Helping Asperger’s and High-Functioning Autistic Teens Deal with Their "Disorder"

Teens with Asperger’s (AS) and High Functioning Autism (HFA) bring their unique flavor to adolescence, essentially determined by the levels of three principles: avoidance, insight, and interest. Let's look at each in turn:

Level of avoidance— In the social development of AS and HFA teens who show some interest in peer interactions, social anxiety and resultant avoidance play an important role. Some of these teens get very nervous just with the thought of approaching others and may choose to avoid it at all costs. Their avoidance may appear as if they are not interested in others. It’s important to differentiate this since anxiety can be treated much more easily than genuine lack of interest.

Level of insight— Some teens with AS and HFA will not avoid interacting with others younger, older or similar age. Rather, they are eager to communicate, though, often in a clumsy “in-your-face” way. The level of their insight into their social deficit will then become the determining factor of their social success. If they are unaware of their shortcomings in gauging the social atmosphere and reading social cues, they may inadvertently come across as rude, insulting or boring. They may miss subtle criticism, sarcasm or teasing. As they develop better insight, they become more motivated to learn what had previously not come naturally and intuitively. They also have a better chance to work through a sense of loss.

Level of interest— Some teens with AS and HFA will show little or no interest in others. They may seem to be totally unaware of their friends’ presence, or they may appear indifferent when friends try to interact. As the symptoms of this disorder get less severe over time, the level of interest in developing friendships usually increases. For these “special needs” teens, the quality of social interactions mostly depends on the levels of avoidance and insight.

Regardless of the individual developmental route, most teens on the autism spectrum start realizing that they are not quite like others at some point during their teenage years. A few factors seem to facilitate the process: (a) a higher level of interest in others; (b) a higher level insight into difficulties in social interaction; and (c) a higher IQ.

Once the young person realizes that he has significant difficulties in conducting social relationships compared to his peers, he needs to deal with this loss. Understanding the thoughts, feelings and behavior of an adolescent on the spectrum is the necessary first step in helping him. Parents need to consider the following coping process that AS and HFA teens go through when dealing with their losses:

• Denial (e.g., “I don’t have Asperger’s!”)
• Anger (e.g., “Why do I have this stupid disorder – it’s not fair.”)
• Bargaining (e.g., “Maybe there’s a cure or some medication I can take that will make it go away.”)
• Depression (e.g., “I guess I really do have this disorder. I can’t seem to make friends like everybody else can. Nobody likes me.”)
• Acceptance (e.g., “O.K. So I have this thing called Asperger’s – so what?! A lot of people have it. I don’t care what others think about me. If they don’t like me, that’s their problem.”)

Most commonly, the young person on the autism spectrum will not go through these stages one after another, but rather display a larger or smaller aspect of each at any given time. This is a painful process for both the teen and his parents. Moms and dads may find themselves trying to avoid addressing their teen’s painful circumstances. We are all tempted to avoid pain – and denial is an excellent painkiller. However, as much as denial is contagious, courage and strength are contagious as well. An AS or HFA teenager seeing his parents dealing with the hard issues calmly and rationally will be encouraged to talk about his anger and frustration. This will in turn help him get closer to acceptance.

Teenagers with Asperger's and High-Functioning Autism: Special Considerations for Parents 

Tips for helping your Asperger’s or HFA teen to deal with his disorder:

1. You don’t have to bring up the subject of “spectrum disorders,” but if your teen does, give him a good listening ear – and be patient. Don’t try to change the subject unless he does so.

2. If your AS or HFA teen seems to be depressed, offer the option of counseling. Sometimes it’s easier to talk to a stranger. But try not to push the idea directly, even if you feel that your teen clearly needs professional help.

3. Don’t try to minimize your teen’s difficulties, but also don’t let him exaggerate. Provide gentle reality-testing.

4. Most teens with AS and HFA excel in one or two subjects. They tend to accumulate a lot of information on the subject and love to talk about it a lot. Unfortunately, at some point, parents (and siblings) end up losing interest and start getting bored with this “special interest.” Rather than avoiding the subject, try finding out new ways to engage your teen in the subject. Structure the topic in a different way. Find a way to challenge him. Be creative and let the sky be the limit! Your interest will make your teen feel better about himself, and realizing his mastery on the subject will boost his self-esteem.

5. Consider trying an antidepressant medication if your teen doesn’t seem to be able to move on. Look for the following common symptoms of clinical depression (if 5 or more of these are present week after week, you will need to take action):

• Withdrawing himself from the rest of the family
• Waking up in the middle of the night and having difficulty falling back to sleep
• Refusing to participate in group activities
• Putting himself down (e.g., saying he is “stupid”)
• Not being able to fall asleep
• Needing to take naps during the day
• Making comments such as he hates life, he hates you, nobody loves him, or he wishes he were dead
• Losing interest in activities he usually enjoys
• Eating less - or more - than usual
• Complaining that he is tired all the time
• Blaming himself unfairly for anything that goes wrong
• Becoming irritable and angry with the drop of a hat to the point where parents and siblings start walking on egg shells
• Appearing sad for most of the time

6. Some teens with AS and HFA resolve their sense of loss by turning the issue upside down. That is, rather than clinging to depression and despair, they find their “identity” in their disorder. For example, they may (a) get in touch with other kids on the spectrum, (b) begin educating their peers about AS and HFA at school, (c) set up web sites, chat rooms, or even write books about the disorder, and (d) explore treatment options.

Encouraging your teen as he takes action in these ways may turn out to be the best antidepressant treatment ever. How can you encourage an AS or HFA teen to be proactive? Consider the following ideas:

• Get in touch with organizations like Aspergers Society of America or Asperger Syndrome Coalition of the U.S., and contact their local chapters.
• Leave brochures, leaflets and other information about teen groups around to catch the attention of your teenager.
• Never get discouraged and keep trying, always letting your teen make the first move in showing interest.
• Attend support groups for moms and dads of teenagers on the spectrum, and make acquaintances.

7. In contrast with their rather slow social development, teens on the autism spectrum develop physiologically and sexually at the same pace as their peers. As your “special needs” teen grows older and displays sexualized behavior, you may find yourself worrying. For example, worrying that: (a) your teen will get pregnant (if a daughter) or will impregnate someone else (if a son), (b) he will be taken advantage of, (c) he will contract sexually transmitted diseases, (d) he will not have the opportunity of enjoying sexual relationships, or (e) he will be misunderstood by others.

While some moms and dads get concerned that their AS or HFA teens show no interest in sexual matters, others have to deal with behaviors such as touching private parts in public, touching others inappropriately, talking about inappropriate subjects, stripping in public, staring at others inappropriately, or masturbating in public. To address these concerns, consider the following tips:

• Rather than making a few comments about sexuality after an issue becomes problematic (e.g., right after an incident when everybody feels quite emotional about what has just happened), set up a time with your teen to talk about sexuality.
• Talk about “normal” behavior as it relates to adolescent sexuality, then begin to set realistic - but firm - limits about inappropriate behavior. Seeing your level of comfort around this sensitive topic, your teen will get the message that it’s OK to have sexual feelings – and it’s OK to talk about them. Getting this message alone will bring the tension around sexuality down a few notches.
• Ask about your teen’s desires and worries. Ask direct questions about what he already knows about sex.
• Don’t be shy about asking for help. Consulting other moms and dads with teens on the spectrum is a good starting point. Your teen’s school may also be able to help. You can also inquire about professional help, which should provide (a) behavioral modification techniques to discourage inappropriate sexual behavior and promote appropriate sexual behavior, (b) sex education based on your teen’s specific needs, and (c) an individualized sexuality assessment.
• The key is addressing these issues – not avoiding them.

Hormonal changes, self-identity, and the pressure of being socially acceptable are just a few of the challenges that adolescents have to face. If you add AS or HFA to the equation, then you really have your work cut-out for you as a parent. You can help your “special needs” child, but this begins with becoming knowledgeable about what he must face as a teenager. Learn as much about the disorder as possible and how you can support and help him face his unique challenges during this time.

==> Discipline for Defiant Aspergers Teens

 COMMENTS:

•    Anonymous said... OT can help... Parents just got to know to find the right ones. My OT private practice company has been trying to target adolescents and young adults like this- but nobody really knows because OT is not recognized as a MH provider in the US and the fact that it is done via telehealth. Parents need to know such options EXIST- as OT is not just about sensory integration or handwriting. If parents want to know more, message me. It's such an oxymoron that services do exist, but parents have little or no idea where to look for it. That is why I (as an OT and a self advocate) am trying to educate the autism community about what OT can do beyond what you might know from other parents or advocates. Bottom line- I want to make a difference for the autism community in this regard. I just want parents and other autistic individuals to give me a chance to make an impact. It's going to be a win-win for the autism community... Your teens and young adults get high quality care and you are supporting a fellow self advocate's advocacy efforts to the OT community about autism. Not that I couldn't make an impact at a clinic based job, but supporting my private practice will allow me to make a bigger impact.
•    Anonymous said... I've homeschooled my daughter since she was 13 and compared to when she was younger she is now a joy and easy to parent. We no longer have school related social anxiety and meltdowns. She attends after school clubs and home school get togethers and has made a selection of good friends for the first time in her life. She has a maturity and understanding of things beyond her years and can choose who to share her HFA with and who not. She can find NT girls aobssions with peer conformity amusing or annoying but now has the confidence to be true to herself. She is focused on knowing her limits and finding a place in the world with employment she will cope with and find fulfilling. She has never slept but now is old enough to leave. Compared to my firends and neighbours with NT girls I have no fears concerning alcohol, drugs, underage sex or unwanted pregnancies, and very little in the way of opposition or defiance.
*  Anonymous said... My daughter has been lucky enough to bond with other children on the spectrum in her class. They have formed a peer group that has slowly grown since 6th grade (she is now in 10th) I think the fact that they understand each other and some are better at social skills has really helped them all.

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