PFA Tips: Struggling to Launch (part 2) The Adulting Journey of the Neurodivergent Brain

By Rick Silver, MD, Thrive Emerge

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In Part 1 we explored the idea that our neurodivergent young adults are designed to be different – that is, genetics has driven the creation of a brain that is challenged in its emotional, cognitive and social development. Add to this two decades of struggling with school, friends, family and jobs, and we see a young adult who experiences a great deal of anxiety and copes with the demands of independence through avoidance. Now we explore how parents can learn to champion their young adults’ unique experiences of life and how the young adults themselves can create a life rooted in how their brains work.

Treatment

To be successful in meeting the demands of an independent life, your child will need support and treatment – possibly for their lifetime. For some individuals, symptoms of ASD/ Executive Dysfunction can wane over time as skills are acquired and as the prefrontal cortex matures – and hence the efficiency and effectiveness of the brain’s “software”.

Many individuals will continue to benefit from several kinds of treatment, including:

Executive Function Coaching – to lay a foundation of “externalized” executive function
Medication Management – with stimulant +/or non-stimulant medication – to increase the activity and effectiveness of the prefrontal cortex; and to deal with the depression and anxiety that often accompanies ASD
Accommodations at School and in the Workplace – to adapt the child’s environment to better fit their unique brain
Family and Parenting Support – to deal with the sometimes disruptive nature of ASD in the home; and to help parents better manage these symptoms
Individual Therapy – to deal with issues of shame and lack of confidence that often accompanies ASD/EF issues
Social Skills Training – for those kids who struggle with impulsiveness in social settings; or with social anxiety; or with missing social cueing as is common with ASD
Emotional Self-Regulation Training – individuals can learn to better manage their emotional swings and overwhelming feelings using techniques from Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT)
Addictions/ Overuse Treatment – for both marijuana and video screens/electronics – these two issues often go hand in hand with ASD – as coping skills to manage anxiety and to provide stimulation and a sense of short-term reward that might be lacking in other aspects of the person’s life.
Self-Care Work – keeping the body healthy keeps the brain healthy. This is certainly important for everyone, but particularly so for the neurodivergent brain that has to work twice as hard just to keep up with life demands. Helping the individual structure a daily schedule, normalize sleep hours, improve diet and increase exercise can support the other treatments.

Parent’s Role

Parents play a critical role in helping their older teen and young adult transition successfully into an independent life. Here are a few key tips:

Understand that executive dysfunction/ ASD is biologically based: it is first and foremost driven by genetics, present at birth and will most likely continue throughout the person’s lifetime.
Other than broadly encouraging our child to always do their best, we must remember that ASD has nothing to do with willpower. It is not a moral shortcoming, it has nothing to do with laziness or not trying hard enough; and it will not respond to criticism, comparison with others or belittling.
If you are angry, frustrated or scared, find ways to soothe your own feelings. Don’t direct them at your child. The degree to which you are willing to look at your own emotional reactions about having a neurodivergent child is the degree to which you will be able to help that child.
Work towards compassion and away from blame.
Explore your role as an EF coach: do I push too hard, am I too lax? Get professionals’ opinions about how your role needs to change over time to allow continued strong support while making ample room for their individuation.
You cannot take away your child’s suffering. Just as we all did, they will learn from their sometimes very hard and painful mistakes. Find that fine line between appropriate support vs. rescuing. And always be alert to risk – too depressed, too isolated, too many drugs. There are times when your vigilance is very much required.
Don’t do this alone: get help for them and for yourself.
Expect to be in the saddle for the long haul: ASD brains mature about 4-6 years later than peers. What looks like a more competent version of adulthood begins to show up in the late 20s. Be patient.
Expect complexity: Many of those with ASD have some other mental health diagnosis: anxiety, social anxiety, tic disorders, mood disorders, OCD and learning disabilities. Be alert and provide support and treatment for all of these challenges.
Make room for your child to grow up as they need to – not how you expected them to. The road may be longer, with more twists and turns, ups and downs than expected. Make room for options: gap years, community colleges rather than 4-year colleges, vocational training and so on. Encourage them to discover how they want to live, learn and love.

But most of all: be hopeful and enjoy them. I have three daughters, two of whom are neurodivergent; and I work with many more neurodivergent young adults. They are each challenging, fascinating and wonderful in their own right. They want to grow, to explore, to love and be loved. More often than not, they find their own way of connecting with a fulfilling life.

Be open to how they experience the world. Their journey – with all its struggles – is still a gift that we as parents have had the good fortune to receive. When scared and frustrated, step back and hold them in this larger perspective. The reward for doing so will be immense for all involved.