Download file | Play in new window | Duration: 16:46 | Recorded on February 15, 2018


In this week’s episode of ASD, A New Perspective, Dr. Gutstein gives parents of children with autism hope as he discusses that the age of the child is not what’s important. What is important Dr Gutstein says, is the child’s movement towards growth.

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Full Transcript

Kat Lee: Welcome back to ASD A New Perspective, the podcast show that helps you understand what is going on in the mind of your child. We do encourage you that growth for your child is possible. I’m Kat Lee, and as I visited with Dr. Gutstein this week, he reminded me that the age of children is not what’s important. What is important and hopeful is their movement toward growth. Dr. Gutstein continues.

Steven Gutstein: Looking at people in terms of their own development and what’s benefiting them as a next step in the development of them again. It also, of course it influences the way you function as a guide or a non guide, too, and how you have to adapt and make transitions in the way you’re thinking about your guiding relationship based on those needs. So it impacts it. If you think about it, there’s two levels going on. One is the progression and development of the guiding relationship, first of all forming the guiding relationship, the initial guiding relationship around sort of a meeting of actions in terms of our bodies and our actions in the world and how we meet them together and how, through your guidance, I learn to become more competent. I like to feel more of a sense of agency in my personal life, in my personal experience with the world, and my interpersonal experience.

And then we move to a second level, which is sort of a meeting of minds, or a meeting really around our perceptions of the world. Or our general intentions. We move from our bodies, our actions and the guide’s focus is around helping that child recognize that they can coordinate themselves and their own actions with the actions of others, and then the next step is how we meet together around our shared experience of what we see in the world, what we hear in the world out there.

And then we move and make a transition to the next step, which is a meeting of minds. Which is that, even though we’re doing some activity or some action out in the world, what our encounter is really about is what’s going on in here. So that’s one developmental transition that can’t be rushed in terms of age. There has to be a developmental progression. Along with that of course is the progression in terms of that child taking more initiative and becoming someone who is themselves driven by that motivation for growth and for challenge, and who brings that into a relationship.

So that’s on one level is the development of what we call the mind guiding relationship. And as you pointed out, the other is how it’s really important to focus on providing opportunities for each of our students or children of any age to develop in a way that makes sense for them, rather than a way that compares them to someone of the same age, or any age and understand that development requires a progression, a series of many, many different steps. And it’s not linear, you know? There are a number of things that have to be going on together and developed together, and then come together for different areas. That may have to do with remembering, it have to do with being aware of your emotions, and being present to your feelings, maybe with your being able to recollect, but maybe working memory. The ability to hold onto something that’s your motivations, your habits. There’s so many different areas that have to start coming together to build up each of those next developmental steps.

So, just to say this person is this age, so we should be doing this, really makes absolutely no sense, does it? Because it neglects the fact that they may or may not be ready. And if we push them into that place, then they never develop the readiness to move on to continue to develop. I think that’s the real shame. You know, we talked the other day, the real shame we see in the autism community is that, when I review the articles … It’s so interesting, when I read the articles on whether it’s theory or intervention, there isn’t a single article that talks about developmental progression.

When you look at all the intervention papers, all the papers on here’s how you should work with a person around this skill or this ability or this ability, they take a group of people, who might have a similar age or might not, but let’s say they have a similar age, with no regard at all for their developmental radius for what they’re trying to provide for that person. No regard for whether any of the prior foundations are in place, whether what’s really needed for that whatever they’re trying to achieve to be situated into the real world for that person, they don’t look at the motivation, they don’t look at the ability or the habits. None of those things. It’s like development doesn’t exist.

It’s like you can take a group of people and just, no matter what their readiness or whatever, just throw something at them for a few weeks or months, or whatever, and expect to get results. What a bad way to treat people, especially children. We never do that with something like reading. When we think about someone, we always think about building motivation, if you’re doing a good job reading, if you listen to the experts, we have to build a motivation to read. You have to build the language system behind reading. You have to build the monitoring function of reading, which is checking on your comprehension. You have to build the decoding, the visual perceptual pieces, and then you have to build each of those so they’re linked together, and you have to do it at different levels where you keep increasing each one, and sometimes you’re focusing more on one or the other, but you’re moving, and you’re never comparing it to the rest of the world. You’re comparing it only to that own person and their progress, developmentally, towards the goal, which is proficiency in reading.

In autism, unfortunately, we have failed miserably, I think, to address development and the real developmental needs of our population, regardless of their age. If somebody’s 21, we assume that they’re ready to go out in the work world, so we give them job coaching. Because of their age. Or we assume that job interviewing skills are what they need, or something. That’s the way the work goes on. There is no attempt to say, “What does this person need? How do we develop that, even if it takes a number of years to be ready so they could do it? How do we build the foundation so they can be autonomous, so we can build on whatever they’re doing and continue to develop, and then give people the opportunity to move into a developmental pathway.” That’s the key. There’s absolutely no emphasis on having a developmental pathway.

I don’t know how you can do any kind of work with a child or an adult without considering that. Even as an adult. Psychotherapists, which I have been for many years, are always thinking about the readiness of this particular person. What’s the next step for them? What are the issues that they have to be bringing to bear to move to that next step? What is their readiness? And I don’t think about them being a 43 years old person, or a 63 year old person, or a 38 year old person.

Although I will tell you, though, in our modern psychiatric intervention, we’re falling victim to the same thing. You look at the interventions like cognitive therapy, cognitive behavioral therapy, and I’ve seen casualties of those. It’s like one size fits all. It’s as if, if you have depression, everybody’s depression is the same depression, and you have the same needs as the next person who has the same, that depression. And you have the same resources that are available to you or not, or the same limitations. It’s the way, unfortunately, I think, that things have gone on in essentially in the mental health world.

But I think the worst, most blatant example of it is in the area of autism. We’re dealing with children, a lot. A lot of the time. And we’re just throwing … the only interventions I see are just giving them one size fits all treatments, or things to do, or whatever. And assuming, somehow, that that makes sense. I don’t understand it, but it doesn’t change. I keep looking at the literature day after day, because I get updates, and all the autism literature that comes out pretty much every day, and it’s actually getting worse. It’s not getting better.

Kat Lee: Well, and I want to go back to what you said, because I think it’s such a really incredibly important part. Two things. First, your emphasis that these are children, and in some cases I would consider them babies, when they’re two years old and 18 months old, and the stress on them if we’re not very careful how we work with them. And then also that we can put them in positions where they cannot … we’re devastating for them, and then we wonder why we see these breakdowns.

Steven Gutstein: You know, and there are many ways we can approach this. Most certainly one of them is that there’s no sense that how important it is to develop the intrinsic motivations that don’t just appear out of nowhere. They have to be developed through success, through gradual progression. Whether that’s through the motivation for challenge, the motivation for creature relatedness, or if it’s agency, the motivation to want to reflect and look into the future and plan and prepare, all those things don’t just come about. And there’s complete neglect in any of the autism community on addressing that.

That’s part of the foundations that we have to develop. Before we worry about skill, we have to worry about those intrinsic drives to maintain. And of course you have to worry about the habits that also you want to develop so that you continue to still do them. But yeah, again, there’s such a … I don’t know how to say it, but it’s a very one-dimensional, I guess, viewpoint. One of the reasons that parents make such good guides when they’re working is that they get to do what I call bookmarking. When you have a regular relationship with someone. If you’re mindful and you start to become aware of it, then each time you rejoin them, if you stop to reflect afterwards, you can have the sense of where we left off. You have the sense of, “Okay, we got up to here, and now what would be a good next step?” Or we’re struggling with this, maybe we need to take a step back. But you’re continually sort of getting that little update of a regular relationship.

And of course, the child is getting that as well. And that’s a continuity in a relationship, that we don’t just come out of nowhere. When we see somebody an hour a week, or two hours a week, whatever, where they just come in and do a program with you, there is none of that sense of where are we? Where are we moving? Where have we come from? Where do we go up to? If we put a bookmark in a book, think about oh yeah, we’re up to here. Oh yeah, now we can move on to this, or now we need to go back and re-read the few pages because we had trouble here. And you get that sense of moving on.

That’s why from parents, people who have a regular relationship with, a daily relationship with their child, are critical in this, because they can maintain that on a number of levels. I’ll say one is to be sort of aware of it, and one is to provide that sense of continuity for the child, as well, that we’re not just jumping around. That we can make sense of where we’ve been, or I can remind you of where we’ve been. You can walk into the next one and say, “Oh yeah, here’s what we did. We were able to do this, and now we’re just taking a little step more.” So it’s not coming out of nowhere. Now we’re ready for this. Now we’re at this. We continue to have that continuity.

On so many levels, these clinical issues are just neglected in this field. It’s a nonclinical field. You look at the interventions, and it’s like, “There’s no way you guys had clinical training.” It’s like there’s nobody who’s had clinical training doing it. It’s like people who just had techniques or some workbooks that they’ve been given and they don’t have any understanding of how you help someone to develop and to move into a developmental pathway that is a lifelong pathway approach. It’s very odd, isn’t it?

I think, in RDI, that’s one the things that we need to be clear about is that we do offer that. We believe that that’s critical, and that becomes a mindset for everyone involved. Parents, professionals, and really for the children as well, to feel like they don’t have to … They can become aware of their own momentum, their own progress, even if they’re not yet caught up, or even if they’re not yet at the same level. They can look back, and we can start helping them see how they’re growing, how they’re moving and developing, and start to become aware of evaluating themselves or judging their own progressed, based on themselves and their own movement, which you have to work extra hard at, because our society doesn’t do that, doesn’t provide that for them.

So the danger is, they never see themselves. They never see. They lose sight of that. They only see where they are compared to somebody who they’re “supposed to be” similar to. Right? One of the things I’ve said for years is that this idea of age matching, or age comparisons, is really ridiculous because, when you think about somebody who’s 25, who is going to know that they’re only operating on a 22 year old level? Or 35? You know, 35, if they’re operating on a 28 year old level, who is going to care? How does that make any sense? It’s a completely artificial distinction or way of comparison that we have cooked up because it’s simpler. It means we don’t have to think. We don’t have to use our minds as much. We say, “You’re supposed to be like this because you’re at this age.”

Kat Lee: Doesn’t make any sense. I want to say that, I think for parents, your message is so hopeful, because they don’t have to compare their children to other children who are six or 20 or 30 or whatever. They are only looking at their child. I think it’s really a message of hope for them.

And thanks for joining us for ASD A New Perspective. The podcast show where we help you understand what is going on in the mind of your child. We encourage you that growth for your child is possible. I’m Kat Lee. See you next time.


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