NEURO-STREGTH-BASED APPROACH TO AUTISM FOR EDUCATORS AND THERAPISTS: INTRODUCTION

What will be covered in this section
  • What is a Neuro-Strength-Based Approach to Autism?
  • What can educators and therapists expect to achieve by using this approach?
  • What can your clients expect to learn when you use the autistic-specific strategies and tools that are integrated into the NSB approach?
  • Additional reading recommendations

What is a Neuro-Strength-Based Approach to Autism (NSBAA)?

The NSBAA is NOT another form of intervention. It IS an approach to the way we, as therapists and educators, interact with autistic individuals. The NSBAA focuses on identifying and building on an individual's strengths. It also recognizes the neurological differences in the way the autistic brain processes experiences. Experiences are the foundation for learning and growth. Positive experiences provide the motivation for further learning. Negative experiences are avoided, tolerated, stored in our emotional memories, or go unused. Whether an experience is positive or negative depends on how the brain takes in, processes, and interprets that experience. Different minds will interpret the same experience differently. Thus, respect for neurodiversity is an essential key to this approach.

Why is the NSBAA not another form of intervention? The definition of intervention is "an action taken to improve a situation, especially a medical disorder." Synonyms for intervention include "interference", "intrusion", "meddling", "arbitrament."  Most types of intervention start with an assessment. Based on that assessment, goals are generally written to achieve one or more of the following: an increase in what others consider adaptive behaviors, a reduction in what others consider problematic behaviors, or learning new skills that others decide will enhance the individual's quality of life. Where does what the individual wants to learn, and the best way for the individual to learn, come into play in an intervention? The NSBAA is, quite simply, a practical, strength-based, and neurodiverse approach that educators and therapists can use to look more critically at the goals they write and the strategies and tools they select to implement these goals when developing treatment or educational plans for autistic individuals. The needs and desires of the individual and their family play a key role in determining which goals are targeted. The individual's motivation and differences in learning are key factors in how these goals are achieved.

Why do we need a new way of looking at the plans developed for autistic people? Because, frankly, the current way of establishing goals and creating plans is not as effective as it could be for the following reasons:

1)  Goals tend to target what are perceived as missing skills or deficits in functional performance. The assumption is that when the individual acquires these missing skills their functional performance will improve. Yet the only measurement of the success of the intervention is whether the goals have been met, not whether it has resulted in improved functional performance in that individual's life. The best people to both identify and observe improvement in functional performance are the parents, relatives or others who support the autistic individual. Yet their input, despite being included in an assessment report, is rarely included in the writing of goals that will lead to function. The goals that the individual has for themselves (based on what they seek to learn and do) are never even mentioned. Goals are set for the individual by others based on their assessment of what they think the individual should want or needs. This may be another reason why some goals are never achieved, or only learned under duress and never used.

2)  Goals identify WHAT observable behaviors are desired but rarely HOW these behaviors are expected to be attained (by identifying the strategies that are expected to work with that specific individual). Yet, when an individual fails to attain a goal, the goal is retained rather than revised. It is assumed that the goal is still valid but because the strategies selected to achieve that goal are never listed, there is no way to assess what needs to change to improve the outcome. Some individuals have the same goals, most likely using the same strategies, for years.

3)  The individual's strengths are typically listed as part of the assessment process, yet they are never mentioned in the educational or treatment plan. Strategies and tools are typically selected because they have been shown to be effective in teaching a particular skill, not a particular individual.  Research has clearly demonstrated that the autistic brain does not process information or respond to social expectations in the same way that non-autistic individuals do. Autism presents as a spectrum. No two autistic individuals respond in the same, or even a predictable way, to the same experience. It makes sense that the strategies and tools need to be selected that recognize both the individual's strengths and differences.

4)  When using a "deficit" approach to setting goals for autistic individuals, skills that are assessed to be below what is considered the "standardized norm" are focused on for remediation. Behaviors that appear to be interfering with development of these skills are also often targeted. Goals are set to improve or develop these skills, or eliminate or modify these behaviors, instead of goals that focus on enhancing the quality of the individual's life, despite these underdeveloped or missing skills and behaviors. Setting goals and selecting strategies and tools that ignore the core differences in neurological functioning in autistic individuals are doomed to fail. Development is based on how an individual adapts to what they experience. Sometimes the way in which an individual adapts does not foster further development, especially if the experience is negative. The individual develops coping behaviors. These behaviors can become limitations to further development, but they need to be recognized and respected for what they are, not eliminated. The experience that triggers the behavior needs to be modified.  The individual then needs to be offered and allowed to adopt other ways of responding that will foster further development, not made to conform to, or perform in, ways that reflect what others expect and want from them.

In summary, the NSBAA is an attempt to guide educators and therapists who work with autistic individuals in using critical thinking skills to:
  • recognize and incorporate autistic strengths into therapy and educational goals
  • identify what are coping mechanisms that need to be respected and accommodated, not eliminated
  • identify and respect the neurological differences in the way an autistic brain processes information
  • write observable, measurable, goals that are linked to the individual's desired outcomes rather than simply achieving missing or underdeveloped skills
  • select methods that best match the autistic individual's strengths when developing a plan to implement goals
  • recognize what needs to change when a goal is not being achieved, including the goal itself

The need for a strength-based approach to working with autistic individuals is not a new concept. An article from 2006 published in Research and Practice for Persons with Severe Disabilities recommends, four areas that need to be included within the assessment process: (1) child choice of items and activities; (2) family strengths; (3) child strengths; and (4) environmental assets. All of these, and more, are included in the NSBAA. I have listed at the end of this section 4 other references that emphasize the need for a strength-based approach when working with autistic individuals. The one that I strongly recommend that you read is Authentic Strength-Based Practice, Can Neurotypical Professionals Make A Paradigm Shift?  (https://autismspectrumnews.org/authentic-strength-based-practice-can-neurotypical-professionals-make-a-paradigm-shift/?fbclid=IwAR0ExrSoarILpUh5-gQeY39i5vKNRVJEkcEU2ET4rtoV_zdiCBjD_I7-k90). 
 
Theories on how the brain learns are abundant (https://www.learning-theories.com/). Solid research into the neuroanatomy of brain function in learning is more limited. Current research on autism has only recently recognized that there are sensory processing differences, not just anatomical differences, in the way the autistic brain works. Since Sensory Processing theory (https://en.wikipedia.org/wiki/Sensory_processing) has explored the neuroanatomical foundations of brain functioning, I have included these neurological findings in the NSB approach to autism. In addition to finding and building on a person’s strengths, it is important that those working with individuals with neurological differences understand and respect those differences, not confuse them with defects or deficits that need to be fixed or corrected.  Everyone has strengths. Everyone has limitations. Limitations are physical and mental obstacles that can and do get in the way of a person's ability to function (execute an intended or purposeful action). Physical and mental strengths can help an individual find a way around those limitations. Focusing on limitations is not motivating to anyone and can trigger highly negative reactions. How much better is it to help an individual identify their strengths and then learn to use those strengths to get around their limitations to achieve goals they set for themselves that capitalize on their strengths? Thus, learning to share control and developing a reciprocal communication system between the individual, teacher/therapist, and family that taps into each other’s strengths and respects each other’s limitations is a strong part of the NSB approach to autism.

The challenge of a strength-based approach is when working with individuals on the autism spectrum who have difficulties in communicating their strengths, needs and wants…at least in ways that the typical person can easily understand. The way in which an autistic individual functions (executes an intended or purposeful action) may be not perceived by others as “appropriate” or "normal" and these actions or behaviors may be discouraged (if not outright prevented). Because the autistic person’s way of communicating (remember behavior IS communication) is so poorly understood people ignore it or assume the autistic person is incapable of thinking, learning, or making decisions for themselves and must be taught how to think, learn and behave. Conformity has social value, but it should not be at the expense of individuality. No one can understand what they have never experienced. Therefore, understanding the neurological differences in how the autistic brain functions is important in understanding what the autistic person is communicating about themselves, their strengths that motivate them, and their needs as individuals via their behaviors.

The Neuro-Strength-Based Approach to Autism is an attempt to help you, as a teacher or therapist, assimilate into the autistic person’s world and to learn their ways of communicating and functioning, so that you can become mentors in helping them to better understand the world in which they live, and become more comfortable and trusting in establishing relationships with those who live and work with them, without losing their sense of identity as an autistic individual.  
     
What can you expect to learn by using this approach?

            Hopefully, the most important thing you will gain by using this approach is a better understanding of, and respect for, the differences between how your brain and the autistic brain learn and communicate. The behaviors that you see will make more sense as you are able to interpret them as communication, not an inability or resistance to learning from you. Keep in mind that the autistic person is as perplexed by your behavior and ways that you communicate as you are by their ways. I guarantee they would love to learn from you, once you learn how to communicate with them in ways they can understand.

            In the process of learning this approach you will be challenged to use critical thinking to gather observations of behaviors and analyze them from a neurological perspective to better understand their meaning. You will be asked to discriminate between what is, and should be considered, a strength (despite it not appearing to be “normal”) and what is a limitation that impedes learning or progress. You will learn how to explain and/or model, in ways the client can understand, the unspoken social rules and thought processes that non-autistic people “pick up” without being taught that can help your client to make sense of WHY people keep expecting them to know things they obviously don’t know or understand. You will be encouraged to ease up on your image of yourself as the authority figure who controls and directs decisions in your therapy sessions if you want your client to develop a sense of self-actualization and a desire to assert and advocate for themselves (the lack of which creates fear, anxiety, and the reluctance to engage with others). You, and the client, are more likely to enjoy your sessions together as you will be learning from each other and developing a relationship based on trust and respect for each other.

            You will not be asked to give up or replace the methods and strategies that you have already learned. You will be given additional tools and options to choose from in planning your client's/student’s goals and activities and the clinical reasoning needed to determine which ones will best fit that particular individual’s functional needs and motivate them to want to achieve goals that are tailored to, and use, their strengths. You are likely to have greater compliance from parents in following home program recommendations once you pass on this change in perspective to look at strengths rather than limitations and the effect that it has on the child’s willingness to engage in these activities.

            Think of this approach as immersing yourself into another culture…from learning a new language to looking at others who may differ from you from another perspective. It’s a way to grow personally as well as professionally.

What will you be helping your clients/students to learn when you use the tools that are integrated into the NSB approach?

When you use rapport building strategies, you will be modeling social interaction skills (the power of, as well as the give-and-take in, communication; exploring likes/dislikes; finding fun in playing together or comfort when you are upset; building trust by turn-taking and sharing control).

By setting goals and selecting methods for achieving them that are based on their strengths, you will be pointing out to them that they do have strengths (not just limitations due to their differences) and that those strengths can be valuable contributions to society.

By exploring each of you as a generator of sensory input, you are teaching them about non-verbal communication cues and their meaning.

When you make changes in the environment or adapt an activity to make it less or more stimulating, you are teaching your client how to adapt and how to advocate for what they need.

By using the problem-solving tool, you are teaching them that they always have choices, but choices come with consequences, so they need to choose thoughtfully.

When you explain not just what they will be learning but also the why, how, and when, you are helping them to understand the value in asking when they don’t know or understand something.

By giving them shared power in making decisions about what they do, in what order, and for how long, you are teaching them to not only make decisions but accept responsibility for following through with those decisions. 

When you review what they have accomplished or learned at the end of the session, you are helping them to store memories that they can use to plan and make wise choices the next time.

By giving them options to deal with stress and then always respecting their decision when they use them, you are teaching them self-calming strategies as well as self-advocacy skills.

When you explore the use of assistive devices in making tasks faster, easier, or better, you are expanding their awareness of how they might use these tools to compensate for their limitations or tasks they would otherwise avoid as too difficult.

By using the self-measurement tool to monitor their successes, you are showing them that failure is a part of learning and nothing to fear.

Rather than you directing what they learn and how they learn it (which leads to learned dependence), you will be using these tools to help your client think and make decisions and accept responsibility for their own actions and choices.

I’m sure that there are more benefits to this approach than I have listed. I leave it to you to discover them.

Additional reading and viewing recommendations

*  Thinking and learning strengths in children with autism spectrum disorder.  https://raisingchildren.net.au/autism/learning-about-asd/about-asd/learning-strengths-asd
*  A Strengths-Based Approach to Autism.  https://www.health.harvard.edu/blog/a-strength-focused-approach-to-autism-2017042011607
*  A Strength-Based Approach Helps Children Learn to ask "What’s Right" instead of "What’s Wrong"   https://www.psychologytoday.com/us/blog/worrier-warrior/201504/strength-based-approach-helps-children*  Strength-Based Assessment for Children With Autism Spectrum Disorders, Merith Cosden, Lynn Kern Koegel, Robert L. Koegel, Ashley Greenwell, and Eileen Klein, Research & Practice for Persons with Severe Disabilities 2006, Vol. 31, No. 2, 134–143
*  Autism And Sensory Integration Dysfunction (Sensory Processing Disorder), https://www.sensory-processing-disorder.com/autism-and-sensory-integration.html
*  Ten Things Every Child With Autism Wishes You Knew, https://www.sensory-processing-disorder.com/10-things-every-child-with-autism-wishes-you-knew.html
​*  Characteristics of Brains in Autism Spectrum Disorder: Structure, Function and Connectivity across the Lifespan, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4688328/
​*  “The Nature of Brain Dysfunction in Autism: Functional Brain Imaging Studies”, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2975255/
* "A Strengths-Based Approach to Autism Interventions" (podcast by Meg Proctor, MS, OTR/L), https://www.learnplaythrive.com/podcast/episode/2c3afafd/a-strengths-based-approach-to-autism-interventions-with-dr-kristie-patten
​©  Susan J. Golubock, M.Ed., O.T.    7/03/2020