Autism and Temperament

When working with children in the autism spectrum, there are assumptions of behavior based on children we have worked with before.  But is there any truth to the assumptions?  Below is a graph looking at the temperament profiles of 56 patients I saw between Jan 1, 2010 and Dec. 31, 2011.  There were 56 seen in all, with 14 being female and 42 being male, making for a 4:1 ratio.  As  you can see there are certain trends that are  predictable, such as adaptability.  The 1 level (green) means that the person is very slow to adapt to change.  That is what we see with problems in changes in routines, differences in opinion, and transitions. Individuals who are slow to adapt to change also have more problems taking others perspectives, much like the concept of theory of mind.

From the composite of the 56 patients I worked with the following profile would be expected.  Very few would be of a low activity level (blue).  The majority have an average range, with a significant number also needing to be active most of the time in order to be relaxed (red). The more stressed the child is, the more active they become trying to relax.

Rhythmicity is how in tune to time and rhythm a child is.  It is part of our internal clock.  This is needed for organization, planning, and work efficiency.  The majority of individuals had significant problems with sensing time and being able to plan, sequence, do activities and work in a timely manner.

Approachability is how long it takes to become comfortable with different people, places, and situations. While the majority can become comfortable with an average amount of time, there is also a very large group that takes a very long time, which means that they don’t like attention focused on them.  They also would be very slow to seek help if they didn’t know how to do something.

As noted in adaptability, the vast majority of these children are very slow to adapt to changes.  Also important to note, there were no children who were overly adaptable.

Intensity of response is how soon a child shows changes in emotions and how much they show from moment to moment.  As the composite profile shows, there are a number who don’t demonstrate their emotions immediately and may therefore develop physical symptoms if stressed over time, such as headaches, stomach-aches, sleep problems, etc.  There is also a small group that always shows all emotions immediately and to an extreme degree, kind of like a light switch rather than a dimmer switch.

Basic mood is the first impression to a situation, stimulus, or suggestion. Out of the 56 patients, there was only one who always looked at things in a positive first impression.  The majority can go either way or are very negative in their first impressions, which irritates most adults.

Persistence is the ability to stay at an activity or task without help or motivation.  As the profile shows, none of my patients were overly persistent.  In fact the majority found it very difficult to persist.  It is important to understand which have problems due to motivation and which shut down since they don’t know how to problem solve, because the approaches would be different.

Distractibility is how much the child can divide his attention to different aspects of his surroundings.  What was important was the fact that a large minority were hyperfocused, and only a few were distractible most of the time.  Being hyperfocused means that they can’t multitask very well since they can only focus on one thing at a time and become very distressed if they are forced to try to focus on two or more things at a time.

Sensory threshold is very important since sensory issues have been proposed to be a part of the DSM-V for autism spectrum disorders.  As the profile shows, there was a large number who were actually hyposensitive, leading to an over seeking or under responsive style of behavior and needing higher levels of a sensory input to recognize what is happening.  There were very few who were oversensitive to everything.

The importance of understanding temperament when working with individuals in the autism spectrum is in realizing that these are wired in behavioral responses.  This means that interventions have to include teaching strategies for the poorly fitting temperament traits in a situation.  It means not trying to give negative consequences or trying to extinguish behaviors.  It requires the professionals working with this population to understand how to create “good fits” and making this one of the goals for life success.  This is what a pediatric profiler does.  Check out the different programs that I have through my listing on Speaker Match in order to learn how to become proficient at this skill.


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