The Eclectic Behavioral Therapist

Interviewed on ADHD Support Talk Radio - Understanding ADHD and Understanding Yourself

2011-12-15T11:18:00.000-08:00

Listen to me being interviewed by ADHD Coach, Tara McGillicuddy, president and founder of ADD Classes.com. You can listen now, or download it to your portable mp3 player.

Listen to internet radio with ADHD Support Talk on Blog Talk Radio

JJs List Parent Review

2011-12-14T10:04:00.000-08:00

This was posted on JJs List, about me. JJs list is a website promoting disability friendly businesses.

Great!
Mr. Tivers, who is both a clinical social worker and a school social worker, specializes in working with individuals who have autism, ADD and related disabilities. He was recommended to us by another family, and I was very impressed during the consultation we had with Mr. Tivers. He has a positive, encouraging attitude, and specializes in issues around disclosure. In my experience, this is not an area in which many professionals feel comfortable.

Disability Awareness: Welcoming, Talked directly to the person/people with disability, Friendly, Respectful, Helpful with assistance or accommodation, Has employees with disabilities, Flexible service, Physically accessible, Other or suggestions, Accessible Parking, knowledgable

-advocate
12:16am 12/03/11

Parent-Nominated as one of Chicago's Favorite Kids Doc

2011-09-16T22:05:00.000-07:00

By Andrea D on Wednesday, May 18, 2011

Eric Tivers has helped my son who has High-Functioning Autism better understand himself and helped him gain much needed social understanding of his relationships with others in the world. He also is the only therapist that we have worked with that genuinely cares about involves, and supports our entire family. He walked us through telling our son about his diagnosis by leading and facilitating an activity in which each member of the family identified our strengths and challenges and helped us define sensory differences. He then congratulated our son for having high-functioning autism, and being unique just like Einstein, Mozart, Van Gogh and many other individuals that have made important and great contributions to the world. Before we met Eric Tivers, my husband and I were dreading having to do this ourselves. By doing it with Mr. Tivers, this turned into a wonderful pivotal moment for my son, his typically developing brother-our entire family!!!

AD/HD is a lot like car trouble. Sometimes the brakes don't work, the gears don't shift, the steering seems off, and the radio comes in and out...

2011-03-20T22:28:00.000-07:00

Inhibition and Activation are a lot like putting on the brakes, and shifting into first gear. But when the brakes don't work, it's not because you're not pushing the pedal, but something failed in the braking mechanism. In AD/HD, inhibition, just like many of the other Executive Dysfunctions, is not a matter of not knowing what to do, rather it is a matter of not doing what you know. So when you try to put on the brakes, and you tell yourself to "stop the action," but the brakes don't work it is vital to have back up systems.

Imagine having calls to return, and other tasks to do, and you get sucked in to something a bit more interesting. As this less important, more fun thing pulls you in, the voice in you head tells you not to do it, but your brakes don't work and you do it anyways. You rationalize the brake failure, and try to minimize the damage by setting a timer for 10 minutes. The timer goes off, but you miss your turn, you try to step on the brakes, but no luck once again, so you set the timer for a few more minutes, and you say out loud "when the alarm goes off, Stop the action, and get to work! It will feel great to return those phone calls!"

Continue to imagine with a minute left on the timer, you stand up in front of the less important, more fun thing that you are doing, anticipating the need to shift gears, you stop the action, put something away, but then on the way to go do your work, you notice just 'one more thing' that you want to do, and end up spending another unintended hour doing the more fun, less important thing.

The brakes didn't work, but they were applied, the gears didn't shift, although the engine was revving, and the work did not get done –at least not today. But then you know you’ve been taking care of your car, and feel okay because when you look in the rear view mirror and reflect on the past few weeks, and you see the brakes have been working pretty good, and the gears have shifting without much difficulty, and you now the only consistent thing about AD/HD is it’s inconsistency.

Whether you are a coach, a therapist, or an adult living with AD/HD, I can not over emphasize the importance of acceptance of the occasional brake failure, or other mechanical problems. This is what I call, having an ADD-Day. It is also important to recognize that when an occasional ADD-Day, turns into multiple days or even weeks, it is time to bring your car to the shop, or at least open the hood and try to figure out what needs be changed in order to increase consistency of overall performance. And when you don’t know what you’re looking at, or how to fix the problem, ask for help, find support, or get a ride, just make sure it gets you to where you intended on going.

Starting to use a planner is like building a relationship. It begins by courting it.

2011-03-04T21:01:00.000-08:00

To build your relationship with your planner, you must not forget The Courting Process

Co-dependent relationships are expected. You need it. It needs you.
Schedule time to get to know it. Spend lots of time with it - Morning / Noon / Night
Leave special notes to remind you.
It’s okay to go to bed with it.
It will be there when you wake up. Take it with you to breakfast.
Don’t give up on the relationship if it’s not love at first sight.
Don’t be afraid to add spice!!! Color, Stickers, Cover Design, etc.

AD/HD & Time-Blindness: What to do when your internal clock never came with batteries.

2011-03-03T13:13:00.000-08:00

Do what you have to, but if you ask me, I believe that wearing a watch is a must. Sometimes AD/HDrs can verge on obsessive when they find a strategy that works. I say, "If it works, do more if it, if it doesn't, do less." Teaching by examples, my clients find it humorous that I actually have 8 time keeping devices going during therapy and coaching sessions. I have a large analog wall clock, 2 Time Timers, (one for ADD-Time set for 50 minutes) the other with the real time set for an hour. A digital clock next to the 3 inch Time Timer next to my chair. I have a Time Tracker, which uses green, yellow and red lights to cue you show as to you where you are in time. It can also make noises, but I usually mute the sound. I have a vibrating hip timer I use to cue me during the last 15 minutes of a session. This helps me with attention shifting, as I have 6 unique vibrating cues that tell me where I am in time. Finally, I have use my wrist watch with dual chronographs and an alarm. You can call it obsessive, or even borderline neurotic, but I’d rather think if it as effective. So, If it works do it, if it doesn't don't.

RTI May Not Delay a Special Education Evaluation

2011-02-25T12:25:00.000-08:00

The U.S. Department of Education has recently released this memo to state special education directors. If a student is being evaluated with response to intervention tools, this may not be used as a reason to delay or deny an evaluation for special education.

This is particularly important for families who are just beginning the process of asking for an evaluation. RTI has become the first step of this process in many school districts and has been known to delay consideration for a special education evaluation until after the RTI process has been completed. For the child that needs more than RTI can provide, this has sometimes felt like a barrier to being approved for special education services. Therefore, this guidance from the Department of Education is important.

Mind Wandering Syndrome???

2011-02-15T22:32:00.000-08:00

It's been a while since I've made a blog post.
This past weekend, I was momentarily distracted by the jar of hot cocoa, which I was about to begin making, until my wife lovingly asked me what I was doing. I paused, then laughed, realizing that I did not get up to make cocoa but to turn down the lights as we were about to begin watching our latest DVR'd episode of Parenthood. (C'mon, like it's never happened to you before?) It was then, that I turned to my wife and said, "You know, I think it would be more accurate to call AD/HD inattentive type, Mind Wandering Syndrome," I think when you really think about how your think, (meta-cognition) or as one of my clients recently called it, meta-attention - thinking about what you are paying attention to, it becomes possible to recognize where the intended action fell offline (working memory) and how the unintended action began.
By discovering where the mind wandered, you have also discovered the point of performance. The place and time when performing the intended action matter.

Humor helps self awareness

2010-09-08T22:58:00.000-07:00

NPR Story: Autism Gives Woman An 'Alien View' Of Social Brains

2010-08-23T22:28:00.000-07:00

Think different

2010-08-18T14:19:00.000-07:00

Superflex Parent Involvement

2010-07-01T21:51:00.001-07:00

It is wonderful to see how kids with social thinking challenges respond to social thinking interventions when parents are fully on board and implement the recommendations consistently on a daily basis. Like most things in life, what you put into it, you will get out of it.

Social Thinking is slowly coming back to Social Town thanks to our superhero, Superflex! (and from a lot of support from his mom and dad).

Social Thinking. Brilliant!

2010-06-01T21:20:00.000-07:00

by Eric Tivers

As I write this article, alone, in my home office, I'm heavily engaged in the act of social thinking. Allow me to explain in social thinking terms...

I'm thinking about you, thinking about me. I am hoping that what I am writing is giving you good thoughts about me. I know when you have good thoughts about me, I may experience good things like a phone call or email indicating that you liked what I wrote. When that happens, that makes me feel good about myself. I really hope that what I am writing does not feel too unexpected causing you to have weird or uncomfortable thoughts about me, which may result in you unsubscribing to my newsletter, which would result in me feeling kinda bad, worried, or even frustrated. While writing an email newsletter does require social thinking, it is actually a lot harder since I can't think with my eyes, which is really helpful for being a social detective.

If you are not familiar with Social Thinking, you may have had some "Uncomfortable Thoughts/Weird Thoughts" about me while you were reading. That is because when anyone does something that is considered "Unexpected" it causes others to have "Uncomfortable or Weird thoughts" about that person. On the other hand, when people do what is "Expected" people tend to have good thoughts about that person. When someone does something that causes others to have those uncomfortable or weird thoughts about them, sometimes that person may experience something negative, such as getting yelled at, made fun of, bullied, etc. And I think we can all agree that nobody feels good after getting bullied, yelled at, teased, or getting in trouble. However, we do feel good when good things happen as a result of making others feel good about us for engaging in "expected behaviors."

Many of the poor social behaviors we see kids, teens and adults exhibit make parents, teachers, and peers uncomfortable. Consequently, it is common for adults to point out the odd behavior by telling the violator of an unwritten social rule that their behavior is "inappropriate." I believe that this is done with the intention of helping the individual recognize that they violated a hidden social rule. However, if we know that picking up on social cues is part of the person's disability, does it make sense to use a word that has significant emotional content attached to it - primarily judgment - attached to it? These hidden rules govern the expected social behaviors in every environment which for most of us comes intuitively. So, when somebody violates one of these rules we have uncomfortable thoughts about the person, because the behavior was unexpected. It is important to give individuals with social-cognitive deficits feedback about their behaviors. However let's help them understand these rules intellectually (which plays to their strengths) instead of intuitively. How do we do this? One way is to use Social Behavior Mapping of the behaviors that are Expected and Unexpected in social situations.

As one of my 10 year old clients with Asperger's said when I was introducing Social Behavior Mapping to him, "Oh, it's like cause and effect." My response, "Exactly!"

Social Behavior Mapping Looks like this:

Expected Behavior --> Thoughts of Others --> Consequences Experienced --> Feelings about Self.

Social Behavior Mapping helps to explain the logical sequence of Social Thinking starting with the fact that as soon as you share space with others, they are having thoughts about you. It is up to each of us to figure out what is expected in order to keep people having good thoughts about us. In other words, whether you like it or not, people are having thoughts about you, trying to figure out what you want, and making judgments about you all the time. This is not a matter of "it's not nice to judge," it's the facts about social thinking! We all make judgments about others. We need to encourage individuals with social thinking deficits to do the same, to reinforce the idea that I'm thinking about you thinking about me.

For more information about Social Behavior Mapping and other related Social Thinking ideas, visit the Social Thinking Website for books, posters, curricula and videos. (I have no financial interest with them).
www.socialthinking.com

Contact me if you are interested in individual and/or group Social Thinking therapeutic services.

Teachers, Educators & other related service providers...Interested in a presentation on Social Thinking for professional development? Call me.

Eric Tivers, LCSW, MSSW
224-636-3742
etivers@aol.com
www.erictivers.com

2010-05-05T23:08:00.000-07:00

Telling your child they have autism, asperger's, ADHD, or related disability.

2010-04-27T07:53:00.000-07:00

Telling your child they have autism, asperger's, ADHD, or related disability.

Your child has been in therapy and/or receives special services in school; but does your child know why? Sooner or later (and it's usually sooner) children with special needs realize they are different from their neruo-typical peers. How do they know? They feel it emotionally, and it is seen behaviorally. They become frustrated, they isolate, rebel, lose interest in others, give up, or just shut down.

Guilt and fear of their child's response are two of the most common barriers preventing parents from telling their child. The other is, not knowing how.

It can be a daunting task, but you don't have to do it alone. Giving your child the gift of self-awareness will help them maximize their strengths and understand what they need to do to compensate for their challenges. Self-awareness is the first step towards self-advocacy and self-determination.

In all my experiences helping kids with various disabilities learn about who they are, including talking directly about labels and diagnosis, the responses have been 100% positive.

If you're looking for help or have questions about talking to your child about their differences, click on the contact link on my website, www.erictivers.com

Parent Coaching is Often Not Enough

2010-04-19T00:03:00.000-07:00

Parent Coaching Is Often Not Enough.

Parent training and coaching is a vital component of successful behavioral interventions when working with children with autism, asperger's, add/adhd and other related disorders. We know that whether it is one hour or 20 hours a week of behavioral interventions, what the child does when they are with the therapist does not matter. Sure, as a therapist we pat ourselves on the back and speak of the success of our intervention when we are able to extinguish the negative attention seeking or escape behavior we first saw with the child. However, as a therapist I'm not that interested in how well they can do with me. My primary concern is how well they can do at home, at school, on the playground and in those environments that prompted parents to seek help in the first place.

In the world of Applied Behavioral Analysis, many therapists use Koegels' Pivotal Response Training (PRT) to help parents identify those "pivotal areas" to promote language, growth, etc. in the natural environment. I use PRT and think that it is great, but I also think it is not enough. To learn more about PRT click here.

In working with parents I have come to realize that providing all the behavioral strategies for parents is usually not enough. You may be wondering what I mean by this. What I mean is, there is a cognitive-behavioral disconnect between the understanding and the doing. Allow me to explain.

I have taught parents about the ABCs (Antecedent ->Behavior -> Consequence) of behavior. This is also refered to as the three-term contingency. After teaching one parent about the four functions of behavior (Attention, Tangible, Escape, Sensory), I had them teach it to their partner to make sure they understood. I believe strongly in the notion of, "to learn is to know, to teach is to understand." However even this idea falls short of the action component. For many parents knowledge and understanding does not always equate to action.

For example, I was working with a family who had an adorable 4 year old boy with autism. He had some language and a lot of escape behaviors. This little boy had learned when mom said, "it's time to go" or "go get your shoes" or "it's time to clean up" that he could successfully escape these demands by approaching mom with his innocent smile and sing twinkle twinkle. After about 4 weeks of parent coaching sessions this mom was very good at explaining what she is supposed to do, but unfortunately, she was not doing it.

This made me stop and ask myself, "what is preventing this parent and many of the parents I've been working with from turning this knowledge into action?" The answer: emotions.

Now, I am not suggesting by any means that parents need to stop having emotions. What I am suggesting is that as parents, look inwards to figure out what thoughts, feelings, emotions, etc. you are experiencing when your actions are in contrast to your understanding.

There is nothing in the world that can prepare you for the complicated grief and loss of not having a "neuro-typical" developing child.

When I was 14, my father had an aneurysm is his brain stem. He had to have major brain surgery, which left him with many life altering disabilities. It was not until I was about 21 years old that I realized I had lost my father when I was 14. The father that I knew - the one I played catch with and taught me the things that make dads a child's hero - was gone, yet he was still there. I share this with you because once I realized that I was experiencing this complicated form of grief, it allowed me to redefine, recreate and renegotiate the relationship I was going to have with my father.

My father did not ask for a brain aneurysm, my mother did not ask to become a caretaker, and neither of them pictured their lives taking this course. However, like the saying goes, life happens while you're busy planning it. And like many of you who never planned on having a child with special needs, life doesn't always go according to plan. So, like anybody who is faced with circumstances which are entirely beyond their control, you ultimately have two options in how you respond: rejection or acceptance.

Your first option consists of being angry, depressed, bitter, absorbed in self-pity, asking, "why me." Allow yourself to spend some time here, and even revisit it from time to time. The second option is to learn about the disability, how you can help, and how your expectations as a parent can be redefined so you are able to genuinely take joy in the accomplishments of your child.

Where there is a child with special needs, there is a family with special needs. Taking care of your child also means taking care of yourself and not neglecting other relationships in the family. Take a deep breath and realize that this is not a sprint, it is a marathon. Tighten your laces, get plenty of rest, and if you're not sure if you're going to make it, suggest to your coach a change in the game plan.

- Eric Tivers, LCSW, MSSW
from my newsletter, April 2010, No. 3

April is Autism Awareness Month

2010-03-31T23:37:00.000-07:00

Autism Awareness Thought of the Day...
If you've met one person with autism, you've met one person with autism.

Social Thinking - Social Skills Redefined

2010-03-17T23:02:00.000-07:00

For next months CHADD meeting, I will be presenting on what Michelle Winner calls, Social Thinking.

Social Thinking and Superflex - Redefining social skills instruction

As many parents, educators and professionals alike know, teaching your child "social skills" can be a challenge. One of the reasons is because, historically, social skills have been taught in isolation, without giving kids an understanding of the thinking behind the action. Social Thinking is a a cognitive behavioral approach, that works on one basic principle. If you want kids to successfully be social, they have to THINK social. Social Thinking helps kids and adults improve perspective taking, and teaches generalization of social skills.

Superflex is a curriculum geared towards children K-5, but I think it can also be effective through the 8th grade. As a clinical social worker, and a school social worker, I have not found any program (and there are a lot of them out there) that comes close to reaching kids the way this program does.
Superflex is the superhero that is trying to save Social Town from the team of Unthinkables. These unthinkable are the characters that are getting into kids brains that are preventing them from making smart social choices. Characters such as Glassman, who shatters or has big meltdowns over little problems, or the BrainEater who gets into kids brains and makes them wonder, to Bodysnatcher, who makes kids bodies go to other places other then where they should be. There are 14 different Unthinkables that Superflex is trying to stop from destroying Social Town.

If you are a parent or teacher and want to learn more about how to help your kids become Super-flexible social thinkers, I highly recommend attending this meeting. You can also learn more about Social Thinking and Superflex from the Social Thinking website at www.SocialThinking.com.

I hope to see you there!!!

When: Monday, April 19, 2010 6:45 PM

Where:
Family Service Center
4100 Family Service, 4100 Veterans Parkway 3rd floor Conference Room
McHenry, IL 60050

Social Skills & Video Modeling

2010-02-26T16:36:00.000-08:00

I spent the day at an autism conference in Crystal Lake. The speaker, Scott Bellini, who is the assistant director at the Indiana Resource Center for Autism at Indiana University presented on Building Social Relationships. Towards the end of the talk, he demonstrated the use of video modeling where you film, then edit the video so you have a new video of the child only engaging in the behaviors that are positive. I have used video modeling with surprising success in providing social skills training for a group of kids on the spectrum. What was surprising was not that it was successful, but how successful it was. What I saw, was supported with Research presented by Scott Bellini. The outcomes reported based on valid research methods were amazing. The fact that we know this works as well as it does only has me echoing Scott's same question; Why isn't everybody doing this?

Thank you CASPAN

2010-02-11T12:13:00.000-08:00

It was a pleasure to speak with the NW CASPAN group last night about organization. Please feel free to post any organization related questions here.

NPR Interviews NW Suburban CASPAN leader Brian Tozzo

2010-02-11T12:09:00.000-08:00

Speaking at CASPAN: Chicago Autism SPectrum Adult Network

2010-02-08T15:28:00.000-08:00

I am happy to announce that I will be speaking at the Northwest Suburban CASPAN. The Topic is, "Getting Your Life in Order." I will be sharing some tips and strategies on getting your life (a little bit more) organized.

When: Wednesday, February 10, 2010 at 7:15pm

Where: Willow Creek Community Church

67 Algonquin Rd. Building F Room 176-C

South Barrington, IL 60010

To be or not to be (self-aware) should not be a question

2010-02-07T21:08:00.001-08:00

My Thoughts on Teaching Self-Awareness,

Self-Determination & Self Advocacy

I wrote this for part of my website, but I believe that is also deserving of a blog post.

Civil rights and legal protections have been fought for and earned by both advocates and individuals with disabilities. Yet, despite the many legal protections and accommodations available, individuals with disabilities still face countless barriers and discriminatory practices when it comes to the day-to-day realities of life.

When it is an “invisible disability” like those with asperger’s, high-functioning autism, add/adhd or other learning disabilities, the barriers may also be invisible. This is especially true for individuals with average to above average IQs. The fact is that even many highly educated and well intended professionals do not understand the complex disparities that exist between an individual’s abilities and --their often difficult to define-- disabilities.

There is a saying, “if you’ve met one person with autism you’ve met one person with autism...” There may be as many similarities as there are differences for individuals with autism, aspergers, ADD/ADHD and other related disorders that fall on the “Spectrum.”

Helping teach individuals about their disability is an absolutely critical first step to helping them lead an empowered and meaningful life. While the notion of, “you can do anything if you put your mind to it,” is a nice sounding euphemism, it is neither true, practical nor helpful for most people, both with and without disabilities.

Individuals who understand their disability are better equipped to deal with or seek help in dealing with the difficulties they will surely encounter. The fact is that the greatest protective factor individuals with disabilities can have is not the law or their educational rights. It is to be self-aware of their strengths and weaknesses, to be self-directed and to have an ability to advocate for their needs and rights in both discrete and formal ways.

Teaching self-awareness can start as early as 5 years old. It is only a matter of time before children with disabilities start seeing that they are different from their peers. Without the proper support, children who suddenly realize that they are different from their peers frequently face significant emotional distress including depression, anxiety and increased social withdrawal.

Parents often report a variety of complex emotions when deciding to teach their child(ren) about their disability. Feelings often range from guilt to fear to anxiety. While the emotions may differ between individuals, they are all fundamentally rooted in the most primal and universal parental instinct - protection.

This is truly an issue that I am very passionate about. This was the focus of my research during grad school, and has continued to be the cornerstone of my work with individuals and families.

- Eric Tivers

CNN Segment on Autism and Retracted Vaccine Study

2010-02-04T09:04:00.000-08:00

The "news" that the original vaccine study linking some of the chemicals found in the MMR vaccine with autism was aired yesterday on CNN. This link is to a follow up segment in which a parent of three children with autism was interviewed, as well as a medical researcher. I was impressed by this CNN anchors use of person-first language, and for coming off as trying to help people understand both sides of the issue.

What do you think?

Great Quote

2010-02-03T11:10:00.000-08:00

"We all have ability. The difference is how we use it." - Stevie Wonder

ADD Friendly Strategies For Structure & Organization

2010-02-02T20:26:00.000-08:00

I know that lists are very helpful for organizing our thoughts and ideas. I really like this article, "Top 10 Routine Builders: Organizational Help for ADHD Children," from ADDitude online. I think this could just as easily apply to adults. Enjoy.

Music & ADD

2010-02-01T08:09:00.000-08:00

Monday March 15th 2010 6:45-7:45 pm
I will be presenting at the Northern Illinois chapter of C.H.A.D.D. (Children and Adults with Attention Deficit Disorder) on therapeutic and other uses of Music with ADD. You never know, I may spontaneously break out into song. Please join us, all are welcome.

Family Service Center
4100 Veterans Parkway
3rd Floor Conference Room
McHenry IL, 60050