Friday, November 17, 2017

Anxiety and Decision-Making in Autistic Adults

Anxiety and Decision-Making in Autistic Adults

Although there has been a dramatic increase in the research and clinical studies related to children and adolescents, there is a paucity of information regarding more capable adults on the autism spectrum. It is only recently that psychologists have begun to appreciate the complex challenges faced by a “lost generation” of adults with autism spectrum disorder (ASD).  Even though the core symptoms of ASD (impairments in communication and social interaction and restricted/repetitive behaviors and interests) may improve overtime with intervention for many individuals, some degree of impairment typically remains throughout the lifespan.  Consequently, the focus of intervention/treatment to promoting adaptive behaviors that can facilitate and enhance ultimate functional independence and quality of life in adulthood. This includes new developmental challenges such as independent living, vocational engagement, post-secondary education, and family support. 
Decision-making is an important part of almost every aspect of life. However, several autobiographical accounts (e.g., Temple Grandin) suggest that making decisions can be stressful and anxiety-provoking for many autistic adults. Likewise, a small number of studies have suggested differences between the decision-making experiences of adults on the spectrum and their neurotypical peers. Despite autobiographical accounts and limited studies, the extent to which, in everyday life, autistic individuals experience difficulties with decision-making is largely unknown.  

Research 
A study published in the journal Autism sought to extend this important area of research by comparing the “real-life” decision-making experiences of adults with and without autism spectrum disorder (ASD). The researchers hypothesized that compared with a neurotypical group, participants with ASD would report: (a) more frequent experiences of problems during decision-making (e.g. feeling exhausted), (b) greater difficulty with particular features of decisions (e.g. decisions that need to be made quickly), and (c) greater reliance on rational, avoidant, and dependent styles of decision-making. In addition, it was expected that participants with ASD would report interference from their condition when making decisions.
The participants were 38 adults with ASD and 40 neurotypical comparison adults (with no family history of ASD), aged 16 to 65 years. The groups were matched for age, gender and verbal IQ. All participants completed a novel questionnaire to evaluate their decision-making experiences. The questionnaire asked participants to rate: (a) the frequency with which particular problems in decision-making were experienced; (b) the extent to which they perceived difficulties in relation to particular features of decisions; and finally, (c) the extent to which participants with ASD believed that their condition enhanced or interfered with their own decision-making. Ratings of the frequency of 12 potential problems in decision-making were indicated on a four-point Likert-type scale (from ‘never’ to ‘often’). Participants also completed the General Decision Making Style Inventory (GDMS), a 25-item questionnaire probing reliance on five, non- mutually exclusive, styles of decision-making (rational, intuitive, dependent, avoidant, and spontaneous). Levels of anxiety and depression were assessed using the well- established Hospital Anxiety and Depression Scale (HADS).

Results
Compared with their neurotypical peers, the participants with ASD more frequently reported difficulties in decision making. Decisions that needed to be made quickly, or involved a change of routine, or talking to others, were experienced as particularly difficult, and the process of decision-making was reported to be exhausting, overwhelming, and anxiety-provoking. The participants with ASD reported significantly higher levels of anxiety and depression and were more likely to believe that their condition interfered with rather than enhanced the decision-making process. Not surprisingly, the participants with ASD were also more likely to report that they avoided decision-making.

Conclusion and Implications
The overall findings of the study suggest that, compared with neurotypical individuals, autistic individuals experience greater difficulty with decision-making. Decision-making in ASD was associated with anxiety, exhaustion, problems engaging in the process, and a tendency to avoid decision-making. These findings are consistent with previous autobiographical accounts, known features of the condition, and previous studies of decision-making in autism. In addition, the difficulties reported by the participants with ASD may be exacerbated by higher levels of anxiety and depression. The researchers found that ratings of perceived frequency of interference from ASD increased proportionally with levels of anxiety and depression. Despite limitations of the study (e.g., self-reports), the results are consistent with suggestions from the literature relating to decision-making for individuals with ASD. 

There are also some practical implications for improving the decision-making process for autistic adults. For example, it may be helpful to: (a) provide additional time to reach a choice, (b) minimize irrelevant information, (c) present closed questions, (d) offer encouragement and reassurance, and (e) address general issues around anxiety. Unfortunately, expecting to make the perfect decision, postponing and second-guessing a choice, all leads to more anxiety. Strategies derived from cognitive-behavioral therapy (CBT) might be helpful in coping with indecisiveness and perfectionism by focusing on accepting life’s unpredictability and changing behavior to more effectively work toward a goal. This includes examining several sides of an issue, and creatively generating options for action, all in the effort to engage in more thoughtful, realistic, and productive decision-making. Understanding how autistic adults experience decision-making is essential for both family members and professionals in helping the individual achieve greater self-understanding, self-advocacy and improved decision-making in lifespan activities such as employment and personal relationships.
References

Luke, L., Clare, I. C. H., Ring, H., Redley, M., Watson, P. (2012). Decision-making difficulties experienced by adults with autism spectrum conditions. Autism, 16(6), 612–621.
Wilkinson, L. A. (2015). Overcoming anxiety and depression on the autism spectrum: A self-help guide using CBT. London and Philadelphia: Jessica Kingsley Publishers.
 
Wilkinson, L. A. (2008). Adults with Asperger syndrome: A childhood disorder grows up. The Psychologist, 21, 764-770.
Wilkinson, L. A. (2007, May). Adults with Asperger syndrome: A lost generation? Autism Spectrum Quarterly.
Lee A. Wilkinson, PhD, NCSP is a licensed and nationally certified school psychologist, chartered psychologist, and certified cognitive-behavioral therapist. He is author of the award-winning books, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools and Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT. He is also editor of a best-selling text in the APA School Psychology Book Series, Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in SchoolsHis latest book is A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd Edition).

Best Book Awards - A Best Practice Guide to Assessment & Intervention for Autism Spectrum Disorder in Schools


A Best Practice Guide to Assessment & Intervention for Autism Spectrum Disorder in Schools (2nd Edition) was selected as an Award-Winning Finalist in the "Education/Academic" category of the 2017 Best Book AwardsFully updated to reflect current assessment tools, procedures and research, this award-winning book provides a practical and scientifically-based approach to identifying, assessing, and treating children and adolescents with an Autism Spectrum Disorder (ASD) in school settings. Integrating current research evidence with theory and best practice, each chapter features a consolidated and integrative description of best practice assessment and intervention approaches for children and youth with ASD. It brings the topics of assessment and intervention together in a single authoritative resource guide consistent with recent advances in evidence-based practice.  Illustrative case examples, glossary of terms, and helpful checklists and forms make this the definitive resource for identifying and implementing interventions for school-age children and youth with ASD.

This Guide is intended to meet the needs of school-based professionals such as school psychologists, counselors, speech/language pathologists, occupational therapists, counselors, social workers, administrators, and both general and special education teachers. Parents, advocates, and community-based professionals will also find this guide a valuable and informative resource.

                                          
Editorial Reviews  

“It is rare that one book can pack so many resources and easy to digest information into a single volume!  Families, school personnel, and professionals all need the extensive, and up-to-date tips, guides, and ‘must-knows’ provided here. It’s obvious the author is both a seasoned researcher and practitioner – a winning combination.” — Dr. Debra Moore, psychologist and co-author with Dr. Temple Grandin, of The Loving Push: How Parents & Professionals Can Help Spectrum Kids Become Successful Adult 

“Dr Wilkinson has done it again. This updated and scholarly Second Edition reflects important recent changes regarding diagnosis and services for students with Autism Spectrum Disorder. With its numerous best-practice suggestions, it is a must-read for school psychologists, school social workers, and those who teach in general and special education.” — Dr Steven Landau, Professor of School Psychology in the Department of Psychology, Illinois State University 

“This book is an essential resource for every educator that works with students with ASD! The easy-to-read format is complete with up to date research on evidence-based practices for this population, sample observation and assessment worksheets and case studies that allow the reader to apply the information presented.” — Gena P. Barnhill, PhD, NCSP, BCBA-D, LBA, Director of Special Education Programs at Lynchburg College, Lynchburg, VA  

Availability

A Best practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd Edition) is available from Jessica Kingsley PublishersAmazon.comBarnes & NobleBooks-A-MillionBook DepositoryTarget.com,Walmart.comand other booksellers. The book is available in both print and eBook formats.
Author
Lee A. Wilkinson, PhD, NCSP is a licensed and nationally certified school psychologist, chartered psychologist, and certified cognitive-behavioral therapist. He provides consultation services and best practice guidance to school systems, agencies, advocacy groups, and professionals on a wide variety of topics related to children and youth with autism spectrum disorder. He is also a university educator and school psychology trainer. His research and professional writing has focused primarily on behavioral consultation and therapy, and evidence-based practice in assessment and intervention for autism spectrum disorder. He has published numerous journal articles on these subjects both in the US and internationally. Dr. Wilkinson is author of the award-winning book,  A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools and editor of a best-selling text in the APA School Psychology Book Series,  Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in SchoolsHis previous book, Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT, was honored as an “Award-Winning Finalist in the “Psychology/Mental Health” category of the 2016 Best Book Awards.”

Wednesday, November 15, 2017

APA School Psychology Book Series - Autism in Schools: Evidence-Based Assessment & Intervention



Part of the Applying Psychology in the Schools SeriesAutism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools, is an essential reference for professionals in need of the most recent and reliable research information on identifying and providing interventions for the increasing number of children with autism spectrum disorder (ASD).

This book is an authoritative resource that presents up-to-date research and evidence-based tools for accurate assessment and intervention. It includes procedures to help identify children using the new DSM-5 symptom criteria and offers essential guidance for assessing a variety of emotional, behavioral, and academic problems. The book provides practitioners with an evidence-based assessment battery, which includes tests of cognitive, academic, neuropsychological, and adaptive functioning. The pragmatic, social-communicative functions of language are considered together with assessments to identify language deficits. 

Readers also learn to identify co-occurring emotional and behavior problems of children with ASD and understand techniques and strategies to enhance home-school partnerships and engage parents as active partners in the decision-making process. Each chapter is based on the principles of evidence-based practice. Many chapters feature case vignettes to illustrate best practice in the school setting. The volume concludes with a primer on ASD-related litigation issues and discusses relationships between special education law, provision of services, and placement decisions.

"This fantastic resource is a must-read for professionals and students across many disciplines. Contributors provide critical information on a comprehensive range of topics with an emphasis on evidence-based approaches and practical applications." -Natacha Akshoomoff, PhD, Associate Professor, Department of Psychiatry and Center for Human Development, University of California, San Diego

"Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools serves as an excellent resource for professionals working with children with ASD in educational settings and covers many fundamental aspects that need to be considered in assessment and intervention practices. Overall, this book thoroughly integrates current research and theory as well as relevant practice in school settings and will allow practitioners to further their conceptual understanding of assessing and treating ASD."
- Canadian Journal of School Psychology

“Wilkinson has put together a book that is quite readable and interesting. Difficult concepts are explained clearly but concisely. The style and quality of writing is consistently good across chapters. A strength of this book is the breadth of coverage. The authors meet the goal of providing professionals with information on ASD, screening, assessment, and interventions for the classroom.” - Journal of Psychoeducational Assessment 

"This concise book provides a comprehensive and very readable introduction to best practices in the assessment and treatment of ASD in school settings. It succinctly informs the professional reader about the theoretical and research foundations underlying its many suggestions for practice, which are further enhanced by the liberal use of vignettes." -PsycCRITIQUES

"An excellent and accessible synthesis of the evidence base for school-based interventions in ASD and a comprehensive look at the psychological profile of the child with autism." - The Association for Child and Adolescent Mental Health 

"In its current form, Wilkinson has fashioned a very good book for ASD school practitioners, with commendable interdisciplinary appeal and a much needed dose of empiricism!"
-New England Psychologist

“Overall, Wilkinson’s text is like a guided tour of the parallel yet overlapping worlds of school and clinical practice, which many of our patients and families navigate daily. It will contribute to the reader’s knowledge of ASDs and more broadly of how schools accommodate and work with special-needs children.” – Journal of the American Academy of Child & Adolescent Psychiatry
Availability

Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools is in stock and available from APA Books. It can also be ordered from Amazon.com, Barnes & Noble, Books-A-Million, Book Depository, and other booksellers. The book is available in both print and eBook formats. Examination and desk copies are available to college and university faculty.

Lee A. Wilkinson, PhD, NCSP is a licensed and nationally certified school psychologist, chartered psychologist, and certified cognitive-behavioral therapist. He provides consultation services and best practice guidance to school systems, agencies, advocacy groups, and professionals on a wide variety of topics related to children and youth with autism spectrum disorders. Dr. Wilkinson is author of the award-winning books,  A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools and Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBTHis latest book is A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd Edition).

Tuesday, November 7, 2017

Legal and Appropriate Educational Programs for Children on the Autism Spectrum


Individuals with Disabilities Education Act (IDEA)

Since Congress added autism as a disability category to the Individuals with Disabilities Education Act (IDEA), the number of students receiving special education services in this category has increased over 900 percent nationally. The number of students receiving assistance under the special education category of autism over the past decade has increased from 1.5 percent to 9 percent of all identified disabilities. Autism now ranks fourth among all IDEA disability categories for students age 6-21. It’s critically important that parents and educators understand the provisions for providing legally and educationally appropriate programs and services for students identified with autism spectrum disorder (ASD).
Research indicates that education is the most effective treatment/intervention for children with ASD. The most recent re-authorization of the Individuals with Disabilities Education Act (IDEA 2004) entitles all students with disabilities to a free, appropriate public education (FAPE). FAPE encompasses both procedural safeguards and the student’s individual education program (IEP). The IEP is the cornerstone for the education of a child with ASD. When a student is determined eligible for special education services, an IEP planning team is formed to develop the IEP and subsequently determine placement.
Although clinical diagnoses, psychiatric reports, and treatment recommendations can be helpful in determining eligibility and educational planning, the provisions of IDEA are the controlling authority with regard to decisions for special education. While clinical information is professionally helpful, it is neither legally required nor sufficient for determining educational placement. Therefore, it’s especially important for administrators, parents, advocates, teachers and non-school professionals to keep in mind that when it comes to special education, it is state and federal education codes and regulations (not clinical criteria) that determine eligibility and IEP planning decisions. 

According to IDEA regulations, the definition of autism is as follows:
(c)(1)(i) Autism means a developmental disability significantly affecting verbal and nonverbal communication and social interaction, generally evident before age 3, that adversely affects a child’s educational performance. Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experiences. The term does not apply if a child’s educational performance is adversely affected primarily because the child has an emotional disturbance, as defined in this section.

(ii) A child who manifests the characteristics of ‘‘autism’’ after age 3 could be diagnosed as having ‘‘autism’’ if the criteria in paragraph (c)(1)(i) of this section are satisfied.
Guidelines

Legal and special education experts recommend the following guidelines to help school districts meet the requirements for providing legal and appropriate educational programs and services to students with ASD.
1. School districts should ensure that the IEP process follows the procedural requirements of IDEA. This includes actively involving parents in the IEP process and adhering to the time frame requirements for assessment and developing and implementing the student’s IEP.  Moreover, parents must be notified of their due process rights. It’s important to recognize that parent-professional communication and collaboration are key components for making educational and program decisions.
2. School districts should make certain that comprehensive, individualized evaluations are completed by school professionals who have knowledge, experience, and expertise in ASD. If qualified personnel are not available, school districts should provide the appropriate training or retain the services of a consultant.
3. School districts should develop IEPs based on the child’s unique pattern of strengths and weaknesses. Goals for a child with ASD commonly include the areas of communication, social behavior, adaptive skills, challenging behavior, and academic and functional skills. The IEP must address appropriate instructional and curricular modifications, together with related services such as counseling, occupational therapy, speech/language therapy, physical therapy and transportation needs. Evidence-based instructional strategies should also be adopted to ensure that the IEP is implemented appropriately.
4. School districts should assure that progress monitoring of students with ASD is completed at specified intervals by an interdisciplinary team of professionals who have a knowledge base and experience in autism. This includes collecting evidence-based data to document progress towards achieving IEP goals and to assess program effectiveness.
5. School districts should make every effort to place students in integrated settings to maximize interaction with non-disabled peers. Inclusion with typically developing students is important for a child with ASD as peers provide the best models for language and social skills. However, inclusive education alone is insufficient, evidence-based intervention and training is also necessary to address specific skill deficits. Although the least restrictive environment (LRE) provision of IDEA requires that efforts be made to educate students with special needs in less restrictive settings, IDEA also recognizes that some students may require a more comprehensive program to provide FAPE. 
6. School districts should provide on-going training and education in ASD for both parents and professionals. Professionals who are trained in specific methodology and techniques will be most effective in providing the appropriate services and in modifying curriculum based upon the unique needs of the individual child.
Adapted from Wilkinson, L. A. (2016). A best practice guide to assessment and intervention for autism spectrum disorder in schools. London and Philadelphia: Jessica Kingsley Publishers.

Key References and Further Reading
Individuals with Disabilities EducationImprovement Act of 2004. Pub. L. No. 108-446, 108th Congress, 2nd Session. (2004). 
Kabot, S., & Reeve, C. (2014). Curriculum and program structure. In L. A. Wilkinson (Ed.), Autism spectrum disorder in children and adolescents:  Evidence-based assessment and intervention in schools (pp. 195-218). Washington, DC: American Psychological Association.

Mandlawitz, M. R. (2002). The impact of the legal system on educational programming for young children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 32, 495-508.
National Research Council (2001). Educating children with autism. Committee on Educational Interventions for Children with Autism. C. Lord, J. P. McGee (Eds). Division of Behavioral and Social Sciences and Education. Washington, DC: National Academy Press.

Wagner, S. (2014). Continuum of Services and Individualized Education Plan Process. In L. A. Wilkinson (Ed.). Autism spectrum disorder in children and adolescents:  Evidence-based assessment and intervention in schools (pp. 173-193). Washington, DC: American Psychological Association.

Wilkinson, L. A. (2010). Best practice in special needs education. In L. A. Wilkinson, A best practice guide to assessment and intervention for autism and Asperger syndrome in schools (pp. 127-146). London: Jessica Kingsley Publishers. 
Wilkinson, L. A. (Ed.). (2014). Autism spectrum disorder in children and adolescents:  Evidence-based assessment and intervention in schools. Washington, DC: American Psychological Association.

Wilkinson, L. A. (2017). Best practice in special education. In L. A. Wilkinson, A best practice guide to assessment and intervention for autism spectrum disorder in schools (pp. 157-200). London: Jessica Kingsley Publishers.

Zirkel, P. (2014). Legal Issues Under IDEA. In L. A. Wilkinson (Ed.), Autism spectrum disorder in children and adolescents:  Evidence-based assessment and intervention in schools (pp. 243-257). Washington, DC: American Psychological Association. 
Yell, M. L., Katsiyannis, A, Drasgow, E, Herbst, M. (2003). Developing legally correct and educationally appropriate programs for students with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 18, 182-191.

Lee A. Wilkinson, PhD, NCSP is a licensed and nationally certified school psychologist, chartered psychologist, and certified cognitive-behavioral therapist. He is also a university educator and trainer, and has published widely on the topic of autism spectrum disorders both in the US and internationally. He is author of the award-winning books, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools and  Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBTHe is also editor a best-selling text in the American Psychological Association (APA) School Psychology Book Series, Autism Spectrum Disorder in Children and AdolescentsEvidence-Based Assessment and Intervention in Schools. His latest book is A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd Edition).
©Lee A. Wilkinson, PhD

Wednesday, November 1, 2017

Sensory Sensitivity in Autistic Adults


Sensory Sensitivity in Autistic Adults

Anecdotal reports and empirical evidence suggest that atypical or unusual sensory responses are a common feature of autism spectrum disorder (ASD). Studies report that from 45 to more than 90 percent of people with autism either ignore or overreact to ordinary sights, sounds, smells or other sensations. Sensory issues are now included in the DSM-5 symptom criteria for restricted, repetitive patterns of behavior, interests, or activities (RRB). This includes hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of the environment; such as apparent indifference to pain/heat/cold and adverse response to specific sounds or textures.  Although no one single type of sensory problem is consistently associated with ASD, auditory sensitivity is often cited as the most disturbing and challenging for autistic individuals.
We live in an incessant cacophony of noise. In fact, scientists say it’s the noisiest age in human history. We know that “noise pollution” can cause hypertension, high stress levels, tinnitus, hearing loss, sleep disturbances, and other harmful effects. Sound becomes unwanted when it either interferes with normal activities such as sleeping, conversation, or disrupts or diminishes one's quality of life. Certain sounds are particularly annoying collectively to us all. However, many of the everyday noises other people take for granted can be very painful and cause unwanted intrusions for autistic adults. For example, many autistic adults report sound sensitivity problems such as hyperacusis, misophonia, hypersensitive hearing at certain frequencies, and phobias (phonophobia) related to specific sounds. When present, sensory problems can interfere with adaptability in many areas of life (communication, daily living, socialization, occupational). Understanding sensory issues in adults on the autism spectrum is critical to the identification and prescription of appropriate interventions especially considering studies that suggest a link between anxiety and sensory over-responsivity which can further compromise an individual's ability to function successfully in daily life.
Research

A study published in
Autism investigated sensory over-responsivity in adults compared to control participants and the extent to which daily life experiences were endorsed as uncomfortable or distressing by those on the spectrum. The researcher’s hypothesized that adults with autism would report more sensory over-responsivity than controls. A second objective was to test whether sensory over-responsivity is linked to autistic traits in adults with and without autism.
Adults with (n = 221) and without (n = 181) autism spectrum conditions participated in an online survey. The Autism Spectrum Quotient (AQ), the Raven Progressive Matrices and the Sensory Processing Scale were used to characterize the sample. Adults with autism spectrum conditions reported more sensory over-responsivity than control participants across all sensory modalities (vision, hearing, touch, smell, taste and proprioceptive). However, the highest mean scores were reported for Hearing and Touch on the Sensory Processing Scale.
These findings highlight the importance of measuring each sensory domain separately rather than combining scores from various sensory domains. Notable in this study was the association between sensory over-responsivity and autistic traits. Increased sensory sensitivity was associated with more self-reported autistic traits, both across and within groups. These results indicate that autistic adults experience sensory over-responsivity to daily sensory stimuli to a high degree and that a positive relationship exists between sensory over-responsivity and autistic traits.
Implications

Despite its limitations, this study shows that autistic adults self-report over-responsivity across multiple sensory domains (vision, hearing, touch, smell, taste and proprioceptive) that affect their daily life routines and thus quality of life. Auditory over-responsiveness was among the most frequently reported by participants indicating that autistic adults experience challenges to daily auditory stimuli to a high degree. Although sensory symptoms may improve with maturation for typical individuals, sensory features in ASD remain stable and often become more challenging during adulthood. Likewise, sensory over-responsivity has also been linked to higher rates of depression and anxiety. 

Although there is no cure for sensory sensitivity, there are various techniques as well as some lifestyle modifications that can tone down the symptoms of auditory sensitivity, so it does not severely interfere with everyday life. They include exposure and response prevention (E/RP) treatment; habituation training, applied relaxation, positive imagery, attention shifting, psychoeducation, cognitive restructuring, and background sounds to cope with hyperacusis. The most effective solutions involve increasing the tolerance of noise by exposing the person to sufficient noise to build up his or her “immunity.” Over-protection may only further increase the effect of extreme sensitivity to sound. Evaluating and attending to over-responsivity have implications for understanding and addressing the sensory components of autistic adults' daily life routines and roles. Appropriate intervention should be directed towards sensory issues that may be contributing to emotional and psychological challenges and towards designing sensory friendly domestic and work environments.
Tavassoli T., Miller, L. J., Schoen, S. A., Nielsen, D. M., & Baron-Cohen, S. (2014). Sensory over-responsivity in adults with autism spectrum conditions. Autism, 18, 428–432.  
doi: 10.1177/1362361313477246

Lee A. Wilkinson, PhD, NCSP is a licensed and nationally certified school psychologist, chartered psychologist, and certified cognitive-behavioral therapist. He is author of the award-winning books, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools and Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBTHe is also the editor of a best-selling text in the APA School Psychology Book Series, Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in SchoolsHis latest book is A Best Practice Guide to Assessment and Intervention for Autism Spectrum Disorder in Schools (2nd edition).

Follow by Email

Top 10 Most Popular Best Practice Posts

Search BestPracticeAutism.com

Blog Archive

Best Practice Books

Total Pageviews