Connect with Success Podcast - Episode 3, Launch Date: April 14, 2021
With Dr. Rich Smith and Dr. Lynette Scotese-Wojtila
Welcome to Connect with Success with Dr. Lynette Scotese-Wojtila where we help connect you with knowledge. Our mission is to lead you to a new and exciting way of understanding, responding to and helping all those with autism. We hope to expand your thinking about how to best serve these amazing people and how to support you in your daily struggles and celebrations.
Dr. Richard Smith
Welcome everyone to episode three of our Connect with SUCCESS podcast built around The S.U.C.C.E.S.S. Approach (sm), the person who coined it, Dr Lynette Scotese-Wojtila and the people who use it and benefit from it every day. In today's episode Dr Lynette is going to discuss one of the most basic components of helping a child or adult with autism. She's going to give it a name that you may or may not have heard before in the field of autism. My name is Dr. Richard Smith and I'll be facilitating our discussion about this basic idea that we all need to know when it comes to autism. So Lynette, what's our term for this episode?
Dr. Lynette Scotese-Wojtila
Today our term is sense making.
Dr. Richard Smith
So what is sense making?
Dr. Lynette Scotese-Wojtila
Sense making, it's kind of a simple concept, but we don't always talk about it. Basically, sense making is the process through which we learn, or we come to understand or comprehend something. It's how we arrive at an understanding of people or things, events, experiences, and how we make sense of what's going on around us, and what's going on within us.
Dr. Richard Smith
So it's a combination of both auditory and visual cues and just trying to put all those pieces together, right?
Dr. Lynette Scotese-Wojtila
Yeah, you're kind of talking a bit about how it all works, and it does have those components. It has components of sensation, and it really relies a lot on awareness, like you can't make sense of something if you're not aware of it, and that is where things like auditory or tactile or visual information come into play.
So when we talk about processing information, or sensation, we have to recognize that when the brain does that, which is quite natural and normal by the way for the brain to do, it will inform our awareness centers of our brain. It will inform us -- these senses will inform us -- that something's going on we have to pay attention to, and as we become aware of it, we sort of go through this circular process, and it's actually in the field of Gestalt therapy -- Gestalt psychotherapy, specifically. There's this circular process of awareness they call it, or the experience of awareness experience. And what happens in this sort of circular process is we were taking in that information, like you talked about, the sensation, and something kind of grabs us and we become aware of it and we put a name to it, and then we sort of move from being aware of it, to kind of wrapping our brain around it and getting in contact with it we say. And when we come into contact with something, we have sense making about it.
And I know that's a lot of words to describe something very simple, but it's kind of a heady, a heady idea, heady topic. It's kind of theoretical, if you will, but those are just the words to describe it, the actual experience of sense making is internal, and it's natural, and it's organic, and it's important for us to know how to recognize it and how to help kids through that sense making process.
Dr. Richard Smith
Alright well let's jump into this episode because it sounds like we've got a great one for you today. So when we were talking about the awareness of what sense making is, is there anything more to that sense making process?
Dr. Lynette Scotese-Wojtila
Yeah, I think if we understand that sensemaking is the product, you know, it's the outcome of the experience. When a child is born, they don't come out of the womb already knowing and having a lot of sense about their world. They slowly evolve to understanding through their experiences.
So, you know, at some point when we were young, we, at one point in our life experience, let's say a sensation of thirst. Okay. And it's a very normal experience, we all have it, and it doesn't always register. It's sort of in the background, but as the day goes on, the longer it is between times when you drink and quench yourself. Your thirst kind of bubbles up, right, and all of a sudden it moves from like this little something to something that grabs your attention and you focus on it, so there's lots of sensations coming into your body all day long but this particular sensation bubbled up above all the others, and grabbed our focus, sort of our attention, and as it was there. Those of us who are old enough to have language, put a name to it. And we might have said, “Oh, I know what that is. That's thirst.”
And so once we were aware of it and we sort of put this label to it. We can do something about it, we can take action about the thirst, and move, in this case, our bodies through space to probably get in contact with a water bottle or a drinking fountain or a cup or something, so that we're putting into action, sort of resolution to our thirst problem. And as we gather our water, and we bring it to our mouth and we take that first thirst quenching gulf, we have contact with the concept of quench. So thirst and quench kind of go together in that moment and we have an understanding of how those two things relate and how we relate to both of them. I have the experience and then I fixed the experience, and we're in contact with that concept of thirst and in this case quenching, and we take that gulp and then we're over it, and we're done. And we don't need any more water, we kind of go on to them the next sensation.
But if I said you know, to a toddler, “you're thirsty.” A toddler who is maybe, you know. tumbling around at 13, 14, 15 months, something like that. They probably don't understand what thirst is because it's kind of abstract isn't it? It's a sensation, but they might associate a bottle or a typical sippy cup with what mommy shapes then as the concept of thirsty. So this is how we learn. This is how we have sensemaking through experiences, through sensation, through becoming aware of those sensations and those turning to put labels to them and and fix or make contact with whatever it is that we are having sensemaking about. So it's a lot of words to describe this simple concept isn't it.
Dr. Richard Smith
Yeah, absolutely. I mean it makes sense you know how we make connections to things and how we draw from our experiences, and trying to make those connections.
Dr. Lynette Scotese-Wojtila
That's right and in the Gestalt way of thinking about things, some of the greats in the field, like Lattner for instance, doing a lot of Gestalt therapy would say that everything and everyone in the environment can somehow be connected. That baby is connected to that Mother. Mother is connected to the sippy cup, the sippy cup is connected to the milk or the juice, and the juice is tied back to the thirst. So, this is a really kind of complex idea but it's so simple when you think about sense making. You really have connectedness to things that people around you, and using that connectedness to achieve something to make contact with something to explore or experience something the way it was intended to be used or experienced is the sense making jewel in all of our existence.
Dr. Richard Smith
I'm just thinking as you were talking like I remember when my children were younger, and they were just getting ready for tummy time, you know, being able to play and there was always this set of blocks that they enjoyed and I could tell when they were, you know, wanting to explore looking at some of these blocks, and you know just seeing what shapes they were drawn to or what colors they were drawn to or, you know what it was that if they kept going back for that white square versus that red triangle and kind of just observing how they were connecting their play behavior.
Dr. Lynette Scotese-Wojtila
And when they were doing that when they were eyeballing these blocks as you're describing in their environment, they became aware of the dimension of it, the feel of it, how it looks when it hits the reflection of the light versus when it's in a shadow cast over all these little tiny, itty bitty miniscule details that together brought them some experience about that block, and as they then approached it, and took action to make contact with it, they realized that it wasn't static -- if they pushed it or tipped it or kicked it, it moved it had movement properties, and then eventually they learned that two things can go together and the block started to be connected to each other in a certain way and then they learn all sorts of things like balance and I hand coordination and gravity and all sorts of things that then start to kick in as the child gets older, so it's a good example I think blocks is something everyone can relate to.
And what I want to emphasize for everyone is it's a normal, beautiful, spontaneous, organic process, where it's very subconscious you don't go around thinking let's see a red triangle and if I tip it a certain way it's going to be this angle I'm going to bounce around that. It's not that robotic. It's not that heady. It's sort of natural and almost subconscious but experience is accumulating in our brains all the time. and that's how associations are built through experience.
Dr. Richard Smith
I'm just thinking one more example too you know I, all of my kids have had something that they've enjoyed that brings them comfort and they associate with comfort, you know, I'm thinking like the blankets or a stuffed animal and they associate that with just feeling good or feeling secure feeling safe, is that some something similar here right?
Dr. Lynette Scotese-Wojtila
it is, and you know we're talking about kids, but even people without disabilities adults, you know, we understand we have sensemaking about our paycheck. We put in the effort. And within a number of weeks or hours or days, however we're paid, something comes back to us that we rely on that's related to -- connected to -- our labor. And so we have sense making about that. And we need that because we also have sense making about the economy and the purchasing systems and how you have to purchase food to live and pay bills, bills need to get paid, and put out money so that you can live and thrive and so that's why that paycheck is important and we have these national associations and the almost cause and effect, symbiotic relationship that these things rely on each other. These things are connected to each other. And that is very natural, normal for every human being. I think what's hard is when there's a disability on board, and some of those processing systems don't work so well. So sense making can be a struggle.
Dr. Richard Smith
So what does sensemaking rely on specifically?
Dr. Lynette Scotese-Wojtila
Well it relies on experience and a brain that can process that experience and it relies on sensation, a lot, we talked about the senses informing the brain and helping the brain to become aware of something, something becoming figural that they can then attach meaning to and make contact with. And so this reliance on awareness and sensation is critical. And it is not to be taken for granted because it's again, natural and many people, but it's not always so natural and kids with disabilities.
Dr. Richard Smith
And does everyone process through this cycle and the circle of awareness?
Dr. Lynette Scotese-Wojtila
They should. They're designed to, you know, the brain and body are designed to work together so that experiences are meaningful and we can thrive and sustain. So I would say yes we all go through the cycle but sometimes there are blockades in the cycle. And, you know somebody maybe doesn't have good language and so we might be attaching the concept of thirst or bottle or drink to a child, let's say a toddler, and if they're not grasping the concept that are the words that we're labeling, they may not have a lot of sense making around that sensation of thirst because they miss the tie to the language. So when mommy says do you want a drink? Are you thirsty? Or do you want juice? If they're not processing that word they might have the sensation of thirst, they may have that bodily sensation, but it's not tied or associated or connected as you said earlier.
Dr. Richard Smith
So do people with autism make sense of things that the way others do? Is it the same for everyone in that process, in terms of having autism?
Dr. Lynette Scotese-Wojtila
Yes, that's actually a great question. It is the same process for everyone. Those six or seven steps that we go through from the sensations something becoming figural, or in focus, and that becoming aware of it, and taking action to get in contact with it, those steps are very natural and normal for everybody that can process well, but for kids with autism and other sensory processing problems, they get stuck, and they get stuck at various places in this circular process we talk about.
So, you know, think about if anyone has seen the movie Rain Man. There is this great scene where Dustin Hoffman, who plays Raymond Babbitt, is in Vegas, and his brother Charlie Babbitt, gets him a “date” for the evening. And he's with this date, who is a paid date, we'll just leave it at that, in the bar with him, and she's dressed to the nines. And she has on, as part of her apparel, this chain, this necklace. And in the movie Raymond is noticing, very much so, that necklace. And the viewer, the person watching the movie, is just kind of seeing him look at it and he's there this woman talk to him, and they're kind of picking up that the woman's a little turned off because all Raymond is doing is staring at her jewelry, and isn't making eye contact, and he starts to say weird things. And it's comical when you see how they, you know, very artfully relate this kind of issue. In the movie in Hollywood, but it isn't funny at all.
When you think of what it represents, and what it represents is that Raymond was stuck on this cycle of experience, he was stuck on the necklace, which is a sensory factor. It was a human relationship, a human conversation, and what his attention was on was the necklace. And we know this, not only because we can watch his eyes and see him looking only at that versus her, but when he goes back upstairs to his brother Charlie Babbitt, Charley says, “How was your date?” And he says, “Shiny, very shiny.” Right? And so, you can tell that what he processed -- his takeaway from this lady of the night, if you will -- wasn't a relationship, certainly wasn't any bodily relationship. He took away the image or the sensory experience, the sensory association for her necklace, which means he probably didn't look at her face. Probably didn't look into her eyes. Probably didn't really engage with her.
And so, those limits, and how these individuals with autism, adults and children, these limits and how they process sensemaking information is so different from how we do. We would look at the person. We would acknowledge their presence. We might even have a conversation, depending on the relationship. If it was her sister in the bar that night, the sister, she'd be able to have the conversation with her sister. So that's a really important difference. So, we have to acknowledge that individuals with autism may be stuck on this circular process -- the cycle of awareness that we would call it English talk terms, or this sense making cycle, and so they need help, they need help to work through, where they're stuck.
Dr. Richard Smith
So, if, and that goes back to the last episode when we talked about observing readiness, being able to observe that they're not ready for that. That's right, I always go back to the example we took our daughter to a birthday party, she was maybe about three or four years old, and it was at an arcade. And she watched and knew it was time for the party to begin. But once all the lights started flashing, and the sound started happening, it just triggered something in her that showed me that she wasn't ready to be social in that particular setting. We actually had to remove her from it. So it was this trying to make sense of what was going on in the room to feel safe and she couldn't get past it?
Dr. Lynette Scotese-Wojtila
Well, I would say that the object of the event was socializing. So Mom and Dad, and the person who through this gathering, their intention was to make contact with socializing. But in order to do that, you have to be able to get through everything that you're exposed to. So you can make contact with the people who are supposed to be your social partners.
And if you can't get past the sensory load, you're not going to see people. you're going to stop at lights and sound. So, in that instance, your daughter was stuck in sensation, and there's nothing you could do at the moment to talk her through it, because you, as someone speaking to her would be just another stimulus. so another source of sound.
Dr. Richard Smith
Gotcha. Yeah, And that's what we wound up doing. We had to pull her back into the car and kind of talk about what she might see and what she might experience to try and help her through it.
Dr. Lynette Scotese-Wojtila
Yeah. So you had to bring her back to the car to validate her experience. Bring her back -- like a rewind and potentially do over -- helping her to focus on the friend. So one strategy would be, you know, you're gonna hear some things that might be loud, and you're gonna see some things that might be bright. But what we're going to look for is Mary. Mary's the name of the friend right, we're going to use our eyes to find Mary. I will help you. I can help point to her, I can take your hand and bring you to her, I can wave to Mary to come to you, but we're going to think about Mary. And when we meet Mary, when we're close enough that she can hear us. We're gonna tell her happy birthday and give her a gift. If it was a birthday party example.
And so if you give them, you know that directive, and you support them to actually enact that joining to, in this case, this person named Mary, in my little analogy, then they have a focused intent, and you've already warned them about the sight and sound. Now that's a great outcome if that child can be talked through it, cognitively. If she can and your daughter probably can, knowing her, she has what we call cognitive override that can sort of tell her okay dad said, “Think about Mary. Think about Mary” Thinking about Mary. It doesn't mean she's not hearing the sounds and not seeing the sights, she is, but you have given her something, a focal point. And, you know, setting her up to succeed, would be minimizing how long she has to endure all that. And then you can also make a plan, you know, “Honey if you can't find Mary fast, your mom can stay at the door, I will find Mary and give her your gift, and she will be still happy.” Like you can compensate and let them know so just maybe the only expectation that day on her is to go in and hear a sound and see some lights and that's your experience, you can still pass a gift along and have some well wishes for the birthday girl. It's just not the social contact that it was intended to be
Dr. Richard Smith
Great strategy. Thank you so much for that. Sure. So then looking at this, why is it so important for parents and teachers to understand how to help a child with autism to achieve sense making?
Dr. Lynette Scotese-Wojtila
I think it's important because they get stuck, they get stuck too often, and they get stuck in ways that we don't. So, if we're not careful, we become angry. If we're not careful we become frustrated, like, just go give her the gift, you know in your example, or you know for a teacher just finish your math “Come on, you've got three more, you know this, you know.” But if there's a fire alarm that just went off for that child who's trying to finish their math, and that resonating sound of the chirping alarm is still bothering their ears, they're not going to be able to make contact with their pencil, and the concept of computation for their math problem. They are stuck in sensation because of the auditory memory pulsing through their ears. Well, the teacher doesn't hear it anymore. But the child does. So we have to understand that these kids get stuck because it explains their behavior. And once we understand where they're at in the cycle, we have to join them. We have to join them where they're at. Stay with them as long as they need us to, and then help them through it.
So in that instance, it might be telling your third grader trying to finish three math problems. I know you're hearing the noise, it's loud. Take one minute, put your hands over your ears and press as hard as you can. And while you're pressing the sound might be less, and if it is you can finish your math. If it isn't, you can do it tomorrow. I understand. So just giving them that validation yet you're still hearing it we don't hear it but you hear it. Let me help you get rid of it. Right. And if nothing else, if I can't help you get rid of it, I'm going to take the demand away from you to perform while you're having it.
Another interesting thing about sense making. And helping kids go through it and get to it, is how it helps them developmentally, so actually in my class, called An Introduction to The S.U.C.C.E.S.S. Approach (SM) for parents and caregivers. There is a research study that we talked about, and it was done by Sylar and Sigmon in 2002. And the study found that caregivers of children with autism who tried to maintain their child's spontaneous contact with toys by pointing or showing or commenting had children, who later developed superior communication skills, measured at one year 10 years, and 16 years. So just by helping that child stay in contact by pointing to the toy, labeling it, showing, commenting, all those “joining” things that we do with kids. Those children ended up having superior language, over the course of 1, 10 and 16 years which is really phenomenal. When you think about it. And that's compared to children who maybe had more demands placed on them, or more directive kind of intervention. When it was undemanding language, and they were focused on staying in contact, versus performing, those children have superior communication skills. It's exciting stuff.
Dr. Richard Smith
Absolutely. Are the parents or teachers you explain this to able to make sense of this?
Dr. Lynette Scotese-Wojtila
You know, I think they do. I think they do make sense of it, at least in theory, you know, like you said it's sensible, it's logical and makes sense. Here's the challenge though. It's not easy to operate this way. It's not easy to operate from the perspective of joining somebody else, as they're on the journey to sensemaking. And so, in order to get good at that, we have to sort of disconnect from our self for a minute, and really look and assess where the child is in the process. And the challenge, when we're talking about a child with autism, discerning that is it's so different from where we are.
Again, the example of Rain Man with a woman with him, didn't have a clue that he was looking at her necklace. It was me. At the bar with him, and I had a necklace on. And he looked at it, I would join him rich. I would say, Raymond. You see, my necklace. I might even say, holding it kind of juggling it. It is, As you might say, shiny, and I'd say, Yep, it is. I have shiny eyes too. And what do you think he might do
Dr. Richard Smith
Look at your eyes.
Dr. Lynette Scotese-Wojtila
Look at your eyes. Check it out. He's into shiny, why wouldn't he. Right. And so there you have it contact. Now notice I didn't say, Look at me, I made a comment, I commented on the here and now. And that's a real key in Gestalt psychotherapy and Gestalt theory. Now we're talking a lot about Gestalt it really comes to the field of psychology but many people use it, thank goodness, more and more, and a lot of my capstone doctoral work was done around Gestalt theory and autism.
And what we know is that if we can join a child let's say Raymond in his experience of "shiny." Then we can expand what we do with shiny, in this case relate to my eyes. That is very different from, "Look at me. You're being rude. Stop staring at my neck or my chest, or stop!" Do you see the difference in those approaches?
Dr. Richard Smith
Yeah, one is observing where they're at and helping them to process it whereas the other one is more directive, and behavior, right?
Dr. Lynette Scotese-Wojtila
There's an expectation to stop something. I would rather it be an expectation to do something. A lot of our kids with autism and a lot of our girls with autism are constantly told STOP. One way or another, they're told to stop. They're inhibited, they're prevented. They're held back. Don't do that. Whatever it is, don't run, don't touch this, don't eat that, don't ask for that, don't scream. Don't -- whatever it is -- don't, don't, don't, don't, don't! But by saying “My eyes are shiny too” I didn't even tell him to look at me, and I didn't tell him to stop looking at my necklace. I joined him in his awareness of my necklace, and gave him the opportunity to comment on it, and what we know about people with autism is they really want to talk about what they're thinking about right. We know that. And so by joining them and saying yes it is shiny, it's silver, or it's 14 karat gold, isn't that interesting? Well now I've opened up a whole conversation. And my tactic initially was my eyes are also shining, and then when he looks, you know, he might say yes they are. I would say they're shiny and they're brown, and yours are whatever, and I comment then, then we're commenting on the here and now. And that's very very central, it's a centerpiece of Gestalt theory, being in the here and now, very present centered, and sensemaking. Those are the three factors that really identify Gestalt theory. And if we understand this, we can make use of this awareness process, the sense making process, and stay present centered till the child understands what we're presenting. It's exciting work.
Dr. Smith
It really is, and you know you speak to the parents who instinctively, that word stop is because we're feeling protective, and we want to make sure that they're not going to do something that's going to hurt them, or learning from that process. But the whole idea of sense making is a teachable moment. That's right to bring them into focus. That's right.
Dr. Scotese-Wojtila
And if we want them to learn something new to keep them safe, you bring up a good point, like I think of children running, you know say stop, stop running, stop. Let them to stop. But if we tell them what to do. It sounds more like, try walk. I will help you. Let's walk together. That's right, we have walking feet. Let's walk to brother's room. Let's walk to the parking lot.
Whatever you're doing, you join them. And what you want them to do, and model in the process what you want them to do and guess what they do, what you want them to do. If you don't tell them what else to do, then what their first inclination is is going to win. So we always say The S.U.C.C.E.S.S. Approach wins when we reshape something to the outcome that we want, that's better for the child, the greater good of the child, like not running in the parking lot, but autism wins when we do it wrong. And they take off running because we said things like stop right versus what to do, they can't process, if they could stop, they would stop, Right, so yelling stop doesn't necessarily become effective for some kids for many kids, if they don't know what else to do.
Dr. Smith
That's great. So, how else can I help a child that's having difficulty making sense of something?
Dr. Lynette Scotese-Wojtila
Well I think we talked about lessening that demand when they're trying to make sense of something that they're struggling with. But we can also make the message brighter or bigger. So if there's a child that you know, going back to your idea of, the block. If there's a toddler or any age child that's trying to build something but let's stick with toddlerhood, and you're trying to get them to look at a block or to build a block. If the block isn't salient for them. In other words, they're missing that you're holding this block in front of them. You can add something like a tapping on the block, tapping on a table and tapping list another blog. If it has a jingle component like some box of bells and things that you can shake it to make it more salient for the child, and then it grabs, like you said that auditory system, it informs the auditory system, because the eye is going to go to a word the ears hear most often, and in so doing, you're bringing a child to awareness about the block that they might have otherwise missed. And then once their awareness is on it, you can say block, whatever it is you want them to know square or blue if you're working on colors, but they have to first see it and be aware of it, to have sensemaking about it. So, increase what is salient about the thing you're trying to expose them to. Does that make sense?
Dr. Smith
Oh that's wonderful advice, it totally makes sense. Absolutely, and we've talked so much about sense making. So much so, that actually makes sense! Right?
Dr. Scotese-Wojtila
Isn't that a good outcome!
Join the cast from Connect with Success for our first ever virtual live event for Autism Awareness Month on Saturday, April 17 2021. We will be highlighting those who have been champions of The Success Approach, talking to community partners, hearing some special stories of those impacted by The Success Approach, and a few more surprises up our sleeves. Be sure to follow The Success Approach for Autism Facebook page for more information about how you can join this highly anticipated autism event. https://www.facebook.com/thesuccessapproachforautism
Dr. Lynette Scotese-Wojtila
So this week's challenge for everybody out there listening, is to look for signs of where your loved one might be getting stuck in their cycle of awareness. Look for them getting stuck in sensation. Look for them, maybe getting stuck in action, where they can't stop something once they start, and try to join them so that they can complete the cycle, and actually achieve sensemaking. Turn to your occupational therapist to help you with this. They can help you identify where they're at, how to move them, and how to achieve sensemaking.
Dr. Smith
In our previous episode we discussed observing readiness and our child or adult with autism. In other words, to see what that they're ready to learn and what really struck me in this episode is that sensemaking, it seems to be that natural next step in helping our individual process what's happening in the moment. Once you see that they're making that observation.
Dr. Scotese-Wojtila
That's it. That's exactly right. So, the readiness is our read on when to introduce information. And as we're introducing the information, in sensemaking, we're going to support them so that they can make contact with the idea, and actually comprehend what it is that we're trying to explain to them. It's a very supportive process that starts with readiness, and basically ends with sensemaking.
We hope that you learned something today to help you on your journey with autism. We'll share more on our next Connect with Success Podcast.
Until then, expect success!
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