Sex Education For People With Special Needs, Mindfulness Isn’t Always Effective & Corny Jokes For Handwriting

There has been a trend in therapy of all flavors in recent years to attempt to treat many hard problems with mindfulness.

While there’s no doubt that cognitive behavioral therapy and other mindfulness strategies are effective in lots of people (especially adult people), the effectiveness of mindfulness as a treatment strategy is definitely over-hyped in popular culture.

A group of 15 psychiatrists, psychologists and experts in mindfulness recently published a critique of mindfulness in the journal Perspectives on Psychological Science.

They note that the “mindfulness industry” (my word for it) has been pushing mindfulness, meditation and other similar strategies as be-all, end-all approaches for many hard-to solve-problems like anxiety and addiction.

And they’ve made boat-loads of money doing it. I mean, who doesn’t want an easy way to get rid of anxiety? I’ve definitely been taken in by the hype.

I see this as an issue in pediatric therapy, as well. I have had parents of elementary school-aged children complain to me about their child’s inability to meditate or to think mindfully about their behavior.

The irony is that many, if not most, adults with well-developed frontal lobes have the same issues.

While I agree we should focus on helping children attend to and associate meaning with interoceptive feelings and emotions, I think it’s unrealistic and just plain bad therapy to expect mindfulness or cognitive behavioral strategies to lead to self-regulation in an immature brain with faulty wiring.

Self-regulation, emotional regulation, & behavioral regulation tend to be better accessed through the body rather than through cognition in very small children and in most children of any age with developmental challenges.

This is why we cuddle and rock a crying infant rather than trying to get them to take deep breaths. Many of our patients have social-emotional control systems that haven’t really progressed much since infancy.

Bottom-up, body-based approaches tend to be more effective in the populations we treat. No child in the throes of code-red tantrum is going to be able to stop and take deep breaths and “be mindful” until the emotional storm is just about over.

I agree with the authors of the critique that we need to be more thoughtful and evidence-based about how we use cognitive approaches and help parents understand when these approaches may be effective and when they are likely to be pointless at best.

And in case you need more convincing: AOTA takes a similar stance (see number 5).

You can read a good summary of the article here and access the abstract here.

I’ve been getting a lot of mileage out of an article I found on artofmanliness.com. It’s called “50 Best Jokes For Little Kids” and it also has links to other great articles: the best riddles, the best jokes for kids of all ages, and non-cheesy knock-knock jokes (note: they are definitely cheesy).

These short blog posts have been a treasure-trove of handwriting activities for my older kiddos who love a good joke.

So far we’ve:

• created joke books by writing the jokes on small pieces of paper and stapling the pages together.
• created joke ‘flash-cards’ by writing the joke on one side of an index card and writing the answer on the other side. One group had a great time using the cards to try to get each other to guess the answers to the riddles.
• used these jokes as a jumping off point to write our own very silly and often non-sensical jokes.
• talked a lot about humor and what makes something funny.
• had really good discussions about the differences between a good joke and a bad joke (such as playing mean pranks on your friends).

Have you heard of Stephanie Mitelman, M.A., CSE? She is a sex education guru and the owner of sexedmart.com, one of the best resources out there for sex education. She is a specialist in providing sex education to people with disabilities, especially autism.

The site has a whole section for teaching people with disabilities. It’s a resource I share with parents and teachers all the time.

We tend to get really uncomfortable just thinking about talking to our patients about sexuality, which is a shame because OT’s are often in the best position to provide real education about it.

Regardless of their developmental challenges, girls are going to start their periods and boys are going to get erections they can’t predict or control. Many kids with special needs don’t have the social appraisal skills to understand how to handle their changing bodies without attracting more negative attention.

How do you deal with a teenage boy with autism who masturbates over his clothes every day in class? Punishment isn’t the answer (and hardly ever works). This kind of thing happens all the time and no one discusses it.

There’s a real need for structured sex education and very honest conversations about sexuality in children with special needs. Mitelman has created some awesome resources to facilitate that.