Sunday 29 January 2012

Why parent emotional regulation is key to remediating autism

Righto.  There are a few clips in this blogpost – all of the same activity, interspersed with some explanatory narrative that helps to tell the story of our work on emotional regulation – both mine and Philip’s.

We are making kebabs.The first clip from the activity is where Philip withdraws. 

Prior to this clip, we had been going for about 6 mins without really getting anything done.  At the beginning of the clip, I set some limits around scripting (because it’s becoming a distraction and interfering with our interaction) and then P shares something daft that he and Louis have been doing together that they've been having fun with.  I allow this and share around it, as it isn’t scripting, he is sharing experience.  What’s also nice about this is that he is looking for my non-verbal emotional reaction to the daftness. 



At 0:59 I set a limit around silly name calling by saying ‘we’re not having any silly name calling right now’ and he responds ‘after’. He is managing to inhibit himself here and I spotlight his competence by repeating the word.

At 1 min 14, P withdraws.  He has just come back from the loo, where he washed his hands and got some soap in a cut on his finger that is now irritating him.

I immediately feel a mixture of disappointment, frustration and anger at Philip.  Those of you who have been in this situation will recognise how I was feeling.  You have built yourself up to have a positive, enjoyable interaction (that includes remediation) and it’s all gone belly up L

You get that sinking feeling in the pit of your stomach as you think to yourself ‘Oh blast it, we’re not going to be able to do this activity’ and ‘Oh why can’t he just do it!!’ Very un-RDI like feelings…….but you can’t help your initial emotional response.  Fortunately, about 2 seconds later, the good old pre-frontal cortex kicks in and boots out the amygdala’s initial negative emotional response. 

I quickly get a handle on my feelings by thinking that I will just give it some time and hope that he will re-engage.  The pre-frontal cortex reminds me what I know about his condition - that he can’t help his response because he hasn’t yet got the thinking tools to emotionally regulate in the moment. 

I can be quite fiery myself (it’s the red hair gene) and it has taken a lot of work for me to become more mindful about my feelings so that I can manage them more positively.  The added bonus is that this has paid off in other areas of my life (RDI – my own personal Psychologist!!)

I leave P for 3 mins and then go to the room he has withdrawn to.  I explain that I’m sorry his finger is hurting, suggest that if he rinses it under water it might help, tell him I am going to get on with the cooking and say that I hope he will be able to return once he feels better.  He tries to engage me in a negative discussion (spiralling about how things always go wrong) but I reiterate that I’m going back to the cooking and walk off. 

I have previously had a tendency to be sucked into the negative spiralling by trying to rationalise with Philip (wanting to ‘fix’ things for him and to counter his negativity).  I have learned the hard way that this is counterproductive and actually just makes things worse.

It’s hard just to put a lid on it and walk off like that, because my natural instinct is to want to help him to feel better and I kinda feel mean leaving him in that dysregulated state.  However, I am determined to put the plan that I have discussed with my RDI Consultant into action and to give him space to regulate himself.

It takes him a further 10 mins to regulate himself enough to return to the cooking but he does regulate himself without my help.  Hooray!!  During this time I am doing some preparatory cooking work, as time is getting on and school will be closing in about half an hour.

This next clip is of 4 mins immediately after he re-engages



You can see at this point, he is still locked into his negativity.  During this time I go at a slow pace. 

At 0.52 I scaffold by prompting him for where to look for the peppercorns.

1.23 I take the lid off to begin with - another scaffold as I'm thinking that this may be too much of a challenge for him at this point i.e. after the previous frustration, this new challenge will frustrate him sufficiently to be the straw that broke the camel’s back.

At 2.48 I scaffold by taking the tablespoons out of the picture and looking again at the teaspoon measures.  At 2.58  I can see he has the idea to use 2 x half tspn and he does select the half tspn.  My Consultant commented that my pacing and pausing here were allowing some great problem solving.

We have a bit of a non-verbal miscommunication about how to put the tspn in the jar then at 3.23 his frustration is stopping him from thinking through what he might do here.  I pause and at 3.32 he says he's ready to give up so at 3.34 I come in with the scaffold of removing the spoon from the ring to make it easier to maneuver it.

At 3.42 he speaks disrespectfully to me (this is borne of his frustration with the measuring spoon).  The tone of my response lets him know he has overstepped the mark.   I would have counted any more of this (one of our family our behaviour management tools is 1-2-3 Magic) and I think he knows that.

This clip is where I model for Philip how to take the top off the cloves.


0.02 P references me

0.11 I take the opportunity to model for Philip how to get the lid off

0.29 He pulls the lid off and spills the cloves - I say not to worry.  My Consultant fed back that my calmness around this helps Philip tremendously.  Again – I am being mindful about my emotional response by not getting lost in the frustration of the spill.

0.43    We share a joke.

The final clip is where P does quite a bit of referencing around measuring the cumin and then I model again the grip that is needed in order to take the top off the spice.



0.06 P references me for info, I do thumbs up
0.08 P checks in, I nod
0.15 P checks in re having a heaped spoon, I respond with gesture and facial expression
0.18 A quick flick check in
0.20 I gesture to stop and he references me
0.22 He checks in again but I miss that one
0.58 I model again how to take the top off
1.18 I do it again with more pronounced and slower movements
1.22 He manages to do it and I celebrate his success with a 'yay!

So here we can see a prime example of how important it is for the parent guide to be in the right emotional ‘headspace’ – staying calm, going slow, not treating withdrawal as any kind of failure, being prepared to wait it out.  Self regulation develops from co-regulation: just as we do with our typical children, we parents need to scaffold it for our kids with developmental delay.

And by the way, the kebabs were delish JJ

6 comments:

  1. Zoe, this post was a fabulous example of RDI in action. The activity was not the focus of your interaction with Philip. The making of kebabs was used as your prop and throughout each of your videos; it was clearly visible that you were mindful of your pausing, pacing and the type of language used. Your interaction with Philip could easily have swung the other way.... in that, he took control. Yet you remained calm and consistent and at one point you specifically pointed out that he was being disrespectful. I can see that Philip likes pushing the boundaries, however, you are able to let him go when needed, draw him back in without any fuss and then get on with the business of *engagement*. Way to go Zoe…....

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  2. Thanks Di for your kind feedback. I'm not always in this headspace when I'm doing RDI....but I'm working on it and getting better at it, thanks to the support from my Consultant :)

    'Keep calm and carry on' has got to be the motto for those of us doing RDI!!

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  3. Zoe,
    Thanks for sharing your videos as well as your thought process. We all have those natural thoughts running through our head, and sharing your struggle is affirming to a lot of parents. You demonstrated patience, thoughtfulness, and mindfulness as you proceeded with this activity. I liked the pauses. They gave P time to respond and to be a partner. Video is always helpful to analyze what has happened. Emotional regulation and mindfulness are keys to success. I will be sharing your blog with my families. Keep up the good work.
    Blessings,
    Terry

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  4. Hello Terry

    Glad you liked the post and found it useful. Thanks for your feedback :)

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  5. I love this video sequences Zoe, I am going to use the link for one of my trainees who is working on her parents' self-regulation. You do such a beautiful guiding work!

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    1. Thanks Maisie - your feedback is very welcome :) Also I had forgotten all about this post and I think I may use it for some training myself - cheers for the reminder!

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