Alternative Choices in Psychotherapy and Autism Evaluation

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Dr. Naseef's Blog

Robert Naseef's blog provides insightful views on neurodevelopmental disorders, especially Autism Spectrum Disorders. Combining personal experience and professional insight, he explores challenges faced by individuals on the spectrum and their families. The blog highlights understanding, acceptance, and practical support, serving as a valuable resource for caregivers and professionals seeking deeper awareness and effective strategies.

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Dealing with Adversity: Everyday Traumas and Lessons in Mindfulness

Robert Naseef October 28, 2014

I never thought when I woke up that I would have a lesson in mindfulness this particular day.  It was a beautiful day, and then in an instant, I wiped out on my bicycle and landed hard on my right shoulder. I thought I would be okay in a few days, but that was not the case.  My summer plans were out the window.

Shoulder surgery meant 6 weeks with my right (preferred) arm in a sling. I couldn’t drive for at least 2 months. Bike riding, swimming, and gardening were out. Not to mention 12 weeks of physical therapy and up to 12 months for maximum recovery.

I was shaken, scared, and somewhat traumatized. But it was just an everyday trauma, almost trivial in a world where war, famine, and natural disasters impact millions of people daily. What it meant for me was that a piece of my stability and security vanished. My personal sense of safety was altered.

I was confronted by the inescapable reality that trauma is an indivisible part of the human experience. It’s a fact that we rather not face but is not the last word. Some trauma, if not too severe, actually offers a chance to grow and broaden our horizons.

Having been healthy and strong, I wasn’t used to feeling weak and vulnerable and needing to ask for help. I surprised myself that I wasn’t filled with resentment. I unexpectedly found more peace from accepting and settling into life as it unfolded.

Now with my physical discomfort as a focus of attention, I am more aware of every step I take, more aware of my body in space, and more aware of speaking and listening to the people around me. Most of all, I am experiencing a deepened gratitude for everything I can do and for the support from my wife and daughters, family and friends—and others who ask about my “broken wing.”

There have been good days and bad days, with slow healing and recovery. There are more than enough tragedies and painful experiences in the world. There is no need to exaggerate or minimize. My own trauma has deepened my compassion for the small and large traumas around me – everyday trauma and more serious inescapable traumatic events.

Life is fragile, and we are powerless in the face of this reality. By facing it, we find wisdom, tolerance, connection, and love. My everyday injury continues to be a profound lesson in humility and how much I have left to learn.

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A Magical Connection

Robert Naseef July 31, 2014

While catching up on my reading, I found a real gem: Life Animated: A Story of Sidekicks, Heroes, and Autism by Ron Suskind. I had heard and read about it, but the original motivated me to write about this family’s story and the wisdom of their son with autism.

Owen stopped speaking just before his third birthday, had trouble sleeping, and cried inconsolably. However, he remained fascinated with Disney animated movies which he loved before the autism emerged. His father’s account of how the family connected with him through this special interest led to a series of breakthroughs. The family watched those movies over and over and began to communicate with their son through the movie scripts.

Joining with a child’s interest is not a new concept; in fact, it came from developmental psychology and has become an accepted part of most autism treatment programs. What is remarkable in this book is the intimate account of how this worked day in and day out in a family: their thoughts, feelings, frustrations, and experiences. We also learn how they built partnerships in their son’s interest with teachers, therapists, and mental health professionals.

Having read hundreds of autism books from parents, researchers, teachers, various therapists, and people with autism, and having written a few myself, I would have to say this is one of the best yet.

It’s so much more than just the memoir by a Pulitzer prize-winning journalist. It has a broad applicability across the autism spectrum and across cultures and social classes. Beyond that it’s about what it means to be family.

Of course, average families do not have the financial resources of the Suskinds who poured about $90,000 per year into resources to help their son. With adequate public support, the methods they used can be made broadly available to address the rapidly expanding public health crisis of autism which currently affects over 1% of children born worldwide, 80% of whom are boys.

There is real grit devoid of a storybook ending; Owen Suskind does not recover from autism. He does make amazing progress, graduates from high school, attend a transitional program on Cape Cod and meets a Disney producer. He does not become a Disney animator as he had dreamed. Owen will likely never become completely independent as his parents had dreamed.

Nonetheless and maybe because of this, Owen, like my adult son with autism who is nonverbal, is a good son and a good brother who has taught his family incredibly profound lessons.

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What Do Guys Talk About

Robert Naseef January 21, 2014

At last week’s meeting, a guy turned up with the “Guy Talk” flyer in his hand and said, “My girlfriend said I should come here.” After going around the room and introducing ourselves, I asked the new guy what he wanted now that he was here with the rest of us.

“I just want to know how you guys deal with it.”

One man said he meditates in the morning and that helps him stay calm throughout the day.

Another guy talked about going to a cigar lounge once a week and just hanging out.

One father mentioned how he and his wife are finally working together “on the same page” with their boy who has Asperger’s.

Another father going through a divorce talked about how hard it had been, but he mentioned that his son’s special needs were not the core of their marital problems.

Another guy whose son was diagnosed only a few months ago talked about how he has not been able to tell many people. He enjoys coming to this group where he can speak openly, and guys with similar experiences understand.

There was the talk of the embarrassment that sometimes arises in public when a child with special needs acts strangely or is noticed because of poor hygiene.

In this environment where guys were being honest, one guy shared that he is in recovery from alcoholism. He revealed that he had spent years self-medicating and trying to escape his feelings.

Having a safe place to share their experiences brings men together to share how they are coping and give each other ideas. The guy who came because he was told to said he would be back.

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Should you tell your child?

Robert Naseef January 21, 2014

Parents often agonize over if and when they should tell their child he or she has autism or other developmental issues.  If your child had asthma or diabetes, you wouldn’t keep it from her.  If she is on the spectrum or has ADHD or OCD, telling her is still the right thing to do.  Your child needs to know.  You need to be comfortable discussing your child’s diagnosis intelligently and unemotionally. This means working to get past being tongue-tied when people ask you.  Talking about the diagnosis doesn’t need to be THE talk.  It’s actually better to share information as things come up.  For example, “We are going to occupational therapy to learn ways to calm down when your head hurts from all the noise around you.”

A child is ready to know about her diagnosis when she begins asking questions like why it’s hard to have friends, or why handwriting is difficult, or why certain noises bother her more than other people.  Not beginning to talk about your child’s differences will have a negative impact on self-esteem because by this point your child knows something is going on.

Dr. Stephen Shore has developed a four step approach:

1. Discuss strengths and challenges which your child is experiencing.

2. Align your child’s strengths and challenges in two columns.

3. Next make nonjudgmental comparisons by looking at friends and family members and how they compensate for their challenges by using their strengths.

4. Finally discuss the diagnosis by talking about how your child’s set of challenges and characteristics match those with autism or other developmental conditions.

Dr. Shore stresses that there is no particular age to begin discussing your child’s diagnosis. There is no need for a “sit down” talk. Stephen recalled how his parents used the word autism matter-of-factly just like they would talk about brown hair or blue eyes, and this is how he recommends parents go about the process with their children.  Start with the positive aspects of ASD, such as what your child is really good at or knowledgeable about.  People with ASDs often have an incredible memory for detail, especially on their special interest.  They are usually very honest with other people and say whatever is on their mind. It’s important to tell your child all the “good stuff” about him that you would never want to change.

Parents can explain in a matter of fact way that having a spectrum disorder or ADHD just means that your brain works a little differently which makes some things harder but some things easier. Stress your love and devotion in helping your child become all he can be.  These issues will come up repeatedly in various contexts, so it’s important to realize that just one talk won’t suffice. This is all part of the evolving journey of acceptance for parents, children with special needs, and their siblings.

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De-Stressing from Holiday Distress by Drs. Cindy Ariel and Robert Naseef

Robert Naseef December 20, 2013

No matter what tradition you celebrate, holidays are often filled with stress.  There is a lot of pressure to make the holidays perfect and fun while enjoying yourself.  When you add to that the stresses around having a child with special needs it can become even more overwhelming.

Everything needs readjusting in your family life and you are left with many strong emotions. It is on you to make warm experiences and wonderful traditions.   It’s important to sit back for a few minutes and reflect. What is it about the holidays that you’ve always enjoyed?  Special foods?  Pretty decorations?  Certain activities?   The gifts?  All of it?  Whatever it is start there.

Some things may need modification in order to enjoy the holidays with your child.  For example, if there is a danger of injury on fragile decorations, you may have to put them higher out of reach or get new ones that are less fragile.  Some special foods may not be able to be served.  These modifications can be disappointing, but if the goal is a nice family holiday, we can adjust.

Make the demands on yourself realistic. Try to put some limits on how much you do so that you can feel some of the joy, not only the frustration.  Make sensible lists and work on things one at a time.  Looking at the whole holiday season is less overwhelming if you take it in small pieces.  You may have to manage your expectations to lower your stress level and make the holidays special.

For gifts, think about what will put a smile on your child’s face.  Maybe she can’t handle the new games that every other kid is playing, or the current popular book series, or new sports equipment.  But she may be thrilled with a cushy new ball, a big soft bean bag chair to flop on, a favorite food (within dietary constraints), or even an hour away from the noise and confusion to walk outside or go to the playground.  The National Lekotek Center has recommendations on the “Top Ten Things to Consider When Buying Toys for Children with Disabilities” 

These may not be the holidays you dreamed of, but you can still offer your family the love and warmth that really matters.  More than new toys, it is parents’ time and attention that is so exciting and wonderful for children.  In the consumer-driven rush this holiday season, let’s not forget what’s really important.  Let’s try to connect with our families and friends and all whose lives we touch.  Let’s enjoy quality time together.  As Ralph Waldo Emerson wrote many years ago, “The only true gift is a portion of thyself.”

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Alternative Choices in Psychotherapy and Autism Evaluation

Philadelphia, PA

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