The Intersection of ASD and Mental Health DEVELOPING CAMPUS - PowerPoint PPT Presentation

The Intersection of ASD and Mental Health DEVELOPING CAMPUS PARTNERSHIPS Jane Thierfeld-Brown, Yale Medical School , College Autism Spectrum Michelle Rigler, University of Tennessee Chattanooga, Navigate U Amy Rutherford-Moody, University of Tennessee Chattanooga, Navigate U

Autism Spectrum Disorders Complex neurobiological disorder characterized by deficits in communication, social relationships and restricted/repetitive pattern of behavior Occurs across all racial, ethnic and social groups and the effects last a lifetime Not classified as a psychological or mental health disability, but the impact often presents itself similarly to mental health Thierfeld-Brown, Rigler, Rutherford-Moody, AHEAD, 2017

Thierfeld-Brown, Rigler, Rutherford-Moody, AHEAD, 2017

ASD and Mental Health Issues ASD is not a mental illness or psychological disability however: ◦ Impact is = if not more debilitating ◦ High comorbidity ◦ ADHD ◦ Tourette’s ◦ Depression ◦ Sensory processing disorder ◦ Seizures ◦ OCD ◦ Anxiety THIERFELD-BROWN, RIGLER, RUTHERFORD-MOODY, AHEAD, 2017

ASD and Mental Health • Areas of affected by ASD • Communication • Socialization • Interests/patterns of behavior • Therefore: • Difficulty expressing emotions and thoughts • Difficulty making and keeping friends • Difficulty dealing with change • These can lead to psychiatric stressors Thierfeld-Brown, Rigler, Rutherford-Moody, AHEAD, 2017

The College Experience Thierfeld-Brown, Rigler, Rutherford-Moody, AHEAD, 2017

Barriers Stress Management Central Coherence Social Skill Difficulties Theory of Mind Communication Executive Function Thierfeld-Brown, Rigler, Rutherford-Moody, AHEAD, 2017

Common Misconceptions on Campus • Everyone who is “quirky” has ASD • Everyone with ASD is “Quirky” • People with ASD are lazy • People with ASD can “snap out of it” • Everyone with ASD has a high intellect (savant, photographic memory, etc) • People with ASD do not want to be socially engaged • People with ASD do not want friends Thierfeld-Brown, Rigler, Rutherford-Moody, AHEAD, 2017

When Behavior Impacts Campus Culture Stimming External self-talk Talking about inappropriate subject matter Perceived stalking Unsafe trust of others Poor hygiene Failure to show up for class Always alone Meltdowns Thierfeld-Brown, Rigler, Rutherford-Moody, AHEAD, 2017

Building Campus Partnerships Work with other departments to offer workshops/trainings Create a ongoing list of resources and publicize them Find “go - to” staff in different departments who have expressed interest in supporting students Know what the other departments are responsible for – what are the roles of the other departments in relation to mental health? Tap into existing committees and teams to gather support Recognize and celebrate campus partners Thierfeld-Brown, Rigler, Rutherford-Moody, AHEAD, 2017

Disability Services Detailed intake will help predict potential supports needed ◦ Previous hospitalizations ◦ Times away from school ◦ Medication management Listen to the students’ story Accommodations may be different Take time to build rapport Communicate with students about self advocacy/responsibilities Inform students how support might be beneficial to them Thierfeld-Brown, Rigler, Rutherford-Moody, AHEAD, 2017

Faculty Educating faculty on the impacts of ASD and how that affects the classroom experience Empowering professors to “join” Establishing a contact to communicate concerns Collaborate to establish rules for the classroom Share professor packet or educational material Thierfeld-Brown, Rigler, Rutherford-Moody, AHEAD, 2017

Adapted from Rochester Institute of Technology Thierfeld-Brown, Rigler, Rutherford-Moody, AHEAD, 2017

Counseling Centers Training counselors about the unique impacts of ASD on mental health Establishing ASD specific resources within the Counseling Center (ex. autism confident counselors, ASD focused support groups, etc.) Consulting with counselors on specific cases Learn who staffs your counseling center Be familiar with how the center operates Thierfeld-Brown, Rigler, Rutherford-Moody, AHEAD, 2017

 Introduce students with ASD to counselors  Attempt to match interests  Introduce concept of joining to counselors  Meet with Psychiatric Service Provider to give accurate info on medication management  Serve as an interpreter as needed  Be available for case study meetings with counselors  Coach students to take notes during sessions if needed  Be dramatic…(Amy story)  Release to discuss as needed  Provide visual representation  Provide Professional Development each semester Thierfeld-Brown, Rigler, Rutherford-Moody, AHEAD, 2017

Some “Big” Clinical Problems ◦ Poor integration & synthesis ◦ Misses the big picture ◦ Rigid ◦ Planning, shifting, prioritizing ◦ Perspective taking ◦ Poor social agent ◦ Initiation & self direction ◦ Motivation Thierfeld-Brown, Rigler, Rutherford-Moody, AHEAD, 2017

Do we treat the symptoms differently? YES ◦ People with autism respond to therapy differently. ◦ HOW? Thierfeld-Brown, Rigler, Rutherford-Moody, AHEAD, 2017

Differential Dx Dx – Anxiety D/O Anxiety Autism Typical History? Atypical history Compulsions which protect Stereotypies, restricted interests feel good against anxiety are uncomfortable Difficulties with social functioning, reciprocal communication, Relationships can be distorted understanding emotions but basic communication is working “ Aloof, detached ” Avoidant Medication can work with both groups Thierfeld-Brown, Rigler, Rutherford-Moody, AHEAD, 2017

Differential Dx Dx - ADHD ADHD ASDs History of high anxiety, ASD history energy, poor sleep etc Attentional difficulties reflect Attentional difficulties reflect autistic functioning primarily attentional difficulties Co-morbidity is not uncommon Social difficulties tend to be (Medication can work with both less severe in nature groups) Thierfeld-Brown, Rigler, Rutherford-Moody, AHEAD, 2017

Linking Symptoms to Treatment Social Difficulties Lack of quality/fulfilling relationships Trouble with peers / coworkers, bosses Isolation (patterns of interest take over) Mood disorders, anxiety, substance abuse More isolation Thierfeld-Brown, Rigler, Rutherford-Moody, AHEAD, 2017

Clinical Work Teaching vs. Talking Facilitating development/skills Independence vs. “ Curing ” Learning a new language/Culture Thierfeld-Brown, Rigler, Rutherford-Moody, AHEAD, 2017

Career Services Educating Career Services the unique challenges students with ASD face in preparing for the professional world. Communicate the value of honest feedback Working with Career Services to teach professional skills to students with ASD. ◦ Etiquette dinners ◦ Professional dress seminars ◦ Video interviews ◦ Scripting response Thierfeld-Brown, Rigler, Rutherford-Moody, AHEAD, 2017

Thierfeld-Brown, Rigler, Rutherford-Moody, AHEAD, 2017

Health Services Educate staff on the unique impacts of ASD Proactive vs Reactive ◦ Help students through the paperwork process ◦ Be familiar with how the center operates Medication Education Scheduling and Appointments Thierfeld-Brown, Rigler, Rutherford-Moody, AHEAD, 2017

Medication Spiral Thierfeld-Brown, Rigler, Rutherford-Moody, AHEAD, 2017

Residence Life Educate staff on the difference between ASD behaviors and more significant mental health concerns ◦ Utilize your RAs Students with ASD tend to struggle significantly in residence halls due to the intensely social environment Accommodate with a private room ◦ Allows individual control of sensory environment ◦ Place to decompress and recharge ◦ Control in routine Help identify low sensory areas in buildings Thierfeld-Brown, Rigler, Rutherford-Moody, AHEAD, 2017

• Create partnerships with Housing and Residence Life Staff • Know process • Understand rules and procedures • How to/offer to educate roommates • Participate in RD/RA Training • Discuss creative accommodations • Furniture • Single Rooms • Sound Blockers • Visual Reminders • Need for and participate in Roommate Contract/Agreement Meeting • Be a resource for unusual behavioral issues • Provide visual cues/meeting agendas Thierfeld-Brown, Rigler, Rutherford-Moody, AHEAD, 2017

Campus Police/Emergency Services Educate campus police on how someone with ASD may respond in high stress situations Collaborate to create victim advocacy service programming specific to individuals with ASD Educate on sensitives of ASD and how to interact during times of high stress ◦ Proactive vs Reactive Discuss appropriate response to common college police/emergency situations (alcohol violation, sick or injured roommates, wellness checks) Thierfeld-Brown, Rigler, Rutherford-Moody, AHEAD, 2017

30 COLLEGE AUTISM SPECTRUM 2017 DO NOT REPRODUCE

Judicial Affairs Conduct codes are strictly applied ◦ Academic ◦ Residential ◦ Community Disability is not an excuse for breach of conduct Some behaviors may be translated to judicial affairs so that they may understand the context (e.g. stalking) Make sure student understands the rules and the consequences for breaking them 31 COLLEGE AUTISM SPECTRUM 2017 DO NOT REPRODUCE

AND DISABILITY NEVER EXCUSES BEHAVIOR 32 COLLEGE AUTISM SPECTRUM 2017 DO NOT REPRODUCE