Upset because... You can help me by....

A few times in the past I have posted about the success of using a "Upset because/You can help me by" set up on a communication device, book or in a separate binder.

(Link to the first post and the second.)

The "Upset because/You can help me by" framework was something the SLP and I created at my old job to assist a student and have since used with many, many students. The general principal is that when a student with communication challenges becomes upset (angry, sad, irritated, frustrated or any other version of upset) a staff member cues the individual to use the framework to identify the feeling, the cause of the feeling ("I don't know why" and "I am a teenager!" are both acceptable) and how a staff member can assist in easing the situation.

Upset Because And Help By Binder

View more documents from teechkidz.

This booklet is also available on Adapted Learning.

Currently this framework is being used in my classroom, yet again, with a student to ease in periodic distress. This morning myself and the other adults in the room were quite convinced of the power of this method when an AAC user, whom was just introduced to a page set using this method, was able to go from vocalizing in distress to communicating "sadness" because of a "schedule change" and requesting "explaination". Once the staff member responsible for the confusion (that would be me, oops) apologized and promised to make sure to communicate better next time the student pressed, "Sweet!"

The power of simple communication never fails to blow my mind.

All behavior is communication.

Why do our students need to know the words for emotions?

Image via WikipediaAlexithymia (aka Alex) literally means "no words for feelings". It is also a state in which a person cannot find the words to express or explain his or her feelings. It is not a lack of emotions or stoicism but an inability to use words to describe feelings.

Recent studies have used fMRIs to look at what happens when individuals identify emotional states by picture versus by using language. In the study individuals were asked to match photographs of face showing matching facial expressions and then they were asked to match the photograph to the printed word for the emotion displayed. Matching only images caused the amygdala to become active. This is the part of the brain associated with emotional distress. However, when matching images to words the amygdala shows less activity and the right ventral lateral prefrontal cortex shows more activity. The right ventral lateral prefrontal cortex is a language center of the brain and its activation along with the suppression of the amygdala mean that using language to describe emotions lessens emotional pain. Long story short if you can use language/words to label feelings then the feelings will have less of an impact. (Here is a link to the APA article.)

This is all reinforces our responsibility to work to increase not only our students vocabularies, but also their emotional intelligence. It also explains why some students who finally receive AAC devices and therefore can now use language to label and explain emotions show a decrease in maladaptive behavior.

In particular it has been found that up to 85% of individuals on the autism spectrum have some level of alexithymia. (It is also co-morbid in many cases of anorexia and other eating disorders, depression and individuals exposed to early and/or ongoing childhood trauma.) Add that to the fact that many of the students in our classrooms have limited expressive language and we are likely to see students who either have organic (neurogenic or psychogenic) alexithymia or students who have secondary alexithymia because of expressive language limitations.

It is recommended that those with alexithymia learn a large repertoire of words that describe emotions and that they work with someone who can teach them how to recognize the physical signs of various emotions and the labels for those emotions. This is, of course, where we teachers (and therapists and parents) of learners with alexithymia or limited expressive language come in. We must teach our students through direct instruction, modeling, role plays, incidental teaching and other methods of instruction the words for emotions, how to recognize emotions in themselves and others, and how to understand the degrees of emotions (angry to furious, happy to ecstatic). We can't just expect our students to "use their words" without teaching them the words and how to use them. The bonus of teaching our students the words is that when they do use those words they will be able to lessen the intensity of their feelings.

Here are some tactics I use in teaching my students about emotions and the words for emotions:

• Start by teaching "mad, sad, glad", then add scared and move on from there
  
• Emotion communication boards and pages on AAC devices
• Daily check in during morning meeting where students are taught to use feeling words
• Use of "cloze" style statements, "I feel...." and "I need..." (with use of AAC to answer if needed)
• Feelings pages on AAC devices link to "because" pages which link to "you can help me by" pages (For example pressing and saying "I am so mad!", links to a page with choices about why the student is upset, thus the student may press, "I am so mad because someone who is supposed to be here is not here!", this links to a page with choices of things that are calming so the student may say, "You can help me by giving me some space so we will all be safe.")
• Role plays where students draw a picture card of an emotion out of a hat and then must act out that emotion through facial expression and label the emotion with his or her words (in whatever form that takes)
• Bingo and matching activities that ask student to match photographs or drawings of various emotions with words/picture symbols
  

Here are some products I have used with my students:

• emotional bingo from PCI
• Talk Blocks
• How are you feeling today? Poster

Here are some books I use with students:

• Today I Feel Silly and Other Moods That Make My Day by Jamie Lee Curtis
• Feelings by Aliki
• The Feelings Book: The Care and Keeping of Your Emotions by American Girl Press

The Creative Therapy Store also has some nice resources. And here is a journal article with some ideas.

Here are some communication boards about emotions for all levels:

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