“Size of the Problem” goals are a big problem.
When families ask me to look over potential goals from IEPs or treatment plans there is one that I will always suggest they remove and that is a “size of the problem” goal. These goals often read like this; “With no more than 2 verbal prompts in 3 out of 5 opportunities, when becoming upset the child will identify the size of the problem and use calming techniques to initiate a response appropriate to the problem”.
How big a problem is is subjective and determined by a number of external factors and as a society we seem to understand this. If someone drops their keys they can easily pick them up, but if they drop their keys when they are running late we understand they might let out an exasperated sigh and be visibly upset. It may even alter their mood for a while after. We accept this because it falls within neurotypical expectations of what is frustrating. On the other hand, if an autistic child gets a different color cup than the one they always use and becomes upset, neurotypical adults tend to minimize the child’s experience.
Most therapists addressing a “size of the problem'' goal at this point bring out a chart that delineates problem sizes from small to big as a visual support and then asks the child the size of the problem “Is this a big problem or a little problem”. The child knows there is only one answer: “a little problem”. Then the child is directed to a list of appropriate responses to little problems and prompted to have a response from that category. This whole process is a perfect example of how we teach and reinforce autistic masking. Autistic masking is when an autistic person hides their true feelings and emotions in order to make the neurotypical people around them feel comfortable. Masking is tied to depression and suicide later in life and is not something professionals should take lightly.
Rather than coming in to try and “teach” a child in a moment of frustration or meltdown we validate their experience “You wanted the red cup and didn’t get it. That is tricky for you” and validate their emotions “It looks like you are angry”. We then offer tools that are emotionally regulating. Offering regulation is not reinforcing behavior. I want everyone to say that to themselves again- offering regulation is NOT reinforcing behavior.
Obviously we want to build emotional capacity within all children, autistic or not. Instead of invalidating the autistic experience we need to understand it. When we are looking at a child’s emotional triggers at EACS we often utilize our background in DIR. We look at the child’s developmental levels. Are there areas of vulnerability in lower levels of development that make self and co regulation more challenging. We look at the child’s individual profile and get a deep understanding of their sensory system. And finally, and possibly most importantly, we need to keep building a relationship of trust with the child.
By building foundational regulatory skills through our play based sessions and groups we help increase that emotional resilience. By teaching self advocacy and communication we can teach a child to ask for the support they need. By creating trusting relationships children begin to feel secure that the adults in their life will help them get their own individual needs met. This is how you provide more affirming support.
