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

Education and Counseling for Individuals Affected by Autism Spectrum Disorders

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Violent Behavior in Teens with Asperger's and High-Functioning Autism

“Is it common for aspergers teenagers to retaliate (sometimes violently) when they feel that they are being mistreated by siblings, peers, etc.?”

Common? No. Does it happen? Yes.

Most juveniles with Asperger’s (AS) and High-Functioning Autism (HFA) have strict codes of behavior that often include a dislike or even hatred of violence. Even among them, however, aggression can be a problem when the juvenile or young adult becomes frustrated, feels unfairly treated, or feels excluded. Juveniles with AS and HFA can persuade themselves that aggression is justified in these circumstances. Aggression toward younger siblings may be a problem, as may aggression at school, but the usual arena is at home.

This kind of aggression may be explosive, in which case there is often a sharp onset and a sharp offset. The AS or HFA juvenile may be even more unaware of the impact of his aggression than others who have tantrums. Parents often say something like this: “He calmed down quickly, long before we could feel calm. He just seems to want to carry on as if nothing had happened. If we try to talk about the tantrum, we might set him off again.”

Aggression of this kind may begin at an early age, and moms and dads find it difficult to deal with. Counter-violence makes matters worse, but it is a solution that often appeals to fathers. Withdrawal during the tantrum, and then discussing how it felt to be on the receiving end of it, are often useful. But living with this level of aggression can be one of the most difficult aspects of raising a child on the autism spectrum.

These juveniles have a lively sense of self-preservation. They may therefore suppress an aggressive response to a bully or another aggressor, but turn the aggression on to a more vulnerable person later, who may have had nothing to do with the situation. The target of aggression is most likely to be a juvenile's mother, or later in life, a spouse.

Emotional processing is difficult for AS and HFA juveniles. They can’t tell themselves to “just forget it” or “life's too short to worry so much.” They want answers – and they want justice. Incidents that have happened in the past (sometimes many years before) may linger in the mind of an adult with AS and may resurface at regular intervals (called “rumination”). When they do, it is as if the individual is re-experiencing the episode over again, and he may become suddenly and unexpectedly aggressive.

Discipline for Defiant Aspergers Teens

Is Poor Social Interaction Part of High Functioning Autism?

“My 10 year old only child has recently been diagnosed on the Autism spectrum (what is closest to Aspergers).  He has always had a difficult time making friends, which has become more problematic with the loss of 2 best friends in the last year.  He has never made lasting friendships. Is this part of high functioning autism? How can I help?”

Yes, poor social interaction is part of the disorder. Some kids with Asperger’s (AS) and High Functioning Autism (HFA) do seem to lack interest in others and may prefer solitary activities. For example, Ronnie, age 7, was very skilled at building with blocks and Legos. However, when another youngster would approach to try to join his play, he would become extremely angry, not wanting his play to be disturbed.

Inappropriate overtures towards others, or inappropriate responses to the approaches of other people are common occurrences. Michael, age 6, was fascinated with his next-door neighbor, Tyler, a toddler of 18 months. Unfortunately, his way of showing his interest in Tyler was hitting him over the head. Another youngster with Asperger’s, Craig, was somewhat more sophisticated in his technique. His way of showing his interest was throwing his arms around another youngster in a bear hug.

Difficulty forming friendships is a common fact of life for kids on the autism spectrum. Interestingly, what these kids mean by friendship may be decidedly different from what their typically developing peers mean. For example, Carson repeatedly referred to another youngster in his school, Brandon, as his best friend, although no one had observed the two boys talking or playing together. When asked what makes them friends, Carson replied that Brandon said hello to him.

Impairment in group play with peers is another common difficulty. Unfortunately, most of the team sports so common to school-age kids are terribly difficult for kids on the spectrum. Their troubles with social interaction and peer relationships make organized group sports a real challenge. Oftentimes, sports in which individual achievement is stressed (e.g., track, archery, fishing) are more successful.

Also, these young people have difficulty sharing enjoyment. They are less likely than their typical peers to share objects (e.g., food or toys) with others. They are not as likely to show others any items in which they are interested. And, they generally make more limited efforts to share feelings of enjoyment with peers.

So what can you do to help? Here are some tips:

1. Teach and model compassion. By giving your “special needs” youngster the skills he needs to be confident and compassionate, you increase the likelihood that friends will eagerly come into his life. And friends will give his life a richness and happiness he will always treasure.

2. Show your youngster how to be a good friend and make friends. The best way is to model the behavior you would like to see. There are several ways you can accomplish this at home: (a) be kind, give compliments, wave to a friend, and open the door for someone; (b) be understanding of what others are going through by showing empathy; (c) don’t complain, instead teach your son to accept what can't be changed by working hard to change the things that can; (d) have a sense of humor about yourself and your shortcomings; (e) help your youngster realize his own strengths; and (f) listen to your youngster without criticism.

3. Plan for some unstructured play time. Giving AS and HFA kids some unstructured time to play is important, because they learn the social skills they need so they can keep playing and have fun.

4. Offer a variety of opportunities for play and socializing. Host friends over for play dates or lunch. See if you can participate in a carpool and sign-up your youngster for group activities (e.g., art, drama, dance). Exposing him to different areas of play will help him learn to socialize.

5. Include your youngster when talking to people out of his normal range of peers. Take him to visit a neighbor, or bring him along to the dry cleaner. The more he is exposed to interacting with all kinds of people, the more he will learn to do the same.

6. Empathize with your youngster’s pain, but keep it in perspective. Making friends is a lifelong process and will have its ups and downs. Pain, unfortunately, is a part of it. All kids will experience some form of ‘normal’ social pain in their friendships. We can support them by listening and acknowledging their feelings.

Teaching Social Skills and Emotion Management

Anger-Control Contracts for Frustrated Kids on the Autism Spectrum

Would you say your child has frequent mood swings and an anger-management problem? If so, then read on…

As a parent of a child with Asperger’s (AS) or High Functioning Autism (HFA), it’s a very good idea to draw up a written contract detailing the things you want your child to practice in the course of his anger-management program. Drafting such a contract is a way of providing structure and support, which is crucial for children on the autism spectrum since they need and crave structure.

The items included in the contract should be written from the perspective of the child (i.e., phrased in the first person). For example, “When I get angry, I will stop what I’m doing and go get my favorite stuffed toy to hug” …rather than, “When Michael gets angry, he will stop what he’s doing and go get his favorite stuffed toy to hug.”

The details of the contract are important. You want to be very specific in describing:
  • The goals for the anger-control program (i.e., what you hope to accomplish)
  • What your child agrees to do in the service of those goals 
  • How and when your child will practice those things he has agreed to do

Do not include any obvious generalities as a program goal. For example (again, phrased from the child’s perspective), "I will stop over-reacting when my sister annoys me." Vague goals are impossible to measure and leave too much wiggle-room to compel real change. Instead of vague goals, describe specific situations that are upsetting to your child, and the specific behavioral techniques he will practice and use when confronted with those situations. For example, “I will take 10 deep breaths instead of hitting my sister.”

The contract you draw up should only cover a short span of time (1 to 3 days works best). Holding your child accountable over shorter periods of time will allow him to adapt to the contract as he learns to put anger-management techniques into practice. Shorter contract terms also help him to feel successful. You can reward your child upon successful completion of a short contract, feel good about that, and then create a new contract (also for a short time). Contrast this with a long contract where the child doesn’t get rewarded for weeks! Shorter contract terms and frequent small rewards for success make for the best, most effective contracts.

Examples of items to include in your child’s anger-control contract:

1. Timeouts: Have your child agree that he will take a temporary break (i.e., timeout) when confronted with angering situations, whenever this is possible to do. Taking the opportunity to step away from an angering situation will give him the space and time he needs to calm and gather himself, and to evaluate the situation from a more cool-minded perspective. He can return to the situation when he is done with his time-out. Often, a few minutes of “alone-time” can help AS and HFA children to better handle stressful situations.

2. Examining Angry Thoughts: The first thoughts that come into your AS or HFA child’s mind when he is angry are likely to be judgmental and based on incomplete information. If he simply reacts to these incomplete impressions, he will end up attacking the people he is upset with. Instead of just “going off,” have your child agree that he will carefully look at each circumstance that provokes his anger. The best time to do this is during the time-out that he should take before his anger gets out of control. Help your child learn to recognize the types of situations that trigger him, and the types of characteristic angry thoughts that tend to occur to him when he is faced with those triggers. He can take a timeout to decide whether or not reacting in anger will be his best choice. Help your child to retrain himself to think about provocative situations that would otherwise be guided by his automatic (and frequently wrong-headed) emotional reactions.

3. Listening Skills: Becoming a skillful active listener will improve your child’s communication abilities, thereby expanding his options for getting what he wants from other people. Thus, consider add a “listening skills” item to the contract, such as “I will stop what I’m doing and listen to my mother when she says she has something important to tell me.”

4. Relaxation Exercises: Have your child agree that he will practice relaxation exercises on a regular basis (preferably on a daily basis). Since learning to control his anger often means learning to react less violently during stressful situations, it will be beneficial for him to become skillful at relaxing himself. Relaxation techniques (e.g., deep breathing exercises, meditation, physical exercise, etc.) are an effective means of calming down. When practiced daily, relaxation techniques become a proactive means of reducing general overall arousal.

5. Signaling: Agree on a signal that you can give your child (e.g., hand gesture) when you see him starting to slide into old aggressive patterns. Once he receives the signal, he will know he needs to change his behavior to avoid escalating his anger. He may want to take a time-out, or agree to postpone an argument until he can speak about it from a more calm and rational place.

6. Speaking Assertively: Have your child agree that he will spend some time each day practicing assertive communication skills. He can write down the aggressive things he would like to say to people who make him mad (e.g., “I hate you for saying that”), and then re-write them in more assertive ways (e.g., “When you said _______, it hurts my feeling”). Have your child practice speaking the more assertive statements out loud in front of the mirror, or with you during role-playing. Practicing these statements in advance of angering situations will make them easier to use when he is confronted with the real thing.

7. Rewards: Write rewards for your child into the anger contract. He should receive a small reward each time he successfully does the things he said he would do during each short contract. The reward he chooses should be simple and reasonably healthy (something he won't mind going without if he has a setback in working his program, but nonetheless, something he really wants, is willing to work for, and can feel good about enjoying when he succeeds). Small, frequent rewards are more useful than infrequent, larger rewards.

Example of an anger-control contract:

Rule #1: I will treat family members respectfully. This means no kicking, pushing, shoving, hitting, throwing things, spitting at someone. No verbal (e.g., threatening to hit, kill, hurt) or physical threats or gestures of harm (e.g., holding up a fist, moving to push, shove) toward family members. No swearing at - or about - family members.

Consequences for violating Rule #1 within a 24-hour period: On the first violation, I lose my computer privileges for 24 hours. On the second violation, I also lose my iPhone for 24 hours. On the third violation, I also lose television privileges for 24 hours. On the fourth violation, I also lose my snacks for the day. On the fifth violation, I also get grounded FROM my bedroom until bed time. If I violate Rule #1 more than 5 times within a 24-hour period, I lose all the above privileges for 48 hours.

Rewards for following Rule #1: If I am respectful for three days in a row (i.e., no violations), I can choose one of the following rewards approved by my mom and dad:
 
1. Go to a movie on the weekend with an approved friend.
2. Have an approved friend spend the night on the weekend.
3. Have a pizza night. 


The short contract above is just one example of how consequences and rewards can be applied to a particular rule violation. There are as many variations as there are families. But let's discuss the example above for a moment...

Some parents may be look at this example and decide that it is simply too strict. They may believe that if they take away this many privileges for this long, it will create more problems than it solves. To those parents, I have a few very important points to make:

First of all, it is not likely that your child will push the envelope to the point where he has lost everything for two days. That is the exception rather than the rule. He's probably much smarter than that.

Secondly, AS and HFA children are notorious for testing the limits. They want to see just how far they can push their parents and bend the rules. If the parent is of the mindset that it's simply easier to give in and let the child have his way in order to keep the peace, the child learns the following destructive lesson: "All I have to do is make a fuss, and my mom backtracks on the consequences." As you can imagine, this lesson will cause huge problems for the child in the future, because the real world does not operate like this, which brings me to my third point.

Thirdly, your child needs to understand the concept of "stacking the consequences." Let me explain: Imagine that you got pulled over by a police officer who accused you of speeding and is preparing to write you a very expensive speeding ticket. You are outraged and believe strongly that the officer is wrong in his assessment of how fast you were going. The officer asks you for your driver's license, but you refuse to show it to him. Then he “insists” that you produce a driver's license immediately! So you take it out of your purse and throw it in his face, which inadvertently hits him in the eye. Then the officer tells you to get out of the car and put your hands behind your back because you're now under arrest. Now, you believe the officer is out to get you, so you take off running. What just happened here? Well, you turned one charge (speeding) into three charges (speeding, assaulting an officer, and fleeing). You "stacked the charges." And you are going to pay the price for "stacking."

This is just one example of how the real world operates. In the real world, if you decide to make a series of poor choices, you also decide to receive a series of negative consequences associated with those choices. So, we as parents want to set up a system at home that is representative of the real world, because your child is going to have to deal with the real world eventually. And if you don't teach your child that violating rules results in negative consequences EACH AND EVERY TIME, the world will teach your child this lesson. But, unfortunately, the world doesn’t care about what is right or fair – and will teach this lesson in a very harsh and abrupt manner that may send your “naïve” child into a state of shock.

Lastly, consequences have to hurt to be effective. Let me repeat that: consequences have to hurt to be effective. Unfortunately, I see too many parents of children on the autism spectrum who are afraid to allow their child to experience uncomfortable emotions associated with poor choices. They believe that their child will simply crumble under the weight of their discipline. This is called overprotective or overindulgent parenting. As a therapist, I have to tell you that this is the #1 parenting mistake I see in my practice, and it does more damage than I have time to discuss in this post. (Additional information can be found here).

The overprotective parent does tend to be a good advocate for her child, but unfortunately, this parent has moved from advocacy to enabling. If this sounds like you, then please understand that you are underestimating your child’s strengths and intelligence. He is capable of learning anything – and yes – this even includes learning how to receive consequences without tantrums or meltdowns.

Why anger-control contracts work for children on the autism spectrum:
  • A vital skill that every responsible youngster needs to learn is accountability. Anger-control contracts can help AS and HFA kids learn this critical principle early in life, and that will serve them well as grown-ups.
  • AS and HFA kids are highly motivated by anger-control contracts because they bring clarity to the situation. Oftentimes, these young people find themselves caught in a situation where they are not sure whether the behavior is acceptable or not, or whether it is worth it to them to make an appropriate choice (e.g., if the youngster throws a dinner plate and breaks it, he may or may not have understood the value of the plate or the consequence for breaking it). An anger-control contract helps both the parent and the child clearly understand what is expected. 
  • One of the key elements of a good anger-control contract is that it brings structure to the discipline process. Whether they admit it or not, AS and HFA kids are best served when there is clear structure. Specific rules and expectations, written down and associated with positive and negative consequences, provide a level of structure that helps these “special needs” kids feel more secure.

Summary of an effective anger-control contract:
  1. Have clear goals for the contract. You can't write an effective contract if you're not clear on exactly what you want your child to accomplish. Know what behaviors you want your youngster to change, and what you want him to do instead.
  2. Allow your youngster to have some input. Kids will be more likely to follow the terms of a contract when they have a hand in its creation. While you need to be the one to prepare the main aspects, leave some room for negotiation (e.g., allow your youngster to help you choose the consequences for breaking the contract rather than simply dictating the disciplinary measures yourself).
  3. Write out the contract, spelling out the goals, expectations and consequences very clearly. An AS or HFA youngster can’t abide by a contract if it's too vague or unclear. Be as specific as possible to reduce the chance of any misunderstandings.
  4. Go over the contract with your youngster and have him sign-off on it. This gives him a chance to ask questions or to seek clarification. By having him sign it, you get a concrete sign that he is agreeing to the terms. This also gives him subconscious “buy-in” because he is making that agreement in a tangible way.
  5. Get one or more people who want to support your child’s anger-management progress to co-sign as witnesses. Other caretakers, teachers, and even siblings (especially if they are older) can often recognize when the AS or HFA child is getting worked-up better than he can, so it is a good idea to include them in the anger plan, if possible.
  6. Keep the contract in a conspicuous place so you can easily refer to it. If your youngster is on the verge of breaking it, you can take it out and remind him of his agreement in concrete terms. If he still violates the contract, you can use it as a neutral touchstone by saying, "Remember when you signed your anger contract and agreed to follow these rules? You also agreed to these consequences if you broke the contract." This will help reduce anger and defensiveness when the consequences are issued.

Have you ever had a day where it seems that everything goes wrong? For example, you forgot to set your alarm clock. As a result, you really need to rush to work (and break the speed limit a bit - or a lot!). But there's a bad car accident on your usual commute, so that makes you even later. Then when you finally pull in the parking lot, you notice the place is unusually busy and congested, so you have to park 3 blocks away - now you're really late!! But this is just the beginning!!! The day doesn't get any better from that point on. When you finally get home, all you want to do is take a sleeping pill and hit the sack.

Imagine if most days were like this one. Unfortunately, for a lot of kids on the autism spectrum, many days feel this overwhelming. Little wonder why some may have more than their fair share of moodiness and meltdowns. But, as a parent, you can make life less stressful for your child by drafting a contract that will help him find some structure and support in an otherwise chaotic and unfriendly world.

Teaching Social Skills and Emotion Management

Does My Aspergers Child Have No Feelings For Others?

“Is it common for children with aspergers syndrome to come off as rude? My son will say and do things that can be inappropriate (especially to his younger sister), which makes him appear as if he has no feelings for others.”

It is fairly common. But this isn’t to say that kids with Asperger’s (AS) and High Functioning Autism (HFA) are heartless. These children have difficulty using non-verbal behaviors in social interaction.

Here are some examples:
  • Body postures regulating social interaction may be affected. A very common example of this difficulty is that kids with AS and HFA may not know how to judge social distance and may stand too close.
  • Eye contact may be impaired, meaning that the youngster may not look at others upon greeting or during conversations, and may not respond when others try to catch his eye. It’s easy to see why others might inaccurately perceive the child to be rude for not paying attention.
  • Facial expressions used to communicate may be odd. Sometimes the expressions are limited or flat. Sometimes they are inappropriate. At other times, they are exaggerated. Is the child trying hard to be impolite in this case? Probably not.
  • Social smiling may be impaired. In this case, AS and HFA kids may not smile back at someone smiling at them, may not smile during greeting, or may not smile in response to something someone else said. This, too, may seem rude to others.

Again, it's easy to see why others could misread what the AS or HFA youngster is thinking or feeling. For example, Kevin, a rather sweet and kind 7-year-old boy with Asperger’s, broke out into laughter when his sister fell down the stairs. Clearly, his response was inappropriate to the situation and would not be expected. Does this mean Kevin can’t empathize with others’ pain? I don’t think so. How many times have we busted out in laughter while watching a TV show like America’s Funniest Home Videos after witnessing someone falling or slipping? It’s funny at the time, but that doesn’t make us heartless, uncaring viewers.

When your child says or does something that seems rude or inappropriate, rather than punishment, a simple reminder to respond differently the next time may be all that is needed (e.g., “I know you thought it was funny when your sister fell down the steps. But she banged her knee, which was painful. A better response would be to help your sister get back up and ask if she is O.K.”).

Teaching Social Skills and Emotion Management

 
COMMENTS:

•    Anonymous said...  My 17 year old grandson has aspergers, it's been quite a journey, especially before he was diagnosed. Since he lives far away, I only have snap shots of his life, but he seems to have come a long way!
•    Anonymous said... I agree with this I am having lots of trouble with school over my son as he is in a main stream school and the teachers don't understand him so they just say he is spoilt and so rude which just isn't the vase but when I try to explain they think I am just trying to make excuses for him.
•    Anonymous said... lol - my husband says, "I never saw him/her before in my life." Ugh ... not aspergers though ... or is it? hmmm
•    Anonymous said... My 5yo is halfway through kindergarten. He goes to a big public school and also knows a lot of children in his on-site after school program. Many of the other kids seem to want to be his friend and when they see him they respond very warmly- but about half of the time he's not in the mood for their greetings and turns his head away or refuses to say hi or hi-five them back. I just hope they keep giving him chances instead of deciding he's unfriendly. I talk to him gently about it but he likes to run his own show.
•    Anonymous said... My 7 year old son is the same way. Very blunt. We work with him constantly but his social interactions stay the same. It has gotten to where he is now hitting and kicking teachers and getting kicked out of after school care programs. We are lost at this point. He sees a psychiatrist and we have tried so many medications... This has to get better. I adore him and hate to see people judge him so harshly.
•    Anonymous said... My daughter gets lots of lectures at school how it is polite to look at people in the eye when they talking to her. She finds this too difficult.
•    Anonymous said... My son concentrates better when he is not forced into making eye contact, teachers think he is not listening..but he is one of the smartest kids in his year...they are not listening or seeing.
•    Anonymous said... My son just turned 22. You will live through it, I promise. It's a long difficult journey that's ongoing to this day. At a young age they are not able to understand why they think the way they do. They just plain can't help it. My son was almost 19 before he would go into a store and pay for anything. If he had a $10.00 and the total was less, he would throw down the ten and leave the store. Since he's been able to research for himself and realize that it's a social disorder ONLY, that he has an IQ of 135, and only he can control himself, things have gotten a lot better. Be patient with your child. Be good to yourself. Your child is awesome for their uniqueness. Your child is brilliant and oh so funny. Will never lie to you when you wish to heaven they had just a little tact! It's hard but I wouldn't have a different child for anything and I know you wouldn't either.
•    Anonymous said... Oh yes..my is the one for saying "dont speak to him/her"when we are out and someone enages conversation. ..I do have to tell them "hes stilll learning the social rules".
•    Anonymous said... People think my 7 yr old has bad manners. Not the case he has aspergers
•    Anonymous said... Plenty of "wish the floor would open up and swallow me" moments with master 8. We saw a doctor that knows him luckily and he asked him "why he was so fat", only problem was we were 1 side of the surgery and the dr was the other, and it was said very loud. He often speaks his mind in a loud voice on making comments about other people. He is improving and now I am very quick with covering his mouth when I pick a rude comment about to come out.
•    Anonymous said... Yes and we are still working with my 10 year old with this. Some adults think I need to teach him manners but they just don't understand that aspies are blunt and to the point.
•    Anonymous said... Yes, many people judge quickly with us who are dealing with AS. Partly because there is no obvious disability and they just feel we, as parents, have done our job. Our awesome 3rd grade MVCA teacher is working 1:1 with our son and actively teaching him appropriate social behaviors and etc. WONDERFUL!
•    Anonymous said... YES. I agree 100% with you Amber Dingman. Because there is nothing obvious the general observer who does not know the situation will judge and often scold an Aspie. Happened a week or so ago at school. A teacher called my Aspie "dear". He said "please don't call me that." He was brought into the hall for a "talk". I of course explain to him about terms of endearment, but he doesn't want anything to do with it. Just one of his things that irritates him. I told him to always be polite. Learning social cues and skills is a 24/7 task.
•    Anonymous said... Yes. My 10 year old once said to some friends at church, "why do they act like they know me? I don't know them" (old family friends who knew her as a baby) ugh. That's one of dozens of stories.
•    My 10yo Aspie has empathy, but he lacks a social filter. He doesn't notice the small cues that show when he has hurt someone's feelings unless explicitly pointed out. We have done a lot of modeling, standing behind him like a puppet and feeding him a script to diffuse the situation.

Please post your comment below… 

From Anxiety to Anger to Meltdown: An Asperger's Dilemma

“Can an aspergers child’s anxiety play out as anger, and then morph to a meltdown?”

Good question. The answer is yes. There are many scenarios, but the most popular one I see goes like this:

The Aspergers child begins to feel anxious ...his anxiety turns to anger ...his anger is misdirected toward the parent ...the parent becomes offended and pursues some form of punishment ...the child’s anxiety increases ...the conflict escalates (meltdown).

A meltdown is a state of neurological chaos where the Aspergers (high functioning autism) child's brain and nervous system overheat and stop working properly. A good analogy is a nuclear power plant where the fuel in the reactor core becomes so hot that it melts and releases energy. Sometimes it gets so hot that it causes an explosion, and the energy is released outside of the core. It’s this explosive reaction that most parents and teachers refer to when they talk about meltdowns (although many confuse meltdowns with tantrums).

Here's how to stop meltdowns and tantrums...




 

COMMENTS:

•    Anonymous said... An even better question is "How do we get schools to recognize this so they don't punish"?
•    Anonymous said... Single parent here. Fully recognise that anxiety meltdown scenario! I find it a real struggle on the days I'm tired and have less patience than I need but mostly I think we all just do the best we can
•    Anonymous said... Exactly! My daughter's anxiety & frustrations will build to an inevitable meltdown if the wrong thing happens at the wrong time. We make sure she has an escape from known stressors so that she can calm herself when she is getting too upset. She is getting better about self regulating but we still have a ways to go.
•    Anonymous said... feel u frustration I have 3, my eldest has Aspergers, the younger children don't always understand. Also a single parent. It can sometimes feel like yr alone it does help to read others have similar problems, especially as others have no clue to yr child's uniqueness.
•    Anonymous said... How do u stop this anxiety manifesting in violent outburst when at school. My son has problems with fair play and gets very frustrated that people are cheating, he then gets angry and sometime violent. This then turns into deep remorse and guilt leading to feeling he's ruined his life due to these meltdowns.
•    Anonymous said... how do you manage to help them through a melt down or help them calm?
•    Anonymous said... I also took my son out of school and placing him in a special school that has services he needs.
•    Anonymous said... I feel your pain .
•    Anonymous said... I give my son updates on time we have to leave for dr appt ect. He says ok mom. Then when it is that time to leave he states "no" gets anxious then mad. Strikes out of me. Hates me ect. Total meltdown and I still have to get h in car. If I physically force him to car. I would get hurt. He is 10. Does anyone have suggestions? He had Aspergers
•    Anonymous said... I have 4 boys my oldest 12 was just diagnosed with aspergers we are having a lot of issues with anger and anxiety he is in counseling but feel we need to do something more. I am familiar with austim spectrum has my youngest is on it but they are totally different. Any tips or suggestions that could help us. Thanks
•    Anonymous said... I have one son diagnosed aspergers but my oldest,almost 15,has struggled in school since the start.he is diagnosed adhd and odd but he just can not have a single good day in school.he is in 9th grade now with an I.E.P. but i cant figure out why he has daily anxiety that leads to anger outbursts at school.i am at this point very desperate
•    Anonymous said... I now have my 12 yr old 6th grader home...public school doesn't work..next yr I will have a person from disability services come for iep
•    Anonymous said... I took my now 16 year old out of school her 8th grade year and did home school (i also worked full time as a sped teacher in the same district she was pulled out of- you can imagine how that went over!). She also did a lot of behavior therapy that year. It was very difficult, but she started her 9th grade beautifully and so much stronger emotionally. She still has struggles, but is making strides in a positive direction.
•    Anonymous said... I went round and round with the school. nothing was being done.So i took it in my own hands.
•    Anonymous said... It is the same for me , my 11yr is just like this anxious and meltdown and hart herself and me!!!
•    Anonymous said... It's expensive so I'm asking school district to pay. I know I have an uphill battle.
•    Anonymous said... Ive done deep breathing with my son to help him calm when he knows he's geting anxious and now he does this himself when he feels he's getting "frazzled" as he calls it. Helps he(and I) focus on what issue really is rather than explosion of temper. Not 100% of the time, but does help focus.
•    Anonymous said... I've had the same problem! Jared was hospitalized for attacking a teacher over that lack of fairness. He is now in a different school with a wonderful teacher. We've had 1 major meltdown in school that resulted in a suspension with her. And 1 when he had a sub. I laid it out for her at the start of school and in the IEP mtg. She has since been very fair (4 other kids, no mainstream ed) and tells him and I ahead of time when she will be gone.
•    Anonymous said... Just as it happens in our family!
•    Anonymous said... My son is 14 and i took him out of school.and Home School him .Took him in the 5th grade.He also had IEP.
•    Anonymous said... My son is 7 and having a tough time at school he's now refusing to go and when I get him there he won't work
•    Anonymous said... My son is ADHD, but I have noticed that "they" try to label the disability as simply a behavior. Then try to convince all that the behavior is a choice. Pointing the finger always back to the child in making a bad choice. I've always wanted someone to say a kind word to my son like, "Hey, I know this is difficult for you, . . ." Recognizing that EVERTHING is more difficult for him.
•    Anonymous said... Now my son DR. Has him on bipolar meds. Lithium and he still isn't at the level takes 900mg in the morning 1200mg at night and with another meds. and the behaviors are still the same maybe we have 2 or 3 days that i would call good. He has broken so many thing in my home a list a mile long .and 2 of my car windows WE done so much counseling i think i get more out of it then he does.
•    Anonymous said... OMGsh, yes! It took me forever to realize what was going on, but that is exactly what can happen. Through behavior therapy and practice, we are working toward avoiding triggers and then if triggers still happen , ways to self sooth so she doesn't get angry and or have a melt down. It is a process, but worth the effort.
•    Anonymous said... Same in mine.
•    Anonymous said... So true!
•    Anonymous said... Some times you feel like your alone and dont no what do.There days i could throw the towel in and give up. But that my and i love him he is on meds but they change all the time.Iam single mom i do have two other kids they are older and help me when they can. Well i just had to vent some time it helps.
•    Anonymous said... Thats how it goes with my daughter
•    Anonymous said... we are having a very ruff time , with our local catholic school , to the point they want her to leave ,,, but she Dosent want too , do I persist as its not children pushing her out its teachers ..... as she loves going to her high school angry .....
•    Anonymous said... We have recently developed a big deal, little deal hand sign. I use it as a reminder not to blow a minor annoyance into a major meltdown. It seems to help a lot. I also focus on remaining calm and try to offer face/scalp massage, or other reassuring touch, once he'll allow it. Yoga, with a focus on breathing is next.
•    Anonymous said... We too have the exact scenario as the original post (14yr old boy in our case). Tell me, there seems to be some very desperate parents crying out for help and support on this forum, is this just a place to vent or are there people monitoring these answers who can help? Genuine question not a criticism!
•    Anonymous said... when we learned about the Aspergers it made such a difference because we stopped getting offended and punishing and started working harder to prevent, redirect, help him center, change our process of expectations, and things improved dramatically
•    Anonymous said... Wow, spot on!
•    Anonymous said... Yes, just like that!
•    Anonymous said... Your formula is right on. It happen like that for my 9 yr old son in school today. Never ending cycle. It just takes one thing to throw him off.
•    Anonymous said... Yup, so frustrating! That's the pattern here, too.

*   OH MY GOODNESS! He explained that SO very brillantly! I'm 58 and STILL have meltdowns sometimes~makes me feel like a naughty little girl and that no one understands me AT ALL! I think my eldest son has Asperger's, but it just hit me that maybe I do, as well...I'm highly intelligent but didn't have as severe anxiety and depression as he did at as young an age...
 

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"Emotionally Fragile" Children with Asperger's & High-Functioning Autism

As some parents may have discovered, many young people with Asperger’s (AS) and High Functioning Autism (HFA) are “emotionally fragile” (to coin a term). In other words, these individuals have great difficulty coping with day-to-day stressors, and exhibit unusually withdrawn or aggressive behaviors as a defense mechanism.

Emotional fragility is most prevalent in school-age AS and HFA kids. It can manifest itself in many ways, all of which are challenging for the youngster, parents, and teachers. These young people often exhibit a variety of symptoms that cause school psychologists to misdiagnose them with depression, bipolar disorder, or some other disorder. A wrong diagnosis can often lead to the youngster being placed in inappropriate special education classes, or even being treated with the wrong medication.

Traits of Emotional Fragility —

1. An emotionally fragile AS or HFA youngster may become socially anxious and withdrawn in public. When faced with risks or decisions, however trivial, he may become tense and fearful. He may have extremely poor self-esteem, and may seem to have a distorted sense of reality, usually preferring to live in his own fantasy world. These kids will often internalize their feelings and emotions, and have difficulty talking about them when asked. Occasionally they may act out and hurt others out of fear and a desire to be left alone.

2. Emotional fragility often causes AS and HFA kids to regress developmentally. They may behave as though they were much younger, even to the point of seeming overly dependent on others. As these kids become older, they may be at risk for substance abuse, although due to their lack of social skills, they may be less likely to use drugs in a peer-group context.

3. An AS or HFA child with emotional fragility usually has some degree of difficulty at school. A “typical” child will be able to follow a teacher's instructions independently, and will have no problem asking for help if needed. The emotionally fragile youngster will have difficulty carrying out these same age-appropriate instructions, and may be fearful of asking for help. This can create an inability to learn on the same level as other peers of the same age, which causes the youngster to view school as a source of misery and confusion. This often leads to poor grades and excessive absences.

4. Emotional fragility can have detrimental effects on a youngster's ability to make friends and interact with others. A “typical” youngster will be able to approach a group of his peers, converse, and join in their activities. The emotionally fragile youngster will be consistently rejected or ignored by these peers due to a lack of appropriate social skills, and may even be taunted or called names. This youngster may be viewed as immature or "weird" by his peer group.

Warning Signs—

Some of the most common warning signs of emotional fragility are a loss of interest in school, depression, social withdrawal, hyperactivity, sleep problems or fatigue. However, these are just a few of the most common warning signs. It is also important to keep in mind that just because a youngster has some of these behaviors doesn't necessarily mean that she is emotionally fragile. All kids experience these things at different points in their lives. Parents should only be concerned if their youngster is displaying any of the associated behaviors over a prolonged period of time.

The most difficult part of determining eligibility for special education services is deciding if the child is emotionally fragile, or has a behavior disorder (one can often look like the other).

Let’s draw a distinction between the two along the following domains:
  1. Affective Reactions— Emotional Fragility: disproportionate reactions, but not under child’s control. Behavior Disorder: intentional with features of anger and rage; explosive.
  2. Aggression— Emotional Fragility: hurts self and others as an end. Behavior Disorder: hurts others as a means to an end.
  3. Anxiety— Emotional Fragility: tense; fearful. Behavior Disorder: appears relaxed; cool.
  4. Attitude toward School— Emotional Fragility: school is a source of confusion or angst; does much better with structure. Behavior Disorder: dislikes school, except as a social outlet; rebels against rules and structure.
  5. Conscience— Emotional Fragility: remorseful; self-critical; overly serious. Behavior Disorder: little remorse; blaming; non-empathetic.
  6. Developmental Appropriateness— Emotional Fragility: immature; regressive. Behavior Disorder: age appropriate or above.
  7. Educational Performance— Emotional Fragility: uneven achievement; impaired by anxiety, depression, or emotions. Behavior Disorder: achievement influenced by truancy, negative attitude toward school, avoidance.
  8. Interpersonal Dynamics— Emotional Fragility: poor self-concept; overly dependent; anxious; fearful; mood swings; distorts reality. Behavior Disorder: inflated self-concept; independent; underdeveloped conscience; blames others; excessive bravado.
  9. Interpersonal Relations— Emotional Fragility: inability to establish or maintain relationships; withdrawn; social anxiety. Behavior Disorder: many relations within select peer group; manipulative; lack of honesty in relationships.
  10. Locus of Disorder— Emotional Fragility: affective disorder; internalizing. Behavior Disorder: conduct disorder, externalizing.
  11. Peer Relations and Friendships— Emotional Fragility: difficulty making friends; ignored or rejected. Behavior Disorder: accepted by a same delinquent or socio-cultural subgroup.
  12. Perceptions of Peers— Emotional Fragility: perceived as bizarre or odd; often ridiculed. Behavior Disorder: perceived as cool, tough, charismatic.
  13. Risk Taking— Emotional Fragility: avoids risks; resists making choices. Behavior Disorder: risk-taker; daredevil.
  14. School Attendance— Emotional Fragility: misses school due to emotional or psychosomatic issues. Behavior Disorder: misses school due to choice.
  15. School Behavior— Emotional Fragility: unable to comply with teacher requests; needy or has difficulty asking for help. Behavior Disorder: unwilling to comply with teacher requests; truancy; rejects help.
  16. Sense of Reality— Emotional Fragility: fantasy; naïve; gullible; thought disorders. Behavior Disorder: street-wise; manipulates facts and rules for own benefit.
  17. Social Skills— Emotional Fragility: poorly developed; immature; difficulty reading social cues; difficulty entering groups. Behavior Disorder: well developed; well attuned to social cues.
  18. Substance Abuse— Emotional Fragility: less likely; may use individually. Behavior Disorder: more likely; peer involvement.

Accommodations for Emotionally Fragile AS and HFA Children: Tips for Parents and Teachers—

1. AS and HFA kids with emotional fragility are often achieving academically below their “typical” peers in reading, writing, and arithmetic. Accommodation: early detection and intervention is the best strategy; set up personalized goals and strategies so that the youngster can find success.

2. Kids with emotional fragility may appear easily distracted, less attentive, and have poor concentration. Accommodation: by setting up an environment and materials that are stimulating, these kids can stay more engaged and interested; set clear rules and expectations with visual stimulating material.

3. Some young people with emotional fragility may be blame others, manipulate situations, and even bully others. Accommodation: use behavior contracts; use a highly structured environment; stay consistent in expectations; set limits and boundaries; develop a cue word for the youngster to note inappropriate behavior; clearly post rules.

4. AS and HFA kids who are emotionally fragile often have skewed views of their long term possibilities and desires. Accommodation: include these children in the planning process and IEP so they can visualize and voice their goals; it can also be helpful for them to note the goals it will take to get there.

5. Youngsters with emotional fragility may present extra challenges to parents in the form of outbursts and disobedience. Accommodation: parents should not give into this as it only validates the youngster’s behavior; instead parents need to challenge their child to keep him learning new skills.

6. Children with emotional fragility may have difficulty establishing a variety of relationships. Accommodation: use seating arrangement to encourage social interaction; use role-playing situations; set up goals aimed at social interactions.

7. Children with emotional fragility often have low self-esteem, high stress points, and may engage in self-injurious behaviors. Accommodation: be aware of your speech and non-verbal cues when talking to the child; establish a quiet cool off area; provide time for relaxation techniques; teach and put in place self-monitoring and self-control techniques; teach self-talk to relieve stress and anxiety.

8. AS and HFA children with emotional fragility are often truant from school and disruptive when present. Accommodation: communicate with moms and dads so similar strategies and expectations are used at home.

Additional Strategies to Assist Emotionally Fragile AS and HFA Children—

1. Create a new behavior to replace the behavior you want to change. If the AS/HFA youngster is aggressive toward others while working in a group, you may want him to take turns or talk in a quiet tone of voice while in a group. Remember to create an alternative behavior that is directly observable.

2. Establish rewards and/or consequences for behaviors. Overall, it's more effective to reward the positive behavior that you are trying to increase than to punish the behavior you are trying to decrease. If the behavior does not pose an immediate threat to you, the AS/HFA youngster or other kids, or does not disrupt the entire group lesson, try to ignore the disruptive behavior while rewarding the positive behavior.

3. Identify the behavior you want to change. Keep a written record of the behaviors the AS/HFA youngster exhibits during social and independent play and academic activity (e.g., "I want Julie to play without pushing other kids …or to remain quiet during a test …or to stay seated during a lesson"). Once you describe the youngster's behavior in terms of observable actions, you will be able to monitor and mediate the behavior.

4. Provide plenty of opportunities to practice new behaviors. AS and HFA children with emotional fragility usually have difficulty working with others whether they are aggressive or withdrawn. You will want to set up social situations where the youngster can practice taking turns in a group or with a partner, and sharing and talking appropriately.

5. Role-play and hold conflict-resolution meetings so the AS/HFA youngster can practice and discuss alternative responses to social situations.

6. Teach the youngster to monitor progress independently. Have charts in folders, in a locker, or at home where she can document progress in achieving a particular behavioral goal. Have her write or verbally explain why a certain behavior is unacceptable and what behavior she can do to change it.

Services—

Children with emotional fragility often have an early diagnosis among school districts. This is because educators initiate the referral process among concerns over behavior in class. Often, the DSM is used by a school psychologist, whom may conduct interviews and distribute surveys as part of the social-emotional evaluation.

When it is determined that the child is emotionally fragile, he should receive an Individualized Education Plan (IEP). Children can also receive specific behavioral plans such as a 504 in the state of California. This often includes goals towards appropriate behavior, productive coping strategies and academic skills. Effective services should focus on these, and can mandate an educational assistant for support in regular education classes, access to a resource room for individualized instruction, medication management provided by a mental health professional, as well as individual counseling.

Emotionally fragile children are often considered at-risk for dropping out of school, suicide, criminal activity, as well as being diagnosed with a learning disability. Nonetheless, with the appropriate supports in place, these young people have been shown to have enormous potential to succeed.

Teaching Social Skills and Emotion Management

How Will My Aspergers Son Do As An Adult?

“I have a 19 y.o. son with high functioning asperger’s. I am curious how he will do out in the world as an adult. How well do people with asperger’s truly “function” when they actually have to fend for themselves?”

One of the most interesting and useful sources of data on outcome derives indirectly from observing those parents of kids with High-Functioning Autism (HFA) and Asperger’s (AS) who themselves appear to be somewhere on the autism spectrum. From these observations, it is clear that HFA does not preclude the potential for a more "typical" adult life. These grown-ups will often gravitate to a job or profession that relates to their own areas of special interest, sometimes becoming very proficient.

Many young people with HFA and AS are able to successfully complete college – and even graduate school. However, in most cases, they will continue to demonstrate (at least to some extent) subtle differences compared to “typical” adults. For example:
  • Many find their way to psychiatrists and other mental health providers where the true, developmental nature of their problems may go unrecognized or misdiagnosed.
  • Their rigidity of style and idiosyncratic perspective on the world can make interactions difficult, both in and out of the family.
  • There is a risk for mood problems (e.g., depression, anxiety).
  • They can be challenged by the social and emotional demands of marriage, although many do marry.
  • They may exhibit significant differences in social interactions.

It is estimated that 30-50% of all grown-ups with HFA or AS are never evaluated or correctly diagnosed. These individuals are simply viewed by others as "different" or “odd.” I’ve counseled many young adults that I believe fall into this category, yet I’m frequently amazed by how many of them have been able to capitalize on their strengths (usually with support from family) to achieve a high level of functioning, both personally and professionally. In fact, some of these high-functioning men and women represent a unique resource for society in general, having the single-mindedness and consuming interest to advance our knowledge in various areas of engineering and science (just to name a couple).

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

Does My Preschool Daughter Have High-Functioning Autism?

"How can a parent tell whether or not her preschool daughter has high functioning autism? I’m beginning to have my suspicions!"

There is no single, uniform presenting picture of High-Functioning Autism (HFA) in the first 3-4 years of life. The early picture may be difficult to distinguish from typical autism, suggesting that when evaluating any young girl with autism with apparently normal intelligence, the possibility should be entertained that she may eventually have a picture more compatible with an HFA diagnosis. Other girls may have early language delays with rapid "catch-up" between the ages of 3 and 5 years. Some of these young people (especially the brightest ones) may have no evidence of early developmental delay (with the possible exception of motor clumsiness).

In most cases, if you look closely at the girl between the age of about 3 and 5, clues to the disorder can be found, and in most cases a comprehensive evaluation at that age can at least point to a diagnosis somewhere along the spectrum. Although these young people may seem to relate quite normally within the family setting, problems are often seen when they enter a preschool setting. For example:
  • appearing to be "in one's own little world"
  • difficulty regulating social/emotional responses with anger, aggression, or excessive anxiety
  • difficulty with transitions
  • having a preference for a set routine
  • having odd verbal responses
  • hyperactivity
  • problems sustaining simple conversations
  • tendency to avoid spontaneous social interactions
  • tendency to be perseverative or repetitive when conversing
  • tendency to over-focus on particular objects or subjects
  • tendency to show very weak skills in interactions

In reality, this list is much like the early symptoms of autism. But, compared to the autistic child, a girl with HFA is more likely to show some social interest in others, will have less abnormal language and conversational speech, and may not be as obviously "different" from her peers. Also, areas of particularly strong skills may be present (e.g., letter or number recognition, rote memorization of various facts, etc.).

Assisting “Highly-Sensitive” Children on the Autism Spectrum

As a parent with a child on the autism spectrum, you have probably already figured out that kids with Asperger’s (AS) and High Functioning Autism (HFA) are often easily upset by minor circumstances. They may cry at the drop of a hat, or crumble when the parent raises his or her voice at them (even slightly). They seem to have a bionic sense of smell, and want all the tags pulled out from their shirts. They enjoy quiet play more than big and noisy groups, ask lots of questions, and are incredibly perceptive – noticing all the minor details of life. These children may have even been labeled as "shy" or "highly emotional" by parents and teachers. But before you write-off these “special needs” kids as drama queens, consider the fact that these behaviors may part of their disorder.

Parenting highly-sensitive AS and HFA youngsters can be challenging. These kids are often tender-hearted, easily upset, and fearful of many aspects of everyday life. They are often wonderful, caring and loving children who feel emotions deeply, and care about things that their peers seem oblivious to. They are often born with these traits, and it is usually obvious to their mom and dads that they have been highly-sensitive from day one.

The highly-sensitive AS or HFA youngster tends to have many of the following characteristics:
  • asks lots of questions
  • complains about scratchy clothing, seams in socks, or labels against the skin
  • considers if it is safe before climbing high
  • doesn't do well with big changes
  • doesn't usually enjoy big surprises
  • feels things deeply
  • has a clever sense of humor
  • is a perfectionist
  • is bothered by noisy places
  • is hard to get to sleep after an exciting day
  • is very sensitive to pain
  • learns better from a gentle correction than strong punishment
  • notices subtleties (e.g., something that's been moved, a change in a person's appearance, etc.)
  • notices the distress of others
  • notices the slightest unusual odor
  • performs best when strangers aren't present
  • prefers quiet play
  • seems to read the parent’s mind
  • seems very intuitive
  • startles easily
  • uses big words for his or her age
  • wants to change clothes if wet or sandy

Sound familiar? Have you often wondered if some of these traits were due to your “bad parenting” or some other unknown cause? Not to fear.

Here are 25 important tips for assisting your highly-sensitive child on the autism spectrum:

1. Embracing your youngster as a highly-sensitive individual is step #1. Many moms and dads bring highly-sensitive AS and HFA kids to therapy in order to "change" them into less sensitive, more typical children. This simply can’t be done. Being able to see their sensitivity as a gift and accept it as part of your shared journey (whether you yourself are highly-sensitive or not) is the proper perspective to have.

2. Add structure and limits to your empathy. Empathizing with the youngster's plight helps him understand that you feel his pain. Adding structure and limits shows that, while you understand his frustration and anger, some of his behaviors are not acceptable and require that he handles them in a more appropriate manner. For example, when your youngster won't go to bed and is becoming aggressive about it, you can calmly say, "You are going to sleep now." As the youngster progressively becomes more aggressive and complaining, acknowledge what he said, and then repeat your original statement: “You are going to sleep now.” For example: Child says, “But I want to finish playing that game!” Parent says, “I know that you want to play longer, but you are going to sleep now.” Continue to repeat this over and over again if needed (similar to a CD in player that repeatedly skips over a particular spot).

3. Develop a partnership with your sensitive child. Love and accept her unconditionally. You can’t change who she is. She needs to know you love her no matter how she perceives or reacts to the world. Partnering with your youngster includes learning her triggers (e.g., sensory sensitivities), avoiding them, and also giving her coping tools when she feels overwhelmed (e.g., breathing exercises).

4. Most children on the autism spectrum don’t like crowds. Crowds are known to be “meltdown triggers.” So, as much as possible, avoid the mall, supermarkets with bright lights, and going into places where there might be swarms of people or over-stimulation. Perhaps you can do things in “off hours” or plan them when there will be less people.  

5. Try to avoid situations that are tremendously distressing, but within reason. Don’t “force” your sensitive youngster into situations that make her feel upset. While you likely mean well and hope to conditioner her against these situations, they can cause her to withdraw further. For example, if you want your youngster to be less sensitive at school, pushing her is going about it the wrong way. Instead, gently nurture and introduce her to coping strategies that will help her manage her sensitivity at school.

6. Work with your youngster to create ways to interact with the world safely. For example, he’ll likely have an easier time interacting with classmates 1:1 than in larger groups, so set up individual play dates so he gets comfortable with several classmates. Highly-sensitive AS and HFA kids are drawn to other "birds of a feather," and getting these children together to nurture each other's strengths is a good thing. This may mean a little extra effort on your part to help the youngster make play-dates and find other children that play well with highly-sensitive peers.

7. Since highly-sensitive AS and HFA kids are majorly impacted by their home and school environments, it is worth taking the time to create spaces that match their comfort level. For example, Kyle (a 5-year-old child with Asperger’s) is highly-sensitive and loves his "Calm Corner" at home where he relaxes with his headphones, favorite plush toys and markers to feel calm. It is this type of serenity that highly-sensitive kids crave with just the right lighting, colors, sounds and surroundings.

8. Encourage self-observation. Oftentimes, AS and HFA kids feel overwhelmed by their emotions and have a difficult time putting a name to the emotion. For example, when your youngster says he is angry because his sister wouldn't let him play with her friends, you can encourage him to place a mental image to his anger so he can easily identify it the next time he feels it. Putting detail to feelings helps your youngster more accurately describe his feelings.

9. Encourage your youngster to become more assertive and in control. When a youngster feels helpless and experiences feelings of despair, he often feels like he is not good enough, that no one likes him, and that he is not worthy. Begin by empathizing with him (e.g., "I have days when I feel the same way"). Once you've shown that you are on his side, encourage him to figure out how he could better handle a similar situation in the future so he feels more assertive and masterful of the situation.

10. Explain to your youngster why he may feel sensitive and why some things trigger him to feel sad or upset. Talk about grades and testing and how they help to measure his progress. Let him know that his teacher is trying to help. Explain that other kids may taunt and tease because they are unhappy or sad themselves, and teach him about understanding. Explaining the reasons for each episode of “high sensitivity” can help your youngster manage his reactions to different stressful situations.

11. Reminding yourself that your highly-sensitive youngster is an incredibly talented individual is essential – especially when she is "acting out" because of feeling overwhelmed or emotionally upset. This is seeing the forest instead of the trees. Training yourself to see your youngster's strengths first (e.g., her incredible creativity, perceptiveness, keen intellect, etc.) is important because it helps you accept her challenges (e.g., being highly emotional, shy, picky, overly active, etc.).

12. Being “highly-sensitive” is actually a stigma, so it’s important not to “label” your youngster. Help her understand that she experiences the world more deeply than most kids, and help her see the strengths associated with this. She may notice things most people don't, have a better imagination, focus or concentrate better, be a gifted student, or empathize and be sensitive to others. These are all examples of strengths.

13. Just because your youngster is highly-sensitive doesn't mean he doesn't need structure and limits. Being able to give your youngster gentle structure and clear limits with respect goes a long way. For example, if it is “homework time” and he is resisting, you can say, "I realize you want to play video games all evening, but it is time to do your homework. We have agreed to the 6:00 PM study time – and it is 6:00 PM. So please get your books and papers ready.” This is an example of gentle discipline versus punishment.

14. Give choices. Giving your youngster choices helps her feel a sense of control (which is important, because most of the time she may feel like she has no control). For example, you could say, “Okay. It’s time for bed now. If you want to read in bed for 20 minutes before lights out, you need to take a shower, brush teeth, and comb hair now. It’s your choice.” Choices help AS and HFA kids feel empowered in their otherwise chaotic world.

15. Highly-sensitive AS and HFA children need their own space. They often like to play alone. And after a long day of school, most want to chill out. Be sure to give your child some downtime just to recuperate after a busy day.

16. Make an appointment to talk to your youngster's teachers in private. Talk about your youngster, some of her triggers concerning her sensitivity, and what the teachers can do to help her when she becomes distraught. This can help put your youngster's teachers on alert so that they know what to watch for to make school a better experience for your youngster.

17. If you need to make changes to your youngster’s environment (e.g., redecorating his bedroom), make them little by little. He will feel less overwhelmed as a result.

18. Most highly-sensitive AS and HFA kids get easily distressed when they have to make a decision. They often reject opportunities out of fear.  Sometimes the best thing you can do is nudge your youngster to take a risk or try something new. If your highly-sensitive youngster knows you will be there for her and love her no matter what she is feeling, she will have less hesitation in new situations, and will be less self-conscious or risk-averse. If she knows you’re not going to push her to be something she’s not, you’ll both be a lot more relaxed and prepared for the rough spots ahead.

19. Sensitive kids on the autism spectrum respond far better to “requests” rather than “demands.” Parental demands can elicit the exact behavior you are trying to avoid (e.g., emotional meltdowns, outbursts of energy, temper tantrums, etc.).

20. Many AS and HFA children are very sensitive to what people say to them, and who spends time with them on a regular basis. The children that get regular “play time” with a parent feel stronger, more self-confident, and are able to face the world from a place of inner strength versus weakness.

21. Most AS and HFA children love to be creative and playful, whether it is creating a new video game, painting, singing, or discovering their unique talent. The sooner that you match your child with a creative outlet that she loves, the sooner you find someone who has a “place to rejuvenate” and heal herself from the harsh world out there.

22. Instead of viewing your "sensitive" youngster as being inherently flawed, see him as having a special gift. Sensitivity is typical of creative artists and innovators. Some of our greatest thinkers (e.g., Carl Jung, Joseph Campbell, Abraham Lincoln, Eleanor Roosevelt) are believed to have been highly-sensitive.

23. Highly-sensitive AS and HFA children need grown-ups to help them (a) manage their rich emotional lives, (b) let go of overwhelming feelings in a healthy way, (c) develop their “special gift,” and (d) gain insight into doing the things that make them happier. Ideally, this “happiness teacher” is their mother or father (but it can be some other trusted adult, too).

24. Work together with your husband or wife to create a home environment with the following 6 elements:
  • self-observation
  • encouragement
  • empathy
  • structure
  • limits
  • empathy

These 6 elements help greatly when dealing with a highly-sensitive AS or HFA youngster.

25. The best that a parent of highly-sensitive youngsters can do is to accept them for who they are, and try to teach them to manage their life in as balanced a way as possible.

In conclusion, remember that highly-sensitive AS and HFA kids should never be ridiculed or punished for their feelings and sensitivities. If their feelings have been hurt, acknowledge that. Their feelings should not be disregarded simply because you may not see the logic behind them.

Teaching Social Skills and Emotion Management
 
 

COMMENTS:

•    Anonymous said... Validation is an incredibly important tool. It will take my daughter from 60 back to 0 in minutes. Just knowing that I understand how she's feeling really allows her to calm down enough to talk through the situation.
•    Anonymous said... As a grandparent to an AS/HFA child, when they start getting upset, validate their feelings instead of criticizing them for what lots of people think is bad behavior. Understanding what has upset them is truly amazing since a good portion of the time, they are not upset for something in the moment but rather something that has stayed with them for much longer.

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Asperger’s and High-Functioning Autism: Do Symptoms Improve with Age?

Asperger’s (high functioning autism) is a lifelong developmental disorder, but ironically, most research studies on the disorder have been cross-sectional (i.e., they only provide a snapshot of what it looks like at a single point in time). Why? Because following people with Asperger’s over long periods of time is expensive and requires a lot effort on the part of families and researchers, which is unfortunate since long-term studies are the only way to understand what early-life factors help some kids with Asperger’s do better than others over the long haul (something that can’t be assessed in cross-sectional studies).

Thanks to new statistical techniques, researchers can now group their study participants based on shared characteristics that unfold over time. A handful of long-term studies, each including up to several hundred participants, have now followed individuals with Asperger’s for nearly 20 years. As the young people in these studies come of age, researchers are piecing together how the disorder progresses through the life span. Let’s look at a few of these studies (in no particular order):
  • Study #1: The researcher assessed cognitive skills in 37 kids on the autism spectrum and average IQ. She found that kids between 4 and 7 years of age who have the strongest “executive function skills” (i.e., skills required for planning and carrying out complex tasks) also have the strongest “theory of mind” (i.e., the ability to understand others’ thoughts and beliefs) 3 years later. The study suggests that improving executive function skills in kids with Asperger’s may also yield benefits for “theory of mind.”
  • Study #2 showed that kids whose moms and dads are more engaged in their treatment early on have better verbal and daily living skills as teenagers. Unpublished data showed that the kids with the best outcomes (e.g., able to attend college with no extra support) all had moms and dads who had been involved in their treatment beginning at age 2 (this should not be interpreted as assigning blame to parents if their kids do poorly though).
  • Study #3 revealed that adolescence is a time of behavioral and symptomatic improvement for some Asperger’s teens; however, this improvement slows down around the time the teens leave high school. This may be in part because (a) the structure and routine of school is beneficial for Asperger’s teenagers, and (b) these young people frequently lose access to services around the time they finish school.
  • Study #4 followed about 300 participants from age 2 to 21, and found that about 10% improved dramatically by their mid-teens. It should be noted that these young people tended to (a) start out with a high verbal intelligence quotient and (b) improve their verbal skills early on. This is supportive of other studies suggesting that language skills and IQ are the strongest predictors of a youngster’s outcome.
  • Study #5 was a longitudinal study that tracked 39 kids with Asperger’s from about age 4 to age 19. Analysis of the data suggests that building “theory of mind” skills may help kids who start out with poor language skills overcome their deficits. These findings are typical of the way researchers are using longitudinal studies to analyze how changes in one area of development influence another.
  • Study #6: According to yet another study, most teenagers and grown-ups with Asperger’s have less severe symptoms and behaviors as they get older.

It has long been the hope of moms and dads with Asperger’s kids that the right care and support can reduce - or even reverse - some of the developmental problems associated with the disorder. But, while studies find that behavioral intervention programs are linked with improved social skills, the question of whether kids can technically “outgrow” Asperger’s remains difficult to answer. Studies to date that have hinted at this possibility are fraught with questions about whether the kids who apparently shed their Asperger’s traits were properly diagnosed in the first place.

Who better to poll than the people who grew up on the autism spectrum? So, we asked a few young adults with Asperger’s to address the following question: “Was there a reduction in Asperger’s-related symptoms as you got older, or did things tend to get worse?” Here are their responses:

“Although the condition remains a constant certainly, the expression can change over time. At times, I might seem quite neurotypical (albeit shy) and at other times....well, the opposite. From my own personal observation, I have days when I really seem to "read" others better and other days are not. Certainly I've had really rough periods, but inside I am still the same.”
 
“Asperger's is actually supposed to get easier to manage as the person gets older. This isn't to say, however, that big set-backs can't happen. The truth is that they WILL happen. I have improved overall since my teenage years, but this 'improvement' has brought with it two suicide attempts and many really low moments too.”

“For me, when under stress I'm just not able to put in the effort to initiate my coping mechanisms. Some of them are automatic (e.g., blocking out too much sensory input) and fail when I'm under stress. The net effect is my autistic nature affects me worse - it's not that I'm any more autistic, it's that my coping strategies aren't working.”
 
“From my experience I have gotten more aspergery every year since 16 years old, however I got less every year from 11-16, which was high school. So the high school environment must have made me much more NT, almost certainly because I was in a group of NT guys the whole time. Now as I get older the differences become increasingly apparent and it's increasingly harder to relate to people and to tolerate society. A lot of things changed around, for example when I was young I used to collect rocks and I was much more verbose for my age, now I find it harder to relate to people though and I have more social anxiety. I'm sure AS traits will continue to switch around as I grow. I think a part of it is the people you have in your life and the way you see yourself.”
 
“I don't necessarily think your Aspergers gets worse as you get older, or better for that matter. The things you're doing and the skills you've learned can either help you manage your condition, or make things go out of control. Stress fluctuates, and stress/anxiety makes our coping mechanisms less effective. So, sometimes, it looks like we're getting worse as we get older because there are life changes that are very stressful... spouse, kids, home, job, etc. The longer you work, the more "upper level" you are generally expected to become, so you get promoted into a job that has more social interaction.”
 
“I don't think it is a matter of AS getting worse (at least in my case), so much as comorbidities and just plain life making it harder to compensate for. It's tough to do anything when you also have to deal with depression or anxiety. I know that during the very stressful times in my life, it was extremely hard to deal with the negative effects of AS on top of it all. Changing jobs, graduating, recuperating after a bad relationship, etc. I found that my ability to compensate and adapt could at times drastically decrease.”
 
“I think I have improved some things over the years what are related to my disability, for example I am better at handling my special interests at a ''safer'' level. By that I mean when I was aged 13-15, I got obsessed with some local people who lived next door to my cousin. I started this obsession, and got to a point where I tried getting really involved in their lives (in other words, stalking), and it got too ''freaky'' for them (plus they had a baby), so they went to the police station and reported me. The obsession got so out of hand, and I went on about this couple to people at school - who got so fed up with me that I did lose a lot of friends because of it. Now I am obsessed with some people who I didn't know before (these are bus-drivers), but they don't know it. So I have learnt to keep my obsessions under control more - which is one improvement. I'm proud of myself there.”

“I would have to say it is up to the individual. Though technically Aspie symptoms are supposed to get better with age, your will to constantly struggle with it can weaken. Some Aspies choose to give up and seclude themselves and with no social interaction to keep your symptoms in check. And some Aspies are perfectly content like this… it's all about what makes you happy.”
 
“In some ways it seems like I’m getting more autistic as I get older, and in other ways less. My autistic traits have mostly just moved around, and in some cases just show up differently. As a kid I didn't stim much, at least not noticeably. Now I stim A LOT. But I’m more tolerant of certain sensory things... My social abilities have improved a little as I’ve gotten older and learned things, and I’ve gotten more outgoing around people. So, I talk more sometimes, but that means that I'm more likely to make mistakes in socializing and that my special interests are more obvious to other people. When you're an adult there's more stuff expected of you than when you're little, so my problems with life skills are more apparent now.”

“It doesn't get worse, but it may seem like it does because there is the anxiety and the depression. Depression makes your AS symptoms worse. It's just an illusion.”
 
“I've found myself becoming more isolated as time goes on. I think in school you have friends (often with similar traits) but once you leave, your true nature slowly takes control. If you are stressed or don't like being around people much, then you will inevitably find solitude. I'm not sure if things have gotten worse regarding my aspie traits or if I'm just more aware of what they are.”
 
“I've had some 'worsening,' but it's not been like a path back to where I was when I was younger. It's just different. Even though I have cognitive losses, I still have what I learned when pushing myself hard to interact with people. As a teen, I found interacting even with store clerks to be terrifying, but I eventually learned how to deal with it, and it remains not-a-very-big-deal, today. And, I can still even manage short bursts of small talk (though it is still exhausting).”
 
“Periods of high stress definitely regress my symptoms, my obsessions become more intense and impulsive behaviour harder to control. You lose those management skills developed over many years. I would say yes, your AS can appear to deteriorate (get worst) during periods of high stress throughout life.’
 
“Stress is my culprit. All of the coping strategies I've learned over the years shut down systematically as stress increases. Verbal communication is the first to go... I do not desire it, I shy away from it to the point I finally don't bother to speak at all. Meltdowns start to increase. Auditory problems seem to get more sensitive. One by one, it seems to be getting worse. But, if I can eliminate the stress, my ability to cope increases. I don't think there is any literal change in my challenges, only my ability to deal with them.”

In working with clients on the autism spectrum over the years, it has been my experience that many of these individuals do not get worse over time. In fact, it often gets somewhat better with time as they learn some coping skills that they lacked earlier in life. Most people with Asperger’s tend to gain these skills by default as they age (the concept of “the longer you live, the more you learn”).

Having said this, there does seem to be a period of time (lasting about 5 – 10 years) post high school where there is an increase in symptoms (e.g., anxiety, depression, isolation, etc.). As suggested in the information above, this may be due to (a) the loss of structure provided by regularly attending school, and/or (b) the absence of frequent association with “typical” peers. But, by the time these young adults reach their mid-to-late 20s, many find that the accumulation of life experiences has helped lessen some their (unwanted) Asperger’s-related symptoms. However, the exception to this (again, based on my practice) seems to be those who are unemployed, not attending college or some other form of continuing education, and still living with their parents. This suggests that being insulated from the community (i.e., isolation) exacerbates Asperger's-related symptoms - and possibly stunts emotional growth due to the lack of ongoing, multifaceted life experiences.

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References:

•    Anderson D.K. et al. Am. J. Intellect. Dev. Disabil. 116, 381-397 (2011) 
•    Bennett T.A. et al. J. Can. Acad. Child Adolesc. Psychiatry 22, 13-19 (2013) 
•    Georgiades S. et al. J. Child Psychol. Psychiatry 54, 206-215 (2013) 
•    Gotham K. et al. Pediatrics 130, e1278-e1284 (2012) 
•    Green S.A. et al. J. Autism Dev. Disord. 42, 1112-1119 (2012) 
•    Pellicano E. Autism Res. Epub ahead of print (2013) 
•    Smith L.E. et al. J. Amer. Acad. Child Adolesc. Psychiatry 51, 622-631 (2012) 

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