Parent Support University: Week 2

April 8, 2020

AnswersNow Chief Science Officer, Adam Dreyfus, speaks about the topic Cognitive Behavioral Intervention and answers questions live.

Transcript:

Speaker 1 (00:01):

Hey Facebook family Adam Dreyfus here from AnswersNow, sorry for the slight delay. Mild technical trouble. I don't know about the rest of you, but the internet connections are not doing great these days. I live in a kind of mid sized condominium complex, but everybody is watching Netflix right now, so it slows stuff down. We appreciate all the parents out there that are signing in and checking us out. Again, I'm Adam Dreyfus. I'm the chief science officer of AnswersNow. What is AnswersNow?  AnswersNow is a mobile platform that connects you directly to your own live clinician. I've been doing this a long time and one of the reasons that AnswersNow was built four years ago was because my co-founder and I were both clinicians were really frustrated that parents of children on the spectrum and adults on the spectrum did not have enough access to the so called experts.

Speaker 1 (00:57):

And more importantly, the experts weren't doing a great job of explaining to them how to do this expert stuff. Because one of the lesser known facts about autism therapeutic treatments is a there's a nobody here from there is no medication for autism. There's no blood test for autism. And all of the therapies that understood therapies are all behavioral, which just means it's one person working with another person. So we hear from parents all the time. Hey Lauren, nice to see you. Lauren sent us a very nice email, just one of our newer clients. We connected her to her own clinician and things are going really well. I think this is her first AMA, feel free to ask questions, Lauren along the way. So this is our, I want to say third, fourth one.

Speaker 1 (01:48):

So what we're doing in this long series, we're going to do about 20 of these is we're going to unpack all of the little things in the expert toolkit and kind of demystify them for you. So last week we did antecedent based interventions, which is a fancy way of I'm going to convert it to parents speak. I've got two kids, is there something I could do before my kid pops off that will prevent him from popping off? That's what an antecedent based intervention is. Antecedent just means before, before the date behavior. And so we talked about that. And we're just going in order right now. And so this week is going to be cognitive behavioral interventions. One of the things I realized as we got started is almost all of these mention an FBA functional behavioral assessment as a part of their solution.

Speaker 1 (02:35):

Probably should've started with that. But we've got our plan, we're sticking to it. So we're going to talk about how you can help change the way that your kid thinks. Cause for a lot of parents it's kinda of depends on where your kid is on a spectrum. If you have a nonverbal kid most of those upsets are around something very tangible, right? Something happening in their environment right now. Like their iPad ran out of batteries or they communicated to you somehow that they wanted a snack and you bring the wrong snack. There's very few parents that I know of that have not had that moment where they're standing in the kitchen and the kid is screaming and they're going through the fridge, they're going into the cabinets. They're like, do you want this? Do you want this? Do you want this?

Speaker 1 (03:19):

What is it that you want? And it can be super frustrating. That's where kind of the antecedent based interventions can kind of help out. But these what we're talking about today is cognitive behavior interventions and these mostly are only effective for kids that have roughly the skill set of their same age peers. So generally cognitive behavioral interventions are not deployed for kids who are several grade levels below. You know, like if they're, if you're an eighth grader but your sort of developmental capabilities are at first grade level, probably not going to have somebody suggest cognitive behavior interventions. So this is more for an we don't it's not the exact word anymore, but more for your kind of Asperger's kids, right? You're kind of higher functioning kids and their behavioral issues are around a lot of negative self thinking.

Speaker 1 (04:14):

So it is a, you know, Oh, I'm terrible. Oh, that person doesn't like me. Oh. So, and their behaviors can be intense, right? Like it's a, it's, it's not different than any other kid on the spectrum. These behaviors can be persistent, intense and caused quite a bit of trouble for the individuals involved. Most of the time we frame this as or is it aggression? Are you trying to hurt someone else or is it a self-injury? Are you trying to hurt yourself? So the types of behaviors that can be effectively remedied by cognitive behavioral interventions are in the same category as the ones that you would use all of the other ones for it. So we're going to unpack that a little bit tonight. And what we are using is the affirm modules.

Speaker 1 (05:02):

The affirm modules are free modules that you can take wherever you want, whenever you want. If you go to the national professional development center, I'll get that link up here in a second while I can kind of get going. And you can, it, it teaches you how to kind of do these interventions. And we love it because it is right with our core mission. This stuff is free. It is available. Yes, it is nice having someone like myself who's been trained in this stuff to kind of help you walk us through it. But the truth of the matter is you can practically learn it all for free. So AnswersNow is all about reducing the barrier of entry for you, the parent to this information. So you're not as isolated, you're not as stressed and you're not as overwhelmed.

Speaker 1 (05:43):

That's our core mission. It's the everything that we do revolves around that core piece. Ah, and I'm thinking that little hearts, Oh, we got some folks in here. That's nice  to see you Sasha. So before we do that, I wanted to talk about something that a lot of you, so I'm assuming everybody who's watching this has a family member or a child that is on the autism spectrum, which would mean that you have an IEP, an individual education plan either in your kid can be at a public school, at a private day placement, doesn't matter what you've got an IEP. So here we are in day whatever, 25 of the Corona virus. And what you are seeing happen is that a lot of the school divisions are reaching out to parents and saying, Hey, we need to amend the IEP to reflect the current situation.

Speaker 1 (06:39):

And that should make you a little bit nervous because they don't need to amend the IEP because of the current situation.  I was on the phone with the school division earlier and what they wanted to do is they're going to amend all 2,600 of their IEP to reflect, to put on hold the goals that they don't think that they can reasonably accommodate or reasonably be successful. Tackling just through remote education which makes sense. Your IEP goals, your schools are required by federal law to show progress on every single IEP goal. So if you're a school and you're in a situation where you can't show progress on the goals for whatever reason, it is, I get it in their best interest. But what you're seeing happen right now is the schools are using this fog.

Speaker 1 (07:38):

It's one of those things I've heard in the news quite a bit. The fog of the coronavirus and the anxiety around it to call these identify IEP meetings. And then like, say your kid has some sort of special, you have a one-on-one or, and they'll say, Oh, well, you know, we're not, nobody's doing the one-on-one right now because your kids at home and we're all practicing social distancing. So we need to write that out of the IEP. Well, good luck getting that back in there on the backside of this. Much more devastating impact on parents would be, you fought long and hard to get your kid into a private school. That is the kid is being successful at and you love it. Now the kid's not going to that school. Hopefully like my school. That school will be attempting to do as much education as they can remotely.

Speaker 1 (08:31):

Some kids are really severely impacted. They're not going to sit in front of a computer, they're not going to work with software. But there's a lot of supports that you can kind of get. So, but this is going to pass. You know, I mean it's might take a little while, but at some point we're all going to be back in school and if you amend your IEP so that they write out of it that you get a private day placement, you now your kid just goes to whatever public school. They are associated with you know, every kid, even if they go to a private day placement has a school, the public school that is their homeschool. And for most of our kids, that would be not a great outcome. That would be taking them out of an environment that they're being successful on and putting them back in one in which they were by definition they fail that.

Speaker 1 (09:21):

So happy to answer questions about that. I know it's a little aside, but it has come up quite a bit in my life. Parents contacted me like, Hey dude, my school wants to do an a IEP. I'm like, well, heads up and here's the kicker. They can't make a placement change without your permission. They may frame it like they can. And I usually don't speak this way about the public schools. I worked with public schools all the time. They're 99.9% of them are great people trying to do great work. But it is not past them to make decisions that are not necessarily in a children's best interest. I don't want to say especially, but certainly in my experience, children with severe disabilities and this is one of those times where there's one school division here in Virginia that is trying to bring all of their kids out of private day placements and back into the public school through unbending, their IEPs.

Speaker 1 (10:15):

So this is one of those things that we can help you with. This is a great thing to talk to a clinician about how to communicate, how to advocate for yourself, how to make sure that your rights are being preserved and protected. So that was a little bit of an aside. Let me get back to and I am seeing the comments here. So it's nice to see, I've got a couple messages coming in,  I want to check that. And Nope, that was other stuff. Ah, sorry about that. Just do a little time check. Here you are listening to Adam Dreyfus. That would be me getting increasingly furry. I don't know how you guys are handling haircuts. I have a five year old and a four year old and I think what I'm going to have to do is let my five year old kinda take care of business with some clippers.

Speaker 1 (11:04):

Otherwise it's going to get a little bit more out of control. The joys of quarantine. So we're going to talk about cognitive behavioral interventions. I would say, raise your hand if you are familiar with those. So this is an evidence based practice that has been proven to be very effective at helping certain kinds of behaviors and certain kinds of kids. These are the kids who their behaviors are mostly driven by the thoughts in their head, right? It's not just that they're not getting something that they want or they're seeking something. It's that they've got thoughts in their head negative thoughts. So cognitive behavioral intervention for those who have zero experience of it is not that much different than saying change your negative thoughts to positive thoughts. And I'm sure there's going to be some psychologists and some therapists who will get upset with me for that.

Speaker 1 (11:54):

But that's basically what we're talking about here. Now we want to create a little context for this. So a lot of behaviorists, myself included, will argue that, Oh, the, it's the environment that causes most of the behaviors. That's still true. It is also the environment that can change the thoughts that you're having in your head. Like you might be in a pretty good mood, right? You're like, Oh, my life is pretty good. I'm in  a good day. It's sunny. You're walking down the street and you see somebody that you don't like. Now there's a million different ways that people respond to that. But some folks just default into really negative thinking very quickly, very harsh, negative thinking. You know, Oh, that person must be here to make me feel bad. Right? They're very personalized to it. So we're, that's what we're talking about.

Speaker 1 (12:43):

We're talking how do you change the thoughts around? There's a lot of different sorts of techniques that fall under cognitive behavior intervention. If you are seeking out a clinician who can help you out with this specific intervention package, you will want to make sure that they have some specific training in this. It's not like every therapist knows how to do cognitive behavioral interventions. It's a very specific type of intervention. You'll want to know that they were either mentored by somebody who taught them how to do it or that they had significant professional development. They took some courses. They trained themselves. They  might be certified in it.

Speaker 1 (13:28):

Melissa is asking what's the difference? Student cognitive behavior intervention and cognitive behavior therapy. Nothing. The intervention is just a specific type of a cognitive behavior package that they use. I'll list through some of them. And cognitive behavior therapy is just the umbrella that they fall under. But that was a great question, Melissa. And that's exactly why we're here. This stuff is confusing. It's lots of words. It's lots of acronyms. You know, CBI, ABI, BCBA, ABA. It is not a, I think part of the problem with parents and caregivers being able to access all of this information is the experts create language and create barriers to make it hard to get to this information. So they'll create a lot of language that if you don't understand that language, it's like me picking up a music book. I don't know how to read music. I won't be able to do anything with it. So that's why we're here, Melissa and Lauren. Is to help demystify this and ask, answer questions like that. So cognitive behavior therapy or cognitive behavior interventions are guided at the thoughts. Now here's one of the things I would, I'm gonna ask you to sorta come down the path with me a little bit. Cause this can be a little bit confusing.

Speaker 1 (14:49):

The thoughts that you have in your head, the voice that you hear. Like, if I stopped and counted to 10 in my head, that thing, whatever that thing is that I'm listening to inside of my head is not you. Cognitive behavior therapy is based on this premise that you can change the thoughts and in changing the thoughts, you'll change your whole experience. Almost every religion has the same kind of idea behind it, right? Like there's a great quote that says “moving a muscle changes a thought”. And it kinda combines what we're trying to do here. Like if you do something differently, you will think differently. So a lot of cognitive behavior interventions are about recognizing your thought, but then doing some behavior that is in opposition to that. As I go through some of the explainers, it'll make it a little bit more sense.

Speaker 1 (15:45):

But the best way of saying it is that voice in your head is not always your friend. So you don't have to be on the spectrum to understand this. You don't have to have Asperger's, you don't have to have some sort of mental health issue. You just have to be a perfectly normal human being who may be at one time or another heard a voice in their head. It sounded like them. That was like, you're not a very good person. You're kind of pale, kind of. Frankly. I'm just telling you my voice, the one that is not my friend, where I was like, Oh, maybe you are really pink, your hair kind of wavy, would be better if it was straight. People don't really like you. You're like, yikes, that's not, that is not helpful. And it was, Oh no, you know, that's who I am.

Speaker 1 (16:26):

That's what guides me. I'm like, right. But that same thing guides people into all kinds of behaviors that are crazy. Risk taking behaviors, you know driving too fast or doing drugs or getting in fights like, yeah. Yeah. Seemed like a good idea at the time. You talked yourself into it and I deserve it. I'm going to go over there and I'm going to teach them a lesson. And then you're in jail. So sometimes the extreme examples help. So how do we help? Kids mostly or young adults or even adults change their thinking. So happy to answer any questions as we go along. I want to go through some of the and this speaks to what you were talking about Melissa. So one type of cognitive behavior intervention. Do I need a time check?

Speaker 1 (17:15):

Yeah, we definitely need a time check. I'm Adam Dreyfus with the weird hand things that I do like this. Not sure why. It looks like a minute I'm selling something. I am the chief science officer of AnswersNow that you can find on getanswersnow.com. Or you can download straight off of your phone. You can just go to your app store or, and download it and you type in AnswersNow. All one word, no space. And then you'll see our little purple logo with the  butterfly. You can download it for free. We've got all kinds of free content. You can join one of our communities where you can talk to other parents about a wide variety of issues. You can read our blogs, check out our tips.

Speaker 1 (17:56):

But the real, the core product is, that we can connect you directly with your own clinician who can help you with understanding all this kind of stuff. So cognitive restructuring or reframing is one of the most common types of cognitive behavioral therapy. So what does that mean? Cognitive restructuring? All that means is you're going to try to reframe the negative statements in your head in a more positive way. So I got an F on the paper because I'm stupid, right? That's something that we hear a lot with some of our high functioning kids and not even know. I've dealt with kids who are like, I got an A minus on my paper and I'm a moron. And they personalize it. And it speaks to some fundamental flaw, right? They're stupid. They're not ok.


Speaker 1 (18:51):

But you can reframe it. Math is really hard and nobody gets all of the questions correct. Exactly the same voice in your head, very different content, very different impact that it has on the individual. So cognitive restructuring or reframing basically the intervention there is: see if you can help the individual become aware of the thoughts that kind of bring them fully up to conscious. Like what is it that you're thinking right now? Either write it down or say it out loud. That's really powerful cause most of us don't have sort of a, we're not a hundred percent conscious of the thinking that is going on all of the time. And it can be kind of like, Whoa, I didn't know I was that negative. I don’t know  if you've ever had a conversation with somebody who is a glass half empty person.

Speaker 1 (19:45):

But  they don't think of themselves that way. They're not like “Oh yeah, I'm just really negative. That's who I am”. But you talked to them about stuff and everything kinda is framed in that things aren't gonna work out. It's not a good idea. I had a friend who did that and he broke his leg. They will frequently use terms like, well, it's just common sense. Everybody knows that. But it can have a really negative impact on their life, right? Like these negative thoughts prevent them from doing things. A good way of thinking about a lot of the types of issues that come up in cognitive behavioral therapy is that it's avoid, right? You're trying to avoid something that is causing you anxiety. That's generally a core sort of factor in almost all of this. Once you peel the onion a little bit you know, the person refuses to go.

Speaker 1 (20:46):

Your kid refuses to go to social studies and world history and language arts just flat refuses. And if you try to make them, they will get violent. And it turns out because they don't read very well. And all of those classes have a lot of reading that you have to do out loud in front of your peers. And they would rather get an F and go to detention, then read out loud in front of their peers. So the behavior is and what they're telling themselves. You know, there's a million things they can be telling: “I don't like the teacher. This is stupid. I don't need to know this stuff”. You've as you parents, you probably heard all of it. Feel free to share some of it if you would like to.

Speaker 1 (21:31):

And so reframing that cognitive restructuring would be these classes require a lot of reading. And that is not my strongest suit. But reading like every other skill is a learned skill and I can get better at it. So I'm going to learn how to read better and then I'll feel more comfortable in those classes. And some of the accommodations that you could make with the teachers are, don't call them to read. Like, I want my daughter or my son to know that when they're in that class, there's no chance that you're going to call on them to read in front of everybody. It doesn't mean they're not going to do the work. It doesn't mean they're not responsible for making sure things are turned in. It doesn't mean that you're not gonna tackle reading as an issue, but you take off the table, the thing that frightens them the most.

Speaker 1 (22:19):

So we've got a question here from Melissa. Love the questions. Melissa, can a normal CBT therapist be effective working with a child with autism to change their negative thoughts? Or should it be a therapist who is specialized in the field of autism? Also, does CBT work for kids who get stuck on a thought and won't let it go? Those are great questions. So yes and yes. There are plenty of in fact, there are way more therapists who specialize in cognitive behavioral therapy than there are therapists who specialize in autism and cognitive behavioral therapy. You don't, it is nice to have somebody with some experience with autism. But what you're really looking for is somebody with experience with cognitive behavioral therapy. And so yeah, and I would also think of it, we're always thinking of the parent is the CEO, right?

Speaker 1 (23:16):

Of all the resources that I need to come to bear to help these children out. And so the cognitive behavioral therapists would be part of the team. And you'd be able to rely on some of the expertise, maybe your speech pathologist your BCBA, the teachers, you, right, who's the better expert on their own child, then the parents. And yeah, CBT is absolutely for kids who get stuck on a thought and won’t let it go. That's probably one of, it's a primary functions. So great questions, Melissa. Keep them coming. So we touched base on cognitive restructuring. There's guided discovery, so I'm just walking you through some of these terms as they might come up. So in this place the therapist kind of gets, gets an understanding of your viewpoint and then tries to illuminate how that might not be working great for you.

Speaker 1 (24:12):

But yes, those are your thoughts. And yes, they have a value and you believe in them very strongly. But there might be some other perspectives that you might want to take. So this looks, sounds and feels more like what most of us think about when we think about therapy. It’s the kind that helps you get to a place where you just look at things a little bit differently. So this guided discovery will look, sound and feel almost identical. The one that really freaks one out, someone out or freaks people out is exposure therapy. Can you guys take a stab at what exposure therapy probably means? It means exactly what it sounds like. We're going to expose you to the thing that you're trying to avoid. You don't like loud places. We're going to go to football games.

Speaker 1 (24:59):

You're afraid of water. We're going to the beach. There's all different ranges of exposure therapy. So there's the, Hey, I'm just gonna. It's called flooding. I'm going to put you in a situation like, what was that show where they eat animals and stuff like that. And spiders, I forget the name of it was with Joe Rogan. That was a near perfect example of flooding. Like, we're going to put you in situations that freak you out. You don't like snakes? We're going to put you in a box with snakes. That is generally not recommended. Although sometimes it's usually very gradual. You know, you're really afraid of the ocean. All right, well, we're going to drive past the ocean. You're not going to get out of the car. We're not going to stop. We're just going to drive past it.

Speaker 1 (25:43):

You're going to have your response, right? Like, Ooh, getting kind of scared. But then you just keep driving and it goes away and then you come back down. And if you do that a few times, you get, you don't get overwhelmed, right? You don't get and so they're like, all right. Now that we're getting to a point where we kind of come up and we're being able to control a little bit, we're going to drive to the beach, we're going to stop. We're not going to get out of the car. We're not going to go up to the water. We're just going to stop until you can tolerate it without feeling overwhelmed and then it's just baby steps until you are surfing. Hopefully that makes sense. So that's exposure therapy. Very, very common, very, very effective. If you were a parent on our platform and you had an issue with your child that was a fear and anxiety it's a near certainty.

Speaker 1 (26:39):

The clinician would be like, well, let's try baby-steps. It can be loud noises. And so one of the very common sorts of exposure therapies to that, and I've done this before, is you can get a CD that has a lot of environmental noises, buses, cars, stuff that happens out in the world, and it's kind of loud. And you just put a headset on, play the CD very, very low. And then a little louder, a little louder, a little louder, little louder until they can tolerate a pretty loud, like, what's the big, loud thing that happens at schools all the time and causes so much: the fire alarms. I can't tell you how unpleasant our staff at the school believes that the fire drills are. There's the state requirement for how many we do.

Speaker 1 (27:27):

And we kind of quadruple it. Why? Because one of the reasons the kids are at our school is that they have not been able to tolerate the environments that they're in. So we have to teach them through exposure therapy to be able to tolerate those things. Cause if they're going to be in a regular school, it's going to have fire drills. All right. So we did exposure therapy moving right along journaling and thought records. Not very many of the kids I work with can read and write. I work with more severely impacted kids, but there's tens of thousands of children on the spectrum more than capable of journaling and recording their thoughts down. This is just another way to, like they said with the cognitive restructuring, bring it up into consciousness so that you're aware that this is actually what the words are going through your head.

Speaker 1 (28:21):

And then you share them with somebody else, a therapist and that you begin to maybe see that there's other perspectives. One of the ways, a couple of the ways that the people do that is a role play and modeling. So one of I was working with a young man in a high school and he was terrified of going out into the hallway between classes because there were so many people, it was so overwhelming for him. So he refused and this became a problem, right? Like you're not going to your next class, you're late to class. These schools are very sensitive about their schedules being kept up. So my first suggestion was why don't you just let him leave early? You know, let him leave three minutes early to his next class so he can walk in an empty hallway and then the bell rings and everything goes crazy.

Speaker 1 (29:09):

And he just steps into the new class. He didn't like that idea very much because he had so much anxiety that he'd be caught kind of in the middle of the hallway. He won't have made it to his class. And so we unpacked a little bit. We kinda did a cognitive restructuring. We said, well, what is it? What are you thinking as you're walking down the hall? Nobody likes me and everybody's out to get me. And I said, well, that would be really scary if you were walking down a hall and it was full of people. And you were convinced that everybody in that hallway did not like you and further that some of them wanted to get you. Yeah. That would be a hard level of anxiety to overcome. So he and I started going to our little forays when there was very few people in the classroom.

Speaker 1 (29:56):

So we'd come across somebody or a couple people, and I'd ask, what are you thinking right now? “That girl doesn't like me and that guy, he's going to come over here and he's gonna punch me.” I'm like, Oh wow. Why do you say that? “Oh can't you tell? Like it's obvious? Like he's looks like he's going to come over here and he's going to punch me.” So here you had a near perfect example. I would look at them and there's just two kids walking in the hallway and he wasn't bullied. He didn't have a history of getting beat up. But these are, this is his thoughts, right? These are the thoughts and it made it a, a crippling form. So what my first step doing was I would narrate what was going through my head when I was walking through the halls.

Speaker 1 (30:34):

So it was kind of modeling the thoughts that I have. And so, I'm going to open the door. I'm going out into the hall, I'm going to English class. I've got Matt with me. He's wearing a red shirt. The lights are kind of bright. Oh, here comes somebody. Yeah, she looks really nice. She's smiling. She's checking out her phone. I bet she's checking in with her parents. It looks like that's probably what she's doing. Oh, here come a couple of big guys. Looks like they're on their way to soccer practice. They'd see they have their bag over their shoulder and at first he wasn't very receptive to it. But then what I started doing is narrating from his point of view, Hey, my name is Matt. I'm on my way to English class. I'm wearing a red shirt.

Speaker 1 (31:14):

I'm walking next to my buddy Adam who comes in here. He's wearing a blue shirt. Oh, here come a couple of girls. One has brown hair, one has a blonde hair. Oh, the blonde haired girl smiled. That usually means that she's... so I narrated kind of over his tape. And that worked. What that did is it started giving him sort of new tape to work with that had what's the word? Positive messaging. I would say it's more neutral kind of messaging, not negative messaging. But just very matter of fact, what I tried to do is sort of remove emotional content out of it. So it wasn't about who was trying to get him or what it was. What, how do I pull information out of the world that helps me make decisions? Reading people's faces, reading their body postures, reading how fast are we there?

Speaker 1 (32:01):

All the things that so-called neurotypicals I don't know about you. I don't think I've ever met neuro-typical but so-called neurotypicals are pretty good at this. Like if I'm walking down the hallway, I'm pretty good at knowing whether or not somebody is an actual threat to me. There's a profile that we are like, Whoa, okay. That person, we've all been in a store or in a movie theater or wherever. And usually it's tone of voice, right? Everybody's kind of talking and then somebody talks with a really hard tone and boom, man, it gets your attention. Like, that's not all right. That's what's going on there? Tone of voice. People moving faster than they should. There's all kinds of different ways. So that's one, that was a very effective, I like the little hearts that we got there. So we're still talking about cognitive behavioral therapy which is an evidence based way to help kids change negative thinking. So we've talked about cognitive restructuring, exposure therapy, journaling, writing. I should have these windows set up a little bit better. So activity scheduling and behavior activation, those are fantastic ones. That basically means, hey, there's something that you don't want to do. So you schedule it and you put it on there so you know what's going to happen. You can prepare for it. Cause a lot of the stuff that really

Speaker 1 (33:25):

turns kids sideways are things that kind of happen out of what they consider out of nowhere and are surprising and just think of whatever your fear is, right? Like people are afraid of bees. Well, most of the time they're not afraid of a bee until they see a bee. Right? So it's the same thing with the thoughts. Like most kids are not afraid of the hallways until it's a hallway full of kids at school at a certain time, otherwise not a big deal. So you want to schedule the activity. And you also want to, don't forget like schedule the good stuff like you, they're not going to want to do a whole bunch of, hey, I'm going to spend the afternoon. All I'm doing is doing a bunch of things. I want to check the messages that we've gotten really quick. 

Speaker 2 (34:14):

And 

Speaker 1 (34:17):

That was just my cofounder texted me about a meeting tomorrow. I'm probably not where I should be checking right this second. So Melissa, Sasha and Lauren, feel free to chime in and love the hearts, love the interactions. Feel free to ask plenty of questions. I'll do another time check here. And all the, I mean by that is I am Adam Dreyfus. I'm the chief science officer of AnswersNow. AnswersNow it’s a mobile platform that connects parents directly to their own clinicians. Which in the greater scheme of things, all we're trying to do is reduce the barrier of entry for parents like you to get the answers to questions that you need and to get the support. And not just like a one off, like how do I teach my kid how to, you know, eat cheese or something like that.

Speaker 1 (35:00):

But almost all of this stuff, almost all of these challenges, there is no quick answer. There's no therapist that's going to come in and go, Oh mom, if you paint your house red, then your kid's going to follow all your directions. It took years and years and years and years for the behaviors to get to where they're at and it's going to take a little while to unwind them. But I can see with certainty you can unwind them. There are no behaviors that I've ever seen that don't have a medical basis. Cause that's one of the first things that a good clinician will do is rule out medical issues. You know, the first I do if I see a kid punching himself in the face, I want to know when's the last time you went to a dentist because I've seen a lot of those behaviors that are the result of that.

Speaker 1 (35:45):

Like, Oh, we don't go to the dentist. The dentist is terrible. Like he, it's been five years since he's been to the dentist and it can be quite an ordeal to get to a dentist. And that situation usually requires sedation and then they look and you've got unbelievable like impacted teeth and the reason they're punching themselves in the face is it hurts like crazy. And so you definitely want to make sure, especially with a fairly extreme behaviors that you rule out medical causes right off the bat. There's also a lot of behaviors that can be caused by medicine changes. Our kids, even though there's no medicine for autism, most of the children on the spectrum, are on some kind of medication, it can be an anti-psychotic, it can be a sedative. Those are the main ones. Anti-Anxiety. These are really, really powerful medications generally just for adults or prescribed for adults, but they will be prescribed what they call off label to kids.

Speaker 1 (36:40):

There's most of these medications these kids are on have not been tested on kids. And so apparently Micah said, well, I don't like the, you know, maybe he's putting on weight because of this medication. I'm going to take him off this medication. That can have a really serious impact on the children's behaviors. At our school when we see some big change in behavior,  so the first thing we would call home, “Hey, is there any changes that we need to know about?” And sometimes it's medication, sometimes it's a death in the family. It's some big event. So back to cognitive behavioral therapy, we've been going for a little bit now and I don't want to change gears, but I want to introduce another term. ACT, acceptance, commitment therapy. This is a another type of therapy that is very, very similar to cognitive behavior therapy also kind of flows out of the behavior analytic 

Speaker 2 (37:38):

Oh yeah

Speaker 1 (37:40):

traditions and research. And it's very popular these days. So it's exactly what it sounds like. Acceptance, commitment, therapy. So a lot like cognitive behavioral therapy. You want to bring to 

Speaker 1 (38:02):

awareness and your thinking. And except that it's okay that you think that way. All right. It's OK if you have violent thoughts. It's okay if you have weird thoughts. It's okay if you have self-harm thoughts, thoughts in and of themselves aren't hurting anybody. So you accept like, all right, I'm not a bad person because I had these thoughts. And then there's a commitment component to some kind of behavior. Like we were talking about cognitive restructuring, exposure therapy. I'm going to do something that's going to hopefully change those thoughts. Again, one of my favorite, I don't know what you call it, mantras move a muscle, change a thought. Move a muscle, change a thought. Most of our bad thinking takes place when we're sitting very still, like sitting on our couch, sitting in our bedroom, sitting by herself and it's just us and our thoughts.

Speaker 1 (38:51):

So move a muscle change a thought is a very powerful thing and that's what we're, that's where that intersection of the the voice in the head in the world comes in, get out, go for a walk, go for a bike ride, go get a pizza, something move a muscle, change a thought. And that is acceptance, commitment therapy. There are way more CBT therapists out there, cognitive behavioral therapists, but there's a growing number of ACP therapists. And here we go with all these acronyms. But it's the same idea. How do I reframe the thinking in my head so that it's not working against me so much? I would recommend both especially if you've got a high functioning, nobody's come up with a better word. I'm, I'm an old guy. So high and low functioning are kind of baked into my vocabulary, high functioning kids who have really high levels of negative self talk that really impact their family life, their academic life.

Speaker 1 (39:51):

I would look at either of these acceptance commitment therapy and cognitive behavior therapy. Both are evidence-based, both are proven to help and both have strong literature, backgrounds and resources that specialize in helping kids with autism spectrum disorder. So you don't have to go far. Like you literally just type in cognitive behavioral therapy and autism and there'll be books, there'll be articles and there'll be resources that can help you out. It is also one of the ways that we can help guide the process a little bit and help you sort through the weeds either by coming into one of our communities and touching base with some other parents. Go to getanswersnow.com, click get started and you can join those community groups for free. You can download the app through the Google Play Store or the App Store and get connected to your own Adam, it’s like a little pocket Adam that you can carry around and ask things about.

Speaker 1 (40:55):

So, yeah, those are the best ways. If the one of the things that trips people up when they go online sometimes on their phone, just type in AnswersNow, all one word, if you make it into two words, which makes sense. Like that's the first time what I did. I had two words. You don't always get to come across our app, but if you type AnswersNow all sort of squished together, just like it shows you up in the window there, AnswersNow for autism parents it'll come right up. I myself am active in the communities and so I'm happy to meet you there. And then you don't have to look at my ever-increasing goofy hair. Wanted to create a little bit of room as we kind of wind down for any other questions that might come in.

Speaker 1 (41:40):

We also this is our sort of plan, Parent Support University, we're trying to unpack all of these mysterious tools that these mysterious BCBA used to help you and your kids. But if you have a specific topic or something that you would like us to cover in this format, we're more than happy to, you can feel free to email me personally, adam@getanswersnow.com or our general email: support@getanswersnow.com. We've got a whole team that their whole purpose is to try to help you out. And to get answers to your questions and to another way that I think of things. How do we reduce anxiety? We are not thinking creatures that have emotions. We are emotional creatures that happen to have thoughts. And that is one of the strengths of cognitive behavioral therapy and acceptance commitment therapy is that it is much easier to change someone's thoughts than to change their base emotions.

Speaker 1 (42:44):

People are going to react the way they react. By and large you can learn to kind of turn that dial up or down and if you're gonna use this tool in your hand, the words, you know, like they say like, I don't like public speaking. People are like, yeah, you know, the scariest thing out there is to have to do a public speaking. I get it. I don't like being on stage. People, I said, Oh, just imagine everybody naked. And then that'll kind of calm you down. It just imagined something else. Have some other voice in your head other than, Oh, this is going to be a terrible experience. Anything that you kind of say to yourself will be more effective than the stuff that is causing you huge amounts of anxiety. All right, well with that, I think I'm gonna wrap up cause I'm finding myself rambling a little bit and I definitely don't like doing that.

Speaker 1 (43:30):

I think we've talked about cognitive behavioral therapy very nicely. It's been nice having Melissa, Sasha and Lauren with us and I see some other folks that are in there. As always, we're here in a wide variety of ways for you to reach us. We definitely encourage you to go to getanswersnow.com and check us out there or to download the app. And with that we'll bid you a fair ad on this Wednesday night. We've now covered two topics and based interventions and cognitive behavioral interventions. I forget exactly what's up next week. I probably shouldn’t. But I look forward to talking to you guys soon, and thank you very much.


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