Wednesday, May 19, 2010

This Is Your Brain on Netflix

One of my listmates compared executive function challenges like to having a Netflix brain. No matter what happens the Netflix brain will take the next step, just as the movie provider will send the next DVD in the queue. In real life, events happen that cause us to shuffle our priorities. Suppose you are reorganizing the garage and you managed to clear off one shelf. A huge rainstorm comes and you notice a leak that drips on boxes of clothes on the other side of the garage for the next yard sale. You are going to move that box, get a bucket to catch the drip, and, if the leak is severe, take steps to make the repair. A person with a Netflix brain would continue to clear off the shelves and take care of the leak last.

Beyond planning and prioritization, many aspects of executive function affect how children in the autism spectrum perform life skills. For example, they have a hard time estimating how much time something will take and how to split their time to finish the job with good enough results: if they have 20 minutes to do the bathroom, a 30 minute job, then they have a hard time appraising the areas that look the worst and hitting them first. They have a hard time inhibiting impulses so, during the transition from the mirror to the sink, they become absorbed in flicking the light switch off and on for ten minutes. Since cleaning the bathroom is the most boring thing on the planet, they pay attention to something they enjoy instead: replaying a video in their head. On the other hand, they get in such a groove trying to clean every impossible spot off the ancient bathtub that they fail to turn their mind toward the toilet. The CEO in their brain has a hard time with monitoring, either paying attention to too much or to too little, not knowing what to filter in and what to filter out, and setting up new priorities when new information arises.

The other day, I walked our local RDI discussion group through the process of thinking through how to set up an activity like cleaning the stairs. One thing to consider are issues that get in the way. One parent is due to deliver her baby next month, so working on the stairs with her very active son is out. One boy had brain surgery last winter and the stairs are a no-go. We're the only family with stairs, so the others wouldn't be able to do the activity with their kids anyway.

That doesn't matter one bit! The activity itself is not important! The secret is how you frame it for your objectives. Since my friends are in the early stages of RDI, they would focus on parent objectives like going slow and using lots of nonverbal. They might spend the entire time working on head nods and shakes. My objective is focusing in encouraging both of us to listen, process, think, and formulate a meaningful response. The key is how you structure the activity in a way that spotlights your objective.

Tools are one thing to consider. The larger vacuum cleaners would be too much to handle for all of the kids. While the Swiffer wet-vac is light enough for Pamela, it is still too much for the little kids, some of whom fear the noise. They would need to use cloths. The first time we used a Swiffer, I made sure everything was ready to go: it was fully charged with an empty bag and a brand-new wet cloth. Down the road, I will leave it uncharged, full, or dirty for variation and problem solving.

I figuring out roles you need to consider the skills your child has. You wouldn't try the Swiffer out for the first time on stairs: the floor would help build competence. You could still use the Swiffer by having the parent get the big stuff with the wet-vac and the child mop up stragglers a wet cloth. If the child is adept at the Swiffer, then you could switch roles. Attention span is another issue. If your child can only handle an activity for five minutes, then you may want to have three different five minute activities to lengthen attention span or start adding variation or switch roles to spice things up. Novelty freshens the mind as long as it doesn't induce a core meltdown!

Our stairs provided a great set-up for easing into novelty. We started at the top and worked our way down. Every step was the same until near the end, where a wicked turn, odd shapes, and curves came into the mix! If the natural structure of an activity doesn't provide variety and novelty, it helps to think it through in advance: I can miss a spot, drop the cloth, notice that the cloth is dirty, get a new cloth, sneeze because of my allergies, etc.

The video clip of what we did the next day is below. At the top of the stairs is a hallway that makes a great reading nook. Steve sat there while we took care of the steps and observed how much Pamela smiled while we did what is typically a dull, tedious chore. Under the window is a table with family pictures, which were covered in dust. Rather than simply spray and wipe, we talked about every photograph and even had a moment where tears of joy rose up in me. I realized later that we had never had a conversation about these pictures and saw how to elaborate dusting by talking about knick-knacks as we went.

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