Undeniably, the varied expression of psychiatric problems in kids with Asperger’s is directly related to environmental factors, which suggests the opportunity for planning various interventions. For example, family and daily routines should be considered as environmental factors that can lead to exacerbation (i.e., an increase in severity) or amelioration (i.e., a decrease in severity) of comorbid disorders.
The challenge of understanding the special needs of Asperger’s kids, and the problems associated with building a close relationship with them, often contributes to increased stress in their moms and dads. Parents of kids on the autism spectrum have been shown to have a reduced sense of happiness and security, and tend to display a general lower quality of life – even in comparison with parents of kids with other disorders (e.g., cerebral palsy or mental retardation). Furthermore, moms were found to experience a higher level of stress than dads, and this higher stress is often related to unusual behavioral traits of the youngster (e.g., hyperactivity, conduct problems, etc.).
Other research reports elevated rates of anxiety-related personality traits among the relatives (e.g., siblings, grandparents, etc.) of Asperger’s kids. Moreover, elevated anxiety levels in the moms and dads of these young people can be considered an important environmental factor that can trigger genetically-determined personality traits that are eventually shared with other family members and constitute a genetic family-loading for psychiatric disorders.
The importance of environmental factors in the expression of psychiatric symptoms was investigated in a sample of young people with Autism Spectrum Disorders (ASD), including children with Asperger’s and their siblings, with an evaluation reported independently by parents and educators. Reports by educators showed a much lower prevalence of comorbidity in these children (in particular for somatic, oppositional, conduct, attention, anxiety, and affective problems) as compared to the reports by their moms and dads. These results support the idea that the expression of psychiatric problems in kids with Asperger’s varies depending on the environmental context, and that their identification depends on the type of observer (in this case, teacher versus parent).
There is often a lack of consensus between the reports of parents and educators regarding the behavioral characteristics of kids with Asperger’s, hence suggesting that caution should be used when making conclusions about the presence of comorbid psychiatric difficulties based simply on the environmental context or a single informant source. Instead, information should be gathered from multiple sources and settings, including direct observation by therapists.
The problems that an Asperger’s youngster experiences in terms of social relationships are even greater outside of the home environment (e.g., school, church, scouts, etc.). The lack of adequate teacher-parent communication, coordination among social service providers, and social support often leaves the parents alone with the burden of providing a more intensive level of care and any additional support.
Unfortunately, schools are not always equipped to deal with the unique needs of the Asperger’s student, and this often drives him or her to develop feelings of low self-esteem, sadness, and self-blame, which often leads to other problems (e.g., meltdowns, depression, hyperactivity, conduct problems, etc.).
Research has also reported that negative events (e.g., parental discord, frequent changes of own residence, death of a family member, etc.) have significant influence on the Asperger’s youngster’s mood and functioning – and have been associated with clinical depression. Asperger’s children tend to react to negative life events more severely (and in a different way) than “typical” children do. Asperger’s children are also more vulnerable to developing mood disorders and depressive symptoms than other children (which may be correlated to a genetic predisposition).
Since environmental factors appear to substantially influence the expression of psychiatric comorbidities in Asperger’s children, more attention should be focused on the interactions between these children and their diverse everyday life events. Parents, teachers, and professionals can develop coping strategies and provide a better social support that may contribute to a decrease in the incidence of psychiatric disorders in Asperger’s children.
There are numerous accommodations that parents can make to help their Asperger’s child cope effectively with his or her environment. Here are just a few:
- Allow more time to complete chores, homework, etc.
- Avoid being critical and negative toward your youngster.
- Avoid over-scheduling him and allow him free time to play, read, listen to music, or just relax.
- Avoid placing unrealistic expectations on your child.
- Break tasks down into a few small steps (no more than 5) that can be completed one at a time so that your youngster does not feel overwhelmed with the task. For example, “It’s time to clean your room. So, put your clean clothes in this drawer. Pick up your dirty clothes off the floor and put them in this laundry basket. Then take the basket to the laundry room.”
- Create a special signal (e.g., tapping the tip of your nose) that you can use with your youngster to redirect his attention back to what you are saying whenever necessary.
- Demonstrate active interest in your youngster’s school progress and support her with her learning and homework.
- Encourage physical activity and healthy eating habits.
- Have a crisis plan in place in the case of meltdowns (e.g., due to your child’s sensory sensitivities, due to his inability to cope or interact with siblings, etc.). This plan may include providing a quiet place for your youngster to go when needed.
- Help build your youngster’s sense of self-worth by recognizing his achievements.
- Listen to your youngster and encourage him to talk about his feelings and worries.
- Manage your own stress, and be a positive role model.
- Monitor their youngster’s access to media and ensure she is aware of safe online practices.
- Prepare your child in advance for any changes in routine or other unexpected activities. For example, use this 3-stage warning: “In 15 minutes, we are going to the grocery store.” Then after 5 minutes have passed, repeat your instruction and say “In 10 minutes, we are going to the store.” Then after 5 minutes, say “We are leaving in 5 minutes.”
- Provide a written, predictable schedule of events (e.g., “On school days, you get dressed, brush your teeth, eat some breakfast, get your school bag, and then get on the bus”). Remember, Asperger’s kids thrive on routine.
- Regularly spend calm and relaxing time with your youngster.
- Set firm expectations regarding house rules. In many cases, Asperger’s kids may not want to follow a rule that holds no interest for them (e.g., “Be sure to wash your hands before you come to the dinner table”). It is important for parents to establish and maintain control – even when their child has an Autism Spectrum Disorder.
- Show active interest in your youngster’s activities and hobbies, and participate when possible.
- Support your youngster if he is exposed to bullying.
- Use less verbal instruction, and replace it with visual instruction. For example, use drawings, pictures, or other images to create a “chores chart” or a “house-rules chart.”
- Use positive reinforcement for good behavior as often as possible!
When environmental stress becomes too much to handle, an Asperger’s youngster can develop a range of physical, emotional or behavioral symptoms, and can even be at risk of developing other mental health problems. Also, he may find it difficult to recognize and verbalize when he is experiencing stress. Thus, it is important for moms and dads to teach their “special needs” child to recognize and express his emotions, and to use healthy ways to cope effectively with the environment.
Teaching Social Skills and Emotion Management