable downloadable documents for you to use   in counseling sessions)

In counseling sessions, _____ will accurately identify situations that can be anxiety producing and appropriate coping strategies or relaxation techniques when presented with real or imagined situations with 80% accuracy on 4 out of 5 trials.

______ will demonstrate the ability to accurately recognize her level of anxiety through the use of a visual self-rating system (e.g. Stressometer, 1-5 scale) with 80% accuracy, as compared to teacher observations and data.

During counseling sessions, __________ will use menus and highlight their Stress Triggers, personal Stress signs, and Stress Management Strategies that they believe they could utilize successfully.

In counseling sessions for anxiety, __________ will demonstrate understanding of the cognitive-behavioral model by completing and reviewing the Rational vs Irrational Thoughts Practice excercise,  Thinking Errors, Thinking Errors Practice, and Thought Record for specific anxious episodes with 80% accuracy.

________ will transition when prompted by teachers 80% of trials by interacting with their visual Activity Schedules.

On-Task/ Work Completion

When given a task or direction ______ will begin the task within 1 minute and remain on task for a minimum of 10 minutes independently with no more than 2 prompts on 8 out of 10 independent tasks, as measured by staff data.

Given a maximum of one verbal cue, _______ will attend to a non-preferred, small-group activity and/or independent assignment, without protest, and remain on task with no task avoidance (bathroom, getting a jacket, tying shoes, sharpening pencil, etc.) for 20 minutes, in 3 out of 4 trials, as measured by observations and staff documentation.

_______ will demonstrate on task-behavior in the general education setting for 75% of intervals during a 10 minute period, with the use of an appropriate fidget and one adult reminder, in 4/5 trials, as measured by observation and data.

________ will attend (sit still, eyes on teacher, hands to self, quiet voice) to a task during large and small group instruction across settings for a 10 minute period with no more then 1 teacher prompt in 4 out of 5 trials as measured by teacher charted data.

With movement breaks and the use of self-regulation strategies, _____ will demonstrate the ability to attend to a task for an average 75% of intervals in a 20 minute class period.

With the use of taught self-regulation strategies and self-monitoring checklists, ______ will independently begin a task (including non-preferred tasks) within 2 minutes of direction for an average of 80% of opportunities, across environments.

With the use of taught self-regulation strategies and self-monitoring checklists, once ______ has began an independent task, he will then remain focused on the task for at least 10 minutes, free from adult prompts, for an average of 80% of opportunities, across environments.

When given an assigned task, ____ will independently complete an assignment/task, and ask for assistance, if needed, with 80% accuracy in 5 out of 5 consecutive trials, in a small group setting, as measured by teacher-charted observations.

When given a non-preferred task paired with the use of self-regulation strategies and rewards systems, ______ will begin the task within 1 minute, and complete the appropriately modified version of the task within a predesignated appropriate amount of time (with use of timer) on 8 out of 10 opportunities, as measured by staff data.

In counseling sessions, _____ will accurately identify situations that can be anxiety producing and appropriate coping strategies or relaxation techniques when presented with real or imagined situations with 80% accuracy on 4 out of 5 trials.

______ will demonstrate the ability to accurately recognize her level of anxiety through the use of a visual self-rating system (e.g. feelings thermometer) with 80% accuracy, as compared to teacher observations and data.

Negative Comments and Gestures

With the use of Cognitive Behavioral Intervention (strategy of learning to regulate thoughts and beliefs in counseling paired with daily reinforcement as tools are utilized), _____ will reduce instances of negative comments and gestures to an average of 1 instance per hour, across all classroom settings, as measured over 6 trial days.

Please let me know if you have ideas about how to improve this counseling IEP goals menu.

Non-Compliance/ Following Directions

When given a frustrating situation (i.e. non-preferred task, not being able to choose preferred activity such as computers, etc) _______ will engage in no more than 20 minutes of non-compliance over a week period as measured through time sampling data.

Given a three step functional direction from an adult, _____ will complete all three steps with a maximum of 1 additional prompt in 4 out of 5 trials as measured by teacher observation and data.

Through the use of Self-Monitoring checklists, _______ will reduce instances of Passive Non-Compliance (becomes purposely and increasingly distracted through ignoring tasks, demands, or staff directives) to an average of 20% of intervals or less, both across all educational environments and within each educational environment, as measured across a one week period.

During a 20 minute academic task, ____ will respond to staff directives in an expected manner within 1 minute and with one reminder on 4 out of 5 trials, as measured by teacher observation and data.

Peer Interactions/ Social Skills

During unstructured play times, ______ will interact with peers in an appropriate manner through maintaining personal space and a respectful voice for an average 80% of intervals, measured over a 2 week period

_______ will decrease inappropriate verbal comments (such as “you are weird” or “you are a loser”) to 1 time per week or less by responding appropriately when his/her feelings are hurt (use words, talk to a teacher, walk away, stay calm) and seeking attention in appropriate ways (asking a friend to play, initiating conversation, giving a compliment) in 4 out of 5 trials as measured by teacher charted data.

During unstructured play (recess, choice time), _______will play (participate, share, follow directions/rules, take turns) with 1-2 peers for 10 minutes with no more then 1 adult prompt in 4 out of 5 opportunities as measured by teacher/staff data and observation.

Social/Emotional Problem Solving

When given scenarios of social conflicts, ______ will demonstrate problem solving skills by identifying the problem and generating two solutions appropriate to the situation in 4/5 trials, as measured by data collection.

Organization of Materials

_____ will organize his/her materials in a binder or folder and will bring assignments to and from school with 80% accuracy as measured by binder/agenda checks and teacher records.

_______ will organize his/her materials in a binder or folder and will bring assignments to and from school with 80% accuracy as measured by binder/agenda checks and teacher records.

Given helpful organizational strategies, _____ will present with organized school materials (folders, books, assignments, supplies) in his desk 3/4 times, 3 weeks in a row, as measured by review of his student planner, timely completion of assignments, and teacher report.

_______ will independently perform the task of writing his HW legibly in his planner and compile needed assignments in his binder with 80% accuracy in 5 out of 5 consecutive trials as measured by teacher-charted observations/ planner checks.

Want more? Check out my book Counseling Tools for Kids in Schools here.

Also find tons more free resources and mini courses for managing behavior and teaching kids self-control here.

Or, book me for a workshop! https://www.bradmasoncounselor.com/workshops/

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I hope you like this counseling IEP goals menu. Please let me know if you see ways to make it better or if you have more counseling IEP goals to add to this menu.

Classroom goal bank

Writing meaningful and measureable emotional/behavioral IEP goals

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Your thoughts are so powerful they create your reality. Where do your feelings come from? What happens, or how you think about what happens? For example, it could start raining, and I could think, “Oh no- this is going to ruin everything, I’m supposed to go fishing!” I could be really mad about the rain, and stay mad about it all day. Or, I could think, “Awesome! I’m so glad it’s raining! I hope it rains all day, then my grass won’t need to be watered, and maybe the river will fill up so I can go canoeing!” I could be happy about the rain all day. So it’s the same event- the rain- and depending on how I think about it, I could be either happy or mad. There’s where your choice and power lie.

Many people have difficulty stepping outside of their thoughts to think about what they are thinking about or doing. This is a vital thinking skill called metacognition. How do you edit your thoughts, inhibit impulses, or recognize your behavior does not fit in the context if you don’t think about what you are thinking or doing? Some people think in pictures and don’t use self-talk at all, which makes it hard to question, correct, and guide yourself. Emotional control and behavior control aren’t there. This is why teaching self-talk is so important. Then you can make a thought, and think about it. Is this true, correct, accurate? You don’t have to believe all your thoughts. You are not your thoughts, you are the observer of your thoughts, because you can notice a thought that isn’t right or feels bad, and make a better thought.

Sometimes I explain daydreaming to people, and make sure they understand the concept, and then ask them, “Do you ever daydream?” and they say, “No.” When asked what they are or were thinking, they will say, “I don’t know,” or “Nothing.”

We use the term “train of thought” to describe our stream of consciousness. I like to ask, “Where are you on your thought train? Are you on the caboose, just along for the ride, a victim of your thoughts? Would you rather be on the caboose as a passenger, or up in the engine as the conductor or engineer, driving the train, slowing down by putting on the brakes or speeding up, switching tracks when you don’t like where you’re going?”

Your brain makes thoughts all the time. Many of these thoughts are just garbage. They can be wrong, repeated unnecessarily, they can be worry thoughts about the future or angry thoughts about past regrets. What would happen if you tried to drive by watching the rear-view mirror?

And if you are staying upset about past events, well, I like to tell this story. You’ve seen that image of Santa Claus with his big bag of toys over his shoulder, right? What if someone had a bag like that, and everywhere they went, when they found dog poop on the ground, they scooped it into the bag. Then they said, “Man, I hate this stuff. It’s heavy and it stinks.

What would you tell this person? And if you are worrying about something bad happening in the future, isn’t that like living as if the bad event were true now, and living with the fear all the way from now until the future moment when the bad thing may or may not happen? Why would you want to do that?

Make a list of all your worries and fears on one side of a page, and on the other, write down what those worries ever did for you. Nothing, right? You see, your body doesn’t know the difference between what you think, what you imagine, what you dream, and what’s real.

Have you ever had that dream where you are falling or someone is trying to get you, and you wake up, and your heart is beating really fast and you feel scared for a few minutes until you tell yourself, it’s alright, it was just a dream, I’m okay?

See, all of what happens in your mind is real for your body, and while you don’t have complete control over your thoughts, you can decide which ones to believe and you can make new, better things to think or think about. You can practice thought replacement, or thought stopping. You can say to your thoughts, inside your head, “That’s nonsense, I don’t believe you.”

Another strategy for feeling better is called “mindfulness.” This means to try and focus all your awareness on the present moment. What do you hear? Try to hear at least three different sounds. What do you feel? Try to notice at least three different sensations. What do you see? Here’s the thing. The past isn’t real, it’s gone, it’s not now.

The future isn’t real, either, it’s not here, we can’t know what it will be. The only thing that is real is right now, the present. This is all we really have, the only place we exist. We don’t exist in the past or the future. Right now, what do you have to be grateful for? Make a list of what you like about yourself.

Maybe you have a healthy body, all your arms and legs, everything may work the way it’s supposed to. Maybe you are a good artist, friendly, funny, creative, good at Math, and so on. Do you have people in your life who love and care for you, a home with a roof that doesn’t leak, air conditioning for the summer to keep you cool, a bed to sleep in, food to eat? This is called gratitude.

Make this a list you can look at as school starts, write it on your mirror with a dry erase marker, review it before you go to sleep. Stay focused on what is good and right. One more thing about the present. The present is eternal, it always is. You have always been in the present moment and always will be. And in this present moment, you have everything you need. If you don’t have it and you are still here, you must not really need it. You always have had and will have everything you need, as long as you are here, it can’t be any other way. Mind bending, right?

Make a dream book, use the form I created called “garden of the mind.” Start planting your mindgarden, growing what you want and pulling the weeds of negative thoughts.

Next I want you to start using the “Thought Record” every day to record the thoughts you have either right before or during a time you are upset or stressed. Bring your “Thought Record” sheets back to me so we can look at them and make sure you are learning how to notice and correct your thoughts. This way, you are learning to use your smart brain in even smarter ways. Because if your brain makes thoughts that are inaccurate, not true, or feel bad, and you can make new thoughts that are more accurate, you are becoming smarter and able to feel better more often. Would you be okay with being smarter and feeling better?

Read the above passage and then the items below, and see if you or the person you are working with can identify the category of thinking error from the Thinking Errors sheet (find this in the free resources page on my website www.intensivecareforyou.com). Then try generating a smarter or better feeling way to think- make a better thought.

1. Sam raises his hand in class, and the teacher calls on someone else. Sam thinks, “My teacher doesn’t care about me.”
2. Beth has trouble figuring out the answer to the first problem on her Math test. She thinks, “I can’t do anything right. I’m terrible at Math!”
3. Steve wakes up and doesn’t feel all that great. He thinks, “If I have to go to school today, I’ll die!”
4. Peter’s Mom is running late to pick him up from school. He thinks, “Oh my God, she must have had an accident and gotten killed!”
5. Mary realizes there is a small hole in her shirt sleeve. She thinks, “Oh no, everyone is going to think I’m a slob!”
6. Matt asks if he can join a group in a game at recess, and they tell him no. Matt thinks, “Nobody ever wants to play with me. The kids at this school are all mean.”
7. Leo sees someone cut into the lunch line up in front of him. He yells at the other student, goes up to him and pushes him when he doesn’t respond, and here comes the principal, who tells him to stop and go back to his place in line. Leo argues with the principal, refuses to go back in line, and ends up going to the office. He thinks, “That’s not fair. I always follow the rules, and that kid needs to learn his lesson. I’m going to get him back tomorrow.”
8. Leah’s counselor asks her to try asking some classmates if she can sit with them at lunch. Leah says, “I can’t.”
9. Tanya kicks a girl for telling her she’s stupid. Tanya tells her teacher, “It’s not my fault, she called me stupid!” When Tanya goes home she pushes her little brother and tells her parents she can’t help it, because the kids at school were mean to her and her teacher isn’t fair.
10. Bart says that the best player in the NBA ever was Michael Jordan. Kevin disagrees and says it’s Magic Johnson. Bart argues, and keeps insisting he’s right after the teacher tells him to be quiet.
11. Karen is at home and her parents are arguing. Karen thinks, “I must have done something really bad.”
12. Mike goes home and his mother tells him to take out the trash. Mike thinks, “I hate taking out the trash. My life sucks.”
13. Alex has been good in school all year and made almost all A’s. He tries out for the school play and doesn’t get the part. “That’s not fair. The kid who got picked isn’t even as good a student as me. I never get what I deserve.”
14. Barbara asks Kara over to play after school. Kara says, “I can’t, I have a lot of homework. Barbara thinks, “Kara’s just being mean and doesn’t like me.” Barbara tells Kara, “Fine, see if I ever ask you over again.”
15. Nelson is playing baseball and he strikes out. He throws the bat and marches off the field saying “I’m never playing this game again. I never get a hit.”
16. Mason works really hard on a writing assignment, and Mr. Nelson gives him a B. Mason crumples up the paper and throws it in the trash. He tells Mr. Nelson, “That’s not fair, I did everything right, you should have given me an A.

1. https://en.wikipedia.org/wiki/Cognitive_behavioral_therapy

http://www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/basics/definition/prc-20013594

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