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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Emotional Behavior Disorder in Children on the Autism Spectrum

“My son is 9 years old and he is being very aggressive at home, but mostly in school - especially with teachers and personnel that intervene with him. I know they don’t put in practice his IEP goals, and he expresses to me how awful the school is for him. Now they are telling me that he has EBD [emotional behavior disorder] and they have been destroying his student record. My son is a great kid and I am learning everyday about high functioning autism, but I am suspecting his school is doing a lot of damage to him. Please help!”

The incidence of aggressive behavior among kids and teens with High-Functioning Autism (HFA) and Asperger’s is of great concern. This complex issue needs to be carefully understood by both parents and educators. Parents who witness this behavior are obviously concerned, but they often hope that their child will "grow out of it." However, it should not be quickly dismissed as "just a phase” the child going through. Unless some underlying issues are addressed, aggressive behavior is likely to continue – and worsen.

Faced with a world in which they find it difficult to interact socially, communicate clearly, and control their own behavior, kids on the autism spectrum sometimes respond with aggression. This behavior can include a wide range of behaviors (e.g., use of weapons, throwing objects, threats to hurt others, homicidal thoughts, spitting, pushing, kicking, hitting, explosive temper tantrums, destroying public or personal property, etc.). On the surface, these behaviors may appear to be pure oppositional defiance. But, on closer inspection, it is often discovered that they have more to do with impulsiveness, anxiety-reduction, and low-frustration tolerance – traits that coexist with the disorder.

To be effective, treatment approaches for violent and aggressive behavior in autistic children need to take the following factors into account:

• Due to difficulties with empathizing, many kids with HFA don't recognize the suffering of others. So, when the attack another person, they may not be able to fully comprehend the damage they inflict (i.e., imagine how the victim feels).

• After just a few years of classroom experience, many children on the spectrum think of themselves as victims due to the fact that they may have been teased, ostracized from the peer-group, bullied, and misunderstood (and perhaps unfairly treated) by teachers. As a result, they may believe that their aggressive behavior is totally justified.

• Due to certain traits associated with the disorder (e.g., mind-blindness, sensory sensitivities, literal thinking, social skills deficits, etc.), many kids with HFA view the world as a cold and hostile place. They may develop a “habit of thought” that attributes hostile intentions to others. This attitude leaves them little choice but to defend themselves (or shutdown and retreat). For example, if another student bumps up against them in the hallway, they may immediately take offense, certain that they were bullied (again). They may have a hard time imagining that perhaps the bumping was just clumsiness on the other student's part. In other words, these “special needs” kids may see the world as an unsafe place in which there are only victims and victimizers, so they may (unconsciously) choose to be one of the latter.

What can parents and teachers do to help? Here are some specific techniques to employ that may reduce or eliminate violence and aggression in the HFA child:

1. Many moms and dads are afraid to discipline an unruly autistic youngster for fear that he (a) is too “fragile,” (b) will hate them for being “unfair,” (c) will have a meltdown, or (d) is simply unable to follow instructions to behave in a certain manner. Your youngster doesn't have to like you – or even love you – but he does have to respect the parent-child relationship and realize that there will be consequences for poor choices. You don't have to be your youngster's friend, but you do have to be his parent.

2. Arrange furniture in a sensible way so that your HFA child can easily maneuver through rooms. If he often tries to escape through a certain door, change the path of the room so that he is unlikely to go near that door. Keep surfaces clear, taking special care to place breakables and dangerous or messy items out of reach. Organize and structure your youngster's living space to minimize frustration. Labels can help him understand where things belong and make him less likely to become overwhelmed or anxious. Also, restrict access to items that tend to cause power struggles.

3. Sometimes stress over not being able to verbalize frustration causes aggressive behavior. For example, if your youngster is angry that he can't button his coat, but is unable to describe how he feels about lacking that skill, he could act out inappropriately. Examining the root problem and addressing it may help to curb angry behavior. Calm reactions on the part of the parent or teacher are important here.

4. Many times, mothers and fathers are quick to make evaluations of their HFA youngster’s unruly behavior (e.g., viewing aggression as nothing more than a childish tantrum). Parents need to revisit their evaluations, because an HFA youngster's violence may be stemming from other issues (e.g., anxiety and/or depression). Don't make judgments until you get to the root of the problem.

5. Sometimes an aggressive youngster knows that if she engages in "divide and conquer" tactics with her parents, she will be able to get her way. However, if mom and dad maintain a united front, then there's strength in numbers, therefore disallowing the child to play one parent against the other.

6. Sometimes violent outbursts are predictable. For example, due to sensory sensitivities, the child may become upset when wearing a warm winter sweater. Maybe the fabric feels uncomfortable against his skin, or the smell of the drier sheet is offensive to him. Examine every component of a situation that seems to trigger aggressive actions and make the necessary adjustments.

7. Be sure to learn the difference between tantrums and meltdowns. A tantrum is very straightforward and has several qualities that distinguishes it from a meltdown. Unlike a meltdown, when the troubling situation is resolved, a tantrum will end as suddenly as it began. A tantrum is thrown to achieve a specific goal, and once the goal is met, things return to normal, whereas a meltdown will usually continue as though it is moving under its own power and wind down very slowly.

8. There's not a youngster born that doesn't have currency, whether it's toys, clothes, games, or television. Access to this "currency" needs to be contingent upon proper behavior (e.g., if your youngster throws a tantrum in a crowded store, he should not be rewarded with a toy or a coloring book). She needs to (a) understand the consequences of his behavior, (b) be able to predict the consequences of his actions with 100% accuracy.

9. If aggressive behavior has developed suddenly or has gotten worse over time, then investigate to see if your youngster has an allergy. Seasonal or food allergies can cause discomfort that the youngster can't describe, leading to extreme behavior. Other factors to consider are environmental conditions, change in medication, or a change in the home or school setting. In addition, some drugs cause aggression.

10. Be sure that your child’s Individual Education Plan (IEP) has all the proper stipulations. Not all IEPs are created equally; they need to be tailored to the child’s specific needs. There is probably no process as frustrating for parents and teachers alike as the IEP process. If you feel that your child’s IEP is fairly worthless and that school staff is mostly ignoring it, then some significant changes need to be made immediately. There are several common mistakes parents and teachers make when creating an IEP (or going through the IEP process), for example:
  • The IEP contains goals that can’t be measured. This is the most common mistake made when creating IEPs. It is easy to make - and accept - overly generalized goals and achievement objectives and believe they are acceptable. Many IEPs contain goals and objectives like, "...will improve letter recognition." This is a vague goal which can be claimed as "achieved" with very little progress actually having been made. A better goal would be something like, "...will recognize 9 out of 10 random letters shown, 4 out of 5 times." This is specific and measureable.
  • The parent signs the IEP when she doesn't totally agree with it. Never sign an IEP at the meeting, especially if you don't agree with it. A verbal commitment that "we will work out the fine details later" is not binding, but your signature is. Remember that you have three days to review the IEP before signing it. It is always a good idea to take the IEP home and review it one more time, even if you think that everything is fine.  Never feel pressured into signing an IEP! All schools have a due process procedure you can follow that will progressively escalate any complaints you have through the appeals process. If you can’t agree on your IEP, the school should provide you the information and steps you need to begin the due process procedure.
  • The short-term goals will not meet long-term goals. If a specific long-term goal is agreed upon, make sure that the short-term goals adequately support progress towards the long-term goal.
  • The parent fails to review a preliminary IEP. Without a preliminary look at what is being proposed for your HFA youngster, your first opportunity to see the IEP is in the IEP meeting where you are expected to agree to - and sign - the IEP. This puts you in an unfavorable position, because you can feel pressured to agree to items without having time to really think through their implications. Always ask for a preliminary copy prior to the IEP meeting, and never feel like you have to sign at the meeting.

11. When the youngster with a “disorder” is acting out, the family may blame him for the family's dysfunction. Sometimes, parents will bring their disruptive autistic youngster in for treatment. This is the sacrificial lamb for the family's toxicity. Parents need to examine their own behavior, and if need be, the entire family should seek counseling. One child – even one with “special needs” – can’t be responsible for all the problems in the household.

12. Lastly, medication may be needed – especially if the youngster's behavior is hazardous to him or those around him. Medications are frequently used in the management of aggression, and current psychopharmacologic treatment strategies involve treating aggression as part of each particular syndrome. Before prescribing medication for aggression, the clinician should ensure that the child has a medical evaluation to rule out contraindications to treatment and to determine whether the aggressive symptoms might improve without the use of drugs (e.g., cognitive-behavioral therapy).

Here are a few suggestions specifically for teachers of students with HFA and Asperger’s:

1. Work from the HFA student’s strengths and interests. Find out how he feels about the subject matter, and what his expectations are. Then try to devise examples, case studies, or assignments that relate the subject matter to his interests and experiences.

2. When possible, let the HFA student have some say in choosing what will be studied. Give her options on term papers or other assignments (but not on tests). Let her select which topics to explore in greater depth.

3. Try to promote appropriate social interactions and help the youngster “fit-in” better. Formal, didactic social-skills training can take place both in the classroom and in more individualized settings. Approaches that have been most successful utilize direct modeling and role playing at a concrete level. By rehearsing and practicing how to handle various social situations, the HFA youngster can learn to generalize the skills to naturalistic settings.

4. Try to insure that school staff outside of the classroom (e.g., physical education teacher, bus driver, school nurse, cafeteria monitor, librarian, etc.) are (a) familiar with the HFA youngster's style and needs and (b) have been given adequate training in management approaches. Those less structured settings where the routines and expectations are less clear tend to be difficult for the HFA youngster.

5. There will be specific situations where medication can occasionally be useful. Educators should be alert to the potential for mood problems (e.g., anxiety or depression), significant compulsive symptoms or ritualistic behaviors, and problems with inattention. Occasionally, medication may be needed to address more severe behavior problems that have not responded to non-medical, behavioral interventions.

6. The use of a "buddy system" can be very useful since HFA students relate best 1-1. Careful selection of a peer-buddy for the HFA youngster can be a tool to help build social skills, encourage friendships, and reduce stigmatization.

7. The school counselor or social worker can provide direct social skills training, as well as general emotional support.

8. Realize that the HFA youngster has an inherent developmental disorder which causes her to behave and respond in a different way compared to other students. Oftentimes, behaviors in the HFA student are interpreted as "manipulative" or some other term that misses the point that she responds differently to environmental stimuli. Thus, school staff must carefully individualize their approach for this “special needs” child. It will likely be counterproductive to treat her just the same as her peers.

9. Put as many details as possible into an Individual Educational Plan so that progress can be monitored and carried over from year to year. It can sometimes be helpful to enlist the aid of outside consultants familiar with the management of young people on the autism spectrum (e.g., psychologists, psychiatrists, etc.).

10. Most students with HFA respond well to the use of visuals (e.g., schedules, charts, lists, pictures, etc.).

11. Know that the HFA student usually shows a surprising sensitivity to the personality of the educator. He can be taught, but only by those who give him true understanding and affection. The educator’s underlying emotional attitude influences (involuntarily and unconsciously) the mood and behavior of this “special needs” youngster.

12. Keep teaching fairly concrete. Avoid language that may be misunderstood by the HFA youngster (e.g., sarcasm, confusing figurative speech, idioms, etc.) Try to simplify more abstract language and concepts.

13.  It is very helpful if the HFA youngster can be given opportunities to help other students at times.

14. It is often helpful for the educator and parent to work closely together, because the parent is most familiar with what has worked in the past for the HFA youngster.

15. If motor clumsiness is significant, the school Occupational Therapist can provide helpful input.

16. If learning problems are present, resource room or tutoring can be helpful to provide individualized explanation and review.

17. Hold high – but realistic – expectations for the HFA child. Research has shown that a teacher's expectations have a powerful effect on a student's performance. If you act as though you expect your “special needs” student to be motivated, hardworking, and interested in the subject matter, he is more likely to be so. Set realistic expectations when you make assignments, give presentations, conduct discussions, and grade examinations. "Realistic" in this context means that your standards are high enough to motivate the HFA child to do his best work, but not so high that he will inevitably be frustrated in trying to meet those expectations. To develop the drive to achieve, the child needs to believe that achievement is possible.

18. HFA students with very high-management needs may benefit from assistance from a classroom aide assigned to them.

19. HFA students can be fairly rigid about following "rules" quite literally. While clearly expressed rules and guidelines (preferably written down) are helpful, they should be applied with some flexibility. The rules don’t automatically have to be exactly the same for the HFA youngster as for the other students, because their needs and abilities are different.

20. Help the HFA student set achievable goals for himself. Failure to attain unrealistic goals can disappoint and frustrate him. Encourage him to focus on his continued improvement, not just on his grade on any one test or assignment. Also, help the child evaluate his progress by encouraging him to critique his own work, analyze his strengths, and work on his weaknesses.

21. Give the HFA student feedback as quickly as possible. Return tests and papers promptly, and reward success publicly and immediately. Give her some indication of how well she has done and how to improve. Rewards can be as simple as saying her response was good, with an indication of why it was good.

22. Efforts should be made to help classmates arrive at a better understanding of the HFA youngster in a way that will promote tolerance and acceptance.

23. Educators should take full advantage of the HFA youngster's areas of special interest when teaching. The youngster will learn best when an area of high personal interest is on the agenda. Educators can also use access to the special interests as a reward to the youngster for successful completion of other tasks, adherence to rules, and meeting behavioral expectations.

24. Educators can take advantage of the strong academic skills that many HFA students have in order to help them gain acceptance with their classmates.

25. Direct speech services may not be needed, but the speech and language clinician at school can be useful as a consultant to the other staff regarding ways to address problems in areas such as pragmatic language.

26. Classroom routines should be kept as consistent, structured and predictable as possible. Students with HFA usually don't like surprises. They should be prepared in advance for changes and transitions (e.g., schedule breaks, vacation days, etc.).

27. Care should be taken to protect the HFA youngster from teasing and bullying – both in and out of the classroom.

28. Be specific when giving negative feedback. Negative feedback is very powerful and can lead to a negative class atmosphere. Whenever you identify your “special need” student's weakness, make it clear that your comments relate to a particular task or performance, not to the student as a person. Try to cushion negative comments with a compliment about aspects of the task in which the student succeeded.

29. Avoid escalating power struggles. HFA students often don’t understand rigid displays of authority – and will themselves become more rigid and stubborn if forcefully confronted. Their behavior can then get rapidly out of control, and at that point, it is often better for the educator to back-off and let things cool down. When possible, anticipate such situations and take preventative measures to avoid the confrontation through presentation of choices, negotiation, and diversion of attention elsewhere.

30. If you have tried numerous strategies to address aggression in your HFA student to no avail, ask the parent to consider taking the child to a professional for a psychiatric evaluation to determine whether depression, anxiety, or other problems are present. Treatment of these conditions often result in reduced symptoms of aggression.

It is inevitable that you will have the opportunity of working with students on the autism spectrum in your classroom. You will need to make accommodations for some, and modifications for others. Providing for the needs of these young people will certainly be one of your greatest challenges as a teacher. Consider the tips listed above to make the learning process run as smoothly as possible.

How to Prevent Meltdowns and Tantrums in Children with HFA and Asperger's


COMMENTS:

•    Anonymous said… After years of struggling, took my daughter out in grade 8, home schooled her for the year. Grade 9&10 she did online. She decided to go to high school grade 11&12. She is now in her final year of University graduating with a bachelor of science in Environmental science. I came to realize that school just wasn't as important as her mental well being.
•    Anonymous said… Ask the schools special education department to have him tested. The behavioral specialist is the one who usually does the testing n it should take at least 2 weeks BC the person observes the child as well. I'd call adminstration BC that specialist is the only one that can suggest a diagnosis n it has to be put in their report.
•    Anonymous said… Do you know why he is acting out? What are the triggers? Knowing these will help his behaviour as you can then implement things to help him cope or do some social stories etc. However I agree with everyone else I'd swap schools. Xx
•    Anonymous said… Encourging you to try another school. Did miracle-level wonders for my Aspergers teen & wish we'd done so sooner for him. Mine had an IEP from 2nd to 4th grade, had a good 4th grade year because older male teacher really appreciated his outside the box thinking & encouraged him while setting strict expectations and structure. The kind of teacher we all wish they all were, but unfortunately not. Even with my involvement and guidance, including written materials to enhance their knowledge of his needs, we had ignorant teachers unwilling to accomodate and absolute asshole bully peers & parents. Kids that know they can get away with rottenness toward him because they've been doing it for years. New environment with clean slate did wonders. Wish the same for you..best luck. Hang in there Momma
•    Anonymous said… get all of his records under freedom of information, keep your copies of all IEP's and gete to the head of education, sounds like he needs a change of education setting
•    Anonymous said… He has triggers, u need to watch for them. My sons 9 also n he's violent as well. A lot of times the generic word used is emotional behavior disorder BC not u til they have been seen for a long time
•    Anonymous said… Hire an advocate and force your County public school system to pay for your son to go to an ASD school. That's exactly what I did. A good advocate is well worth it. Believe me!! Best $2000 I could have ever spent on my son's future. My son will NEVER again have to deal with the uneducated and unskilled people within the public school system. YOU are the parent, don't ever let them forget it and try to back you in a corner.
•    Anonymous said… I know this journey all to well. Sometimes, we pray and hope for a better result as the child get older. You may have to seek behavior modification therapy. The teacher can become very exhausted as well. The school has to protect other student's from the violent behavior. You can discuss options with professional services. Perhaps, a smaller setting classroom.
•    Anonymous said… My son 13 has aspergers his school not doing well with his ehcp i feel like i am letting him down he doesnt want to move school and to be honest 8t would only make things worse for him change is not good when he in yr 8 nearly 9 but thats just my son . He is well behaved at school and home mostly just doesnt like to leave his xbox hates shopping lol
•    Anonymous said… Putting a child with special needs in the hands of those who do not understand or accommodate those needs is like sending a person who has a broken leg to an eye doctor.
•    Anonymous said… Same thing happened to me and my kid, I got involved really involved, got to do a meeting with the teachers, and talked to them about what he has , and what he needs, also got to set a plan with the teachers and all of this of course with my kid's Psychiatric psychologists and neurologist advice on paper. Now is not perfect but you can tell they are working on it.... Hard.
•    Anonymous said… They need to do a Functional Behavior Assessment (to find out what causes the behavior)then a Behavior Intervention Plan (to change the behavior). These are both added to the IEP. Ask questions like: What was happening before the behavior started? What did your son see? Was he trying to communicate? What would YOU do differently?
•    Anonymous said… Unfortunatly this is all too common. Not only did the schools insist my son had a behavior problem, one incident when a teacher bent down over him during a meltdown, he swung at her trying to defend himself after a different teacher sat on him. In doing so, he hit her breasts which was the closest thing to him and they tried to claim it was sexual assult..he was 8.
I've since taken him out of school, did one year of "unschooling". He now does online school and the "behavior" has all but gone away.
•    Anonymous said… We changed schools and the phone calls to pick our son up stopped. Only calls I have had in the past 2 years was if he was hurt or sick.
•    Anonymous said… We ended up homeschooling and my only regret was not doing it sooner. Of course we are in a remote area with no other viable options. The school would not acknowledge psychiatric orders.
•    Anonymous said… We moved schools from a well meaning but hugely overcrowded and busy school to a very small rural school and he is doing a lot better. My son soaks up others stress and if he feels overwhelmed then the fight or flight instincts kick in.
•    Anonymous said… Yes, absolutely look around for a school that understand ASD, including knowing how to not let him use it to get out of school. That may sound harsh, but my co-parent and I have been through that. For a couple of years we got called easily two to three times a week to take our son home. He'd learned to use his outbursts to get sent home if he was bored or frustrated. Once we found a school that didn't always call us, he leaned really quickly he could no longer use it as a tool. This was in conjunction with some other improvements as well (imo, it's never just one thing, but multiple factors) that have him doing next, much better. He's now 10, so close in age to your little guy. I don't want anyone to think I believe ALL his outbursts were contrived, far from it. But in addition to real sensory overloads, he'd learned to manufacture them as well. High functioning is a different set of battles.

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2 comments:

liz said...

The school system where I am made my kid a mess .. he is now 14 years old and is riddled with anxiety , just about totally shut down ..its sad to see kids get so mistreated because they dont'' fit in'' ..all i can say is dont let the schools get away with it ...get a lawyer if you have to ..they will run you over like a freight train and then tell you its your fault !!

Charlina Reed said...

My 14 year old has self diagnosed himself with ASD. He was already diagnosed with adhd/odd... I need help to decide what to do! He is.acting out and is saying it's because he has ASD. Help!!

My child has been rejected by his peers, ridiculed and bullied !!!

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