Therapeutic Strategies for Adults with ASD. Professional and Social Adaptation

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Abstract

Clinical tools available to clinicians working with autists are mostly geared to the child and adolescent population: providing early intervention therapies, building academic skills, resolving school age behavioral problems etc. Yet, with the first wave of those diagnosed during the recent “autism epidemics” reaching adulthood, and with advancement in age of those diagnosed earlier, there is an emerging need for new methods. Due to the neurodiversity movement and growing self-awareness of the autistic community, grown-up individuals with ASD rely notably less on the strictly behavioral tools and yearn for comprehensive, sensible strategies to address their complex social and emotional needs. This paper examines unique challenges of adulthood that autists face: e.g., finding an authentic professional self, building and maintaining relationships, all while dealing with additional challenges of their unique developmental profiles. It also discusses making choices of therapeutic techniques, and details benefits and rewards of play- and affect-based therapeutic work. Using DIRFloortime and mentalization strategies offers multiple opportunities for spontaneous, improvised psychotherapeutic contact in the context of unstructured playful intervention. Such work is aimed at building the unique support system for autists and for their families and partners. Case vignettes of adult clients with ASD are used.

General Information

Keywords: autism spectrum disorders, growing up, adult psychotherapy, emotional development, DIR Floortime, mentalization, playful interaction

Journal rubric: Discussions

Article type: scientific article

DOI: https://doi.org/10.17759/autdd.2020180209

For citation: Itskovich G. Therapeutic Strategies for Adults with ASD. Professional and Social Adaptation. Autizm i narusheniya razvitiya = Autism and Developmental Disorders, 2020. Vol. 18, no. 2, pp. 63–69. DOI: 10.17759/autdd.2020180209. (In Russ., аbstr. in Engl.)

References

  1. Greenspan S.I., Wieder S. Na ty s autizmom: ispol'zovanie metodiki Floortime dlya razvitiya otnoshenii, obshcheniya i myshleniya [Engaging autism: using the Floortime approach to help children relate, communicate and think]. Moscow: Publ. Terevinf, 2013. 512 p. ISBN 978-5-4212-0148-9.
  2. Baron-Cohen S., Leslie A.M., Frith U. Does the autistic child have a “theory of mind”?  Cognition, 1985, vol. 21, no. 1, pp. 37–46. DOI:10.1016/0010-0277(85)90022-8
  3. Bateman A.W., Fonagy P. Mentalization Based Treatment for Personality Disorders: A Practical Guide. 1st Edition. New York: Oxford University Press, 2016. 474 p. ISBN 978-0-19968037-5.
  4. Bateman A.W., Fonagy P. Handbook of Mentalizing in Mental Health Practice. 2nd ed. Washington: American Psychiatric Association Publishing, 2019. 446 p. ISBN 978-1-61537-140-2.
  5. Benvenuto S. Autism: A battle lost by psychoanalysis. Division Review, 2019, no. 19, pp. 26–32.
  6. Bretherton I., McNew S., Beeghly-Smith M. Early person knowledge as expressed in gestural and verbal communication: When do infants acquire a ‘theory of mind’? In Lamb M.E., Sherrod L.R. (eds.) Infant social cognition. Hillsdale: Lawrence Erlbaum, 1981. Pp. 333–373. ISBN 0-89859058-2.
  7. Casenhiser D.M., Shanker S.G., Stieben J. Learning through interaction in children with autism: Preliminary data from asocial-communication-based intervention. Autism: the international journal of research and practice, 2013, vol. 17, no. 2, pp. 220–241. DOI:10.1177/1362361311422052
  8. Clynes M. Sentics: The Touch of Emotions. Garden City: Anchor Press, 1978. 281 p. ISBN 0-38508622-9.
  9. DeVincentis R.D. A Dynamic Exploration into Mentalization Among Youth on the Autism Spectrum: Ph.D. dissertation / Antioch University. Keene, 2018.
  10. Gallese V. Intentional attunement: Mirror neurons, inter-subjectivity, and autism. In La Sala G.B., Fagandini P., Iori V., Monti F., Blickstein I. (eds.) Coming into the world: A dialogue between medical and human services: International Congress "The 'Normal' Complexities of Coming into the World", Modena, Italy, 28-30, September 2006. Berlin; New York: Walter de Gruyeter, 2006. Pp. 45–64. ISBN: 978-3-11-019018-2.
  11. Grandin T., Barron S. The Unwritten Rules of Social Relationships: Decoding Social Mysteries Through the Unique Perspectives of Autism. Arlington: Future Horizons, 2005. 383 p. ISBN 1-932565-06-X.
  12. Grandin T. Thinking in pictures: and Other Reports from My Life with Autism. — London: Bloomsbury, 2014, 304 p. ISBN 978-1-40880730-9.
  13. Greenspan J., Greenspan S.I. Functional Emotional Developmental Questionnaire for Childhood: A Preliminary Report on The Questions and Their Clinical Meaning. Journal of Developmental and Learning Disorders, 2002, no. 6, pp. 71–116.
  14. Leekam S.R., Nieto C., Libby S.J., Wing L., Gould J. Describing the Sensory Abnormalities of Children and Adults with Autism [Web resource]. Journal of Autism and Developmental Disorders, 2007, vol. 37, no. 5, pp. 894–910. URL: https://drive.google.com/file/d/0B3YpfYF3-tttakx0Rk8xbjluek0/edit (Accessed 21.05.2020). DOI:10.1007/s10803-006-0218-7
  15. MacNamara J., Baker E., Olsen C. Four-year olds’ understanding of Pretend, Forget, and Know: evidence for propositional operations. Child Development, 1976, vol. 47, no. 1, pp. 62–70. DOI:10.2307/1128283
  16. Premack D., Woodruff G. Does the chimpanzee have a ‘theory of mind’? Behavioral and Brain Sciences, 1978, vol. 1, no. 4, pp. 515–526. DOI:10.1017/S0140525X00076512
  17. Shanker S.G. In Search of the Pathways That Lead to Mentally Healthy Children. Journal of Developmental Processes, 2008, vol. 3, no. 1, pp. 22–33.
  18. Shaputis K. The crowded nest syndrome: surviving the return of adult children. Olympia: Clutter Fairy, 2003. 144 p. ISBN 978-0-97267270-2.

Information About the Authors

Galina Itskovich, LCSW-R, Master’s in Social Work, is a Psychotherapist in Private Practice, and the DIR-Expert, The Interdisciplinary Council on Development and Learning (ICDL), New York, USA, ORCID: https://orcid.org/0000-0002-1722-2203, e-mail: galaitsk@gmail.com

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