Autism and Conditioning

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Disclaimer: I don't really have a thorough grasp on how therapy works nor any other 'treatments' for autism, so if the following appears uninformed that's why.

I'm aware that autistics (more often those that aren't high functioning/Asperger's) are often afraid of change, and as a result have rituals and other behaviours to keep order. What happens if the parents of autistic individuals that fall in to that category strictly prohibit rituals and enforce lots of changes gradually such as in cognitive behavioural therapy?

Would the result be something like permanent meltdowns and/or shutdowns, or could this work in the long run to mitigate/abolish relevant behaviours due to neuroplasticity and conditioning?


EDIT - Also, does it necessarily have to be a fear of change, or can it be something like an annoyance/hatred of it instead?

You dont see the reason behind it. Beside weird phobias a fear is something naturally caused. Normally things you "fear" are things that you have reasons to avoid. The fear to have a car crash, is not, does not exist from itself, but because of an car crash being able to have several negative effects on you: Direct pain, and afterwards effects as being physical disabled for a certain time as well that you can be financially disabled, due to medical costs and an possible non-ability to go to work.

And because of Autists being normal humans as well, there are as well reasons for their "fear", as you call it, of changes.

If you focus very strong on a certain task, that is complicated to you, that takes a lot of ressources from you. If that is changed suddenly, this ressources were wasted for nothing, which can add to your exhaustement, as well, that you need to do new plans agains, which will be again need ressources.

If you are naturally good at something, you wont have much effort on doing a certain task. If you are not that good, then doing something in plans and patterns, help. (Just like that typical "painting according to numbers".) So all that patterns and routines, are nothing else then helpers to ease things down, so that its easier to handle, and you can keep more of your ressources for other tasks.

If whyever, your ressources gets wasted for nothing all day, then that leads to you being exhausted, tired and so more stressed, without additionally having any benefit for it at all.

So its not about fear, its simply about enduring negative consequences. Some you choose on your own to endure, to receive in the end certain benefits. Endure school - get exhausted and stressed - but get school grade in the opposite. Endure work - get exhausted and stressed - get loan at the end of month.

But just like every other humans, you will naturally avoid enduring negative consequences, if there are no sufficient benefits at all to it. And the instinctive reaction of your brain to avoid such situations, is simply by giving you a negative feeling about it, be it now a nasty feeling, or a scared one...

Or easy: Disturbing a routine/pattern = negative effect. Negative effect = negative. Brain does not like things affecting us negative, tells us to avoid them by giving us negative feelings.

Last edited by Schneekugel on 03 Feb 2014, 7:28 am, edited 1 time in total.

I am very high functioning and I have an "order expectancy".

"Order expectancy" means I have memorized the order of an event, and expect that event will follow the same order.

1. If the consequence is trivial e.g., "they ask if I want my bread toasted BEFORE asking me if I want cheese on my SUBWAY sandwich" (something that only happens like 5% of the time) , then the violation of the order was so minimal that I do not get enraged.

2. If the consequence is more than minimal, at least as I see it, then that means the person affected a bad outcome to me because they violated the order. In that case, I develop what seems like a psychotic rage towards the person.



Changes were inflicted upon me growing up, and the "order expectancy" did not go away.

So, is there a point to what probably feels like torture to these kids ? Can you cite some evidence that CBT actually works ?

No, I don't have any. I only referenced CBT because what I was thinking in my mind was similar to that.

I suspected it would be like torture, hence the meltdown/shutdown question. I'm just curious if, in the long run it could ever be good. You seemed to have hit the nail on the head, at least in your case, as the order expectancy definitely didn't go away. If you read this and if you don't mind, could you please provide an example of a break in order that would cause you to go into the rage you describe?

I don't understand why my parents would want to disrupt my system of order. Structure and routine can be altered without being smashed. I mean the things I do and the order I do them in has morphed from what it was like a couple of years ago. But the system is still in place. Its really not that different I think then the system of structure and routine and order in school. Its like I depend on my classes being in order and breaks taking place between certain classes. If everything was suddenly switched around it would cause the whole system to crash.
But of course changes do take place with each new school year. But the changes are part of the system structure and still have a feeling of order.

As far as CBT goes, which I have had, Im not seeing a connection.

Yeah, I explained it pretty badly (CBT). It was the closest thing that resembled what I had in mind.

What do you mean the whole system would crash? I see this written often but I am left to imagine too many possibilities as everyone is different. For you, do you have a meltdown, or what happens to you? Why does it happen? Can you control it? Are you afraid of change in order, or annoyed by it? What would happen if one day a school announcement suddenly read out that recess was happening one class earlier than usual?

Also I respect your decision (and others) if you don't wish to answer, I'm just really, really interested.

I tried changing my routines, it does not really work very well. It does not help that I actually function better with my routines than without them, even if to other people some of them seem unnecessary or odd.

What happens if there are changes, will depend on how much you can take. If you feel fresh and you are still full of ressources it will only force you to redo plans, which needs a certain amount of your ressources, and so adds to make you stressed/feel annoyed/exhaust you.

When you cant take it anymore, depending on your personality and situation, you will crash down => Meltdown or Overload.

Sometimes it was only completely minor crap, that let me burn out, but it was simply the last drop that made the boat sink. *german saying*

So the "order" example at Subways is something that would as well annoy me a bit, but normally not in any critical amount. But it would add up a bit to the "amount I can take", and that you need to balance by relaxing, doing SI = doing things the way they comfort you = patterns.

1. Rewarding gradual change has been shown to work well with people with ASD, even with severe symptomology. For behavioral change to really work, the key is to target one behavior at a time, not lots of changes, otherwise whatever the reward is loses its effectiveness.

2. It's more behavioral therapy than CBT; the C in CBT stands for cognitive; especially for people who don't think in words, I cannot see how CBT would be effective at all.

Sorry but just to clarify, what are the meltdowns and overloads like in a typical situation? Are you referring to a sensory overload or an overload of stress etc?

When I see meltdown, I think of a rage fit that lasts for ages (10 minutes onwards etc) and is completely out of your control. I don't think I've ever had that. Are there smaller variations?

Routines develop to compensate for poor executive functioning. If you introduce a constant element of change into the life of a routine-following autistic, I think you would just teach them to think, "Oh well, I can never plan for anything so I might as well stop trying" and become totally passive and non-functional. People on the spectrum need time to think things through beforehand and pre-plan as much as possible, because it's much harder to understand what is going on when one is in the moment.

I dont know if I refer to the words wrongly, but the meltdown is for me not the aggressive one. (I am native german, sorry if use the words wrong.) Meltdown is for me like the brain closing curtains to cover me. I have troubles feeling then, as if everything was dead. I only want to be left alone then, and try to get away. Its as if everything is damped and trying to interact with others becomes horribly painful. When people see me in that mode or short before, they mentioned that I was very pale then, looked horrible exhausted and were afraid, I´d physically breakdown. And I looked scared to them. Its simply exhaustment. Just like everything else, your brain and your body cant do forever. If you push someone until his mentally and physically exhausted, they break down. Because of my sensory issues, this happens for me faster, my routines help me avoid that.

Overload is for me quiet opposite. Instead of getting tired by disturbances, somehow they influence me otherwise, I get startled up instead. Its as if you drank a ton of energy drinks at one, so thoughts are spinning more and more and the more I get pushed unexpected stuff from outside, the more weird my thoughts get and its as every part of my brain tries to handle 5 similar issues, that are flashing too my brains at once, until some certain s**t simply makes it, to the brain not longer able to handle all that diferent thoughts and being "overloaded". And whatever causes that feels simply threatening to you in that moment, It or the person is causing you to feel miserable = hurting you in an serious amount = is attacking you. So you defend. Luckily I am not really physical when it comes to that, but it was pure aggresitivity. (Yelling, throwing and destroying stuff...)

I hated that aggressive episodes quiet much, so I told horrible things to people, destroyed stuff I cared for while having an anger issue.

Because of me living on my own now, its far easier to control my life now. So the avoidance of disturbances, routines and patterns, ... cause that the amount of stress should be managable for me. As well that I "listen" now more inside me, and so if I feel bad, then I care for myself and avoid certain stuff, until I feel better again. If I need time on my own, then I need time on my own. As well that if I feel that "startling" overload symptoms, that I drastically try to avoid all situation enhancing them.

I still have issues with meltdowns (maybe once a year), but luckily overloads dont really happen anymore and are as well not that intense anymore.

O.O

That sounds a lot like me when I fall out of a routine. Since not having school I've basically become a robot. I wake up, go straight to my computer and research ASDs, talk to my 2 friends on Skype at random times throughout the day, then go to sleep. Most of the time I'll have Big Brother playing in the background, or a movie that I've watched before. I have 2-3 meals (my mum makes dinner so it's easy), usually 2 of those are something minor like noodle cups.

@Schneekugel - Thanks for the explanation.

That would be a terrible thing to do to an autistic child...some of these 'rituals' could be calming and too much change is just simply too much change which can cause a lot of stress. I think at some point someone with autism has to learn sometimes there will be changes they can't control and learn coping skills to help deal with those situations...but just forcing constant change would probably create some kind of stress disorder.

Well I meant is that school the system would literally crash. You would have all these kids who were in the wrong classrooms for those periods. It would be total mass confusion, like when you mess up an ant hill.
And the same thing can happen in my brain. I think what happens is the fight or flight response gets triggered.
I get confused or panicked or angry depending on what it is. Controlling it or not again depends on the situation.
Like last week I had plans that got abruptly changed and I started flying into a rage. I mean all I could see was red (figuratively speaking) but my mom was able to talk me down. It all has to do with hyper sensitivity I think.
You know how something like Dodge Viper is super touchy responsive and its easy for it to go out of control. I'm super touchy when it comes to structure, order, routines etc. And its easy for me to go out of control when a monkey wrench gets tossed into the works.

And its like Schneekugel said, it depends on how loaded with stress or whatever already.
Thats why it often seems when a meltdown happens its over something trivial, but its the straw that brakes the camels back or the last drop that sinks the ship (love that )

Last edited by EzraS on 03 Feb 2014, 12:18 pm, edited 1 time in total.

In my experience, sudden shifts do not cause fear merely as a result of loss of control, but are uncomfortable and difficult to deal with because personally I have issues transitioning between one action and the next. I am capable of large amounts of hyper-focus, but have little to no ability to shift my focus fast, without actually having difficulties processing such shifts in a neurological fashion. If I am reading, and someone starts talking to me while I read, it takes me time to register "hey someone is talking! stop reading, close the book, look up, pay attention". By the last step I have missed a great deal. I guess in a sense change causes my executive dysfunction to be very apparent.