Activating the Second Wave – Intervention for teens experiencing learning challenges.

If you are a parent of a child with special educational needs (SEN), I hope that I do not need to convince you about the importance of early intervention with your child. Usually between the age of 2-4 years old you may have noticed that your child does not respond or develop in sync with their same aged peers. Intervention activities aimed to aid physical, cognitive, communicative, self-help, and behavioural development. Early intervention activities start at diagnosis and usually curb off when they child begins regular school, with some training continuing throughout childhood.

You may think that was it. I am here to encourage you to think of the period between 12-17 years old as the, possible,  Second Wave of intervention. At this time your child, typical or atypical, will go through a lot of change, and similarly to early childhood there is significant developments during these years. As parents and professionals working with teens SEN, the second wave provides a new chance to explore the opportunity for change and positive development. Its important that we honour the struggle that all teens face, and support them accordingly. The Second Wave of intervention needs to meet these children at the stage of development that they have now achieved, not as a simple add on to early intervention plans.

Changes during the teen years.

The teen years are a significant developmental period of internal change for an individual. Together with the growth of body and hormones there is significant development in the learning capacity of teens. This is extremely well detailed in Frances Jensen and Amy Ellis Nut’s fantastic book, “The Teenage brain”

From a neurological perspective, the teen brain is seen as only 80 percent mature. The finer connections in the brain are yet to be firmly established, and the brain is a time when it is more open to learning and being excited. The neurons in the brain are well connected at the back of the brain, the centre of sex and excitability, but not well developed for the frontal lobes, the centre for rational thought, self-awareness, generating insight, assessment of risk and danger, abstract thought and planning. Jensen likens the teen brain to a sports car that is all revved up, with nowhere to go.

During this time teens are also expanding their knowledge base. It is a period of great flexibility, with windows for great development of learning. However, the open brain is more open to dopamine, the neurotransmitter that makes us feel good and drives us into a, “gotta have it” type of state. If you have your teen responding to situations in a FOMO style of anxiety, you know what I’m writing about. Put this all together and you have a teenager – highly excited, easy to learn, find it difficult to explain themselves, difficult to stop an activity, irrational under pressure, and not able to see another person’s view very well. And this is for typical teens!

Adolescents is a period where behavioural and psychiatric issues develop. The general theory is that the onset of such issues may be created with the changes in body chemistry. Therefore, we see issues such as anxiety, depression, self-identify and body image develop during the teen years. Dysregulation of emotion can become common. The atypical teen is as, if not more, susceptible to these mental challenges. Additionally, for some atypical teens conditions, such a epilepsy can suddenly begin in the teen years.

And then there is puberty itself and all that new hormones introduce into and onto the teen: genitals, periods, a desire for physical stimulation (aka masturbation), voice changes, breasts, hair – everywhere – and the new hygiene requirements attached to much of this. You may still think of your teen as a child, but they certainly don’t look like one anymore.

On top of significant internal changes, the atypical teen faces significant changes in their external life. They may be at high school and surrounded by many typical teens, and viewing many behaviours – romantic, personal, oppositional, defiant, illegal – you may have wanted them to avoid. but this is not possible

All of this requires a new intervention plan – one based on their age and the launching pad that the teen years represent. For many children with special educational challenges, they grow into their challenge rather that grow out of it. Rather than trying to change them to fit the world, we have to help them be who they are going to be, but still be able to have a place in the world.

Elements to be considered in the SECOND WAVE of intervention.

The second wave of intervention is different from Early Intervention (ie the first wave) in many ways. Firstly, this wave coincides with the teen years and all the opportunity for growth, and challenge, that those years represent. Secondly, the focus moves away from a deficit model of the child to a strengths model. This is described in detail in another blog from our team , (htps://reddoor.hk/2019/04/02/lost-in-the-language-of-intervention/).

Basically we start to focus away from areas that the child can not keep up with their same age peers, unless those skills are considered essential life skills, and spend a greater proportion of time turning splinter skills into academic success, and hopefully career options.

seond wave graphicLastly, we add specially teen focused training towards new essential behaviours and to revisit some behaviour management issues from the past. These include new and updated behavioural expectations, social and emotional support, relationship advice, academic support, learning about learning, independence and understanding of the self.

Areas of training: There will be some behaviours that were cute when your teen was a child may be perceived extremely negatively now that they look like an adult. For example a young boy’s fascination with girls with blonde hair may seem cute, or even charming, when they are a toddler. When they are 6ft tall, very few people will find amorous fascination acceptable, or cute. We need to help these teens navigate the teen and adult rules of engagement around expected behaviour, conversation topics, expressing themselves, etiquette, personal reputation and dressing appropriately, personal space, and personal hygiene. Many of these topics benefit from some peer-to-peer work, discussion and explicit instruction.

Counselling/Emotional sensitivity: It is extremely important that atypical teens are given the opportunity to learn about and express their emotions. After all their experience in the world is very different from ours, or that of other teens. They are more likely to be ostracized, bullied, or overwhelmed. Yet at the same time like many teens they appraise values such as “independence” and “having friends” as important. So we need to help counsel and guide teens to navigate the world of belonging, the importance of a growth mindset, self-acceptance, mindfulness, self-advocacy, resilience, emotional understanding and regulation.

Relationship navigation:  Friendship is a major need of all teens, although the intensity of relationships may differ. Our kids need to learn the basics of making, and being a good friend to another teen. They also need to be able to distinguish a good influence on them, from a poor. Some atypical teens are being bullied by the very people they consider “friends”. During teen years romantic interest will also be piqued. One needs to learn the expectations and restrictions around interpersonal romantic relationships. This is particularly true for those teens who are poor at reading social cues so may come on a little strong, and risk complete rejection. 

Explicitly learning what doesn’t come naturally: Many teens with special educational needs have difficulty is executive function (learning how to learn, how to think) and theory of mind (understanding how other people see the world differently from you) are sometimes easier to train in the teen years, rather than to children, because of the expectations of all teens are explicit around these topics. Teens passionately learn to express their opinions confidently, and listen to those of others. Performing on tests, and comparison of marks, can be a mixed blessing. Knowing that you didn’t do as well as a classmate on a test can open the door to discussion on your learning practices. Whilst we may have explicitly taught  our kids that, “it’s okay to ask for help”, we may need to update this to include the comment, “but try to do it on your own first”.

Cognitive development: remains important: Some atypical teens may have subjects that they are extremely good at (splinter skills), as well as areas that they perform less well in. As teens age, specialisation allows them to drop some topics that hold no interest or remain too difficult and focus on those skills that may help them form success stories, future studies, or even a career. Some topics – specifically basic math, and English, remain essential skills that require continuous learning within age appropriate contexts. It insults the teen to perform reading comprehension around topics or stories aimed at young children. I encourage children with SEN to take on learning communication training – persuasive text, expression, vocabulary banks, as a lifelong education plan.

Independence: Independence is the reward of the teenage years. All of the teens I have worked with over the years see Independence as a positive trait, even if they are not, yet, capable of many aspects of independence. As the parent of a child with special educational needs I have occasionally found offering independence very challenging – what if she gets lost, what if something bad happens. My own daughter has navigated getting home from school when she lost all her money, dealing with flirtations by weird men, and having to ready herself for an exam which we had recorded on another date. In every challenge she was stressed, but responded. In the exam, she actually passed! Independence can, and must be trained.

I am Me: The last special area that is to be considered within the Second Wave is appreciation of the self. This is not just part of the emotional growth that needs to be undertaken during the teen years, this is understanding your unique position in the world., what you contribute, what you want to contribute and how you are different from others. When our children with disabilities are young children we may focus on trying to fit in. In the teenage years this can change. Their strengths become a pathway to the future. Their quirks may become how they are to be defined. To quote a phrase from the fantastic book about being different, Wonder, “Why try to blend in, when you were born to stand out”?

I hope you found this detail of the Second Wave helpful. If you have any questions about the Second Wave, and your child, feel free to contact us via reception@reddoor.hk to see how our team of psychologists can help frame support for your child.

#specialeducationalneeds #earlyintervention #teens #autism #relationshiptraining #socialskills #reddoor #theoryofmind #executivefunction #splinterskills #secondwave  

Useful books

Frances Jensen and Amy Ellis Nut – The Teenage Brain

John Donvan and Caren Zucker – In a different key

Tony Attwood and Temple Gradin (and others) – Aspergers and Girls

Delia Samuel – Against the odds

Barry Prizant – Uniquely Human: a different way of seeing autism

Tony Attwood – The complete guide to Asperger’s Syndrome.

Blythe Grossberg – Autism and your teen

Liam Dawson – Teens therapy: The mental emotional and physical challenges with teenagers.

Don’t cry for me Margarita: Breaking up from your relationship with alcohol

margarita.jpgHave you ever questioned your relationship with alcohol? Have you ever made rules for yourself in regard to your drinking behaviours (eg, I’ll only drink wine, nothing stronger; I’ll only have 3 drinks max before I go home – no more)? Has anyone close to you asked you about your drinking? Do you ever wonder if your drinking is getting out of your control? Many of us do. You are not alone.

At the beginning of the year it is common to reflect and take stock, and when people do, many choose to take a break from alcohol for a while. Taking a break has numerous benefits including experiencing improved sleep, increased productivity, better mental healths (alleviation of experience of depression and anxiety), better complexion, and potential weight loss. So, it makes sense to take a break.

Perhaps you don’t feel confident to break up, or perhaps you think you really need alcohol in order to be you (ie a co-dependent style relationship). Perhaps you wonder if your relationship with alcohol is unhealthy. Catherine Gray, in the book, the unexpected joy of being sober, suggests that that one third of regular drinkers are worried that they drink too much, but only half of those who worry actually do something about their drinking behaviour.

It isn’t your fault if you are confused or even ashamed about your relationship to alcohol. You have been tricked, entangled, and trapped, in that relationship. Advertising, and society, treat alcohol as a social lubricant when it is more of a social charlatan, hiding the reality of alcohol as silent poisonous killer. The harmful use of alcohol is a global problem as alcohol is a major risk factor in health and social issues such as violence, accidents, child neglect, absenteeism and mental health issues.

If you want to take a break there are a number of options for you to consider – from books, to online resources, to face to face support. There are a number of resources that can help you give up for a week, a month, a year, or forever.

Books

There are a number of books that support breaks from alcohol, of any period. In my opinion the books sharing the experience of the author seem more compelling, and less judgemental than some of the more academic books. I have included both styles of books in the following list. Many of these books are recommended by online support groups. These books can easily be found from online book retailers.

The Naked Mind – Annie Grace 

It is easy to understand why this book is a best-seller. This books is a motivational behaviour change book based on links between the unconscious and conscious mind. These techniques are common in the Allen Carr style of sessions – helping you reframe your relationship to alcohol, so that giving up seems more like  you have regained freedom rather than missing out. I would recommend this as a first book to read if you are considering any kind ofbooks on drinking break.

The Unexpected Joy of Being Sober – Catherine Gray

Another popular best-seller, the unexpected joy is a well written memoir with extremely practical advice and insights. Gray provides information to help you staying sober for 30 days, and abstinence beyond . There is a great Facebook page attached to this label online.

Alcohol Lied to Me – Craig Beck 

Craig Beck was a highly functional, “2 bottles of wine a night” drinker. From the outside he looked like he had his drinking under control, but that wasn’t his reality. Craig Beck has written a treasure trove of quit drinking books and has programmes attached to his model. The process starts with exploring misconceptions that we hold about alcohol.

Nothing Good Can Come from This – Kirsti Coulter 

This memoir of one woman’s journey to sober, provides a sometimes funny, and worrying, commentary on women and their problematic love relationship to alcohol

Girl Walks Out of a Bar – Lisa Smith

Another memoir, this book explores cases of individuals who have been successful career wise, but struggled in their relationships with alcohol. Lisa Smith provides a real, emotive take on her experience of recovery

Almost Alcoholic – Robert Doyle & Joseph Nowinski 

A fairly academic book written by clinical psychologists. This book outlines the problematic drinking behaviour which does not reach the level of diagnostic classification, outlining the cost of their drinking and providing practical cessation and limitation guidelines.

 

Online support groups

Online groups and platforms provide support and discussion possibilities. Some are free whilst others are paid for. The most popular groups can be found on Facebook and online. The benefit of these groups is that you can maintain some degree of anonymity but still get some support.

One Year No Beer – http://www.oneyearnobeer.com. 
One Year No Beer is a cessation programme that provides paid for support alcohol-free challenge options for one month, 3 month and 1 year programmes. Boasting over 55,000 members and plenty of tales from successful challenge completers, you can sample OYNB content on their Facebook page first to see if this is a good match for you. Many of the OYNB members take on positive health challenges aligned to their break from drinking, with added potential health benefits.

The alcohol experiment – http://www.alcoholexperiment.com

Attached to the Naked Mind platform, this 30 day free program (beyond that there is some cost) provides groups, mentors and advice how to move away from alcohol. Currently there are 35,000 users, and many success stories.

 

In real life 

If you have a more serious issue with alcohol a face-to-face option may be your best choice. You can also discuss these options with your general practitioner. Some defining questions follow this section to help you frame if it is time for you to consider change.

Support Group – Alcoholics Anonymous http://www.aa-hk.org

With more than 35 meetings a week in Hong Kong, this is the most famous alcohol recovery programme on the planet. This 12 step program includes all the great milestones of change management including support groups, mentoring, personal exploration and no judgement. Some people have reservations about elements of AA, but there is no denying the good that AA tries to do to support people recovering from problems with alcohol.

Recovery/ Rehab – the Cabin HK (and Thailand) . http://www.thecabinhongkong.com.hk

In Thailand, the Cabin runs a private rehabilitation facility aimed at the treatment of alcohol and drug abuse issues (in addition to co-morbid conditions). In Hong Kong the Cabin provides an outpatient treatment programme including counselling.

Face-to-face therapy: Counselling – various 

You may start your exploration of your relationship with alcohol in a relationship with a counsellor. Therapeutic alliance, ie how much you fit with your counsellor, is a major factor in the success of your therapy, so shop around to find the right fit for you. If you’d like some more questions about the RED DOOR offering feel free to contact reception@reddoor.hk.

 

Is your drinking problematic? 

Is it time for you to consider a break-up? The following is NOT a diagnostic test, but includes some of the types of questions that would be used for a formal diagnosis of substance abuse issues. Please answer Yes or No to the following 10 questions.

  1. In the past year have there been times when you have consumed more alcohol, or drank for a longer period, than you had originally intended?
  2.  In the past year, has your drinking interfered with your relationship with friends, family or work colleagues.
  3. In the past year, have you missed work, or key appointments on a few occasions because of alcohol consumption the night before? 
  4. In the past year, have you wanted to cut down your drinking amount or frequency and found yourself unable to do so?
  5. In the past year, have you blacked-out as a consequence from drinking alcohol?
  6. In the past year, have you lost personal items such as your keys, or wallet, whilst you were inebriated?
  7. In the past year, have you missed work, or key appointments on a few occasions because of alcohol consumption the night before?
  8. In the past year, have you noticed that your tolerance to alcohol has increased, and you now need to consume more alcohol in order to feel it’s effects?
  9.  In the past year, have you found yourself in situations where you may have compromised your personal safety, or the safety of others, as a consequence of consuming alcohol
  10. In the past year, have you started to experience some of the symptoms frequently labelled as  alcohol withdrawal, when you are not drinking including shaking, experiencing a racing heart, sweating more than usual, nausea, or trouble sleeping.

 

How many questions did you answer with a “YES” response? If you answered three or more with a YES, then I recommend you consider to break-up with the booze, if only for a short period, but possibly for more. Certainly take a look at the resources listed in this article. You deserve to feel good, and it might be time to start that journey.

#reddoor #alcohol #alcoholdependence #alcoholrecovery #alcholicsanonymous #thecabin #oneyearnobeer #alcoholexperiment #thenakedmind #theunexpectedjoyofbeingsober #alcoholliedtome #girlwalksoutofabar #almostalcoholic #nothinggoodcancomefromthis.