Drexel University Online - March and May

Developing Self-Reflection and Resilience in Adolescents with Asperger’s Syndrome and High Functioning Autism

Some key ingredients to success as an adult in college or in work are: self-awareness, self-reflection, stress management, social competence, and resilience. This is true for everyone with and without disability. It would be fabulous if we could eliminate stress from all our lives; however stress is a part of life, a part of everyone’s life so developing stress management and resiliency is a critical life skill. At Aspire/MGH we believe the earlier in a person’s life we begin this training the better prepared our participants will be for adult life. Our three core areas of focus: self-awareness, social competency and stress-management are addressed in all programs and they serve as the backbone of all of our instruction and consultation. We serve individuals from the age of five to thirty in a variety of programs including social groups, summer camp, summer teen explorations, internships, college mentoring and consultation and professional development. Focusing on these three competencies and utilizing a strengths-based approach as well as a science based approach serves our participants with Asperger’s Syndrome (AS) and High Functioning Autism (HFA) well.

Given that many individuals with AS and HFA are visual learners, enjoy technology and are generally concrete, sequential learners we made the deliberate decision to incorporate these learning preferences into our instructional methods. Our adolescent programs use a curriculum we developed called the Science of Me (Lucci, D., Levine, M., McLeod D.S., and Challen-Wittmer, K., 2013). In this curriculum we incorporate two pieces of technology as an integral part of instruction: a web and mobile based software system, Symtrend™ and a stress-management tool developed by HeartMath called emWave™ along with HeartMath’s curriculum The Inside Story.

Symtrend’s™ web-based and mobile-based technology system can be used for a variety of purposes: behavior analysis, outcome measurement, data management, self-management, team communication, and coaching/direct instruction (Levine, M., 2013). In our work we used it primarily as a data collection tool and an instructional tool for self-reflection, self-awareness, social competency and stress management. Symtrend™ has the capacity for individualization which allowed us to author our own screen content which mapped onto our Science of Me curriculum and the Inside Story.

Each participant and staff person utilized an Apple iPod Touch with Symtrend™ uploaded onto each device. Our screen content included: feeling states, attitude, cognitive flexibility, group participation, social thinking, anxiety, stress level, stress triggers and relaxation techniques among others. After designated periods and multiple times during the day, participants rated themselves in these areas as did staff. Both sets of data were uploaded to the web, synchronized and then printed and reviewed during social groups. A visual graph/chart was printed that included a comparison of staff/teen plotted together on the same page. This allowed for discussions of personal data and reflection by each participant about themselves as an individual and as a member of a group. Many teens with and without an ASD diagnosis may be reticent to participating in these discussions. Our participants did not view the feedback, even if “negative,” as emotionally triggering. Our hypothesis is they were intrigued by “seeing” their data “concretized and objectified.” It allowed more honest discussions and we found that by using Symtrend™, teens’ self-awareness of their feeling states, cognitive flexibility, stress awareness and management improved as did their social behavior as it related to others. Our data also suggested that teens used the visual graphs to describe their internal states and broaden the neurotypical person’s perspective of individuals with ASD. During a discussion, a staff member rated a teen as “not part of the group” and the participant rated themselves as “part of the group.” Staff rated the teen in this way as he often paced during discussions. Another teen challenged the thinking of staff by stating, “you call yourself a psychologist don’t you know he’s autistic and he paces!” Staff indicated that they understood that pacing is something that individuals with ASD engage in; however we wanted him to understand that others would think differently about the behavior. A rich dialogue ensued about perspective taking and how others (i.e. high school classmates and general education teachers) less familiar with the characteristics of ASD would interpret his behavior. These dialogues are intended to provide knowledge, share alternative perspectives and encourage decision making/problem solving in relationship to self and others – not specifically to try to change behavior. Using Symtrend™ facilitated the teens’ participation and interest in discussing their and others perspectives. Another example is when teens rated their own individual participation in a group and then had to rate the overall group functioning, by viewing the comparison chart teens were able to “see” that when they as an individual were positively engaged the overall group functioned better.

Stress management, relaxation and resiliency were addressed through HeartMath’s emWave Desktop system as well as The Inside Story and The Science of Me curriculum. In the Science of Me curriculum participants learn about the parasympathetic and sympathetic branches of the autonomic nervous system and how these systems play a role in overall health and well-being. The regulation of these two branches has been demonstrated to play a direct role in emotional regulation, shifting attention, resiliency, behavioral flexibility and the ability to adapt to effectively to stress and environmental demands (Appelhans, B.M & Luecken, L.J. 2006). Participants learn that, in simple terms, these branches represent the brake and gas pedals of their body and that they can help regulate how much gas or how much braking is needed, which ultimately will assist them in being able to adapt effectively and deal with stress. We also highlight that stress is a part of life and that learning to cope is essential to happiness, ease and well-being.

HeartMath’s Inside Story curriculum was developed for “typical” teens and adults. They also have other curriculums for preschoolers to adults. Since it was developed for typical learners we modified and supplemented their curriculum. We used these curriculums in conjunction with HeartMath’s Desktop system emWave to help individuals with AS and HFA understand how their inner and outer worlds are connected.

HeartMath’s Desktop system, emWave, is a stress management tool that utilizes a finger or ear sensor that monitors heart rate (HR) and heart-rate variability (HRV). The sensor collects real time, beat-to-beat HR and HRV. It portrays the HR and HRV in graph form and, as one becomes more proficient, a gaming platform can be utilized. It allows the abstract to become visual. HR and HRV act as an indicator of physiological resilience that allowed our participants to “see” the connection between their thoughts and feelings on their heart. When wearing the sensor and being connected to the emWave, they could see on the desktop monitor how if they were frustrated or stressed they had a jagged heart rhythm and when they were feeling calm or peaceful their heart rhythm was smoother and more like a coherent wave. HRV was displayed in a bar graph indicating “heart coherence” (a term coined by HeartMath). Participants learned a variety of stress management techniques some specific to HeartMath (i.e. Heart Focusing, Neutral and Quick) others not (i.e. mindfulness, progressive muscle relaxation, visualization, etc.) to help them manage their stress and develop resiliency. The emWave allowed them to observe the neurological impact of their thinking, their feelings, their breathing, and their utilization of specific relaxation techniques on their heart. The ultimate goal being to be able to recognize one’s triggers of stress, how one’s body feels when stressed (i.e. heart racing, tense muscles, etc) and to be able to practice stress management techniques in real time without being “on the emWave.”

HeartMath as a stress management tool and Symtrend™ as a data collection and instructional tool were integral to learning. Many of them were able to improve their social competency, self-awareness, stress management and self-reflection and develop increase resiliency. They developed an awareness of themselves and others while improving perspective taking skills. They learned that heart focus is kind, gentle and calm and when in this feeling state they are better regulated and happier. Both of these technology tools proved invaluable in getting participants to “buy in” to their personal growth work and being a part of a group process. As professionals, we have a responsibility to do all that we can to improve the lives of the individuals with autism that we work with. Carefully selected technology can be a promising tool in guiding individuals with HFA and AS to lead lives of resilience and optimism.

For information about Aspire/MGH, please contact dlucci@mgh.harvard.edu, call 617-365-7293 or visit www.mghaspire.org.  Apsire was previsouly named YouthCare.

For information about Symtrend, Inc., please contact Minna Levine, President at mlevine@symtrend.com and visit www.symtrend.com. For information about HeartMath visit www.heartmath.com and www.heartmath.org.

References

Lucci, D., Levine, M., McLeod D.S., and Challen-Wittmer, K. (2013) Technologies to Support Interventions for Social-Emotional Intelligence, Self-Awareness, Personal Style and Self-Reflection. In K. Boser, M. Goodwin and S. Wayland (Eds.) Technology Tools for Students with Autism (pp.201-226). Baltimore, M: Brookes.

 

Levine, M. (2013) No More Clipboards! Mobile Electronic Solutions for Data Collection, Behavior Analysis, and Self-Management Interventions. In K. Boser, M. Goodwin and S. Wayland (Eds.) Technology Tools for Students with Autism (pp.229 – 246). Baltimore, M: Brookes.

 

Appelhans, B.M., & Luecken, L.J. (2006) Heart rate as an index of regulated emotional responding. Review of General Psychology, 10(3), 229 – 240.

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