Long-Term Outcomes for People with Asperger's and High-Functioning Autism

What is life probably going to be like for your Asperger's or HFA child when he or she grows up?

Best Way to Teach Communication Skills to Children on the Autism Spectrum

“What would be the best way to teach communication skills to my 4 year old son with high functioning autism?”

These skills are best taught by a communication specialist with an interest in pragmatics in speech. Alternatively, social training groups may be used if there are enough opportunities for the child with High Functioning Autism or Asperger's to have one-on-one contact with the instructor and for the practicing of specific skills.

Teaching often includes the following: 

• Verbal decoding of nonverbal behaviors of others
• Social awareness
• Processing of visual information along with auditory information in order to facilitate the creation of the appropriate social context of the interaction
• Appropriate nonverbal behavior (e.g., the use of gaze for social interaction, monitoring and patterning of inflection of voice, etc.). This may involve imitative drills, working with a mirror, and so on.
• Correct interpretation of ambiguous communications (e.g., non-literal language)
• Perspective-taking skills

If possible, try to consult with a speech-language pathologist. These professionals are trained to teach language and communication skills.

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Guiding Asperger’s and HFA Teens Through Adolescence To Adulthood

Parenting any adolescent has its challenges. When he or she has Asperger’s (AS) or High Functioning Autism (HFA), the challenges are even greater. While most young people on the autism spectrum attend regular school, have friends, and participate in the same activities as their peers, they possess certain traits - and face certain obstacles - that “typical” adolescents don’t. For example:

• Adolescents on the autism spectrum might imitate what they have learned in books or movies, and their voices might sound flat or boring.
• Many AS and HFA adolescents prefer to be alone and may not show an interest in making friends. 
• Some are quiet and withdrawn. 
• They often don’t understand the importance of eye contact – and may avoid it altogether. 
• They have trouble understanding jokes or sarcasm.
• Some AS and HFA adolescents don’t understand socially acceptable ways to express frustration, and may become aggressive or throw tantrums.
• Most of these young people are socially awkward since they have difficulty processing social cues, (e.g., body language, sarcasm, humor, figurative language, emotional responses, and facial expressions). These nuances of social interaction may fall unnoticed to the adolescent.
• Sometimes they seem insensitive or look unemotional, but often they just don't know how to express how they're feeling. It doesn't mean they don't have feelings – it’s just more difficult for them to show those feelings or understand the feelings of others.
• Many of these adolescents have trouble coping with change, and may not react well to changes in routine.
• Most report that they feel "sensory overload" (e.g., they have heightened senses that can make noises seem louder and more startling, and lights may seem brighter). 
• Regarding sexuality, special issues that may need to be addressed for these adolescents include: communicating about inappropriate behavior, dealing with menstrual cycles, distinguishing between appropriate and inappropriate touching, maintaining physical boundaries with others, physical changes, and refraining from self-touch.
• The hallmark of AS and HFA is “social development” issues. These adolescents have trouble interacting with others. The part of the brain that recognizes and displays human emotion has developed differently, and a smile or a frown does not hold the same emotional significance as it does for a “typical” teenager.
• AS and HFA traits can include fixation on objects and ideas, or making repetitive motions or using repetitive speech.

Adolescents with AS and HFA need time to gradually learn and practice adult life-skills (e.g., finding a job, managing finances, doing laundry, preparing meals, driving a car, arranging medical appointments, etc.). They may not be ready for adult responsibilities at the same age as their “typical” peers. Thus, it’s very important that parents help their “special needs” teenagers learn to be comfortable with their own situation and abilities.

Below are some suggestions for how parents can guide their AS and HFA teenagers through adolescence – and prepare them for adulthood:

1. AS and HFA adolescents can learn appropriate behaviors, and many of them work hard to learn emotional interpretation and response. Also, they DO feel emotions (e.g., empathy); however, it’s learning to express these emotions in a way others understand that is difficult. The earlier the symptoms of AS and HFA are addressed, the more likely it’s that the adolescent will have better success in his or her social interactions.

2. Adolescents on the autism spectrum need to know both the mechanics and morals connected with sex. Books and classes have suggestions about how to handle the topic.

3. Assign age-appropriate chores. Your “special needs” teenager can begin with simple tasks (e.g., setting the table, taking out the garbage, etc.). Later, she can take on larger tasks (e.g., preparing a simple meal once a week for the family).

4. Base your support and expectations on your teen's abilities, level of emotional security, and history – not on her chronological age or what her peers are doing.

5. Celebrate and enjoy each milestone your teen reaches on the road to self-sufficiency. But at the same time, understand that you are going to have frustrations, and that this phase is going to bring a whole new set of stressors.

6. Check with your adolescent's school about any transition services the district may provide.

7. Don’t rescue your teenager by paying off her debts or by making excuses to her teacher for a failing grade. Let her feel the consequences, and the lessons will be long lasting.

8. Emphasize that your teen’s main responsibility at this stage in life is to get an education. It’s difficult to become a successful, self-supporting grown-up in contemporary society without at least a high school diploma. If marks and test results start to decline, be sure to show concern and take measures to reverse the trend as quickly and as forcefully as possible.

9. Enroll your teenager in a life-skills class, and also teach these skills at home.

10. Explain how you will help your adolescent move into adult life. AS and HFA adolescents need to know how long they can live at home and whether or not their mom and dad will help them with their first apartment rental, pay college tuition, keep them on the family health insurance, etc.

11. Explore substitutes or assistance for skills that are not manageable. As the parent, you are the best judge of when your adolescent is ready to partially or fully manage adult tasks.

12. Get your teen involved in peer-mentoring groups to learn life and job skills.

13. Group video instruction can help teens with AS and HFA learn important social skills. While the diagnosis rate for AS and HFA for 14- to 17-year-olds has more than doubled in the past five years, very few strategies have been found to help these teens develop the social skills they need to be successful. Studies have shown AS and HFA teens are more likely to pay attention when an innovative technology delivers the information. Video-based group instruction is important, given the often limited resources in schools that also face increasing numbers of students being diagnosed with AS and HFA.

14. Have your teenager meet with other AS and HFA adolescents with similar challenges. This can make her feel not so alone and ostracized.

15. Include your teenager in groups (e.g., support, therapy, social and sports groups).

16. Lead by example. Teens absorb attitudes, behaviors and habits from their parents. When they see the family wage-earners going to work daily, and both mom and dad cooperating to do cleaning, cooking and other household chores, they come to understand that everyone needs to contribute to the welfare of the family.

17. Make a list of the skills you believe your “special needs” teen will need in the outside world. Do this as you go through your day – working, shopping, paying bills, cooking and performing other normal tasks. Writing the list yourself will make you aware of behaviors that you can model and share with your adolescent. Show the list to his teachers, doctor, therapist and any other caregiver who helps him. Ask these people to review and add to the tasks, using their knowledge of your teen’s abilities and problems. Also, turn the everyday activities from your list into “teaching moments” (e.g., at the grocery store, you can ask your teen to find the least expensive canned peaches; wait at a bus stop and demonstrate how to pay the fare, find a seat and get off at the right stop; show your teen simple cooking and cleaning methods, etc.).

18. One of the greatest gifts you can give your AS or HFA adolescent is the ability to handle his emotions. Teaching him how to identify, reflect on, and deal with his feelings by the time he leaves home is one of the best ways to prepare him for adulthood. In fact, this emotional strength and ability will take your child much farther in life than intellectual ability or a specific ability (e.g., athletic or artistic ability).

19. Provide ongoing emotional and tangible support even after your young adult moves out of your home. Moms and dads who visit frequently, assist with household management, help to fill out tax forms, etc., help their adult children not feel too overwhelmed as they adjust to life away from parents.

20. Remember that under Federal law (Individuals with Disabilities Education Act), by the time a special education student reaches age 16, the school is to provide a plan that may include help obtaining further education, getting a job, or living independently. Moms and dads need to advocate for these services. Communicate respectfully, clearly, and often with your school's "transition coordinator" about your teen's transition plan.

21. See that your adolescent gets enough experience in normal social etiquette (e.g., talking to a store clerk, relating to friends at a party, asking for information, etc.).

22. Seek out social-skills classes sponsored by local schools, community centers, colleges or charitable foundations.

23. Teach and re-teach your adolescent adult life-skills (e.g., balancing a checkbook, paying off a credit card balance, cooking, laundry, car maintenance, making doctor appointments, etc.). Provide abundant opportunities for supervised practice.

24. The most important thing moms and dads can do is to “let go” of their “special needs” teen and let him experience success -- and failure -- on his own. No matter how complex the special need is, that teenager will be striving for a state of independence. He wants that, just like all teens want independence. As true as this may be, it can be challenging emotionally for moms and dads to transition from a protective, advocatory role and to permit new degrees of autonomy.

25. The next time you talk to your AS or HFA adolescent about a problem she is facing, help her to reason on how her choices reflect on her. Help her to see how her choices either enhance her reputation or tarnish it, which in turn will help or hurt her future prospects.

26. Very few young adults on the autism spectrum are ready for full "independent" living. They all need ongoing support and encouragement from parents as they learn to negotiate the adult world. “Launching” AS and HFA individuals from the “nest” brings some unique challenges. Initially, "interdependence" rather than "independence" is a more fitting goal for these young people as they begin to venture into the world.

27. When a problematic issue arises, try reversing roles. Ask your adolescent what advice she would give you if you were her child. Have her do research to come up with reasons to support – or challenge – her thinking. Discuss the matter again within a week.

28. When your adolescent shows that she is handling her social life, schoolwork, and part-time employment well, you can start to gradually loosen the apron strings and trust her with more responsibility. This may be the time to go on a short vacation and leave your adolescent home alone to look after herself and the house. Soon she'll be off to college or university (hopefully), and she needs to practice being on her own.

29. Write down one or two areas in which you could extend a little more freedom to your “special needs” teenager. Explain to her that you are extending this freedom on a trial basis. If she handles it responsibly, in time she can be granted more. If she does not do so, the freedoms she has been granted will be curtailed.

30. Your AS or HFA teen needs to be socialized. Give her plenty of opportunities to mix amicably with other people of all age groups. She should visit restaurants, movies, and malls and learn to behave appropriately in all circumstances. Grown-ups don’t live in isolation. They need to interact graciously with different types of people in a variety of milieus. As your teenager matures, she should improve her social skills so she can converse pleasantly with anyone in diverse situations.

As mentioned earlier, young people on the autism spectrum need extra time to learn and practice adult life-skills, because their “emotional age” is much younger than their “chronological age” …in other words, you may have a teenager who is 17-years-old chronologically, but emotionally more like 14-year-old. So, the earlier you begin helping out in this area – the better!

Launching Adult Children With Aspergers: How To Promote Self-Reliance