Self-management

Self-management interventions help individuals with ASD independently regulate their behaviors to respond positively in a variety of settings and situations that involve communication, social interaction, and adaptive functioning.

All of us must self-manage our behaviors as we respond to people, situations and events. We learn to listen or speak up, initiate or respond, problem-solve independently or ask for help, depending on the situation and context. We learn to adapt our behavior to the culture we exist in, whether it is our school, workplace, neighborhood, party, or a foreign country. We imitate the social mannerisms of the group we are in. Although this adaptation seems automatic, it is actually a 4-step process of observation of the environment, self-monitoring of one’s own reactions, self-reflection and decision making, and finally adaptation and reciprocity to ensure successful interaction. Individuals with ASD may struggle to execute these steps, hence they are broken down and taught systematically. Once they learn to do this, it promotes their independence and empowerment.

When teaching self-management to an individual with ASD, the process is broken down into several steps:

• Observation - observe what is happening in the environment and the demands being placed on oneself

• Self-monitor - the individual with ASD observes how he/she is responding

• Discrimination - be able to discriminate between appropriate/helpful responses and inappropriate/unhelpful responses to the situations

• Self-reflect - the individual reflects on what would be the helpful response in this particular situation, makes a plan for engaging in helpful responses

• Self-monitor - design a self-recording system to track responses over a given time period

• Self-reward - set up a rewarding system for meeting intermediate steps and larger goals.

Initially, each of these steps are taught through cueing (such as providing visual supports and reminders in the environment) and the teacher/parent prompting the student/child to engage in the helpful response, to help him record his response, and access his reward if he engaged in the desired response. Gradually, these prompts are faded until the individual becomes independent with self-monitoring, self-recording, and self-rewarding himself. Visual supports/reminders (on a watch or phone or posted on the wall) can remain as these do not require another person and don’t impact independence.

Self-management can be applied to the learning of specific skills such as staying seated during instructional time or initiating a conversation with peers. However, the power of self-management lies with the foundational aspect of this skill - once the individual learns to self-manage his or her own responses, he can apply this toward a variety of skills and situations across diverse settings.

I’m sharing below an implementation of a simple self-management system for an adult with ASD who has just graduated from college and is learning to live independently.

Van (not real name) wanted to eat healthy and save money by cooking at home, but was getting frustrated that he was failing at this. When I talked to him more about this, I understood that he was struggling with planning, organizing, and managing the tasks of making a list of ingredients, grocery shopping within budget, meal planning, and having kitchen supplies available and replenished as needed. So, I helped him make a menu of his choice, a standard grocery list that doesn’t vary from week to week too much, scheduling time to go shopping, and ordering his kitchen supplies (paper towels, etc.) in bulk online. When any of these prerequisite tasks failed to happen, he would not be able to cook, end up eating out, spend more money on meals, and become frustrated.

So, I designed a simple self-monitoring and self-recording system for Van, shown below. At the end of the first week, it looked like this:

What this showed us is that he was very particular about sticking to his menu and having all the ingredients needed before cooking his meal. He was also very exact about the brand and taste of each ingredient. He could not improvise the meal or substitute ingredients. So, I said that he could either work harder on his grocery list and make sure he had all the required ingredients in the correct quantities or he could learn how to make back up meals (use Plan B). At first, he chose to do the former. But anytime he ran out of something, he would get very upset with himself. So, I asked him if he would be willing to try the latter option, and he agreed.

So, I had Van come up with simple meals made up of ingredients that don’t easily run out – at first, he listed almond butter and jelly sandwich, frozen pasta, and frozen pizza. I suggested adding frozen vegetables but he said he hated these for their mushiness – so we dropped them. Also, he insisted that the Plan B meals must match the Plan A meals – that is, a hummus sandwich must be substituted only by butter/jelly sandwich, pasta primavera must be substituted by frozen pasta, etc. So, I had him come up with 5 Plan B substitutes that matched the Plan A meals – a sandwich, a pasta, a pizza, a potato-based dish, and a rice-based dish.

So now, his meal plan now looked like this:

Once he had these backup meals available, he was able to use them. A week later, his chart looked like this:

So, initially, I tried to look at why Van was failing and provided him with supports and skills (listing, planning, shopping, money management, etc.) to succeed. But doing the self-monitoring system revealed another problem – his penchant for exact ingredients and recipes and not deviating from his meal plan – which then had to be solved by creating a list of matching substitute meals that he could accept.

The above is not a traditional, textbook style implementation of self-management but real world problems rarely are. The above situation uses the ideas of self-management but also addresses other issues related to ASD such as the need for exactness and symmetry. The interesting thing here is that Van expanded his choices to a Plan B menu, thus increasing his flexibility. He also problem-solved through this on his own terms, making certain compromises, but holding on to certain preferences - this is helpful for his self-awareness and confidence. I hope you found this example useful and will be able to design your own self-management system for your child or student with ASD to empower them.