What happens when you place a young adult with Asperger’s syndrome or a non-verbal learning disability in a diverse treatment setting with behavioral, emotional, and substance abuse diagnoses? “Good things,” say experts, as long as that environment has the right combination of structure, repetitive cuing, customization, and—most importantly—nurturance. Positive psychology, which emphasizes nurturance and strengths-based approaches, is often the theoretical foundation of programs that successfully treat students with high-functioning autism-spectrum disorder alongside students with other diagnoses.
But regardless of theoretical bias, success with this population depends on a sense of safety and community that should start at the staff level and trickle down to the student community. Once this pervasive sense of safety is established, customized treatment becomes the next priority. Since young adults with autism-spectrum disorders require a nuanced or, in some cases, completely different approach from their behaviorally or emotionally disordered peers, treatment staff must be well versed in these approaches. Effective strategies for working with young adults suffering from autism-spectrum disorders include:
- Repetitive Cuing: Spectrum students benefit from clear instruction coupled with repetitive visual or verbal cueing to help them routinize new behaviors. In certain situations, this might cause embarrassment unless a positive peer culture is consistently maintained. That kind of peer culture really pays off when, for instance, a girl post notes in her bathroom to remind her of positive hygiene habits. Rather than causing ridicule, students operating within a positive peer culture will routinely help each other remember and master even these potentially sensitive new habits.
- Consistency: As a rule, young adults suffering from emotional and behavioral disorders benefit from external consistency and structure. But this is all the more true for those struggling with autism spectrum disorders. Consistency in routine, instruction, social interactions and culture help create a therapeutic sense of safety. This consistency also reduces external distractions so that new behaviors and coping skills can be focused on, practiced, and mastered.
- Customization: Staff should be trained to distinguish between behaviors that stem from oppositional tendencies and those that stem from neurobiological disorders. Many young people with spectrum disorders have been chronically misunderstood by parents, teachers, and even therapists; in these cases, behaviors resulting from rigid thinking or misinterpretation of visual cues may meet with consequences instead of coaching. Often, spectrum students are suffering not only from neurobiological disorders but also from anxiety, trauma, and other co-occurring emotional problems. This means that the therapeutic staff must construct therapies that are flexible, creative, and personalized.
- Talk Therapy and Experience: Particularly with students suffering from a non-verbal learning disorder (NLD), talk therapy is coupled with experiential approaches. These students’ neurological bias for processing thoughts and emotions is verbal, so staff should be careful not to overload them with written or visual therapy assignments. The function of experiential therapies with NLD students is to help them put therapy into action, while the function of verbal processing is to help transform those experiences into sustainable relational habits. NLD students in particular need to develop a ‘muscle memory’ for newly acquired relational skills. This is done by pairing their verbal strengths with a physical/experiential activity.