HELP FOR PARENTS OF CHILDREN WITH ASPERGER'S & HIGH-FUNCTIONING AUTISM

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Asperger’s Kids and Back-to-School “Separation Anxiety”

With the start of school, boys and girls begin to spend much of their day in the classroom, a place where pressures and relationships with other children can be quite stressful. While some youngsters with Asperger’s (AS) and High-Functioning Autism (HFA) naturally greet new situations with enthusiasm, others tend to retreat to the familiarity of their home.

For some children on the autism spectrum, merely the thought of going at school – away from home and apart from parents – causes great anxiety. Such children, especially when faced with situations they fear or with which they believe they can’t cope, may try to keep from returning to school. 

It's natural for your AS or HFA youngster to feel anxious when you say goodbye to him or her in the morning. Separation anxiety is a normal stage of development. However, if anxieties intensify or are persistent enough to get in the way of school or other activities, your youngster may have Separation Anxiety Disorder (SAD). This disorder may require professional treatment, but there is also a lot that you, as a mother or father, can do to help.

Many children with AS and HFA experience separation anxiety that doesn’t go away, even with mom’s best efforts. These kids experience a reoccurrence of intense separation anxiety during their elementary school years or beyond. If you see any of the “red flags” listed below, and your interventions don’t seem to be enough, it may be necessary to “take the bull by the horns” and help your son or daughter by implementing a different set of interventions listed later in this article:
  • Withdrawal from friends, family, or peers
  • Refusing to go to school for weeks
  • Constant complaints of physical sickness
  • Excessive fear of leaving the house 
  • Preoccupation with intense fear or guilt 
  • Age-inappropriate clinginess or tantrums

SAD is not a normal stage of development, but a serious emotional problem characterized by extreme distress when a youngster is away from the parent. However, since normal separation anxiety and SAD share many of the same symptoms, it can be confusing to try to figure out if your youngster just needs time and understanding – or has a more serious problem. 

The main differences between healthy separation anxiety and SAD are the intensity of your youngster’s fears, and whether these fears keep her from normal activities. Kids with SAD may become agitated when away from the parent, and may complain of sickness to avoid attending school. When symptoms are extreme enough, these anxieties can add up to a disorder.

Children with SAD feel constantly worried or fearful about separation. Many are overwhelmed with one or more of the following:
  • Worry that an unpredicted event will lead to permanent separation: Children with SAD may fear that once separated from a mother or father, something will happen to keep the separation (e.g., worry about being kidnapped or getting lost).
  • Nightmares about separation: Kids with SAD often have scary dreams about their fears. 
  • Fear that something terrible will happen to a parent or sibling: The most common fear a youngster with SAD experiences is the worry that harm will come to a family member in the youngster's absence (e.g., may constantly worry about his mother becoming sick or getting hurt).

SAD can get in the way of normal activities. Kids with this disorder often:
  • Cling to the parent: Kids with SAD may shadow the parent around the house or cling to her arm or leg if the parent attempts to step out. 
  • Complain of physical sickness (e.g., headache, stomachache): At the time of separation, or before, kids with SAD often complain they feel ill.
  • Display reluctance to go to sleep: SAD may make these kids insomniacs, either because of the fear of being alone or due to nightmares about separation.
  • Refuse to go to school: A youngster with SAD may have an unreasonable fear of school, and will do almost anything to stay home.

SAD occurs because a youngster feels unsafe in some way. Take a look at anything that may have thrown your youngster’s world off balance, or made her feel threatened or could have upset her normal routine. If you can pinpoint the root cause(s), you’ll be one step closer to helping your youngster through her fears.

The following are common causes of SAD in kids:
  • Anxiety: Stressful situations (e.g., switching schools, loss of a family member, loss of a pet, divorce, etc.) can trigger SAD. 
  • Over-protective parent: In some cases, SAD may be the manifestation of the mother’s or father’s own anxiety—moms and dads and kids can feed one another’s anxieties. 
  • Change in environment: Changes in surroundings (e.g., a new house, school, or daycare situation) can trigger SAD. 

For AS and HFA kids with Separation Anxiety Disorder, there are steps parents can take to make the process of separation easier:

1. Be ready for transition points that can cause anxiety for your youngster (e.g., going to school, meeting with friends to play). If your youngster separates from one parent more easily than the other, have that parent handle the drop off.

2. At times of stress at school, a brief phone call (e.g., a minute or two) with a parent may reduce separation anxiety.

3. Develop a “goodbye” ritual. Rituals are reassuring and can be as simple as a special wave through the window or a goodbye kiss. 

4. Educate yourself about SAD. If you learn about how your youngster experiences this disorder, you can more easily sympathize with his or her struggles.

5. If a school-related problem (e.g., a bully, an unreasonable teacher, disgust of school cafeteria lunches) is the cause of your youngster's anxiety, become an advocate for your child and discuss these problems with the school staff. The teacher or principal may need to make some adjustments to relieve the pressure on your youngster in the classroom, cafeteria, or on the playground. 

6. Remember that every good effort, or a small step in the right direction, deserves to be praised. Use the smallest of accomplishments (e.g., going to bed without a fuss, a good report from school) as reason to give your youngster positive reinforcement. 

7. Help your youngster develop independence by encouraging activities with other kids outside the home (e.g., clubs, sports activities, overnights with friends, etc.). 

8. Find a place at school where your youngster can go to reduce anxiety during stressful periods. Develop guidelines for appropriate use of the “safe place.”

9. If the school can be lenient about late arrival at first, it can give you and your youngster a little wiggle room to talk and separate at your youngster’s slower pace.

10. If your child has missed several days of school due to separation anxiety, initiate a plan for him to return to school immediately. This may include gradual reintroduction with partial days at first. The longer he stays home, the more difficult his eventual return will be. Explain that he is in good health and his physical symptoms are probably due to concerns he has expressed to you (e.g., grades, homework, relationships with educators, anxiety over social pressure, legitimate fears of violence at school, etc.). Let him know that school attendance is required by law. He will continue to exert some pressure on you to let him stay home, but remain determined to get him back in school. Recruit school staff (e.g., school nurse) to help with this.

11. Keep calm during separation. If your youngster sees that you can stay cool, he is more likely to be calm, too.

12. If you allow your youngster to stay home, be sure he is safe and comfortable, but he should not receive any special treatment. His symptoms should be treated with consideration and understanding. If his complaints warrant it, he should stay in bed. However, his day should not be a holiday. There should be no special snacks and no visitors, and he should be supervised. 

13. Keep familiar surroundings when possible, and make new surroundings familiar (e.g., have the sitter come to your house; when your youngster is away from home, let her bring a familiar object).

14. Leave without fanfare. Tell your youngster you are leaving and that you will return, then go – don’t hang around.

15. Make a commitment to be extra firm on school mornings whenever your child begins to complain about her symptoms. Keep discussions about physical symptoms or anxiety to a minimum. For example, do not ask her how she feels. If she is well enough to be up and moving around the house, then she is well enough to attend school. When in doubt, err on the side of sending your youngster to school. 

16. Listen to and respect your youngster’s feelings. For kids who might already feel isolated by their disorder, the experience of being listened to can have a powerful healing effect.

17. Minimize scary television shows and movies. Your youngster is less likely to be fearful if the shows you watch are not frightening.

18. Offer choices as much as possible. If your youngster is given a choice or some element of control in an activity or interaction with a grown-up, she may feel more safe and comfortable. 

19. Place a note for your youngster in his lunch box or locker. A quick “I love you!” on a napkin can reassure a SAD youngster.

20. Practice separation. Leave your youngster with a caregiver for brief periods and short distances at first. 

21. Provide a consistent routine for the day. Don’t underestimate the importance of predictability for kids with separation anxiety. If your family’s schedule is going to change, discuss it ahead of time with your AS or HFA youngster. 

22. While you may try to manage separation anxiety on your own, if your child's fretfulness lasts more than a few weeks, you and your child may need professional assistance to deal with it. First, he should be examined by your doctor. If his anxiety persists, or if he has chronic or intermittent signs of separation difficulties when going to school (in combination with physical symptoms that are interfering with his functioning), your doctor may recommend a consultation with a psychiatrist or psychologist. Even if your youngster denies having negative experiences at school or with other kids, his unexplainable physical symptoms should motivate you to schedule a medical evaluation. 

23. Schedule separations after naps or meals. AS and HFA kids are more susceptible to separation anxiety when they’re tired or hungry. 

24. Set limits in a compassionate way. Let your youngster know that although you understand his feelings, there are rules in your household that need to be followed.

25. Support your youngster's participation in activities. Encourage him to participate in healthy social and physical activities.

26. Talk about the problem. It’s very healthy for kids to talk about their feelings. They don’t benefit from “not thinking about it.” Be empathetic, but also gently remind your youngster that she survived the last separation.

27. Try not to give in. Reassure your youngster that he will be just fine. Setting some healthy limits will help the adjustment to separation.

28. If your youngster's anxiety is severe, she might benefit from a step-wise return to school. For example: 
  • On day one, she could get up in the morning and get dressed, and then you could drive her by the school so she can get some feel for it before you return home with her.
  • On day two, she could go to school for just half a day, or for only a favorite class or two.
  • On day three, she could return for one full day of school within that week.
  • The following week, she could attend school for three of the five days.
  • The week after that, she could attend on all five days.

Moms and dads should be concerned if their AS or HFA youngster regularly complains about feeling sick or often asks to stay home from school with minor physical complaints. Not wanting to go to school may occur at any time, but is most common in kids 5-7 and 11-14 (times when they are dealing with the new challenges of elementary and middle school). AS and HFA kids may suffer from a paralyzing fear of leaving the safety of their home. Their panic and refusal to go to school is very difficult for moms and dads to cope with, but these fears and behavior can be successfully managed by using the steps listed above.

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