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

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Avoiding Social Interaction: The Dilemma for Teens on the Autism Spectrum

Teens with High-Functioning Autism (HFA) and Asperger’s (AS) have difficulty with the basic elements of social interaction, which may include a failure to develop friendships or to seek shared enjoyments with others, as well as a lack of social or emotional reciprocity. The reason this is such a problematic issue is because we, as humans, are social creatures by nature. Social interaction is a “requirement” within our species.

The sad truth is that teens on the autism spectrum desire acceptance and want to “fit-in” with their peer group, but are often ostracized, mocked and bullied. In the adolescent world where EVERYONE feels insecure, the teenager who appears “different” or “odd” is voted off the island.

Many of the traits associated with HFA and AS tend to exacerbate peer-rejection. For example, the “special needs” teen:
  • faces similar academic problems as students with ADD due to his distractibility and difficulty organizing materials
  • finds friendship and all its nuances of reciprocity to be exhausting
  • has poor social skills (e.g., lack of eye contact during conversation, body language that conveys a lack of interest)
  • is not privy to street knowledge of sex and dating behaviors that other adolescents pick up naturally
  • is stiff and rule-oriented and acts like a little adult (a deadly trait in any teen popularity contest) 
  • may be naive when it comes to puberty and sexuality
  • may remain stuck in grammar school clothes and hobbies instead of moving into adolescent concerns (e.g., dating, clubs)
  • often experiences depression that results from chronic social tension 
  • often has poor motor coordination, which leaves him out of high school sports (typically an essential area of male-bonding and friendship in the teenage years)
  • often neglects his hygiene 
  • tends to attract bullies, but is less likely to report bullying than his peers
  • tends to be more immature than his peers
  • typically does not care about adolescent fads and clothing styles (concerns that obsess everyone else in his peer group)

The hormonal changes of adolescence - coupled with the problems outlined above - usually means that an HFA or AS adolescent becomes emotionally overwhelmed on almost a daily basis. Childish temper tantrums may reappear, and it is not uncommon for the teen to experience "meltdowns" at home after another day filled with harassment, rejection, bullying, and pressure to conform.

Parents of teens on the autism spectrum can usually tell whether or not their son or daughter is experiencing some form of social rejection by observing his or her behavior and attitude. HFA and AS adolescents who feel disliked by others and who have experienced some form of emotional abuse:
  • are disengaged from friends and classmates
  • are frequently ill (e.g., stomach aches, headaches, colds, etc.) 
  • are impulsive
  • are less able to calm themselves
  • are socially anxious
  • become avoidant or aggressive when dealing with negative emotions
  • behave in ways that cause them to get into conflicts at school
  • exhibit emotions too intense for a situation
  • experience a significant degree of anger and frustration
  • have a preference for isolation at home and school
  • have difficulty controlling their attention span
  • have difficulty decreasing negative emotions
  • have difficulty understanding emotional experiences
  • may refuse to go to school
  • may skip classes
  • often seem genuinely depressed
  • tend to have poor academic performance

All teenagers are required to use increasingly sophisticated social skills and to interpret ever more subtle social nuances as they progress through high school. For that reason, young people diagnosed with HFA or AS often find themselves more and more in conflict with prevailing social norms as they move through adolescence. Due to the fact that social encounters are seldom reinforcing (i.e., rewarding) for young people on the autism spectrum, they often avoid social interaction all together. Over time, they may develop negative attitudes about themselves, which makes it even more difficult to continue attempts at social interaction. As a result, the cycle continues – they retreat even deeper into their own little world.

Spending a lot of time in voluntary isolation creates a host of problems in-and-of itself. For example, teens who isolate may become depressed due to the lack of social contact. A depressed adolescent often loses interest in everyday activities and drops out of social groups at school. Depression is a Catch-22. It can cause isolation, but may also come from a lack of social interaction. Furthermore, an adolescent who isolates may spend too much time playing video games and on social networking sites, thus losing touch with family, friends and his peer group. He may replace genuine social interaction with chat rooms and conversations with strangers. Adolescents who interact online lose out on genuine social interaction, which stunts their emotional growth even further.

When HFA and AS teens begin to act-out their frustrations (e.g., with verbal or physical aggression), it is usually a sign that they are not receiving adequate support in mastering their environments, both at home and school. In addition, their acting-out does not necessarily reflect willfulness, rather they lack the social skills needed to avoid be targeted as the “odd ball.”

After years of social failures, many young people on the spectrum literally give up. They simply stop trying to make friends and adopt an avoidant personality style (even though they may not have the formal diagnosis on Avoidant Personality Disorder). Teens with avoidant personality traits may display any of the following:
  • view themselves as socially inept or personally unappealing
  • use of fantasy as a form of escapism to interrupt painful thoughts and emotions
  • tend to avoid social interaction for fear of being ridiculed and rejected
  • self-imposed social isolation
  • self-harm
  • self-critical about their problems relating to others
  • mistrust of others or oneself
  • feelings of loneliness
  • feelings of helplessness
  • feelings of inadequacy and inferiority
  • extreme sensitivity to negative evaluation by others 
  • exhibits heightened self-doubt
  • emotional distancing related to intimacy
  • drastically-reduced or absent self-esteem
  • depression
  • avoids physical contact because it has been associated with an unpleasant stimulus
  • avoidance of social interaction despite a strong desire to be close to others 
  • anxiety
  • agoraphobia
  • a pattern of social inhibition

Treatment—

Treatment for HFA and AS teens with avoidant personality traits should involve psychotherapy led by a professional with specific experience in working with individuals on the autism spectrum. Treatment often moves slowly at first, because “special needs” teens who have experienced chronic peer-abuse have a tendency to distrust others, including some adults.

Treatment approaches often include the following:

1. Talk Therapy – This is a technique wherein the therapist leads the teenager in conversation about his experiences, attitudes and behaviors. It can be incorporated into any therapeutic approach. By maintaining a conversational dialogue about the teen’s fears, shame, and insecurities, he learns to be less sensitive to criticisms and rejection.

2. Social Skills Training (SST) – This is a form of behavior therapy that is used by therapists – and even parents and teachers – to help HFA and AS teens who have difficulties relating to others. A major goal of SST is teaching the teenager (who may or may not have emotional problems) about the verbal - as well as nonverbal - behaviors involved in social interactions. There are many children on the autism spectrum who have never been taught such interpersonal skills (e.g., making "small talk" in social settings, the importance of good eye contact during a conversation, etc.). Furthermore, many of these “special needs” individuals have not learned to "read" the many subtle cues contained in social interactions (e.g., how to tell when someone wants to change the topic of conversation or shift to another activity). SST helps autistic teens to learn to interpret these and other social signals so that they can determine how to act appropriately in the company of peers in a variety of different situations. When teens on the spectrum improve their social skills or change selected behaviors, they will raise their self-esteem and increase the likelihood that peers will respond favorably to them. Therapists learn to change the teen’s social behavior patterns by practicing selected behaviors in individual or group therapy sessions.

3. Psychodynamic Therapy – With this method, the counselor actively empathizes with the HFA or AS teen’s painful inner experience to build the trust relationship. The goal of this therapy involves helping the teenager develop a keen and accurate sense of self-awareness. The counselor then assists her in identifying unconscious thought processes that influence her daily behavior. As a result, the teen can examine and find closure for conflicts and painful emotions stemming from past dysfunctional relationships. The counselor will then use talk therapy to guide the teen in seeing connections between her deep personal shame and how it affects social and interpersonal functioning.

4. Group Therapy – Most counselors would recommend waiting until the HFA or AS teen has made some progress toward recovery before putting him in a group therapy environment. But for the teenager who is ready, group therapy can give the avoidant personality a positive social experience and help him accept feedback in a safe and controlled setting.

5. Cognitive Behavioral Therapy (CBT) – This approach assumes distorted and inaccurate thinking patterns create the foundation for avoidant personality tendencies. The counselor uses CBT strategies to change the distorted thought patterns by examining - and refuting - the truth of the assumptions surrounding them. For example, suppose a teen with autism strongly believes she is inferior to her peers and that others do not like her. The counselor would test the validity of the teen’s belief by asking her to name a few friends who have enjoyed spending time with her in the past. The counselor may also ask the teen to talk about past social experiences that she enjoyed. In this way, the counselor shows the teen that people do enjoy her company and that social activities can be enjoyable. This demonstrates that the teen’s fear and insecurity about social situations are illogical and unsubstantiated. This technique is called “cognitive restructuring.”

If you have a teen with HFA or AS, you are dealing with many issues that parents of “typical” teens do not have to deal with.  The teenager on the spectrum is emotionally more immature than his peers. He may be indifferent - or even hostile - to your concerns. He may refuse to do ANYTHING other than play video games. And he may hate school with a passion because he is dealing with social ostracism or academic failure on a daily basis. However, by utilizing some of the treatment methods listed above, you can help your teen to weather the storm of adolescence and prepare for the challenges of adulthood. There is no reason why the future cannot be a bright one if interventions are started early.

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