Re: Self-esteem (is it a behavioral thing?)

[Guest guest]

Sorry for the double posting... but I would like to

disagree with about the " nobody likes me " being

a behavioral problem in the tone of

'stimulus-response', and I'd advise you to think of an

alternative explanation. I don't think AS kids do this

to gain attention from teachers or parents. They get

truly sadden from their misinterpretation of social

and non-verbal cues. As a matter of fact, it has been

shown to be one of their main sources of clinical

depression during their teenage years.

If we wanted to elaborate a little more theoretically,

it corresponds to the so called " theory of the mind " .

AS children usually have more neurons than NT kids,

but they are smaller and less inter connected. Also,

they lack of certain connections between probably 3

areas of their brains, which makes it difficult for

them to interpret emotions in the same way NT kids do.

That is why they rely heavily on verbal cues, and

prefer to use pre-set scripts when facing unknown

social situations.

I strongly believe that it is wrong to assume that

their quasi paranoid characteristics is a way to

manipulate adults around them to gain attention. These

kids get really depressed thinking that they are not

liked. It is something that warrants the appropriate

attention which is probably, as I said in my previous

posting, helping them with the understanding of

non-verbal social cues, and even dealing with the

depression that comes with it. Several interventions

for AS kids address that problem, including the social

stories, and other well known and sound methods. I

think that the scientific literature is clear about

that, and I have seen it myself with my own son.

Thanks. F

Jeanine,

From a behavioral point of view. (working only off of

what you have said in your email).

Your child has begun to use a specific behavior.

" talking about the other kids not liking him. "

Because of potential negative consequences you would

like to address this behavior so that it will reduce.

To find out how to reduce the behavior, you need to

find out what is increasing its use.

__________________________________________________

[Guest guest]

, thanks for your response, and don't worry, although there is of course a

lot of personal involvement in any disagreement, in my case, I'm used to tough

academic debate. If the group moderators consider it appropriate, I'd like to

take the opportunity to debate the issue a little more.

First, about the origin, purpose and results of social stories, I'd rather

refer the readers to Carol Gray's extensive work on the issue

(http://www.thegraycenter.org/).

I completely agre with that reinforcing the negative and sometimes

self-destructive feelings will simply perpetuate them. But I still sustain that

the need for attention is not the origin of those expressions. They may find

that when they express such feelings they get attention, and like it. But that

does not necessarily perpetuate the verbal behavior if their feelings are

addressed properly.

The reason I replied to 's message was because it gave me - and it could

have given other parents too - the impression that he was saying that they do it

to gain attention and that as such it should not be encouraged. They don't do it

to gain attention. No one can ignore the neurophysiologycal origins of autism.

Their feelings of isolation are primarily due to their difficulties preceiving

emotional stimuli in at least two areas of the hypothalamus and integrating them

as social cues at the pre-frontal cortical level - that is, they see/hear the

social situation but can't fully understand its meanings and have difficulties

connecting it to their behavior, as well as NT children can.

This is not my 'generalization'. This is at the very basis of the diagnosis of

PDD (any AU related disorder). If their capacity to understand and process

social cues is not impaired... It is very likely a language developmental

disorder or other problem not in the Austism spectrum. There are many

anatomical, physiologycal, and radiologycal studies that have helped define what

is in the spectrum and what is not.

So, since gaining attention is truly a consequence of their physiologically

modulated reaction to others' behavior (the problem is in their brain biology,

and they get attention as a consequence of that problem), and not the primary

intention of their reaction, I think we can consider the attention-seeking a

secondary gain (in most psichologycal problems there is a level of secondary

gain to the individual from the attention she/he gains because of their primary

problem).

Any good therapist will tell you that secondary gain may have some advantages,

but it may perpetuate non-disease related behavior (and I'm not sure that

calling AS a disease is appropriate, but for lack of a better term, please allow

me to do that). I'm in total agreement with on this issue. But we cannot

intervene on the secondary gain without running the risk of asking these kids to

supress the expression of their emotions... and they already have tons of

problems with that.

We should intervene on the primary origin of the problem - that is, their

difficulty processing and integrating social cues (and I again mention social

stories as one of the possible tools, though not the only or necessarily best

one), and help them modulate those expressions that produce secondary gain (the

gained attention).

In one sentence: we need to help them understand social cues and approriately

react to them, and have healthier and more functional ways to express their

frustrations and anxieties. Both, and more the first than the second.

To the extent that they gain capacity reading, interpreting and reacting to

social cues, their need for attention should diminish if, as suggests, we

are careful not to reinforce the attention-seeking behavior... they need the

attention (a lot!), but not the one that makes them feel right about saying

'everybody hates me'.

Thanks a million, and have a great day. F. Velez, MD, PhD

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