Transition to Adulthood

The strategy that I will use to promote independent living for Adam is focusing on basic social skills. Initially I will focus on the ability to identify his frustration before meltdowns, which usually means running away or self-injury. I will have Adam identify 1 activity he can do instead of running away. He can choose to hold a squeezable ball or other object. I would like him to squeeze the ball instead of running away. I will encourage his mother to carry this over at home. In addition, stopping and starting will be addressed by having him engaging in a grocery cart activity. I will have him start and stop so he begins to understand this concept more clearly. His family has learned to anticipate his breakdowns and have removed many issues. This appears good but environmental complexity is reduced and he does not have to deal with his all-or-nothing responses to stimulation. These are basic skills but will be necessary for the future when he will need to interact with others, participate in school, and pursue an occupation.

The strategy I will use to advance vocational awareness is empowerment to the family. Since this module I have discussed the importance of talking to Adam about having a career just like they do to their other 3 children. Adam’s mother was encouraged and open-minded when discussing these strategies. In addition, I will educate them on the importance of looking at vocation as a longitudinal goal. They can start to focus on extreme areas of interest and talk with the entire family about Adam pursuing a career one day. Talking to Adam in daily conversation about careers is another way to teach him and the family to have occupational expectations. In addition, this is a good avenue to reiterate the importance of social interaction development, since it is a skill needed for the work environment.

Thank you all to Adam’s supporters, your feedback, suggestions, and learning opportunities. I wish everyone the best with your future case studies!

Adam’s family’s well being is very good considering they have 4 children and 2 with the diagnosis of ASD. Church is a large part of their life. They describe their marriage as strong and supportive. They do have limitations in what they can participate in socially do to Adam’s poor modulation. Since reading this section, I began to talk to Adam’s mom about the social issues and how important they are for Adam and the family. She was a little fearful of change due to their busy schedule and factors involved in managing 4 children. My strategy at this time is to identify this issue as important with his mom. I requested she provide me with an activity we could address that the entire family would like to participate in, but is challenged to at this time. I could tell she was surprised that I addressed this issue, but acknowledged the importance of social interaction relating to the entire family. The next session she came up with a concern about their family home schooling conference in Indianapolis. She wanted all of her children to attend the children’s session so she and her husband could attend the adult sessions alone. After learning this, Noah and I sat down and wrote a social story of 6-7 pages. I asked Mom to read this everyday before leaving for the conference to prepare him. Adam’s Mom contacted me via email to inform me that the conference was a success! Adam attended the children’s sessions without difficulty and the parents attended their training alone. She stated she could not explain how thrilling it was to attend something for an entire weekend that the whole family enjoyed! Per the Quirmback article social stories were effective in improved game playing abilities with children with ASD. This is another option that may prepare and teach Adam about the upcoming family event.

Living with autism;Family's well being

Social Skills and Perspective Taking

Adam’s social referencing occurs toward his mother and father at times. He uses them as a safety net whenever there is something he does not want to participate in. He looks toward his mother for approval, but not necessarily to learn how to react or respond appropriately to others. Adam is very concerned with doing something right. If he feels he will do a task wrong he does not want to try or becomes angry immediately. If Mom has a calm, happy face in order to persuade Adam to participate, it is not very effective. She has more success than a therapist does, but Adam is rigid with this thoughts and feelings. This is a challenge because he is not able to understand on an emotional level that others have thoughts and it is important to consider others. This is a clear example of Adam’s deficit of Theory of Mind defined as the inability to understand that other people have thoughts, beliefs, and feelings that are different than their own (Miller-Kuhaneck).

Adam makes eye contact at times and recognizes individuals at the therapy clinic. Emotion processing and face processing challenge him. Adam is easily over stimulated. If I give praise or facially gesture that he has performed well, he covers his ears and says “no” while stomping his feet. He is sensitive to voice fluctuation. Adam typically avoids looking at my face or others when interacting. As I write this I can see how higher-level skills of emotional processing or Tom will be negatively impacted by avoiding eye contact. Adam’s challenges of face processing and emotional processing are over whelming for him. In fact, I will start at the basics for Adam and use Amy’s suggestion of labeling and matching emotional expression cards. As pictured above, I located this and will work on it with Adam. As I think of Adam’s future, I see where these skills will need to be incorporated in the treatment plan and his abilities will need to be challenged and expanded.