NESCA is currently booking for in-person Real-life Skills and Executive Function Coaching in the Newton, MA office! Our experienced occupational therapists work alongside individuals to achieve their personalized goals, which often address functional life skills that allow them to thrive in their homes, schools, and communities. For those not local to Newton, MA, remote services are also offered. Click here for more information. To inquire about our coaching services, complete our Intake Form.

Tag

social anxiety

How to Make the Holidays Less Stressful

By | Nesca Notes 2023

By: Maggie Rodriguez, Psy.D.
Pediatric Neuropsychologist, NESCA

Are the holidays the “most magical time of the year?” Maybe, but they can also be the most stressful. In fact, a recent survey by the American Psychological Association found that 41% of U.S. adults experience increased stress levels around the holidays, while 52% find their stress levels remain the same, and only 7% feel less stressed this time of year. A whopping 43% of American adults acknowledge that the stress that accompanies the holidays compromises their ability to enjoy them (and that number includes only the people willing to admit it!).

As an adult reading this, you may be thinking this information comes as no surprise and you’re all too aware of the stress that comes with the holidays. What you may not realize as fully is that this time of year can be stressful for children as well. While the holidays can bring excitement and fun, they can also present challenges, particularly for our kids and teens who struggle with underlying mental health issues (such as anxiety or depression) or neurodevelopmental conditions (such as Autism, Attention-Deficit/Hyperactivity Disorder, or Sensory Processing Disorder). For the next few weeks, many of us will be attempting to navigate our own holiday-related stress and manage the stress our children may feel and express in a variety of ways. So, if you’re feeling less overwhelmed with excitement and joy and instead simply overwhelmed, you’re not alone. Here are some strategies for making the holidays work for you:

Notice and recognize the impact of expectations. It all starts here. From Hallmark movies to the pictures posted by mom-fluencers on Instagram, we are bombarded with unrealistic images of what the holidays “should” look like. Social media is particularly insidious, as it tends to contribute to a sense that the everyday, real people around us (not just those celebrities in magazines) are living what we see reflected in their carefully edited and curated photos. It’s important to remind ourselves that these images don’t reflect the reality of life and that we don’t see 99% of what happens in the daily lives of those we follow on social media. We may see the images of perfectly decorated Christmas cookies but not the kitchen counters covered in flour, eggs, and frosting (or the parent yelling) in the background. We click on the beautiful photo of three kids all smiling at the camera from Santa’s lap but don’t see the 25 outtakes featuring those same children in tears, sticking out their tongues, or bolting out of the frame. Realizing this and taking a step back is key for ourselves and our children, who may also need explicit information about what they can expect (for instance, regarding the number of and type of gifts they will get based on your family’s budget versus what they envision).

Realize we also all harbor implicit ideas about what the holidays “should” look like based on our experiences growing up and the way our families did things, which we take for granted. If you’re in a relationship, you may have encountered your own hidden expectations if they ever come into conflict with those of your significant other. Even if you celebrate the same holiday(s), you may do so in very different ways. Some of you may be familiar with conversations, such as, “What do you mean your family decorates the tree Christmas Eve? Christmas trees go up as soon as we put our jack-o-lanterns in the compost on November 1st!” If you and your partner celebrate different holidays or your kids split their time between your home and that of another parent, all of this becomes much more complicated. So, talk about it openly and together. As a family, re-evaluate your expectations and traditions, and start with a blank slate. Sit down together, make your expectations explicit, then assess them together.

Ask some questions, such as:

  • What does each family member, kids included, envision the holidays will look like? This might be general and abstract (maybe Mom wants to ensure there’s downtime for rest and relaxation) or concrete (maybe the kids want to go ice skating over winter break, and Dad wants to make sure the family goes to midnight mass on Christmas Eve). How will you make this work both logistically and in terms of balancing different needs?
  • What traditions do you automatically take part in, and do they work for your family at this particular moment in time? Although traditions are important and meaningful, blind and rigid adherence to rituals and routines that don’t work for us don’t benefit anyone. We often take part in traditions without questioning whether they add to our lives or why we started doing them in the first place.

Once you’ve had these discussions, consider that you don’t have to “do” the holidays the same way ever single year. There’s no rule that says every holiday season has to look the same. Do you always go take photos with Santa at the mall even though your kids inevitably resist the idea, become anxious and overwhelmed, and you end up frustrated? Open up to the possibility of forgoing that tradition even if it’s just for the time being. Do you make an elaborate holiday dinner each year but aren’t up to it this year? Consider finding an alternative for now that takes the stress off of you and still aligns with your priorities. If what’s important to you is enjoying a meal with your family, maybe you can still do that while letting go of the need to do it all yourself.

Modify your expectations and make accommodations for your children given their unique personalities and potential challenges. This might mean forgoing busy and crowded events, such as parties, for children and teens who struggle with anxiety in social settings or become easily overwhelmed by sensory input. Or maybe you still attend, but you have a pre-established plan for leaving by a certain time and/or managing distress that may arise. These days, many public spaces that host events (e.g., museums, theaters) hold modified sensory-friendly versions of events at specified times. For many children, building in predictable routines, and previewing special plans or changes to their usual schedules can be very helpful. For kids or adolescents with significant “picky” eating or Avoidant-Restrictive Food Intake Disorder (ARFID), you might consider hosting a holiday dinner at your house so you have control over the menu or bringing food you know your child will eat if you’re visiting others. Many kids with ADHD will need movement breaks, so think ahead about how you’ll work those in depending on your plans. It helps to think ahead and have a flexible plan for meeting your kids’ needs in different scenarios.

Now for the twist. Remember that APA study I quoted at the start of this blog? Well, even though so many people reported significant stress, it also found that 69% of adults feel the stress of the holidays is “worth it,” and many endorse positive outcomes related to the holidays, including an increased sense of togetherness. No matter what or how you celebrate, the holidays can be a wonderful and meaningful time of the year, and the odds of finding joy, connection, and calm will be higher if you take a step back and figure out how to make the holidays fit into your life and work for your family.

References:
https://www.apa.org/news/press/releases/2023/11/holiday-season-stress

 

About the Author

Maggie Rodriguez, Psy.D., provides comprehensive evaluation services for children, adolescents, and young adults with often complex presentations. She particularly enjoys working with individuals who have concerns about attention and executive functioning, language-based learning disorders, and those with overlapping cognitive and social/emotional difficulties.

Prior to joining NESCA, Dr. Rodriguez worked in private practice, where she completed assessments with high-functioning students presenting with complex cognitive profiles whose areas of weakness may have gone previously undiagnosed. Dr. Rodriguez’s experience also includes pre- and post-doctoral training in the Learning Disability Clinic at Boston Children’s Hospital and the Neurodevelopmental Center at MassGeneral for Children/North Shore Medical Center. Dr. Rodriguez has spent significant time working with students in academic settings, including k-12 public and charter school systems and private academic programs, such as the Threshold Program at Lesley University.

Dr. Rodriguez earned her Psy.D. from William James College in 2012, where her coursework and practicum training focused on clinical work with children and adolescents and on assessment. Her doctoral thesis centered on cultural issues related to evaluation.

Dr. Rodriguez lives north of Boston with her husband and three young children.  She enjoys spending time outdoors hiking and bike riding with her family, practicing yoga, and reading.

To book a consultation with Dr. Rodriguez or one of our many other expert neuropsychologists, complete NESCA’s online intake form.

NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; and the greater Burlington, Vermont region, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

Social Creativity and ASD – Challenging the assumption that autistic people are not social

By | NESCA Notes 2018

Photo from the documentary, Autism: The Musical (2007)

By: Rebecca Girard, LICSW, CAS
Licensed Clinical Social Worker

The New York Times recently published an opinion piece titled, How to Meet Autistic People Halfway, an article that challenges the common belief that people on the autism spectrum are avoidant of social interaction and do not desire social connections. The authors, Vikram K. Jaswal and Nameera Akhtar are psychologists and researchers who study the social lives of people on the autism spectrum. They assert that while core deficits of autism may make social interaction more challenging, it does not mean people on the spectrum do not desire meaningful social connection. For years, many in the ASD community and their allies in the neurodiversity rights movement have attempted to combat this anti-social stereotype, but the notion stubbornly persists. Counter-narratives of the autistic social experience often reflect autistic people as extremely emotionally sensitive, hyper-aware of the feeling states of others, and indeed motivated to experience social success in the form of friendships and social acceptance. Additionally, an increasing number of people believe those on the spectrum may actually display more creative and interesting ways to connect and choose to describe autistic individuals as “socially creative” rather than having “social deficits”.

If we then acknowledge the desire to connect is present, how can we best facilitate social learning and promote social success? First, we can acknowledge that a person on the spectrum will have a myriad of ASD-related challenges that will likely make socializing difficult. These include trouble reading and interpreting social cues (eye contact, body language, facial expressions), attending to and managing sensory challenges during interaction, and repetitive and inflexible thinking (getting “stuck”, echolalia), all of which can lead to preemptive social rejection by peers and a lack of social opportunities to practice and improve upon their social interaction skills. These challenges require multi-disciplinary supports, including (but not limited to) occupational therapy, speech therapy, and cognitive-behavioral therapy. Second, we can provide positive social learning interventions that address and ameliorate the impact of these factors, while providing opportunities to explore and understand the social world.

A popular method of intervention is that of “social knowledge”, or didactic social skills training. This entails imparting concrete social skills, in the effort to explicitly teach what a person may not know about socializing. Think – programming a social computer with many algorithms; if a person does A, you do B. While this may be great at teaching the basics, it often does not adequately prepare ASD individuals for the unpredictability and fluidity of everyday interactions. Another approach is that of “social performance”, a dynamic method of encouraging social pragmatic development by providing semi-structured socialization opportunities in small group settings with immediate, in vivo feedback on what’s working or not. Think – flexing a social muscle. Drama-based social pragmatic groups are gaining in popularity as a method for not only promoting social connections but as a fun way to create an encouraging and supportive space to finds one’s own intrinsically motivating social style.

But enhancing individual social skills and providing adequate social opportunities is admittedly a one-sided approach. Equally important is challenging the stigma and bias that plague the ASD community. We need to be allies to this community by promoting greater acceptance of a wide-range of social styles and approaches to social engagement. To honor the neurodiversity mission, which “rejects the idea that autism should be cured, advocating instead for celebrating autistic forms of communication and self-expression, and for promoting support systems that allow autistic people to live as autistic people.” (What is Neurodiversity? [Website]. (2011).  National Symposium on Neurodiversity at Syracuse University)

As a therapist who has worked with ASD individuals across the lifespan since 2004, I know firsthand that autistic people feel the same loneliness and isolation when chronically socially disconnected, and feel the same anxiety and unease when experiencing social rejection. I have also had the pleasure of witnessing individuals find their own distinctive social style and the joy of connecting with others who appreciate what is different as interesting and exceptional, rather than off-putting or strange. The autistic people in my life, both professionally and personally, have challenged me to rethink narrow and strictly defined social expectations, and have made all my relationships richer as a result. Autistic people are often credited with “out of the box” thinking and innovation, which can be applied to their social lives as well, as they are uninhibited by social convention. For example, Asperger’s are Us are the first all-autistic sketch comedy troupe, and their performances reflect their original and offbeat sense of humor, as well as their deep connection to one another as friends. A great example of what is possible.

The New York Times article said it best in its conclusion, “improving the social lives of autistic people will require putting aside assumptions about how social interest is expressed and recognizing that it can be shown in unexpected ways.” As parents, professionals, and allies, let’s commit to challenging this very basic and long-held assumption and appreciate and embrace the unique and creative ways autistic people chose to engage the world around them.

 

About the Author: 

Rebecca Girard, LICSW, CAS is a licensed clinical social worker specializing in neurodivergent issues, sexual trauma, and international social work. She has worked primarily with children, adolescents, adults with Autism Spectrum Disorders and their families for over a decade. Ms. Girard is highly experienced in using Cognitive Behavior Therapy (CBT) as well as Socio-dramatic Affective Relational Intervention (SDARI), in addition to a number of other modalities. She provides enhanced psychotherapy to children with ASD at NESCA as well as to provide therapeutic support to youth with a range of mood, anxiety, social and behavioral challenges. Her approach is child-centered, strengths-based, creative and compassionate.

Reach out if you would like to work with Rebecca: Email rgirard@nesca-newton.com or call 617-658-9825

 

 

 

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.