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Friday, March 25, 2011

It's not rocket science - please, try this at home!

I want to share with you a story from a mom, who saw the information about Adam and the use of drawing for communication when I presented it as a research poster at the 2010 Geneva Autism Symposium in Toronto. We spoke briefly during the poster session, and when she got back home, she decided to try the techniques out with her son. With her permission, I am sharing the story of what happened next (in her words):

"I ... have a 15 year old son on the spectrum - verbal, but with significant academic delays ... I had to share this story with you.

Your approach of using drawing rang a bell with me, because Jake has always been very visual. As I mentioned to you, though, he does not enjoy drawing (or any type of art for that matter), and does it only under duress. You suggested that I draw for him, which was an idea I liked a lot. Anyhow, I came to the conference looking for ways to move forward on making plans for Jake's future as an adult on the spectrum - his delays present some big challenges. A second challenge has been his lack of participation in that planning. When I've asked "hey Jake, what do you want to be when you grow up?" - usually in the context of also asking his four siblings, his response has consistently been "Pfft. Iiiiiii dunno", or something similar.

This morning, he and I sat down with a sheet of paper and a pen. He was immediately intrigued. I drew a series of boxes - like a cartoon. The first was labelled "1995, Age: 0", and showed a stick-baby with a speech bubble saying "gaga". Then "2000, Age: 5" - a little stick kid playing a plastic saxophone (favourite toy at that point). "2005, Age: 10" - slightly bigger stick kid in the Toronto Maple Leafs shirt and hat that he used to wear to drive us all CRAZY at that age. "2010, Age: 15" - stick teenager playing the drums (he takes drum lessons now). I continued: "2015, Age: 20" - he'll still be in school, so I drew a bigger stick-guy with his high school uniform sweater, holding some books and his laptop. Finally, I got to the last box. I labelled it: "2020, Age 25", and handed him the pen. HE BLEW ME AWAY!!! He drew this really detailed picture of himself playing in a band with four of his friends. The two lead singers ("just like Blue Rodeo") got speech bubbles saying "sing", and everyone was playing an instrument and labelled by name. The style was as rudimentary as mine had been (and in keeping with how he would normally draw), but the detail was like nothing I'd ever seen.

When he finished, he put down the pen, looked at me, and said "That's my dream. I want to be in a band with my friends. And not just a FUN band - a WORLD FAMOUS band!" Then we talked about how that might happen. What you'd need to learn, for example ... what that trajectory might look like. He has a dream!!! He's obviously had it in there for quite some time, and now, thanks to you, it's out, and we can talk about it and work towards it! My husband and I are already brainstorming about how else we can use this technique with him. So, you know - THANK YOU!!! You can't imagine what this means to us."

Jake's mom scanned their drawing work, so you can see it below:

And a follow-up note came with the scanned picture:

"... about a month ago now, Jake played drums at a show that his music school put on at the ... arena. He was nervous about getting up on stage in front of his peers, but he overcame his anxiety. He blew the place away, and made the front page of our local newspaper as a result! (Not sure if you can tell in his drawing, but he's the drummer - the drum kit is to the right, and he's holding a drumstick.)"

So in contrast to the usual rider you might see on a television program ("do not attempt this at home"), I would say instead: "Please, try this at home. See what happens." Then do feel free to contact me and let me know how it went (what worked, what didn't) and I'll do my best to suggest some useful "next steps".

Happy drawing! ......... Sheila B

Friday, March 4, 2011

Expressive drawing as "augmentative" communication for verbal ASD individuals

Drawing for communication is also a very effective technique for more verbal ASD individuals (Asperger's and PDD-NOS), especially when dealing with emotional and social concepts (a general area of weakness for any ASD person). When emotions run high and life falls apart, the high distress frequently causes language skills to retreat, and words become a poor tool for working through the challenging situation. In this context, drawing is used as an "augmentative" communication tool (where the drawing "augments" or adds to verbal language to provide more detailed and complete information).

Published research has shown the effectiveness of putting social and emotional information into a visual format for individuals on the autism spectrum (eg. Carol Gray's "Social Stories", Tony Attwood's emotional "thermometers" and "toolboxes"). Expressive drawing adds another dimension to this teaching mode, because the ASD individual processes and acts on the information: presenting their own point of view, generating their own strategies and solutions, and predicting potential outcomes. This type of active problem-solving leads to integrated and flexible social learning, building a skill set which allows the individual to apply the information to novel social situations.

Let me introduce you to another young man on my caseload who has been using expressive drawing to solve difficult social situations for many years now. His name is Brett, he has Asperger's Syndrome, and he has very kindly given me permission to share some of his work with you. Here is an example of his drawing about a tricky upset that happened at school:

Solving the problem started with the green square - this was the event that was visible to others - a loud angry upset at school when the teacher tells him the final copy was supposed to be typed - we went back in time visually to see what the real problem was. Square 1 shows the night before, where Brett is trying to get his homework done, but is having great difficulty understanding the details. He wants his dad to come and stand by the computer while he works, so he'll be available for questions. Dad says "no", so Brett comes up with a strategy where he prints out multiple versions of his written work and brings them out to his dad for editing. Meanwhile, his older sister takes issue with the fact that he's wasting paper doing this ("You're killing all the trees!"). Square 2 shows how "happy" he is to be doing his homework. Square 3, the torture continues as dad edits and changes are required. In square 4, he gives up and simply hand-writes his last version. The circled numbers included in the pictures represent how "hot" Brett reported himself to be on his "angrymometer" (from Tony Attwood's techniques) as the incident evolves. In square 6, Brett comments that "Dad screws everything up". Once we knew in detail what was behind the outburst in class, it was possible to make effective strategies for "next time".

Brett is currently finishing high school, and these techniques have helped him to become an effective and flexible social problem-solver (with an excellent "dark" sense of humour that helps to counteract his angry reactions to social mis-steps). His perspective on everyday social interactions is often surprising and always enlightening.

When I spent a lot of time in the schools, I used this type of problem-solving on an almost daily basis. It's something that can be developed with any ASD student, whether they know how to draw or not. All you need is some paper (or a chalkboard) and practice at rendering key parts of a social situation in simple line drawings (it's not "great art", it's visual information - stick figures are good). I have presented these techniques at many teacher workshops over the years, and a lot of the teachers who attended those sessions have since incorporated the drawing techniques into their "bag of tricks". Let me end with an excerpt from an e-mail I got a few days ago from a long-time teaching colleague and friend (after she took a look at the website and blog):

"I use cartooning all the time ... daily in my job as High Needs Coordinator .... This method works every time for me as we attempt to uncover the truth about 'what really happened when you lunged across the table and squeezed the living daylights out of that kids arm!' It's amazing what we learn ... and we always do the Next time .... which does really prove to work over time."

It's not rocket science, and it does work - take a chance and give it a try!