Why problem solving skills can be difficult in people with Autism? Here’s how to help

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People with high functioning autism can be great at thinking out of the box and coming up with brilliant solutions. Their tendency to note things in details gives them distinctive advantage of being more meticulous and thorough with their work. Recent research has shown that people with autism are 40% better than neurotypical population at solving problems possibly because of paying more attention to visual details and finding patterns .

When it comes to daily life situations, it is here where we often see that people with autism struggle. Daily life problems are much different because of a lot of hidden social curriculum. Researcher Brenda Smith Myles defined hidden curriculum as the social information that is not directly taught but assumed that everybody knows e.g. not staring at people, not standing too close to people in their personal space, knowing how much to eat at someone’s place even though it might be your favourite dessert etc.

In solving the technical problems, the hidden social curriculum may play a very minimal problem due to which people with autism have been observed to show outstanding performances, whereas in situations that involve interaction, communication and transactions with people, that’s where people with autism need further intervention and support.

Let’s take a look at the steps of problem solving:

To explore how people with autism may experience difficulties with problem solving, let’s consider a scenario where a person with autism was learning to drive a car with the driving instructor.

The person with autism realises that the car behind is tailgating his car. He gets anxious and starts to speed up to create a safe distance between his car and the car behind. Upon realising that the learner driver is speeding up, the driving instructor says “If you get a fine, I’ll not pay for it”. The learner driver now becomes even more anxious as now he not only is worried about the car behind crashing into his car, he is also thinking about the speeding fine and the driver instructor stating that they will not pay for the fine. This leads to the learner driver becoming overwhelmed and feeling unsure what to do. The instructor realises that the learner driver is not feeling confident and suggests to pull over the car when safe to do so. This seems like the best option for the learner. He pulls over and decides that he should give up the idea of learning to drive a car.

For many of us, this might be a common scenario that we can experience almost everyday (depending on where you drive) and it does make us feel uncomfortable and sometimes (or most of the times) annoyed, it does not make us think that we should give up driving altogether. So let’s dissect the situation to find out what might had gone wrong in the above scenario and what alternative behaviour could have been more helpful for both parties involved.

Why problem solving is difficult for people with autism?

1. Emotional regulation difficulties:

When the neurotypical population comes across a problem, a sad or a shocking news, depending on the intensity and severity of the news, their information processing abilities of the brain may become deficient and compromised for a short period of time, making them feel as if  they cannot make sense of anything, as if their whole world has come to a halt. After some time, the person’s coping mechanisms kick in and the person starts to realise and process the news (beginning of step 1 and 2 of problem solving). As they identify what has gone wrong wrong, they now transition to the other steps of problem solving (step 3, 4 and 5) and evaluate if the best available solution helped manage the situation (step 6).

As people with autism experience much greater level of anxiety than general population, they are more likely to be upset to a greater degree and for a longer duration e.g. yellow and red zones in the above picture. This may be explained by the additional worry caused by the problem, on top of the already present anxiety, much similar to 1+1=2. Anxiety impairs cognitive abilities, hence even making it more difficult to begin the very first step of problem solving i.e. identifying the problem (step 1). There is also evidence that people with autism have mal-adaptive or counter productive emotional regulation strategies which compromises their stress handling mechanisms. Similarly people with autism have difficulties understanding their own thoughts and feelings. All of this when combined together may mean that the information processing, analysing the problem or the news (step 2), difficulties generating adequate responses and solutions (step 3 and 4), taking initiative to solve the problems (step 5) and evaluating the consequences of their actions may be deficient.

Not only anxiety, but the prevalence of depression is also high in people with autism with studies suggesting that people with autism are 4 times more likely to experience depression across their lifespans . Depression itself can further compromise problem solving abilities.

So when we look back at the above scenario where the instructor says the learner driver is likely to get a speeding ticket, what we see is that the learner who was already anxious because of tailgating, now decides to quit learning driving altogether. This is because by now, their anxiety levels were becoming higher as now they had to deal with 2 more problems in addition to the first problem of tailgating; getting a speeding ticket and arranging money to pay for it. Increased anxiety disrupts concentration span and is not conducive to learning, hence any more suggestions would not have been helpful. So it is good that the driver instructor suggested the learner to pull over and take a break.

2. Impact of stress on communication difficulties:

Stress impacts communication in people with autism. The fact that the driving instructor used implied meaning and focusing on unwanted behaviour “if you get a fine”, it became further difficult for the person with autism to understand and make a link why they would get the fine when they are trying to save their car from being potentially hit. Similarly “I’ll not pay for it” could have meant that someone else will pay without specifying who it will be.

If the person with autism now starts to think about the implied meaning, it requires even greater cognitive processing abilities from a brain that is already experiencing high levels of stress. As a matter of fact when the learner driver shared their problem with me in the first place, they said that it they find driving really difficult as the instructor was rude to them. So out of all the issues that were possibly identified in that situation, it appeared that the learner driver picked the rudeness of the instructor as the first reason they wanted to give up learning driving.

Individuals with autism are more likely to experience difficulties with correct identification and analysis of the problem, generating possible solutions and taking corrective actions to problem solve the errors .

3.Memory reactivation:

When a neurotypical person comes across a problem, their brain quickly analyses the memory bank to see if this problem was encountered in the past, and if yes, what were the actions that were taken to solve the problem? The human brain also combines different individual memories to find if the problem could be solved. The brains of people with autism store memory differently than neurotypical individuals, as a result they struggle to retrieve memory . This coupled with increased anxiety and emotional regulation difficulties also makes memory retrieval difficult . While the memory to recall details and facts is often quite strong in people with autism, the ability to connect past individual experiences with the present situation to make an action plan and think of the consequences is often impaired in people with autism. In the scenario of tailgating, the learner driver had done individual driving manoeuvres like changing the lane and slowing down the car but they could not connect these individual manoeuvres together to formulate an action plan (difficulties with step 3, 4 and 5 of problem solving).

People with autism are also good at noticing the differences instead of similarities which makes categorisation of similar concepts difficult for them. For example if you wanted to talk about pomegranate but you could not remember the exact word to describe the fruit, you may say that it’s a red fruit which will help the listener to exclude non-red fruits such as oranges, bananas etc. So you use your categories of colours and fruits to help your listeners understand a bit better and they may start to help you by naming red fruits. But as people with autism can remember the details so well, they may start by explaining the differences e.g. it is full of seeds, it’s glycemic index is around 67, it has 79% more fibre than other fruits etc. It is very unlikely that such description will help the listeners to guess the fruit in question. Such form of memory organisation makes memory retrieval even harder especially when there is element of stress involved as well.

All of the above factors can make the individual with autism feeling overwhelmed and not understanding what to do in complex situation. Neurotypical individuals who work with people with autism often explain that when faced with problems, people with autism often appear to become “freeze” and looking at others for assistance, without actually asking for help. It is as if the person with autism is waiting for the brain to retrieve memory and generate possible solutions, but the brain is taking too long. On top of it, they may be experiencing communication difficulties caused by stress to describe in words to others where exactly they are struggling with.

4. Low self esteem and negative self talk:

People with autism also experience low self esteem problems as well and low self esteem has been linked with problems with emotional regulation and attention . Interestingly there is also another side to memory and problem solving, in times of stress, people with autism start to recall all the negative self talk as well “You can’t do it”, “You’re a failure”, “Looks like you’re just not getting it”, “Time’s up” etc. So instead of activating the needed memories to problem solve, the inner negative self talk and negative memories instead kick in. This presents further as a multi facet problem e.g. the person may start to think that they are no good, they may dwell on the past experiences instead of focusing on the present situation and they may try to decode implied communication. Some people with autism unfortunately self harm to stop their inner voices and thoughts.

There may also be tendency to overgeneralise the negative events i.e. it may distort the person’s ability to identify the actual problem (step 1).  For example in the above scenario, the learner driver might be struggling to understand what is the problem e.g. the driving instructor not going to pay the fine because I’m no good? Or me getting fine even though I’m trying to save my car and my life? Or the person who is getting too close to my car? Or I can’t learn anything because I know I’ll fail (negative past experiences and self talk). The outcome in the above scenario; the learner decided to quit taking driving lessons thinking that it’s a skill that they don’t have in it.

Coming to everyday situations, friendships and relationships is a particular area of difficulty for people with autism. Often when couples argue they use very generalised statements like “You’re impossible” which really does not focus on any behaviours and what the other person needs to do to minimise the troubles in the relationship. As people with autism can be quite literal, they may think that the problem in the situation is their own existence. A Lancet published study compared the suicidal thoughts in people with autism to be around 66% compared to suicidal thoughts in adults in UK population (17%). When we add the layer of low self esteem, we can see that how people with autism often choose to quit and walk away from situations because they think that their own presence is the real cause of difficulties and troubles.

5. Miscalculating the size of the problem:

Image courtesy: Teachers pay teachers (Free resource)

Not correctly identifying the problem, being on fight and flight mode (anxiety), always thinking of the worse case scenario (low self esteem), feeling helpless (problems with generating possible solutions-step 3) can all lead to distortion in recognising the size of the problem i.e. is it a little problem or a catastrophe?

People with autism are constantly struggling to make sense of the world around them, predictability and sticking to the rules is like a lifebuoy in a turbulent stormy ocean where the winds and the waves are constantly changing. Predictability gives them the security, the understanding which decreases the overly thinking brain and helps it save energy from trying to make sense of everything. When things change or don’t go as they had expected, it is like as if their ship is going to drown. Now even a tiny problem can mean the end of the world to people with autism and their anxiety levels may go up.

6. Making the rules secondary when necessary:

Because of the tendency to follow the rules and the need for predictability is often very strong for people with autism, it can be difficult for them to realise when the rules might become secondary to the situation (difficulties with flexible thinking; executive dysfunctioning). For example in the above scenario, the learner driver could have changed the lane as he was getting anxious due to the driver behind him tailgating. But may be he kept driving in the same lane thinking about messages such as keep within your lane, keep left, do not change lanes frequently etc. Sticking to the rules in this scenario added further more possible complications e.g. getting speeding fine and having money to pay for it (difficulties with step 6).

7. Not understanding the consequences and poor reflective skills:

Sometimes people with autism do not understand the consequences of their actions. This combined with deficient self reflective skills in autism attributed to decreased activity in ventromedial ventromedial prefrontal cortex . This part of the cortex is involved in processing of risk and fears, inhibition of emotional responses, decision making and self control. It is commonly seen that people with autism often engage in risk taking behaviours or seem to do things without being unaware of the consequences, which may make them perceived to be bold and blunt by people around them, however in reality they may not be aware of the consequences. When it comes to problem solving abilities, they are not only have difficulties evaluating correctly the situation and their actions (difficulties with step 4, 5 and 6) but they are also less likely to take corrective actions if they have made a mistake (Vermeulen, P. Autism as context blindness. In Vemeulen P: Context in perception. 1st ed. Shawnee Mission, Kan. AAPC Publishing 2013; 114).

The picture below summarises factors impacting problem solving skills in people with autism.

 

How to support people with autism to develop better problem solving and coping skills?

Reassure: The first step is to calm them down and preventing them from feeling as if the world has come to an end. Reassure them that the situation is under control, nothing to worry about, talk in a positive way and telling them what they need to do (avoiding implied meanings) may decrease their anxiety levels and associated problems with emotional regulation and memory retrieval.

Give them the comfort, trust and space where they can share what they are struggling with. It is only when we know what they need help with that we can offer support.

Help define the problem: As people with autism may have a lot of things going on in their minds at the same time, and they are good at noticing details, help them identify the actual problem so they can focus on it instead of getting sidetracked on the other issues.

In our scenario, the driving instructor could have said that the learner is over speeding, instead of saying that they will get the speeding fine and that will need to be paid by the learner. It really confused the learner and they could not identify what the main problem was, and hence gave the reason of driving instructor being rude, as a reason to quit learning to drive.

Direct communication: Please do not assume that implied meanings and sarcasm will easily convey the message. The reality is that understanding proverbs, idioms and metaphors are advanced stages in language development. We know that people with autism have communication difficulties, so there are chances that they may not have developed understanding of those concepts.

Use direct, concise and precise communication focusing on what you want the person to do. For example in the above scenario, the driving instructor would have been better to say “Keep your speed within 60 km. You can change lane if you are feeling uncomfortable”.

Promote categorisation and understanding of the bigger picture: We have heard that people with autism can often miss the forest for the trees i.e. they can notice so much details but struggle to put the details into a bigger picture. Instead of playing spot the differences games, try playing spot the similarities games. Talk through why you have noticed similarities and help them put into categories. This will not only help with understanding bigger picture but also with better memory retrieval process.

Separate the problematic behaviour from the person: When giving feedback, separate the behaviour from the person to avoid the negative self talk and low self esteem issues such as self doubt which may distort the perception of the size of the problem.

Also focus on their strengths, tell them that they are valued and that you have confidence in them. Share few examples of how their work or thinking has benefited everyone around. Even sharing a light moment, your own personal situation or a mistake that you did may prevent them from drowning into “Why does it always happen to me?” thoughts.

Exercises to help understand the size of the problem: When people with autism are in good space, use exercises and resources to explore the concept of size of the problem to them. Ask them to categorise their problems in each boxes. You may also ask them to give a rating to their problems out of 5 score with 5 being the most difficult.

Once they have categorised their problems and rated their problems, talk with them to find where they are at. You can then ask them to come up with possible solutions and brainstorm solutions.

Giving them time to compose and self regulate: Allow them to do something that makes them happy and calm e.g. listening to music, keeping a comfort object with themselves, taking a movement break etc. Build their emotional regulation strategies.

Developing flexible thinking: Encourage people with autism to understand that it’s possible to use different strategies to achieve the same outcome i.e. you can make 4 by adding 2+2, or 2+1+1, or 1+1+1+1 or 3+1 etc.

The flexible thinking assists the person to be more open and receptive to make the decision of when to make rules secondary depending on the situation, as well as trying out new ideas (step 5).

Self reflection: And finally encourage people with autism to share 2 good things and 2 things that they will like to do differently.

Do not use the words such as weakness, or areas for improvement etc because they might not only take it literally but the negative self talk might also kick in. Share your reflection with them to help guide them to what are the things they need to reflect upon.

For ease of remembering, a summary picture of the helpful strategies is also added.

 

Written by Muhammad Wasif Haq (2018)
Perth, Australia
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