It is important to recognize that each Aspergers kid is different, with his own unique set of issues. No two are exactly the same. However, there are three main subtypes: the Rule-Oriented Child, the Logic-Oriented Child, and the Emotion-Oriented Child, each with its own basic set of issues and several individual subtypes. It is very important to clarify each kid's issues, because each type demands a different kind of response from you. Choosing the right Strategy is crucial if changes are to occur. By determining your kid's type you will be able to identify his most important characteristics and learn what his core issues are. This helps to determine where to begin the treatment program. Once the type is identified, the basic issues for each will become clear and the course of action can be specified. The course of action consists of teaching the various skills that are lacking or replacing those skills that are inappropriate.
Although Aspergers kids differ from others by their worldview and many other ways we've already discussed, the primary issue to be determined is his individual coping strategy. Each Aspergers child has developed a very specific way to deal with problem situations, and his particular strategy determines the subtype to which he belongs.
The Rule-Oriented Child—
Having a set of rules to live by is the most important issue for this type. Once he has a set of rules to follow, there tend to be few, if any, concerns, except in areas where you have not yet established rules. If there is a void where a rule has not been established, the Rule-Oriented Child is not happy; because he doesn't know what to do in that situation, he makes up his own rules. Any situation that has too few rules will be a bad one for this type of child. He must have rules to live by and he will create his own if you don't provide them, which will probably not match what others are thinking. This will cause conflict and upset until someone prevails and the rules are clarified. This child respects authority figures and does well when it is perfectly clear who is in charge and who makes the rules. This child can often be fine in school but a real problem at home, because the rules are not clear enough in the latter situation. It is not unusual for parents of this type to be quite surprised to hear how well behaved their child is in school. There are two main subtypes of Rule-Oriented Child – the innocent/passive and the over-controlled – but not every one has all of the characteristics listed below.
Innocent/Passive Child:
This child or teen is often seen as a teacher's delight. Everywhere he goes, others remark how well behaved he is. He is never a discipline problem, never a disruption. However, at home his behaviors can be terrible. He can be quite bossy and controlling. Tantrums, yelling, and arguing can be a daily occurrence. The key to recognizing this type is the behavior differences between home and school. If he is poorly behaved in school as well, he is not a Rule-Oriented Child.
The Rule-Oriented Child wants to please others. He doesn't want anyone mad at him. He is very cooperative with authority figures and is very obedient, often to a fault. He can be too naive and taken advantage of because he will be reluctant to stand up for himself or be assertive. He tries to "fly under the radar." He does not want to stand out. While his behavior is unusually good, he can become distressed by others who do not follow the rules. Often, these kids monitor others' actions and will "tell on them," becoming the "rule police." Clearly, these kids have anxiety, but it is not overwhelming for them. They manage their anxiety by following the rules and making sure others do as well. Problems only occur for them when rules are absent or vague and the person in charge lacks authority in their eyes.
Recommended Strategy: Structure, routines, schedules, and prompting cards are some of the tools used to create a new set of appropriate rules for this child in every difficult setting no matter how small the situation might be. There is no such thing as a situation that is too small to have rules. Going to a store, taking a bath, deciding where to eat dinner – all need rules. You need to supply a set of rules regarding appropriate behaviors to be demonstrated in each problem situation, and state them like this: "The rule is . . ." Don't hesitate to also explain why you are doing what you are doing. This will help generalize these skills later on.
For example, you would say, "The rule is, when we take a bath we can only put ten toys in the tub" (or whatever number you think is right). "We'll stay in the tub for twenty minutes, and when the buzzer goes off it's time to get out and we'll go in your room and put your pj's on. We'll go back in the bathroom and brush your teeth for two minutes and then get back in bed and we'll read one book before we shut the lights out and go to bed." These rules can be modified to suit your particular situation, but it should give you an idea of the details that may be needed for your child.
Highly structured classrooms run by authority figures won't need to do much of this. Instead, they will be trying to help the Rule-Oriented Child be less rule bound and have greater tolerance for ambiguity.
Over-controlled Child:
This is another type of Rule-Oriented Child, who is very similar to the above subtype, except his behavior is good at home as well as at school. He is also rule bound, with rules for everything. He has learned to control outbursts, sometimes too much, in all situations. In this case, he sees his parents, who have created many rules for him to follow at home, as authority figures just like his teachers. There are no situations that don't have rules for him to follow. All other characteristics from above are similar, and he, too, is far and away overly obedient. He needs to become more flexible.
Recommended Strategy: You won't have to worry about rules with this girl or child. You need to begin a crash course in flexibility to help him see the world as less black-and-white. He will need to learn much more about the reasons behind actions and how the world works, with less emphasis on obedience. Don't throw out the rules altogether, but slowly help him to learn decision-making and problem-solving skills so he can become a more independent thinker.
The Logic-Oriented Child—
This child or teen needs to know the reasons for the rules before he is okay. Blindly accepting your rules is not the way he operates. He wants to know the reasons behind your actions, why something is done a certain way, and it has to make sense to him. If it seems too arbitrary, it's not an adequate reason in his mind, and he won't listen. His coping strategy is to try to make sense of the world through logic, reasoning, and rational thought. He wants the world to be a place with order and rationality to it. This reduces his anxiety. He may ask lots of questions about how the world works. He uses his very well-developed logical mind to understand what is going on, and you need to give him the reasoning behind a decision or an action.
He is often a very bright child with a high IQ. He usually becomes more flexible when he knows the reason for something. The rule alone is not sufficient. After you have explained the reason for your request, many behavioral issues decrease. However, he may not accept your logic unless it is quite convincing, because he may very well have his own reasons and explanations. His view of the world is based on logic and reasons, which can also cause him to become over-analytical. In this case, he often cannot function appropriately because he never gets past the analysis stage to the action stage. He suffers from "analysis paralysis." Remember, not every Logic-Oriented Child has all of these characteristics.
Recommended Strategy: You will need to explain why something needs to be done or why it can't be done before you will get compliance. For the Logic-Oriented Child, understanding precedes cooperation. If your explanations provide him with information he didn't have, might have overlooked, or didn't understand, you will have helped him clarify the way the world works and how a desired action is beneficial to him. As these kids become older, you will need to do much more explaining because rules by themselves will have less impact. As you explain things to these kids, always match your explanation to their cognitive and emotional level. Don't overestimate how much they know because they have a large vocabulary. Always make sure they understand you as you move step by step. As you explain something from a new angle you will help them see it differently. For those who overanalyze, you will have to help them reduce the amount of analysis by helping them see how it is unproductive. Let's look at an example:
Eric was an eight-year-old who always came home from school hungry. Each day he walked in the front door and began to argue with his mother about dinner. He wanted it right away and couldn't wait for her to finish it. These battles led to knock-down, drag-out fights, culminating in Mom pinning Eric to the floor. After going through this struggle on a daily basis, Mom sought help. As always, we discussed the particulars, gathered information, listened to all sides of the problem, and then began our discussion. It went something like this:
Dr. G.: So, Eric, it seems you come into the house pretty hungry, don't you?
Eric: Yes, I do.
Dr. G.: And after arguing with Mom, it becomes a real fight, with you guys rolling around on the floor. Kicking and screaming.
Eric: That sounds like it.
Dr. G.: When Mom is down on the floor with you, she's of course still stirring and mixing and working on preparing dinner, isn't she?
Eric: (A long pause) Oh, I get it. Of course not. She's on the floor with me.
Dr. G.: You mean that wrestling with her doesn't get your dinner finished any quicker?
Eric: How can it?
Dr. G.: Well, that's the point, Eric. It can't, can it? It probably causes a real delay in getting dinner ready instead. Just what you didn't want.
Eric: I guess it doesn't help.
Dr. G.: You guess it doesn't help? Let me spell it out for you. Choice one: You come in the house and calmly and quickly work out a solution with Mom about your hunger and she can finish getting dinner ready. Choice two: You come in and fight with her. Dinner is not done quickly, but instead takes even longer to get ready. You wind up upset, without food, and having to wait even longer for it to be ready. Hmmm. Sounds like a really tough choice to make.
Eric: I get this, but what am I supposed to do when I come home and I'm really hungry?
Dr. G.: How about if the three of us come up with a list of foods you could eat then that won't ruin your appetite and will allow mom to finish dinner?
Eric: Okay.
Dr. G.: Let's write up this list and call it "a little something." That way, when you come home and you're hungry, Mom can say, "Eric, why don't you take "a little something' to eat?" and you'll both know what this means without arguing.
Eric: This sounds like a good idea.
We then drew up a written list on a three-by-five-inch index card, which he took home (and which we reviewed the next week to see if it worked it did). And the fighting ended.
The Emotion-Oriented Child—
This is the most difficult type to deal with because rules and reasons mean much less to him or her. Many of the Asperger kids fall into one of the emotion types. Their emotions control their behaviors. If you do not recognize and deal with their emotions, your success is diminished. This group has many more tantrums, is less available, easily disengages, or is more prone to acting out. Those dealing with the Emotion-Oriented Child can often find themselves in a state of frustration at best and a crisis state at worst. The vast majority of this group will end upon medications for their issues because their coping strategies are poorly developed and inadequate to meet the demands of the world. Fortunately, the right medication and an effective behavioral plan can do wonders.
Paranoid Child:
By far, this is the most difficult type. Fortunately, their numbers are small. Some other subtypes may have characteristics similar to this type, but not all. He sees the world from an adversarial point of view. The world is against him. Everyone is out to get him and no one can be trusted. The only coping strategy he has is to maintain a good "offense" and so he attacks before others do or say anything. Even the slightest issue is a source of provocation. Once he begins his attack he can be relentless, and keep coming at you until he is exhausted. If he is younger, you might have the stamina to deal with this. If he is older, the police are often called. These kids are unusually bright. Their thinking involves violent themes and their actions are hostile and aggressive to others. They want to "fire, murder, devour, shoot, destroy" people who go against them in any situation, no matter how trivial. Typically, they receive multiple diagnoses, often oppositional defiant disorder or some other psychiatric condition such as bipolar disorder.
Recommended Strategy: Since this is the most difficult type by far, you must take extraordinary means to help these kids. Placating your child or "walking on eggshells" will only give you a momentary reprieve. Most parents of these kids refrain from physical interventions, but may be using a good deal of restraining techniques. This again is a temporary solution. To begin with, you must seek professional help, in terms of both medication and behavioral interventions. You must maintain calmness in your interactions with these kids. Only the most powerful reinforcers may be of some use. A highly structured environment with firmness is needed, along with great persistence and patience. Dealing with this type is something you don't do alone.
ADHD, OCD, and Fantasy Kids
The factors marking these three subtypes – attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), and preoccupation with a fantasy world – are very closely related, even intertwined. In all three, the child is often described as being inattentive, but there are a number of reasons for the inattention. If he is an ADHD child, he is inattentive because he is nowhere. He is not focused on any one thing for very long. He is distracted by anything new or different that passes in front of his eyes, and his interest moves from one thing to another and he cannot easily control his focus. He has many of the other signs of ADHD as well. He is easily distracted, disorganized, forgetful, and impulsive. He may or may not be hyperactive.
The OCD child, on the other hand, is inattentive because he is somewhere else. He is not so much distracted as preoccupied with something else that is of greater interest to him, usually related to some preferred activity such as videos, numbers, or how things are placed in his environment. Some kids have one or the other, ADHD or OCD, and most have both to varying degrees. Since symptoms of both disorders can exist at the same time and to varying degrees, it can be difficult to tell which is which at times. In either case, the result is a lack of awareness of what is going on around him. However, it is important to distinguish between the two and decide how much each contributes to the inattention, because your Strategy for each will be different. Under-focusing (predominantly ADHD) and over-focusing (predominantly OCD) are important variables that must be addressed, as well as the child who dwells in a fantasy world.
Predominately ADHD
This child is very unfocused and has difficulty attending to and processing information on a consistent basis. He is easily distracted and forgetful, loses things, and has significant difficulty keeping track of school assignments. He wanders around in the classroom and may not be able to stay in his seat at home and in school. Conversations are difficult because he is always looking around the room at something else, but doesn't stay focused on any one thing very long.
Recommended Strategy: Medication is very important to deal with inattention and impulsiveness. Careful monitoring of all tasks and situations, along with powerful reinforcers, is sometimes helpful. He will find it hard to stay focused on most tasks. Frequent breaks, structured tasks, and supervision are all necessary. If you find the right medication, the inattention reduces significantly, but may not disappear.
Predominately OCD
This child has many obsessions that take him elsewhere, away from the here and now. Although he appears inattentive, in reality, he has other issues that he is dealing with instead. For example, are his shoelaces tied the way he likes them? Is everything around him exactly where it belongs? How many dots are in that ceiling tile over his head? Did he ask the question that he wanted to in the right way? And so on. The list can be endless. But no matter what is on his list, it usually takes precedence over anything that is on your list. He is often a perfectionist, and everything has to go a certain way. If it doesn't, it's the end of the world. There is no middle ground; everything is black or white. It is either perfect or it is terrible.
He may have completion rituals where things must be finished before he moves on. And there are many rituals or routines in this child's life. For example, he can't shut off his Game Child until he reaches a certain level or he can't shut off the TV until the program is totally and completely over. All of this and more can be going on in his head and cause him to disengage from reality and become unavailable.
Let's look at an example: David, age eight, only wants to play his video games. He always plays them after dinner until bedtime. When he is playing them, he finds it very hard to stop. He argues, whines, and may even have a tantrum when asked to try an alternative to video game playing. He has certain requirements for getting ready for bed and an order to them. He changes his clothes under his covers, even though there is no one else in his room. He brushes his teeth for 120 seconds. Mom has to kiss him good night first, Dad is next, and then he gets a story that he always picks from the books on his shelf. He has to have his radio on in order to fall asleep because he has to hear the music and have the light from the radio shining in his room. David has lots of rules about how things are supposed to go in his world. He is an OCD child. Now, it may seem like he is a Rule-Oriented Child with all of these rules, but there is a difference. The Rule-Oriented Child will typically follow others' rules once they are spelled out to him. The OCD child makes up his own rules about everything and only wants to follow his own rules, no one else's. The OCD child is compelled by his anxiety to follow his own dictates: he must be in control. The Rule-Oriented Child's anxiety compels him to follow everyone else's: he must obey. Each has a different motivation and therefore a different response.
Recommended Strategy: You must gain control over his obsessions. There must be limits and restrictions on certain activities. Rituals and routines are addressed through sabotage. You must teach him how to be more flexible by changing routines. You must expand his repertoire of interests, teach him shades of gray, and have him develop a balance in his life. Obsessions will remain, but you can use them as reinforcers as long as you limit the amount of time spent on the obsessions. Each of these things is discussed later on.
Predominately Fantasy
This child is very similar to the OCD type except his distractions primarily involve his preoccupations with fantasy. This means Game Child, Nintendo, Xbox, video games, Pok̩mon, Yu-Gi-Oh!, the Cartoon Network, TV shows, Japanese anim̩, fantasy books, show tunes Рthe list is endless, but often involves electronics in some way. Not only does he obsess over the use of the electronic equipment, but the fantasy reoccurs without it as well. If the fantasy involves books or music, he doesn't need the actual object to experience its pleasure. So he replays, re-creates, or in some way engages in the obsession in his head. As he is eating dinner, sitting in class, doing his homework, or talking to you, there is another tape playing in his head. And this tape is all about fantasy. He does word-for-word scripting of dialogue and scenes in his head, combines different ones together, or makes up his own based on something he has seen or read. He may have many other obsessions, but the strongest are about fantasies. These fantasies serve many functions Рbesides being very enjoyable, they remove him from the unpleasantness of the real world, demands are reduced, and everything goes just the way he wants. As a result, reality is avoided, interactions with others don't occur, and life goes on without him. This is how he copes with stress and reality. Interfere with his preoccupations and you will experience his wrath. Leave him to his preoccupations and he can amuse himself for hours.
Recommended Strategy: Everything we said about the OCD type applies here. Additionally, you must go beyond those techniques to include teaching him the difference between reality and fantasy – how to recognize it, what constitutes each, and how to be in the here and now. You must limit fantasy time and help him to develop the ability to enjoy non-fantasy activities. If he can't enjoy the real world, he won't want to be a part of it. Medication is almost always necessary.
Anxiety Child
This child differs from all other types because he has no coping strategy. While every other type experiences anxiety to some degree, they cope with it through rules, rituals, obsessions, or fantasy. The Anxiety Child has never figured out how to deal with problems. As a result, his anxiety overwhelms him and he shuts down, hides under furniture, cries, wants to stay at home, acts silly, wants to stay inside, and tries to avoid people and places outside of his small comfort zone. In other words, he becomes a mess. He is very rigid but doesn't really know the rules of the world. His anxiety comes from his confusion and lack of understanding of how the world works. He just doesn't get it.
He usually needs much more time to handle even the smallest issue. You cannot give him too many issues to deal with at once, even if they are all small, or he will be overwhelmed. Bigger issues are too much as well and he falls apart. Sometimes the issues are so small that you think they cannot possibly cause a problem. Not true. Even the smallest change can result in upset if his anxiety is too big. The degree of anxiety varies, and not all kids have the same amount, and not all situations produce the same degree of upset. He can be upset if it's picture day at school, his teacher is absent, someone comes to visit his parents at home, he has to get his hair cut, you give him the orange cheese and not the yellow cheese – this list can be longer than any other list we've talked about because everything has the potential to be upsetting. You'll know you have an Anxiety Child because he cries quite a bit, clings to you in new situations or with new people, doesn't want to leave his house, and when away from home often tells you he wants to go back home immediately. His tantrums end when he is allowed to be alone in his room under the covers. Once he gets used to something he can often do better. So once he is desensitized to school, he can be okay if he sees it as a structured, calm, and safe place. He, too, may then act better at school than at home, or he may be the same in both places.
Recommended Strategy: This child or girl needs a great deal of structure, routine, and explanation about every possible troublesome situation. You need to explain the rules of each situation, including what to do and what not to do, before he experiences the situation. You need to give him lots of warning on what is going to happen, preparing him for change. Never overwhelm him. Go slowly and don't try to accomplish too much at one time. Help him get past each issue that has occurred, to "get over it" and move on, or they will build up and the next small one will cause him to fall apart. These are the prevention aspects of dealing with anxiety. That is, you will try to prevent situations from overwhelming him. However, that will never be sufficient and he will need to learn how to cope with it as well. Teach stress management skills: stress resiliency, stress immunity, learned optimism, and "theory of mind." Teach him emotional regulation skills: anxiety management, self-calming, being okay, and the like. Medication may be needed if these skills are difficult for him to learn.
Angry/Resistant Child
This child or teen may look similar to the paranoid type, but he is less adversarial and less intense. He is also easier to deal with if and when he feels safer. He argues about everything, and almost anything can lead to a tantrum of some size. At times, he can be violent and physical or will destroy property. He wants things to go his way. He wants to control situations and has his own rules about the world and how things are supposed to be. He is often diagnosed with oppositional defiant disorder (ODD). This is another child who doesn't understand the way the world works and becomes anxious as a result. He feels threatened by others and thinks they are trying to control him or are being unfair and arbitrary. He needs to fight with them to gain control and get things straightened out to his way of thinking. However, his arguing does nothing but further aggravate the situation. His rigidity, lack of understanding, and disuse of logic prevent him from seeing this clearly. His emotions determine his actions.
Recommended Strategy: Try to avoid power struggles. Do not show much emotion in your responses and try to be matter-of-fact. Stay focused on a particular issue and don't get sidetracked as you have a discussion with this child. It's very easy for the discussion to get off track and become nonproductive. Try to see his arguing as a sign of anxiety and not purposeful misbehavior. Try to get him to see you as a helper or problem solver rather than an adversary or problem causer. Don't over-focus on the content of a discussion, but rather on the process; that is, what is going on behind the content of the discussion.
For example, a discussion may begin around what he is going to get from you for Christmas. Before you know it, you are being accused of buying others bigger and better presents. Or perhaps the accusation is that you never buy him what he really wants. Rather than debate the merits of this argument, which will only escalate further, you should discuss how he is stuck on certain ideas that will only lead to greater upset, and the impact his actions have on himself and others. He must begin to see his role in what is going on and stop blaming others for what occurs. You will need to teach him how to stay focused and how to self-calm, as well as how to compromise and negotiate. But most of all, he needs to see you as trying to help him solve his problems, not making them worse.
Negative Child
This child or teen tends to be more of an annoyance than anything else. He does a lot of complaining and whining about doing things that are not preferred activities because he only enjoys preferred activities. As a result of his actions, there can be a good deal of arguing and refusals. He usually sees the world in a negative way–"the glass is half empty"–and rarely sees the good aspects of an event or situation, no matter how much good has occurred. Tantrums, bossiness, rituals, and rules are not issues. He may even be fairly cooperative at times. The major concern regarding this child is that he is more prone to future depression than any other type.
Recommended Strategy: He must learn to be okay with non-preferred activities and that it is better to "say nothing than be negative." You need to teach her how to use positive commenting and responses. Direct instruction in how to have a "positive attitude" and "learned optimism" is needed. Each child can have many issues that make him unique. You have begun to sort out those factors that make your child who he is. It is his uniqueness that tells you what subtype he is and what techniques you need to use. When you understand your child and his interaction with the world, you will be better able to help him reach his full potential. If you still are not sure of the subtype characteristics your child demonstrates, at least provide the two things every Asperger child needs: structure and predictability.
The Parenting Aspergers Resource Guide: A Complete Resource Guide For Parents Who Have Children Diagnosed With Aspergers Syndrome.
