Showing posts with label Behaviors. Show all posts
Showing posts with label Behaviors. Show all posts

Hostile Attribution Bias

Autism Lexicon: Hostile Attribution Bias 

Hostile attribution bias is a cognitive tendency to interpret ambiguous behaviors of others as having hostile intent or leading to hostile outcomes. In autism, this bias is linked to social communication challenges and a heightened sensitivity to perceived social threats. 

PlainSpeak:   Hostile attribution bias is when someone thinks others are being mean on purpose, even if it's not clear. In autism, this happens more often because autistic people can struggle with understanding social cues and might feel more easily threatened.

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Read more on Hostile Attribution Bias: [Version for Scientific/Academic Audience],  [PlainSpeak for the Lay Reader], [A Simple Definition]

Related Posts on [Neuroception], [Negative Attribution Bias] 


Understanding Predictive Coding in the Brain

In PlainSpeak for the Lay Reader 

Researchers have come up with many theories to try to explain different aspects of thinking and behavior in autism. The Predictive Coding Hypothesis is one such set of explanations. 

Understanding Predictive Coding in the Brain 

This hypothesis says that the brain acts like a prediction machine, always guessing what's going to happen based on past experiences. For example, if you hear a familiar sound, like a door creaking, your brain might predict that someone is entering the room. When something happens, the brain compares it to what it expected and updates its guesses to be more accurate next time.

Predictive Coding in Autism

Scientists think that the brains of autistic people might process these predictions differently. This could explain some common characteristics of autism, like sensory sensitivities, repetitive behaviors, and social challenges.

Slow Updating Theories

What This Means: Autistic people might update their brain’s predictions more slowly. This means their brain doesn’t adjust as quickly when something new or unexpected happens.

Possible Effects:

  • Repetitive Behaviors: They might rely more on routines or repetitive actions to cope with the world because it feels more predictable and safe.
  • Sensory Sensitivities: Because their brain takes longer to adjust, unexpected noises, lights, or touches might feel very intense or overwhelming.
  • Social Challenges: Social interactions often require quick thinking and adapting, so slow updating might make it harder to understand and react to what others are doing or saying.

Examples of Slow Updating Theories:

  1. Predictive Coding Deficit Theory: Autistic people may have a harder time updating their brain’s predictions with new information, which can make adjusting to changes difficult.
  2. Reduced Sensory Prediction Error Theory: The brain might not be good at noticing when it made a wrong prediction, leading to slower updates and more intense sensory experiences.

High-Precision Theories

What This Means: Autistic people might focus too much on the details of what they sense, giving a lot of importance to every little thing they see, hear, or feel.

Possible Effects:

  • Sensory Overload: Because they notice so many details, it can become overwhelming and lead to sensory overload.
  • Literal Thinking: They might take things very literally and have trouble understanding implied meanings or jokes.
  • Detail-Oriented: They might focus a lot on small details but find it hard to see the bigger picture.

Examples of High-Precision Theories:

  1. Aberrant Precision of Prediction Errors: Autistic people might give too much importance to their senses, leading to strong reactions to things like noise or bright lights.
  2. Increased Sensory Precision Theory: Their brain treats all sensory input as very important, making it hard to ignore unimportant details.
  3. Attenuated Priors Hypothesis: Their brain’s expectations (or “priors”) are weaker, so they rely more on the immediate sensory input, giving it more weight.

Other Theories in Autism

Aberrant Salience Theory: Autistic people might over- or under-estimate the importance of certain things they sense, which can make it hard to focus on what really matters.

Precision of Priors and Prediction Errors: There might be an imbalance in how the brain handles predictions and errors. This could lead to rigid behaviors or heightened sensory responses.

Adaptive Coding Hypothesis: The brain of an autistic person might be tuned differently, focusing on details that others might not notice. This could explain both their strengths, like noticing small details, and challenges, like understanding social cues.

Enhanced Perceptual Functioning Model: Autistic people might be really good at noticing small details but might struggle to see the bigger picture.

Predictive Homeostasis Theory: Autistic people might aim to keep their brain in a balanced state, which could explain why they prefer routines and predictability.

Intense World Theory: The brain of an autistic person might be hyper-sensitive, making the world feel very intense. This might lead to sensory overload and a preference for predictable environments.

Combining Theories

These different theories aren’t mutually exclusive; they can coexist in the same person. For example, someone might experience both slow updating and high precision, leading to a mix of challenges, like sensory overload and a need for routines.

Autism and Abstract Thinking

There’s a stereotype that autistic people can’t think abstractly or see the big picture. This isn’t true for everyone. While some autistic individuals might focus on details, many also excel in areas that require abstract thinking, like art, poetry, and storytelling. These creative activities often involve both concrete details and abstract ideas, showing the diverse cognitive strengths within the autistic community.

Final Thoughts

Understanding how autistic people think and process information is complex, and these theories help provide some explanations. However, it’s important to remember that every autistic person is different, and more research is needed to better understand and support them. There’s no one-size-fits-all approach to autism, and each person’s unique experience should be respected.

versions of this post

For the Scientific/Academic Audience

PlainSpeak Plain Language for Lay Reader

A Short Definition

Power dynamics of ABA

https://autisticselfadvocatesagainstaba.wordpress.com/2020/04/13/problematic-and-traumatic-why-nobody-needs-aba/?fbclid=IwAR3aeHROwIEr2uaRmsw7i1oBuOy90Cln8cMgi_nJ4bZGT87VckcUhTUoOqA

Some points that resonated in this article. 

The problem with reinforcements. 

  • "tablet time” is used as reinforcement. This is a problem because many autistics rely on their tablets for communication. Many autistics are non-speaking, and to take away their means of communication is one reason increasingly aggressive or “challenging” behaviors persist — they are not being heard or understood and the only way left to communicate their discomfort, pain, or any other needs has been taken away."
The loss of childhood.
  • "A child is typically expected to participate in 25-40 hours of ABA therapy each week; that is 5-8 hours a day of repetitive, uncomfortable, or potentially painful demands and broken down tasks, of few or no breaks, of being presumed incompetent, and of not having adequate accommodations.
  • A full-time job is expected of kids under the age of 4, and there is no strong evidence to suggest that it is effective or beneficial. Children should be allowed to have a childhood, and that is not possible when they must sit through 25-40 hours of therapy each week. This level of intervention leaves little time for rest, play, and learning outside of therapy, which can wreak havoc on a child’s mental health."
Lack of training and quality control. 
  • "Many ABA practitioners are Registered Behavior Technicians (RBT)s, which any 18-year old with a high school diploma could be by taking a 40-hour training and passing an exam."
Long term trauma and PTSD
  • "A survey of 460 autistic adults and caregivers of autistic children evidenced that 46% of those who participated in ABA therapy met the diagnostic criteria for PTSD, and 47% of those meeting this diagnostic threshold experienced severe symptoms (Kupferstein, 2018)."
Yet, still touted as the gold-standard EBT
  • "Yet ABA is still widespread throughout the United States and it is recommended under the premise of being an effective evidence-based practice. However, there is weak evidence that ABA is an effective behavioral treatment. Rated on the GRADE system the quality of evidence is low to very low (Reichow, Hume, Barton, & Boyd, 2018). In fact, “of the 58 studies done on Lovaas’ ABA therapy, only one was found to meet the U.S. Department of Education’s standards for scientific evidence."
Related Posts

Who has the dx, and who is the professional

This week I heard of an instance where an ABA therapist got offended at a something his autistic client did and quit over the autistic teen not following directions. 

The autistic teen had been asked to wait at a library, looks like that teen hung around for a while, and then decided to just walk back to his home alone after a while. 

I want to ask, who has the diagnosis here, who is the professional "behavior-therapist" here who is supposed to help shape behaviors instead of walking off in a huff. 

Why have the word "behavior" in applied-behavior-therapy if you don't want to even help with or deal with behavior in the first place. 

Autism Space seen as profit making space by Private Equity

This is a continuing and troubling trend in autism. 


'...private equity investments per year tripled or quadrupled from 2018 to 2021 compared to 2015.

 ...expected investment to continue at breakneck speed

“...They needed to start showing profits and revenue that match their valuation. … So at some point, [investors] need to start seeing a return on their investment,”

 ...autism therapy space could be at the point of the investment life cycle where investors are pressuring operators to shift from scale to efficiency and profitability.

...opening clinics that reach targeted patients while being “financially healthy,” Marsh said. 

https://bhbusiness.com/2022/07/22/why-the-massive-investment-in-autism-companies-created-a-ticking-timebomb/


Noise Cancelling Headphones and Autism

Noise Cancelling Headphones are often seen as the solution to sensory overstimulation in autistics. 
Pop on a pair of headphones. And Voila, the autistic problem is solved like magic (sarcasm intended).

Are they really the solution they are touted to be? The answer may surprise you. 

Schwartzman 2023: suicidal behaviors in autistic adolescents

No surprise that suicide ideation and NSSI is higher in autistics!


Key Takeaways

  • Early adolescent autistics (total sample 239, 138 autistic) at higher risk for suicidal ideation and NSSI (non suicidal self-injurious behaviors) compared to non-autistics.
    • 20% autistics reported suicide ideation on self-report questionnaires but not to a study psychiatrist (via the Columbia Suicide Severity Rating Scale)
  • No sex based differences seen. 

Questions that arise after reading. 
  • What are the underlying factors that contribute to the higher risk of suicidal thoughts / behaviors and NSSI in autistic early adolescents? 
  • How can clinicians improve their ability to detect these behaviors given the discrepancies between self-report and clinician-rated measures? 
  • What interventions or treatments are effective in reducing the risk of these behaviors in autistic youth? 
  • How can parents, caregivers, and educators better support autistic youth who may be at risk ? 
  • What are the long-term outcomes for autistic youth with suicidal thoughts/behaviors and NSSI?
References
Schwartzman JM, Muscatello R, Corbett BA. Assessing Suicidal Thoughts and Behaviors and Nonsuicidal Self-Injury in Autistic and Non-Autistic Early Adolescents Using the Columbia Suicide Severity Rating Scale. Journal of Autism and Developmental Disorders 53.2 (2023): 559-570. doi:10.1177/136236132311621. PMID 30938385

This is 2023. Why are shocks still part of Autistic Behavior Therapy?


This is 2023: Shocks are being used on autistics as part of ABA Therapy. The UN calls it "torture". Read this article by Eric Garcia in the Boston Globe. 


1965: The images show a Photo Essay that appeared in the 1965 issue of Life Magazine about ABA therapy being done on Autistic Kids with Dr Loovas. Shocks were used as aversives -  the floor is laced with metal strips and the autistic girl in the picture is barefooted.  



Moser, D., & Grant, A. (1965). Screams, slaps & love: A surprising, shocking treatment helps far-gone mental cripples. Life Magazine, 90-102

Where do the behavior autistics go?

In this month of autism acceptance and autism belonging, I want to point to a very concerning issue. 

When your disability is TOO VISIBLE, you are made INVISIBLE by society, warehoused somewhere where you can be out of sight and out of mind of society. 


This is the plight of many adult autistic peer friends that I know. The adult autism world of inclusion and belonging, only wants the good patients. Special education had never wanted "behavior kids - the ones with meltdowns, aggression and SIBs", so will just house them in some classroom or NPS, ready to spit them out at age 22 at which point their legal obligation ends under IDEA. 

I truly believe that there is a biological basis to all this SIB, aggression and other behaviors. There also seems to be confusion that such behaviors are seen only to those with low IQ or lesser speaking ability or whether you have access to communication.  I know an equal number of autistics, considered "moderate" or "high" in childhood who reach exactly the same place by early/late teen-hood;  tossed between psychiatric facilities or stuck at home with their families. Most are heavily medicated with pharma cocktails that don't seem to work at all for autistic physiology.  

The adult autism world does not want these "behavior autistics" either. Adult Day Programs (ironically meant for autistics) don't want them, even Group Homes for autistics want only the 'well-behaved' and easily manageable ones. 

Let me give you an example of 2 peers that I know -  one sits in the corner all day and is regarded as a model student by that Adult Day Program. The other peer is at home with his aging parents as no day program will take him - "too much behaviors." And he is just one of the many dozens I personally know and grew up with in this scenario.

Behavior therapy agencies will tell the family that that autistic is "not a good fit" for their program. If behavior therapy agencies don't want to help with behavior, then why is the  word "behavior" in their name at all. Autism professionals too will find PC alternatives that essentially say "not a good fit" for the autism they don't want to work with. 

Autism Clinics at major hospitals too, end at age 18. Did the autism and behaviors magic away in adulthood. 

Essentially the entire autism professional space is rending such autistics even more invisible. 

And doing such a fantastic job of it that the other autistics (invisible disabilities/neurodiverse) don't know or believe our existence.  

In a recent twitter post an adult autistic pointed to lack of numbers of such adults as evidence that they don't exist - and since she herself had started to talk at only at age 3 after therapy; it must mean that ALL autistics must have regained speaking ability and inclusion sometime in childhood. 

Are you really surprised at this. When you are out of sight is out of mind of society; it also means nothing need be done to help.  And it merits some societal attention only when it makes it to the news in a dramatic fashion such as in the article below which will be lost in the in the quicksand of short public memory. 

And did I mention, it is incredibly hard to even find support staff as there are enough "easier" adult-autistics clients job market. So staff don't want these autistics either; everyone wants the easy button. 

There is only waitlists or rejection at every turn. 

Where are the services and supports for these adult autistics? What is the long term outcome? What is the plan?

It does not have to be like this. I truly believe that there is a biological basis to all this SIB, aggression and other behaviors.  Where is the biomedical research that looks for answers  as to what's going on at a physiological level so that we can work on targeted solutions. Given that traditional pharma is not working, when are we going to get targeted interventions and pharma that actually work with autistic physiology?

How can there be inclusion and belonging for these autistics unless we find solutions to some prior steps first?

Why is this not seen as an urgent need in autism research? 

And to the growing numbers of Neurodiverse community out there, the action I request of you is -  Include everyone, including the marginalized autistics. Help find solutions to these issues so that every autistic can be part of the dream of Inclusion and Belonging. 



 

Benzodiazepines and Barbiturates



Benzodiazepines

In class today, we studied pharmacology of GABA-A receptors, specifically Benzodiazepine's. Of personal interest as I've been on lorazepam (fast acting for agitation, mood swings) and clonazepam (longer lasting). Unfortunately the body develops a tolerance and these don't work anymore.

ABAS - Adaptive Behavior Assessment System

Lexicon [Measures] - ABAS

 The ABAS-3 (Adaptive Behavior Assessment System, Third Edition) is a  measure of adaptive behavior in individuals from birth to adulthood across multiple domains. It is a widely used measure in autism. 


The ABAS-3 measures various areas of adaptive behavior, including communication, daily living skills, socialization, and motor skills. It consists of both a rating scale completed by caregivers and a performance-based assessment completed by the individual. The rating scale gathers information about the individual's behavior and skills from different informants, such as parents, teachers, or caregivers. The performance-based assessment directly observes the individual's abilities in various adaptive domains.

Scoring and interpretation of the ABAS-3 involve comparing an individual's scores to established norms for their age group. The assessment generates standard scores, percentile ranks, and adaptive levels to provide an understanding of an individual's adaptive functioning relative to their peers. Higher scores indicate stronger adaptive skills in the assessed domains.

Limitations w.r.t Autism
  • Sensitivity to context: It relies on both rating scale responses and performance-based observations, which may be influenced by the specific context in which the assessment is conducted. Autistics may demonstrate variability in adaptive behavior across different settings, and the assessment might not fully capture these nuances.
  • Communication challenges Communication challenges, which can affect their performance on the ABAS-3. The assessment may not fully capture the complexity of their communication skills and may underestimate their abilities in this domain.
  • Limited focus on autism-specific behaviors: While the ABAS-3 covers a wide range of adaptive behavior domains, it may not fully capture the unique characteristics and challenges associated specifically with autism. Additional assessments and measures specifically designed for ASD may be necessary to obtain a comprehensive understanding of an individual's adaptive functioning.

Trapped in Turmoil


Trapped in Turmoil: SIB and Meltdown


In turmoil deep, the mind doth rage,

A tempest wild, within the cage.

A meltdown fierce, the self doth harm,

A trauma deep, the soul doth alarm.


With autism's veil, the mind doth cope,

But oft it strains, and seeks to elope.

In self-injury, it finds release,

But in the wake, a heart doth cease.


Oh autism, thy ways are hard,

For those who bear thy hidden card.

Urgent call for solutions anon,

And hold us close, with open mind.


#autismsolutions

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A poem on self-injurious behavior which is a reality for many autistics and is terribly traumatizing and battering for both the autistics and others around. We need solutions urgently. 


See this earlier post on SIB & Suicide Ideation in Autistics.

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GARS - Gillian Autism Rating Scale

Lexicon [Measures] - GARS 

The GARS (Gillian Autism Rating Scale) is a behavior rating scale that evaluates the presence and severity of autistic symptomatology. GARS assesses various domains related to autism, including social interaction, communication, and stereotyped behaviors. It is administered by a clinician and used for individuals between the ages of 3 and 22 years. 

Limitations
  • potential for subjective interpretation
  • reliance on observer ratings
  • lack of comprehensive assessment of other domains, such as cognitive abilities or co-occurring conditions.

Scoring & Interpretation

The GARS questionnaire consists of 56 items that assess various behaviors and characteristics related to autism. These items are grouped into three main categories: Stereotyped Behaviors, Communication, and Social Interaction. Each item on the GARS is scored on a 4-point Likert scale, ranging from 0 (Not Applicable) to 3 (Severe). The total score is derived by summing the individual item scores, providing an overall indication of the severity of autistic symptoms. Higher scores indicate more severe symptomatology.


History: The GARS was developed by James E. Gilliam in 1995. It was designed as a tool to aid in the identification and assessment of individuals with ASD.



Citation:

Gilliam, J. E. (1995). Gilliam Autism Rating Scale. Austin, TX: PRO-ED.


Autism Spectrum Key Points

Sharing Art made my students in my 1:54 Autism class
Image Credit: Isaias Marroquin

Text on image says
Autism Spectrum 03/03 Key Points
By Isaias Marroquin
- 74% of autistic women are initially misdiagnosed
-Thought to text technology exists
-Over 70% of autistic women are sexually harrassed
- Autistic women exhibit less repetitive behavior
- The workforce for neurodivergents is becoming more inclusive. 




 

ASD and OCD


Sharing a poem written by, Sara Cheng, one of the students in my 1:54 Autism Spectrum Disorder Class, looking at the intersectionality of Autism with OCD. 

I can so relate on many levels having both Autism + OCD + bunch of other things. Thank you Sara.  
When you add ADHD into this mix of Autism + OCD, it complicates the issue even more. The autism part of me wants the comfort of sameness/routine but ADHD part craves novelty and easily gets bored with doing the same task. So I can get terribly frustrated and bored with my OCD behaviors, even as part of me is impulsively doing it perhaps to seek some form of comfort. For instance, I'm opening and closing the same cupboard doors, even as part of me is thinking, "How BORING is this?!!" Or I'm obsessed with the zip being closed on all backpacks around me, even if its the backpack of others around me, just itching to get up and close their backpacks, or noticing that lint on the dark colored jackets of others and just itching to  pick those off - how boring is this = seriously, my mental energy could be better spent elsewhere. 

(Full text of Sara's poem is at bottom of post, for screen reader accessibility). 


This is what Sara has to say about her poem: 

“ASD | OCD” is a creative poem I wrote about the intersectionality between Autism Spectrum and Obsessive Compulsive Disorder (OCD). I personally have OCD, but not autism, so I was interested to learn more about the experience of individuals with both.


My poem describes the morning routines of a person with ASD and OCD. Both columns depict the same actions, but highlight differences in how the individual thinks about the actions, or why they perform the actions, based on the differences between ASD and OCD.


I incorporated narratives from this Spectrum News article and videos from Daniel Jones, (The Aspie World on YouTube), who talks about his experience having autism and OCD. I also drew from my own experiences with OCD.

- Sara Cheng, 1:15 Autism Spectrum Disorder Class, Spring 2022

Here is the full text of the poem for screen reader accessibility 

ASD/OCD (by Sara Cheng)

My life is structured by routine and repetition.


My life is structured by routine and repetition.

When I wake up in the morning I go to the bathroom, wash my hands, brush my teeth, and wash my face. 

Always in the same order.

When I wake up in the morning, I wash my hands, wash my hands, wash my hands, wash my hands, brush my teeth, and wash my face.

Always in the same order.


The water has to run with the same pressure every time. 

That is the right pressure, and it makes me feel content.

The water has to run with the same pressure every time.

That is the right pressure, and if it is not right, I will turn it off, turn it on, until it is right.


I put on a shirt and pants, ones sewn with French seams – the same kind I wore yesterday, the day before, and every day. I wear these clothes because regular seams are too itchy and uncomfortable.


I put on a shirt and pants, ones sewn with French seams – the same kind I wore yesterday, the day before, and every day.

I eat the same breakfast as I do every day. I like this texture and it doesn’t make me feel uneasy.

I eat the same breakfast as I do every day. I have to eat with my right hand, holding my fork at the same angle and between the same fingers, or else I can not take a bite.


Aside my girlfriend, I flick the fingers on my left hand. She knows that I stim to self soothe.


Aside my girlfriend, I try to hide

how many times I pick up and put down my fork. She knows about my OCD but I am embarrassed to show her sometimes.


I structure my day with routines because it makes me feel safe, comfortable and secure.

I structure my day with routines because I am afraid of what will happen if I don’t.

That someone will get hurt if I don’t.


I like to talk about my autism with others, because I can relate to them, and they can relate to me.

I don’t like to talk about my OCD with others, because I don’t want to voice the feelings of guilt and stress around my obsessions and compulsions.


Autism is a part of who I am.

OCD is a part of me I wish I didn’t have.