1. A Video Interactive Guidance Intervention to improve anxiety levels for child with ASD Deborah Lee Ruth McCaskell Stirling Council

2. What do we mean by Anxiety? Developmental tragectory Future orientation Changes our attentional focus

3. Anxiety in ASD population 40-50% have experienced anxiety (Steensel et al 2011) Impact of anxiety differs (Ozsivadjian et al, in press)

4. An ASD Type Thinking skills Profile: a quick tour Difficulty with ‘intersubjectivity’ ? Hobson (2002) Difficulty with imitation (Wing, 1996, Trevarthen et al, 1998) Lack of self awareness, the interpersonal self (Frith, 2003) Inflexibility of thought (Frith, 2003)

5. Cognitive Style “It’s still in the memory bank and will still trigger anxiety, because it hasn’t been filed away. Nobody’s the filer, the filling doesn’t work, it’s never ever put away” “ Putting it in some sort of order before they can talk about how they felt…for M that order will be really jumbled for a while, so he’ll tell you bits of it, he might even tell you key words and in between those key words he’s on the floor and crying” (Ozsivadjian et al, in press)

6. Usual Interventions for Anxiety Started with behaviour modification type, use of reinforcements Psycho-education important Cognitive Behavioural Therapy (NICE guidelines) Mindfulness

7. How VIG may help? Sked (2006) combined the work of Nadel (1993) Short (2010) child and adult initiatives increased using VIG Forsyth+Sked (2011) VIG “straddles the 3 types of intervention identified by Trevarthen” Mindfulness in a different way? Helping child have a sense of agency in the interactive context

8. Anxiety and VIG Offer way into child’s experience of situation – to explore feelings and thoughts via observational analysis? Thus challenge ‘unhelpful thoughts’? Changes attentional bias – picking moments of success. Records a structured narrative that helps memory of events?

9. Video clip – Pupil P6 Asperger Syndrome school fine, anxious outwith Core Belief- “people scare me; I Don’t understand” ? Trigger – social situations Feeling – fearThought – i don’t know what is happening Behaviour – retreating/lashing out