Individuals with characteristics associated with an Autism Spectrum Disorder (ASD) have it harder than the average person. Life is more difficult. The degree of difficulty varies, depending on the degree of Autism, Asperger's, NLD, etc., but there are certain areas that are problematic. Gillberg (1991) identified the following areas:
- Social impairment
- Narrow interest
- Compulsive need for routine
- Speech and language peculiarities
- Non-verbal communication problems
- Gross-motor skill delays
These problems result from differences in "wiring", that is, central nervous system differences identified in specific areas of the brain that correspond to social behavior, empathy, communication, and cognition. There is evidence to support the genetic basis for these wiring differences, as well as some indications of pre- and peri-natal factors. ASD does not result from poor parenting as was thought 50 years ago.
Social problems are a circular causal factor in a child's maladjustment. Children with ASD are a little off, sometimes way off in their understanding of social expectations. Learning social do's and don'ts does not come intuitively. Some adults with ASD have suggested that the name be changed to "wrong planet" syndrome, like they are from a completely different culture and have a completely different way of perceiving and thinking about the world (Atwood, 2007). They often stand out in a negative light. There are often emotional regulation problems, attentional deficits, and executive functioning deficits. By the time a child reaches adolescence he or she has likely had trouble performing in school, been ostracized and mistreated by peers, and has frequently been misunderstood by adults as a very difficult and rigid child. There may be severe damage to self-esteem, self-efficacy, and hope. Anxiety and depressive disorders are common. And life doesn't get easier in adolescence. With the increased social, academic, and affective demands placed on one whose foundation is already shaky, it is no wonder there is an increased withdrawal, avoidance of school, and often a retreat into electronics, online gaming, etc. Unfortunately, this avoidance and withdrawal, results in a widening developmental gap between these teens and their peers.
Wilderness therapy can be an ideal intervention for adolescents who have spectrum issues. It is often a first step, but it can help these teens make huge strides. There are numerous reasons for this.
First and foremost, they need to experience successes; successes socially, i.e., fitting in and being accepted by a group of peers, successes in achievement, which involve completing tasks and accomplishing goals, and "emotional successes, being able to effectively manage anxiety, stress, frustration, and self-doubt. Of course, these successes require effort that many adolescents had given up a long time ago. Wilderness therapy was created for "treatment resistant" clients, and effort is required if for no other reason than to leave the program. This is an "external motivation" which obviously is not the best in the long run, but in the beginning is often necessary to get someone out of the rut they were in and begin to create some movement.
Once progress begins to occur, there are many necessary aspects of treatment with teenagers who have ASD characteristics. A therapeutic wilderness program has many of these: size, structure, experiential nature, Positive Peer Culture (PPC) model, individualized approach, and, particularly important, specially trained staff, and understanding.
The size (usually nine students to a group) and structure (provided by at least three staff, often four or five to a group when necessary) are crucial. Wilderness therapy incorporates the common treatment modalities including an insight approach (cognitive behavioral), relationship based (humanistic), but it is the experiential component that allows for behavioral shaping, "successive approximation", a step-by-step method that is so necessary.
This shaping can only be accomplished in a small group with a high staff to student ratio. It is basically "on the job training" for teens who need social and emotional development. The group works together in a wilderness environment, breaking down camp, hiking, setting up camp, cooking meals, making fire with bow drills, setting up shelters, playing games, sharing responsibilities. With literally dozens of challenges a day, tasks to accomplish, interpersonal interactions, all grist for the mill. Feelings come up, issues come out and problems arise. All in an environment in which ongoing help is there to process what is happening, that is, discuss what is happening, how people are feeling, what they are thinking, what they are "choosing" to do, how they have typically handled situations like this in the past, how effective their efforts have been, looking at new ways of communicating, new ways of problem solving, all of which results in more positive outcomes. New behaviors are learned and practiced. This process can only be facilitated with a lot of structure. This level of structure can only be accomplished with a small group size and sufficient number of staff to constantly monitor and intervene when opportunities, or learning moments, arise.
These learning opportunities, especially involving peer relations, that normally occur in an unstructured setting like, say, public school, can be much more controlled. Wilderness therapy incorporates a therapeutic model called Positive Peer Culture. This model relies heavily on an individual's desire to fit in, to be accepted by peers. The key word in this model is "positive". Improving peer relations requires trying out new ways of communicating and relating. It requires being vulnerable and taking emotional risks. This is hard for individuals who have been the target of peer abuse. The PPC model places a high amount of responsibility on students to cultivate a positive culture in which there is mutual respect and "emotional safety" in the group. A safe environment is created in which social and emotional development can occur. Many students have remarked upon leaving the program, that it was the first time in their life that they have felt like they were accepted for who they were.
There are other challenges specific to individuals with ASD. These include sensory integration issues, problems with transitions, difficulties with verbal abstractions, and executive functioning deficits to name a few. It is important to understand that these problem areas are biological in nature and require extra patience and individualized approaches. It is important to provide a little more "heads up" about transitions. It helps to be to be more concrete, explaining and even teaching the meaning of metaphors and idioms. It is often necessary to break tasks into smaller units with short-term goals. It is often necessary to provide a significant amount of prompting at first to help students stay focused, to be aware of what they need to be doing, and then fade the external support as they begin to develop some consistency, routine, and self-direction.
Life is harder for individuals who have aspects in their biological makeup that we call Autism Spectrum Disorders. Many important aspects of life that are learned naturally by most people do not come naturally. Learning certain skills that promote flexibility and adaptability are crucial. Wilderness therapy, using nature, a positive community, and some degree of challenge, helps students learn step-by-step. It's like learning to drive with a standard transmission. At first, it requires a lot of thought and attention, but with practice, becomes more automatic.
About the Author:
Dr. Huffine is a licensed Psychologist and has been practicing psychology for over 20 years, 12 of which have been as a Wilderness Therapist. His Master's Degree and Doctoral degree are in School/Child Clinical Psychology. He worked for several years as a school psychologist, primarily with special education populations and was part of the autism assessment team for the school district. Dr. Huffine is the Executive Director of Second Nature Cascades Therapeutic Wilderness Program in Bend, OR. For more information, visit www.snwp.com, or contact Dr. Huffine at firstname.lastname@example.org or 541-382-1620.